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IACM-Bulletin of 25 September 2011

Science: Cannabis has a positive effect on Crohn's disease according to an observational study

According to an observational study at Tel Aviv University, Israel, cannabis may have a positive effect on disease activity in Crohn's disease, a chronic inflammatory bowel disease. In this study disease activity, use of medication, need for surgery, and hospitalization before and after cannabis use were examined in 30 patients. Disease activity was assessed by the Harvey Bradshaw index for Crohn's disease. The indication for cannabis use was lack of response to conventional treatment in 21 patients and chronic intractable pain in 6. Another four patients used cannabis for recreational purposes and continued as they observed an improvement in their medical condition.

Of the 30 patients 21 improved significantly after treatment with cannabis. The average Harvey Bradshaw index improved from 14 to 7. The need for other medication was significantly reduced. Thus, before cannabis use 26 patients used corticosteroids, but only 4 after start of the cannabis therapy. Fifteen of the patients had 19 surgeries during an average period of 9 years before cannabis use, but only 2 required surgery during an average period of 3 years of cannabis use. Authors concluded that "this is the first report of cannabis use in Crohn's disease in humans. The results indicate that cannabis may have a positive effect on disease activity, as reflected by reduction in disease activity index and in the need for other drugs and surgery."

(Source: Naftali T, Lev LB, Yablekovitz D, Half E, Konikoff FM. Treatment of Crohn's disease with cannabis: an observational study. Isr Med Assoc J 2011;13(8):455-8.)

Czech Republic: Government wants to make herbal cannabis available for patients through pharmacies

The Czech Ministry of Health has indicated that it will take cannabis off the list of banned substances and allow it to be prescribed by doctors for medicinal purposes. "By the end of this year we will submit to parliament an amended law on addictive substances which will move marihuana from the list of banned substances to the list of those which can be prescribed,” Deputy Health Minister Martin Plíšek pledged, according to a newspaper report of 14 September.

Signs are increasing that more and more Czechs are growing the plant at home in the face of the ban on legal prescription. Ministry experts still have to work out how a Czech regime for legalized sales of medicinal cannabis could be organized. Minister Plíšek said at a conference on the issue on 13 September that he would prefer to see drugs imported for Czech use rather than to grow it in the country to minimize abuse. "We must take steps to ensure that there is no massive abuse without a doctor’s prescription," he added.

More at:
www.ceskapozice.cz/en/news/politics-policy/czech-health-ministry-signals-steps-legalize-medical-marijuana

(Sources: Ceskapozice.cz of 14 September 2011, personal communication by the Czech Health Ministry)

IACM: Results of a survey on methods of intake of cannabis and cannabinoids for therapeutic purposes

A cross-sectional survey was conducted by putting a questionnaire on the website of the IACM between 18 August 2009 and 31 January 2010, which was available in five languages. It was designed to determine how patients perceive possible advantages and disadvantages of different methods of intake and which methods or products they prefer over others. The study also intended to analyze whether perceived advantages and preferences depend on demographic parameters, previous experience with recreational cannabis use, disease, or involvement of a physician in the use of cannabinoids.

953 patients (614 male, 339 female) with a mean age of 40.7 years from 32 countries completed the questionnaire. Most participants were from the USA, Germany, France, Canada, The Netherlands, Spain, and the UK. In 47.6 per cent of all cases, cannabis products were prescribed or recommended by a physician, in 10.4 per cent patients got their cannabinoid medication from a pharmacy, in 26.3 per cent from a coffee shop or another unofficial or tolerated source. Preferred modes of use were smoking of cannabis (62.9 per cent), inhalation of cannabis with a vaporizer (23.6 per cent), oral use of cannabis in baked goods (7.9 per cent), oral use of cannabis as a tea (2.4 per cent), and oral use of dronabinol/Marinol (1.8 per cent). No significant differences in preferred modes of use were found in correlation to diseases, country or any other parameter. Results are not representative.

More at:
www.cannabis-med.org/meeting/Bonn2011/abstractbook.pdf

(Source: Hazekamp A, Grotenhermen F, Abrams D, Russo E, Ware M, Navarrete-Varo R, Brenneisen R, Müller-Vahl K. The medicinal use of cannabis and cannabinoids: an international survey on methods of intake. Abstract, Cannabinoid Conference 2011, 8-10 September 2011, Bonn.)

