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IACM-Bulletin of 31 October 2004

IACM: Call for papers for the 2005 Conference at Leiden University

CALL FOR PAPERS: The program committee would like to invite you to present your research at the IACM 3rd Conference on Cannabinoids in Medicine in Leiden (The Netherlands) on 9-10 September. You may submit your abstract electronically until April 1, 2005 to info@cannabis-med.org. If your abstract is accepted you will have free accommodation and will be invited to the evening dinner on 9 September.

IACM AWARD: During the Meeting the IACM will honour four persons for achievements regarding the re-introduction of cannabis and cannabinoids as medicines. We would like you to propose candidates and send your proposal by e-mail to award2005@cannabis-med.org until 1 June 2005. The IACM Award Committee consisting of Vincenzo Di Marzo, Franjo Grotenhermen, Raphael Mechoulam, and Roger Pertwee will elect the Awardees.

More information on IACM Award and Call for Papers at www.Leiden2005.org

Science: Three studies show medicinal effects of cannabis in multiple sclerosis

Three clinical studies on the effect of THC and cannabis were published in the August edition of the journal Multiple Sclerosis. The trials by Wade et al. (2004) from Oxford and of Brady et al. (2004) from London used a cannabis extract spray and the Swiss study of Vaney et al. (2004) were conducted with a capsulated cannabis extract.

The Swiss study with 57 patients, who received a daily dose of 15-30 mg THC, showed a reduction of spasm frequency and improvement of mobility in those 37 patients who received at least 90 per cent of maximum dose. Authors concluded that the extract "might lower spasm frequency and increase mobility with tolerable side effects in MS patients with persistent spasticity not responding to other drugs".

160 MS patients with one of the following symptoms were included in the study by Wade et al. (2004): spasticity, spasms, bladder problems, tremor or pain. They received daily doses of 2.5-120 mg THC. Following cannabis extract the primary symptom score reduced non-significantly from mean 74 to 49 and from 74 to 55 following placebo. Spasticity scores were significantly reduced.

Brady et al. (2004) investigated the effect of cannabis on 21 patients with bladder dysfunction, of whom 15 completed the study. Urinary urgency, the number and volume of incontinence episodes, frequency of bladder emptying and nocturia all decreased significantly following treatment.

The abstracts of the articles are available online in the IACM database of clinical studies at: www.cannabis-med.org/studies/study.php

(Sources: Vaney C, et al. Mult Scler 2004;10(4):417-24; Wade DT, et al. Mult Scler 2004;10(4):434-41; Brady CM, et al. Mult Scler 2004;10(4):425-33.)

Canada: New regulations intend introduction of sale of cannabis in pharmacies

Regulations announced by the Health Ministry on 23 October "provide limited authority for a pharmacy-based distribution system for dried marijuana that is produced by a licensed dealer."

The new regulations want to respond to concerns and objections concerning the present program by the police, physicians and patients and to move "the provision of marihuana for medical purposes in Canada toward a more traditional health care model." They encourage federal authorities to develop a protocol to allow for pharmacies to provide medical cannabis to qualified patients. The proposed plan is modelled after the Dutch program that started in September 2003.

"Involving pharmacists in the distribution system could enhance the identification and mitigation of risks to the authorized person, particularly when marijuana is combined with other drug therapies the authorized person may be using," the regulations state.

In July 2004, 781 persons in Canada were allowed to possess cannabis for medical purposes. Within that group, 491 persons were also authorized to produce cannabis for themselves, while 81 others have obtained authority for a designated person to produce it on their behalf.

(Source: Health Canada. Regulations amending the marihuana medical access regulations. 23 October 2004)

Science: Association between cannabis use and depression may not be causal, study says

Dr. Michael T. Lynskey and colleagues at the Washington University School of Medicine in St. Louis examined the role of genetics and influence of environment during childhood in the relationship between cannabis use and major depression. His team interviewed individuals of the Australian Twin Register, at around 30 years of age.

