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IACM-Bulletin of 04 May 2014

Science/USA: Cannabis rated most effective for treating fibromyalgia in survey

Cannabis is far more effective at treating symptoms of fibromyalgia than any of the three prescription drugs approved by the Food and Drug Administration to treat the disorder. That is one of the findings in an online survey of over 1,300 fibromyalgia patients conducted by the National Pain Foundation and National Pain Report in the USA. The FDA has approved only three drugs - Duloxetine, Pregabalin and Milnacipran - for the treatment of fibromyalgia. Most who have tried the medications say they don’t work. “It’s always a good idea to listen to what our patients are telling us,” said Dr Mark Ware, an associate professor in family medicine and anaesthesia at McGill University in Montreal, Canada, in a comment.

“Fibromyalgia is devastating for those who must live in its grip. There is much we do not understand. We need innovative … solutions that change the face of this disease,” said Dr Dan Bennett, chairman of the National Pain Foundation. Many who responded to the survey said they had tried all three FDA approved drugs. 62% who have tried cannabis said it was very effective at treating their fibromyalgia symptoms. Asked to rate the effectiveness of the approved drugs Duloxetine was rated as very effective in 8%, Pregabalin in 10%, and Milnacipran also in 10%.

Marijuana Rated Most Effective for Treating Fibromyalgia

Researcher: More Medical Marijuana Studies Needed

Science/USA: The legalization of cannabis for medicinal purposes has not increased cannabis use in adolescents

Among the concerns of those who oppose legalization of cannabis for medical purposes was that one way or the other, the cannabis would find its way to young people and encourage more drug use. But a new study shows that it just hasn’t happened. The study, published in the latest issue of the Journal of Adolescent Health and led by Esther K. Choo, of Brown University’s Alpert Medical School, Providence, Rhode Island, USA, says: “Our study suggests that - at least thus far - the legalization of marijuana for medical purposes has not increased adolescent marijuana use, a finding supported by a growing body of literature.”

The researchers looked at reported cannabis use by adolescents in states where medical cannabis is now legal, both before and after the laws were passed. and compared those numbers with nearby states where cannabis remains illegal for all purposes. The sample was 11.7 million students. Across years and all states, past-month cannabis use was common (20.9%). There were no statistically significant differences in cannabis use before and after policy change for any state pairing.

Choo EK, Benz M, Zaller N, Warren O, Rising KL, McConnell KJ. The Impact of State Medical Marijuana Legislation on Adolescent Marijuana Use. J Adolesc Health. 2014 Apr 14. [in press]

Washington Post of 14 April 2014

News in brief

UK/USA: Sativex receives Fast Track Designation from US authorities in cancer pain
The United States Food and Drug Administration (FDA) has granted Fast Track designation to the cannabis spray Sativex for the treatment of pain in patients with advanced cancer, who experience inadequate analgesia during optimized chronic opioid therapy. Sativex is currently in Phase 3 clinical trials for this indication. FDA's Fast Track program facilitates the development of drugs intended to treat serious or life threatening conditions and that have the potential to address unmet medical needs.
Press release by GW Pharmaceuticals of 28 April 2014

UK: Conservative think-tank pushes for easing of cannabis laws
Prime Minister David Cameron is urged by Tory modernisers of his Conservative Party to abandon Britain’s war against drugs and make partial legalisation a key pledge in next year’s general election manifesto. The provocative plan is contained among a series of policy proposals put forward by the influential Conservative think-tank Bright Blue, a group which is backed by senior ministers including Theresa May, Francis Maude, and the former minister Andrew Mitchell.
Independent of 28 April 2014

Science/USA: American Academy of Neurology confirms medical value of cannabis in certain conditions
A review by the American Academy of Neurology concludes that cannabinoids may be effective in spasticity, pain and bladder dysfunction in multiple sclerosis and that there is only limited data available on Tourette syndrome, cervical dystonia, and epilepsy.
Department of Neurology, New York Medical College, and other institutions, USA.
Koppel BS, et al. Neurology 2014;82(17):1556-63.

Science/Human: Large French study confirms good safety profile of cannabis with regard to cardiovascular disease
The number of heart attacks and other cardiovascular problems blamed on cannabis was five events in 2006 and 11 events in 2010 out of about 1.2 million cannabis users. In France, serious cases of abuse and dependence in response to the use of psychoactive substances must be reported to the national system of the French Addictovigilance Network. In the years 2006 to 2010 1.8% of all cannabis-related reports (35 of 1979) were cardiovascular complications.
Addictovigilance, Service de Pharmacologie Médicale et Clinique, Faculté de Médecine, Toulouse, France.
Jouanjus E, et al. J Am Heart Assoc 2014;3(2):e000638.

Science/Animal: Cannabinoid receptors in skin cells attenuate atopic dermatitis
Research with mice demonstrates that cannabinoid 1 receptors in skin cells help to maintain the skin barrier and attenuate allergic inflammatory responses. Authors write that their “results place keratinocytes at the cross-roads of outside-in and inside-out pathopyhsiologic mechanisms of atopic dermatitis.”
Department of Dermatology and Allergy, University of Bonn, Germany.
Gaffal E, et al. Exp Dermatol. 2014 Apr 21. [in press]

Science/Human: Cognitive inhibition during early adolescence predicts later cannabis use
Adolescent substance use has been associated with poorer neuropsychological functioning, but it is unclear if deficits predate or follow the onset of use. In a study with 175 substance-use-naïve healthy 12- to 14-year-olds it was demonstrated that compromised inhibitory functioning during early adolescence prior to the onset of substance use was related to more frequent and intense alcohol and cannabis use by late adolescence. Cognitive inhibition refers to the mind's ability to tune out stimuli that are irrelevant to the task/process at hand or to the mind's current state.
Department of Psychiatry, University of California, San Diego, USA.
Squeglia LM, et al. Neuropsychology. 2014 Apr 21. [in press]

Science/Cells: THC may reduce inflammation of the brain in HIV
Results of cell experiments indicate that cannabinoids that activate the CB2 receptor “has potential to serve as a therapeutic agent for ablating neuroinflammation associated with HIV-elicited influx of monocytes across the BBB [blood brain barrier].”
Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, USA
Raborn ES, et al. Life Sci. 2014 Apr 15. [in press]

Science/Animal: A cannabigerol derivative protects nerve cells in animal model of multiple sclerosis
In experimental autoimmune encephalomyelitis, an animal model of MS, a derivative of the natural cannabinoid cannabigerol (CBG) reduced cell infiltrates and suppressed inflammation in the spinal cord. Authors wrote that “this study highlights the therapeutic potential of VCE-003 as an agent for the treatment of human immune diseases with both inflammatory and autoimmune components.”
Instituto Cajal, Madrid, Spain.
Carrillo-Salinas FJ, et al. PLoS One 2014;9(4):e94733.

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