News in brief

Holland: Namisol
According to a presentation at the Cannabinoid Conference 2011 the Dutch company Echo Pharmaceuticals is currently conducting clinical phase II studies to investigate the effect of its THC preparation Namisol on spasticity and pain in MS patients, on behaviour disturbances in patients with dementia, and on pain in chronic pancreatitis patients. Namisol is a new formulation of THC using a drug delivery technology developed to improve the bioavailability of lipophilic compounds in humans. After oral administration of Namisol peak levels of THC were observed after 30-45 minutes. (Source: Presentation by Beumer TL, et al. Abstract book of the conference available at www.bonn2011.org)

Science: Obesity
According to French researchers cannabis use is not associated with an increased risk for obesity. The authors used data from 2 representative epidemiologic studies of US adults aged 18 years or older with more than 50,000 participants. The prevalences of obesity were 22 and 25 per cent, respectively, among participants reporting no use of cannabis in the past 12 months and 14 and 17 per cent, respectively, among participants reporting the use of cannabis at least 3 days per week. (Source: Le Strat Y & Le Foll B. Am J Epidemiol. 2011 Aug 24. [in press])

Science: Achilles tendinosis
According to research of Umeå University, Sweden the number of CB1 receptors was increased in Achilles tendons of patients with Achilles tendinosis. This may be a reaction to inflammation and pain in the disease. (Source: Björklund E, et al. PLoS One 2011;6(9):e24731.)

Science: Neuropathic pain
According to animal research at the Universidade Federal de Santa Catarina, Brazil, cannabinoids were effective in reducing neuropathic pain induced by damage of the brachial nerve plexus. Scientists observed a marked increase in CB1 and CB2 receptors in the spinal cord of the animals at both the 5th or 30th day after surgery (damage). (Source: Paszcuk AF, et al. PLoS One. 2011;6(9):e24034.)

Science: Epilepsy
According to animal research at the Shahid Beheshti University of Medical Sciences in Tehran, Iran, the antiepileptic effects of cannabinoids were mediated by L-type calcium channels. The co-administration of the CB1 receptor agonist WIN55,212-2 and a calcium channel blocker (verapamil) attenuated the anticonvulsive properties of the cannabinoid. (Source: Naderi N, et al. Neurochem Res. 2011 Sep 18. [in press])

Science: Food intake
According of research at Shahid Bahonar University of Kerman, Iran, with chickens CB2 receptor agonists act on the brain to induce food intake. (Source: Emadi L, et al. J Comp Physiol A Neuroethol Sens Neural Behav Physiol. 2011 Sep 7. [in press])

Science: Panic attack
According to research at the University of São Paulo, Brazil, with mice the natural cannabinoid cannabidiol (CBD) reduced fear-related behaviours in the presence of a stressor suggesting a panicolytic effect. (Source: Uribe-Mariño A, et al. Neuropsychopharmacology. 2011 Sep 14. [in press])

Science: Spinal cord injury
According to research at the University of São Paulo, Brazil, CBD improved locomotor recovery of rats submitted to spinal cord injury and reduced injury extent, "suggesting that it could be useful in the treatment of spinal cord lesions" scientists wrote. (Source: Kwiatkoski M, et al. Neurotox Res. 2011 Sep 14. [in press])

Science: Lack of oxygen during birth
According to research at the University of the Basque Country in Vizcaya, Spain, synthetic cannabinoid (WIN 55,212-2) reduced nerve cell death in fetal lambs experiencing lack of oxygen during birth. (Source: Alonso-Alconada D, et al. Neurochem Res. 2011 Sep 11. [in press])

Science: Schizophrenia
Researchers at the University of Edinburgh, UK, investigated the effects of cannabis use on volume of two brain regions (thalamus, amygdala-hippocampal complex) in individuals with a high genetic risk of schizophrenia. Two years after the first measurement the volume of the thalamus was significantly lower in 25 cannabis users compared to 32 non-users. Authors concluded that "this observation may be important in understanding the link between cannabis exposure and the subsequent development of schizophrenia." (Source: Welch KA, et al. Br J Psychiatry. 2011 Sep 8. [in press])

Science: Cannabinoids in fibre hemp
Italian researchers found a new cannabinoid of the cannabigerol type (CBG) in the waxy fraction of a fibre hemp variety (Carma). They concluded that this detection "suggests that C. sativa could contain yet-to-be-discovered prenylogous versions of medicinally relevant cannabinoids." (Source: Pollastro F, et al. J Nat Prod. 2011 Sep 8. [in press])

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