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IACM-Bulletin of 28 July 2013

USA: New Hampshire becomes 19th state to legalize the medical use of cannabis

On 18 July Governor Maggie Hassan signed a law making New Hampshire the 19th state to allow seriously ill residents to use cannabis to treat their illnesses. "Allowing doctors to provide relief to patients through the use of appropriately regulated and dispensed medical marijuana is the compassionate and right policy for the state of New Hampshire, and this legislation ensures that we approach this policy in the right way with measures to prevent abuse," Hassan said in a statement.

The law allows patients with cancer and other conditions to possess up to 2 ounces (about 56 grams) of cannabis obtained from non-profit dispensaries. To qualify for medical cannabis, New Hampshire residents would have to have been a patient of the prescribing doctor for at least 90 days and have tried other remedies. The law took effect with Hassan's signature but getting the program operating could take up to two years. The bill calls for a commission to be appointed as soon as possible to implement the new system. Patients must be issued special identification cards to obtain the drug from dispensaries and possess it.

Press Herald of 23 July 2013

Science/Human: No effect of THC on the progression of multiple sclerosis in long-term study

In a placebo-controlled study with 498 patients suffering from progressive multiple sclerosis THC, which was given for 36 months, had no effect on progression compared to placebo. This is the result of a trial conducted in the UK and headed by Professor Dr John Zajicek of Plymouth University Peninsula Schools of Medicine and Dentistry.

Of the 498 patients randomly assigned to a treatment group, 329 received at least one dose of dronabinol and 164 received at least one dose of placebo. 145 patients in the dronabinol group had EDSS (expanded disability status scale) score progression compared with 73 in the placebo group. There was also no significant difference on another scale (MSIS-29-PHYS). Authors concluded that “our results show that dronabinol has no overall effect on the progression of multiple sclerosis in the progressive phase. The findings have implications for the design of future studies of progressive multiple sclerosis, because lower than expected progression rates might have affected our ability to detect clinical change.“

Zajicek J, Ball S, Wright D, Vickery J, Nunn A, Miller D, Cano MG, McManus D, Mallik S, Hobart J; on behalf of the CUPID investigator group. Effect of dronabinol on progression in progressive multiple sclerosis (CUPID): a randomised, placebo-controlled trial. Lancet Neurol. 2013 Jul 12. [in press]

News in brief

UK: Reduced hospital admissions due to psychosis in the period of liberalized cannabis law
There was a significantly increasing trend in cannabis psychosis admissions from 1999 to 2004. However, following the reclassification of cannabis from B to C in 2004, with a liberalisation of the law, there was a significant change in the trend such that cannabis psychosis admissions declined to 2009. Following re-tightening of the law (second reclassification of cannabis back to class B) in 2009, there was a significant change to increasing admissions.
University of York, Department of Health Sciences, United Kingdom.
Hamilton I, et al. Int J Drug Policy. 2013 Jul 15. [in press]

Science/Animal: THC has positive effects on metabolism in diabetic rats
THC had a positive effect on metabolism in rats with type 2 diabetes, among them a reduction of cholesterol, HDL cholesterol and LDL levels. Authors wrote that “these results indicate that delta-9-THC may serve a protective role against hyperlipidaemia and hyperglycaemia in diabetic rats.”
Istanbul Bilim University, Turkey.
Coskun ZM, et al. Acta Histochem. 2013 Jul 8. [in press]

Science/Human: A reason for self-medication with cannabis in ADHD
Several studies have shown changes in striatal dopamine transporter (DAT) density in ADHD (Attention-deficit/hyperactivity disorder). Authors speculate that it is possible “that the use of cannabis and cocaine is responsible for the lower striatal DAT density in this group which would help in understanding the neurobiological basis for the self-medication theory in ADHD adolescents.”
Laboratório de Medicina Nuclear do Complexo Hospitalar Santa Casa, Porto Alegre, Brazil.
Silva N Jr, et al. Clin Nucl Med. 2013 Jul 12. [in press]

Science/Animal: CBD protects against inflammation in a viral model of MS
In a viral model of multiple sclerosis with mice CBD (cannabidiol) reduced inflammation and this effect was long-lasting, ameliorating motor deficits in the chronic phase of the disease in conjunction with reduced production of substances, which increase inflammation (pro-inflammatory cytokines). Authors concluded that their “findings highlight the anti-inflammatory effects of CBD in this viral model of MS and demonstrate the significant therapeutic potential of this compound for the treatment of pathologies with an inflammatory component.”
Cajal Institute, CSIC, Madrid, Spain.
Mecha M, et al. Neurobiol Dis. 2013 Jul 11. [in press]

Science/Cells: CBD and CBG influence proliferation of skin cells
The proliferation of human skin cells was influenced by the cannabinoids cannabidiol (CBD) and cannabigerol (CBG). Authors concluded that this suggests “(especially for cannabidiol) a possible exploitation as lead compounds to be used in the development of novel therapeutics for skin diseases.”
Department of Biomedical Sciences, University of Teramo, Italy.
Pucci M, et al. Br J Pharmacol. 2013 Jul 19. [in press]

Italy: Variation of THC content in cannabis products
Cannabis in Italy of the years 2010-2012 showed high variation in THC content. The variation in the THC content ranged from 0.3% to 31% for cannabis resin (hashish) and from 0.1 to 19% for dried leaves and flowers (marijuana).
Laboratory of Environmental Hygiene and Forensic Toxicology, Department of Prevention - ULSS12 Veneziana, Italy.
Zamengo L, et al. Drug Test Anal. 2013 Jul 19. [in press]

Science/Human: Cannabis doubled the risk of lung cancer in a long-term study
In a 40-year study cannabis use was associated with a small increase in lung cancer risk.
The study examined men (n = 49,321) aged 18-20 years old assessed for cannabis use and other relevant variables during military conscription in Sweden in 1969-1970. At the baseline conscription assessment, 10.5 % reported lifetime use of cannabis and 1.7 % indicated lifetime use of more than 50 times, designated as "heavy" use. “Heavy” cannabis smoking was associated with a twofold risk of developing lung cancer over the 40-year follow-up period.
University of Northern British Columbia, Prince George, Canada.
Callaghan RC, et al. Cancer Causes Control. 2013 Jul 12. [in press]

Science/Animal: Loss of CB1 receptor enhances cognitive impairment in a model of Alzheimer’s disease
In a model of Alzheimer's disease with mice without cannabinoid-1 receptors researchers observed a reduced concentration of amyloid protein in the brain but also reduced cognitive abilities. Authors wrote that “the findings indicate that CB1 deficiency can worsen AD-related cognitive deficits and support a potential role of CB1 as a pharmacologic target.”
Institute for Pathobiochemistry, Johannes Gutenberg University Mainz, Germany.
Stumm C, et al. Neurobiol Aging. 2013 Jul 6. [in press]

Science/Human: The endocannabinoid system is dysregulated in psychosis before treatment
In a study, 95 patients with a first episode of psychosis and 90 healthy controls were examined. Researchers found a dysregulation of the endocannabinoid system in psychosis patients. Patients with a history of severe cannabis use showed a larger dysregulation compared to healthy controls. Authors concluded that this dysregulation “could be contributing to the pathophysiology of the disease and constitutes a possible biomarker of psychotic disorders.”
Neuroscience Institute, Hospital Clínic de Barcelona, Spain.
Bioque M, et al. Neuropsychopharmacology. 2013 Jul 4. [in press]

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