They identified 277 pairs in which one twin used cannabis while the other didn't. The odds of depression, suicidal thoughts and attempted suicide were 1.3 to 3.4 times more likely in the cannabis-using twin compared with the twin who was not a user. The strength of the association was higher in fraternal twins (dizygotic) than identical twins (monozygotic). This latter finding implies that "genetic vulnerabilities make substantial contributions" to the association between marijuana use and depression, the authors report.

These results suggest that "depression does not cause people to use (cannabis), or that (cannabis) use and dependence do not in themselves cause depression," Lynskey said in an interview with Reuters Health. "So from a clinical point of view, it is not necessarily the case that eliminating one of those will automatically get rid of the other." In other words, he added, both problems "need to be addressed within the treatment setting."

(Sources: Reuters Health of 8 October 2004; Lynskey MT, et al. Major depressive disorder, suicidal ideation, and suicide attempt in twins discordant for cannabis dependence and early-onset cannabis use. Arch Gen Psychiatry 2004;61(10):1026-32.)

News in brief

USA: Cannabis on the ballot in three states
Montana, Alaska and Oregon have placed a cannabis-related proposal on the November 2 ballot. If all three measures are approved, Montana would become the 10th state to legalize cannabis for medical purposes, Oregon would dramatically expand its existing medical-marijuana program, and Alaska would become the first state to decriminalize cannabis altogether. (Source: Associated Press of 10 October 2004)

Science: Endocannabinoids reduce psychotic symptoms
Anandamide levels in cerebrospinal fluid are eight-fold higher in first-episode paranoid schizophrenics than healthy controls. Such an alteration is absent in schizophrenics already treated with "typical" antipsychotics. Furthermore, in non-medicated acute schizophrenics, cerebrospinal fluid anandamide level is negatively correlated with psychotic symptoms. The results suggest that anandamide elevation in acute paranoid schizophrenia may reflect a compensatory adaptation to the disease state. (Source: Giuffrida A et al. Neuropsychopharmacology 2004;29(11):2108-2114.)

Israel: Traumatised soldiers get THC in study
Under an experimental program THC will be administered to 15 Israelian soldiers over the next several months in an effort to fight post-traumatic stress disorder. Dr. Raphael Mechoulam of Jerusalem's Hebrew University, the chief researcher behind a project he described as a world-first, said THC could help the brain in suppressing unwanted memories. For soldiers haunted by flashbacks of traumatic battle experiences, he said, the drug could be the answer to hundreds of sleepless nights. (Source: Reuters of 3 October 2004)

Holland: Electronic newsletter of the Office of Medicinal Cannabis
The Dutch Office of Medicinal Cannabis of the Health Ministry started a newsletter in June 2004. One can subscribe to this newsletter for free by sending an e-mail to cannabisoffice-subscribe@yahoogroups.com (English newsletter) or cannabisbureau-subscribe@yahoogroups.com (Dutch newsletter). Subscribers have access to the archives of the newsletter. The Office of Medicinal Cannabis has also a website in English and Dutch: www.cannabisoffice.nl. (Source: Dutch Office of Medicinal Cannabis).

Science: Endocannabinoids in liver cirrhosis
It has been proposed that the cannabinoid system is altered in liver cirrhosis and that the endocannabinoid anandamide is a key substance in the arterial vasodilation of cirrhosis. However, a new study of Spanish researchers shows that the elevation of anandamide levels in liver cirrhosis is unrelated to the extend of arterial vasodilation and the severity of liver damage. (Source: Fernandez-Rodriguez CM, et al. Liver Int 2004;24(5):477-83.)

Science: Cannabis in dyskinesia in Parkinson disease
In a small study of British researchers oral cannabis was ineffective in reducing symptoms of levodopa-induced dyskinesia. Dyskinesia is a frequent side effect of the Parkinson drug levodopa. 19 patients participated in this placebo controlled study. Each treatment lasted for four weeks. 17 patients completed the study. Cannabis was well tolerated, and had no effect on Parkinson symptoms and dyskinesia. (Source: Carroll CB, et al. Neurology 2004;63(7):1245-50.)

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