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IACM-Bulletin of 06 December 2009

Israel: The government wants to implement new regulations for the use of cannabis for medicinal purposes

The Health Committee of the parliament (Knesset) instructed the Health Ministry on 24 November to complete within four months its proposals for regulating the use of cannabis for medicinal purposes. Already by now patients suffering from severe pain and other serious conditions can apply for a license to obtain a free supply of cannabis to relieve their pain. It is intended to supervise the production, quality and marketing of the product and prevent the drug from reaching the illegal market.

At present, medical cannabis licenses are approved for the ministry by Dr. Yehuda Baruch, director-general of Abarbanel Mental Health Centre. He told the committee that the issue involves a number of difficult problems, such as depending on a single supplier who grows cannabis for charitable purposes. As the number of would-be users is expected to grow significantly, the terms for use, cultivation and distribution of the plant must be set down in law, he said. Currently, the Tikun Olam company supplies cannabis for free to 700 patients suffering from serious pain. However, company head Perry Klein said expanding production significantly would be a burden on the enterprise.

Meanwhile, the Sheba Medical Centre in Tel Hashomer has become the first hospital in Israel to administer cannabis to patients for medical purposes. Over the last six months, as part of a pilot project, 20 patients have been treated with the drug. The hospital has developed a formal protocol which states that if a patient needs cannabis, the doctor in charge of treating him will help him secure the necessary permit from the ministry.

More at:
- www.jpost.com/servlet/Satellite?cid=1259010973324&pagename=JPArticle%2FShowFull
- www.haaretz.com/hasen/spages/1130246.html

(Sources: Jerusalem Post of 25 November 2009, Haaretz of 25 November 2009)

Science: Cannabis as a substitute for alcohol and other drugs

According to an anonymous survey with 350 patients at a Berkeley medical cannabis collective 40 per cent have used cannabis as a substitute for alcohol, 26 per cent as a substitute for illicit drugs and 66 per cent as a substitute for prescription drugs. The most common reasons given for substituting were: less adverse side effects (65 per cent), better symptom relief (57 per cent), and less withdrawal potential (34 per cent) with cannabis.

71 per cent of participants reported having a chronic medical condition, 52 per cent used cannabis for a pain related condition, 75 per cent used cannabis for a mental health issue. Authors concluded that "medical cannabis patients have been engaging in substitution by using cannabis as an alternative to alcohol, prescription and illicit drugs."

The study is available at:
www.harmreductionjournal.com/content/pdf/1477-7517-6-35.pdf

(Source: Reiman A. Cannabis as a substitute for alcohol and other drugs. Harm Reduct J 2009;6:35.)

News in brief

Science: Pain
According to a retrospective analysis of 139 patients of a regional pain clinic in Washington State, who received cannabis against pain 88 per cent had more than one pain syndrome. Myofascial pain syndrome was the most common diagnosis (82 per cent) followed by neuropathic pain (64 per cent), discogenic back pain (51.7 per cent), and osteoarthritis (26.6 per cent). Other diagnoses included diabetic neuropathy, central pain syndrome, phantom pain, spinal cord injury, fibromyalgia, rheumatoid arthritis, HIV neuropathy, visceral pain, and cancer pain. (Source: Aggarwal SK, et al. J Opioid Manag 2009;5(5):257-86.)

USA: Conference
The Sixth National Clinical Conference on Cannabis Therapeutics, co-sponsored by the School of Medicine, University of California at San Francisco; the Rhode Island State Nurses Association and Patients Out of Time will be held on 15-17 April 2010 in Warwick, Rhode Island. More information is available on the website of Patients Out of Time. (Source: www.medicalcannabis.com)

Europe: Medicinal use
An article entitled "Another Thing EURope Doesn't Agree On" in the Wall Street Journal analyses the situation on the medical use of cannabis in EURopean countries citing Brendan Hughes, legal analyst of the EURopean Monitoring Centre for Drugs and Drug Addiction in Lisbon. "I can imagine EURopean citizens will eventually think cannabis is a good medicine and that it should be accessible to people who suffer from serious pain as a result of HIV, multiple sclerosis or other grave illnesses," he said. (Source: Wall Street Journal of 27 November 2009)

Science: GW Pharmaceuticals
The British company GW Pharmaceuticals announced that it has completed recruitment of patients into its cancer pain trial with Sativex. This study is being carried out in collaboration with Otsuka Pharmaceutical, as part of the US development programme for Sativex. The trial is due to report results in Spring 2010. In total, 360 patients with advanced cancer and chronic pain have been included in the study across 14 countries in North America, EURope, Latin America and South Africa. (Source: GW Pharmaceuticals of 25 November 2009)

Science: Opioid dependence
Animal research at the Mount Sinai School of Medicine in New York suggest that the natural cannabinoid "CBD may be a potential treatment for heroin craving and relapse." (Source: Ren Y, et al. J Neurosci 2009;29(47):14764-9.)

Science: Suicide
According to a longitudinal study which investigated 50 087 men conscripted for Swedish military service found 600 suicides (1,2 per cent) during 33 years of follow-up. Cannabis use was associated with an increased risk of suicide by 60 per cent, but this association was eliminated after adjustment for factors that may influence suicide risk such as psychological problems. Researchers concluded that "cannabis use is unlikely to have a strong effect on risk of completed suicide." (Source: Price C, et al. Br J Psychiatry 2009;195(6):492-7.)

Science: Platelets
According to cell experiments at the University of Rome, Italy, the endocannabinoid anandamide may improve the survival of platelets through the activation of CB1 receptors. (Source: Catani MV, et al. Cell Mol Life Sci 2009 Nov 20. [Electronic publication ahead of print])

Science: Heart failure
According to research of the University of Munich, Germany, the endocannabinoid system was altered in patients with severe heart failure. The number of CB1 receptors was reduced in their left ventricle of the heart muscle and the number of CB2 receptors was increased. Blood levels of endocannabinoids were significantly elevated in these patients, for anandamide by 3.5-fold and for 2-AG by 7-fold. (Source: Weis F, et al. J Mol Cell Cardiol 2009 Nov 25. [Electronic publication ahead of print])

USA: Irvin Rosenfeld
Since 1982, Irvin Rosenfeld has received a free tin of 300 cannabis cigarettes from the federal government every 25 days to treat symptoms of a rare bone disease. On 20 November he celebrated his 115,000th legal cannabis cigarette. Rosenfeld began receiving shipments as a participant in a federal program 27 years ago. Only additional three other survivors of this program receive cannabis from the federal government. (Source: South Florida Sun-Sentinel of 20 November 2009)

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