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IACM-Bulletin of 11 November 2007

Science: Nabilone reduced chronic pain caused by fibromyalgia

In a placebo-controlled study conducted at the University of Manitoba, Canada, with 40 patients suffering from fibromyalgia nabilone reduced pain and improved quality of life. After a baseline assessment, subjects were either titrated up on nabilone, from 0.5 mg once in the evening to 1 mg twice daily over 4 weeks or received a corresponding placebo. Nabilone is a synthetic THC derivative with similar effects.

There were significant decreases on a visual analogue scale for pain, improvements in the so-called Fibromyalgia Impact Questionnaire, and a significant reduction of anxiety in the nabilone treated group at 4 weeks. There were no significant improvements in the placebo group. Researchers concluded that nabilone "appears to be a beneficial, well-tolerated treatment option for fibromyalgia patients, with significant benefits in pain relief and functional improvement."

(Source: Skrabek RQ, Galimova L, Ethansand Daryl K. Nabilone for the Treatment of Pain in Fibromyalgia. J Pain. 2007 Oct 30; [Electronic publication ahead of print]

Holland: The government wants to extent the availability of cannabis in pharmacies by five years

The Dutch government said on 7 November it wants to promote the development of cannabis-based medicine and will extend the drug's availability in pharmacies by five years to allow more scientific research. The government hopes for progress on a cannabis-based drug by the Dutch firm Echo Pharmaceuticals, the Health Ministry said. In 2003, the Netherlands became the world's first country to make cannabis available as a prescription drug in pharmacies.

"Medicinal cannabis must become a regular registered medicine," Health Minister Ab Klink said in a statement, adding he wanted to give the development of a cannabis-based medicine a serious chance. "The development path, that could take several years, can deliver scientific details and insight into the balance between the efficacy and safety of medicinal cannabis," the statement said. A ministry spokesman said several thousand patients were prescribed cannabis in the Netherlands and up to 15,000 people used it for medicinal purposes, although many bought their supply at coffee shops rather than pharmacies.

More at: www.sciam.com/article.cfm?alias=dutch-want-cannabis-regis&chanID=sa003&modsrc=reuters

(Source: Reuters of 7 November 2007)

News in brief

USA: Montana and Oregon
Montana's medical cannabis program includes 468 people whose doctors have decided that cannabis can help them. The health authorities of the state also have issued caregiver cards to 167 people who can grow up to six plants for each patient. The medical cannabis program of Oregon now includes 14,831 patients. (Sources: Chicago Tribune of 28 October 2007, Bozeman Daily Chronicle of 2 November 2007)

USA: Suicide
Robin Prosser, a woman living in Missoula, Montana, who suffered from a painful severe disease of the immune system (Lupus erythematosus) committed suicide. She used cannabis to treat her disorder. In March of this year agents of the Drug Enforcement Agency seized less than a half ounce of her cannabis, which she was allowed to use according to the medical cannabis law of Montana. In July she had written in a guest opinion for a newspaper: "Give me liberty or give me death. Maybe the next campaign ought to be for assisted-suicide laws in our state. If they will not allow me to live in peace, and a little less pain, would they help me to die, humanely?" The complete guest opinion of Mrs. Prosser is available online at: tinyurl.com/2n6hrr. (Source: Missoulian of 27 October 2007)

USA: American Psychiatric Association
In an attempt to push forward the acceptance of the effectiveness of medical cannabis, the American Psychiatric Association has declared their unanimous vote in support of the legal protection of patients with doctors' recommendations to use the herb for medical reasons. The declaration pointed out, that the association supports "protection for patients and physicians participating in state approved medical marijuana programs." More at: www.salem-news.com/articles/november072007/med_psyc_11707.php (Source: Salem-News.com of 7 November 2007)

Science: Use by adolescents
Adolescents, who only used cannabis did not have psychosocial problems at a higher rate than non-users in a Swiss study. A total of 5263 students aged 16 to 20 years divided into cannabis-only smokers (n = 455), cannabis and tobacco smokers (n = 1703), and abstainers (n = 3105) were included in the study. Cannabis-only adolescents showed better functioning than those who also used tobacco. Compared with abstainers, they had a better relationship with friends and practiced more sports, but they were less likely to have a good relationship with their parents and more likely to skip class. (Source: Suris JC, et al. Arch Pediatr Adolesc Med 2007;161(11):1042-7.)

Science: Prevention of tolerance development
In animal studies Canadian and US researchers demonstrated that the use of ultra-low doses of the cannabinoid receptor antagonist rimonabant prevented the development of tolerance to a treatment with a CB1 receptor agonist (WIN55,212-2). The pain-reducing effects of the cannabinoid decreased after a daily injection of the cannabinoid over 7 days. If very low doses of rimonabant were given together with the cannabinoid, the pain reducing effects persisted. (Source: Paquette JJ, et al. Behav Pharmacol 2007;18(8):767-776.)

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