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IACM-Bulletin of 05 October 2014

Science/Human: Cannabis spray effective against neuropathic pain in long-term study

The THC/CBD spray Sativex was beneficial for the majority of patients with peripheral neuropathic pain. This is the result of a long-term open study led by researchers of Solihull Hospital, UK. In total, 380 patients with peripheral neuropathic pain associated with diabetes or allodynia (increased pain sensitivity) entered this study from two randomised, controlled trials. Patients received Sativex for a further 38 weeks in addition to their current pain therapy.

In total, 234 patients completed the study (62 per cent). The pain score showed a decrease over time in patients from a mean of 6.9 points (baseline in the controlled studies) to a mean of 4.2 points (end of open study). The proportion of patients who reported at least a clinically relevant improvement in pain continued to increase with time. At least half of all patients reported a 30 per cent improvement at all time points.

Hoggart B, Ratcliffe S, Ehler E, Simpson KH, Hovorka J, Lejčko J, Taylor L, Lauder H, Serpell M. A multicentre, open-label, follow-on study to assess the long-term maintenance of effect, tolerance and safety of THC/CBD oromucosal spray in the management of neuropathic pain. J Neurol. 2014 Sep 30. [in press]

Science/USA: More than 90 per cent find cannabis helpful in treating medical conditions according to survey

Cannabis was used by more than 5 per cent of Californian citizens for medical purposes and more than 90 per cent said it was helpful in their condition. Researchers of the Public Health Institute in Sacramento, California, used data from the California Behavioral Risk Factor Surveillance System 2012, an annual, state-wide telephone survey that collects health data from a representative adult sample.

Five percent of 7525 adults in California reported ever using medical cannabis, and most users believed that medical cannabis helped alleviate symptoms or treat a serious medical condition. Prevalence was similar when compared by gender, education and region. "Our study’s results lend support to the idea that medical marijuana is used equally by many groups of people and is not exclusively used by any one specific group," the authors write. Adults of all ages reported medical cannabis use, although young adults were the most likely to use it.

Ryan-Ibarra S, Induni M, Ewing D. Prevalence of medical marijuana use in California, 2012. Drug Alcohol Rev. 2014 Sep 26. [in press]

Washington Post of 1 October 2014

Science/Human: Cannabis rated most effective alternative treatment for pain by women in survey

Medical cannabis has been rated the most effective alternative treatment for relieving chronic pain, according to the results of a new survey. The online survey of over 2,400 women in chronic pain was conducted by National Pain Report. Given a choice of 11 different alternative therapies, many women said they had tried several treatments in the past year. While cannabis was one of the least used alternative therapies, it quickly rose to the top when women were asked about the effectiveness of treatments they had tried. Nearly 80 per cent of the 431 women who used cannabis said it helped relieve their pain.

Many women said they were curious about medical cannabis, but were afraid to try it because cannabis is illegal in the countries and states where they live. “I would LOVE to try Medical Marijuana,” wrote one woman. “But it is not available legally in Australia and I shouldn’t have to commit a crime just to have a chance at living pain free.” “Marijuana… helps more than Tramadol, but I can’t legally get it in Finland. Even if I could get a prescription, it’s too expensive for me,” wrote another woman who suffers from osteoarthritis and back pain.

American News Report of 18 September 2014

Science/Human: Cannabidiol improves quality of life in patients with Parkinson’s disease

There may be a possible effect of CBD (cannabidiol) in improving quality of life in patients with Parkinson’s disease. This is the result of a study conducted by Brazilian researchers of the University of São Paulo. From a sample of 119 patients consecutively evaluated in a specialized movement disorders outpatient clinic, they selected 21 patients without dementia or comorbid psychiatric conditions. Participants were assigned to three groups of seven subjects each, who were treated with placebo, 75 mg CBD daily or 300 mg CBD daily.

The administration of 300 mg doses of CBD per day was associated with "significantly different mean total scores" in subjects' well-being and quality of life compared to placebo. However, CBD did not mitigate general symptoms of the disease, nor was it shown to be neuroprotective. "This study points to a possible effect of CBD in improving measures related to the quality of life of PD patients without psychiatric comorbidities," authors wrote.

Chagas MH, Zuardi AW, Tumas V, Pena-Pereira MA, Sobreira ET, Bergamaschi MM, Dos Santos AC, Teixeira AL, Hallak JE, Crippa JA. Effects of cannabidiol in the treatment of patients with Parkinson's disease: An exploratory double-blind trial. J Psychopharmacol. 2014 Sep 18. [in press]

Science/Human: Patients, who use cannabis, may have a more favourable outcome after traumatic brain injury

“A positive THC screen is associated with decreased mortality in adult patients sustaining TBI [traumatic brain injury],” researchers of the Harbor-UCLA Medical Center in Torrance, California, wrote. They established a relationship between the presence of a positive toxicology screen for tetrahydrocannabinol (THC) and mortality after traumatic brain injury. A 3-year retrospective review of data of patients sustaining traumatic brain injury having a toxicology screen was performed.

There were 446 cases meeting certain inclusion criteria. The incidence of a positive THC screen was 18.4 per cent (82). Overall mortality was 9.9 per cent (44). However, mortality in the THC positive group was only 2.4 per cent and significantly decreased compared with the THC negative group (11.5 per cent).

Nguyen BM(1), Kim D, Bricker S, Bongard F, Neville A, Putnam B, Smith J, Plurad D. Effect of marijuana use on outcomes in traumatic brain injury. Am Surg 2014;80(10):979-83.

News in brief

Science/Human: The endocannabinoid system is involved in pain reduction caused by exercise
In a study with 58 men and women researchers found support for a potential endocannabinoid mechanism of pain reduction following isometric exercise.
Department of Kinesiology, University of Wisconsin-Madison, USA.
Koltyn KF, et al. J Pain. 2014 Sep 23. [in press]

Science/Human: Cannabis use reduces blood clotting
Activation of cannabinoid receptors by cannabis use reduces platelet activation and blood clotting both in experiments with cells as well as in humans after cannabis use. Authors wrote that this “may prove beneficial in the search for new antithrombotic therapies.”
Department of Clinical Chemistry and Haematology, Utrecht University Medical Center, The Netherlands.
De Angelis V, et al. PLoS One 2014;9(9):e108282.

USA: Justice minister says it is time to reconsider cannabis classification
In an interview with Yahoo News US Attorney General Eric Holder, the head of the Department of Justice, said it's time to reconsider cannabis legal classification in the federal government's scheduling system. Under the current classification, cannabis is placed in the same category as heroin. The reclassification, then, could dramatically shift how the federal government handles cannabis in the war on drugs. Mr. Holder recently announced that he will resign his post.
Vox News of 25 September 2014

Jamaica: Cannabis decriminalisation expected at the end of the year
Jamaica's justice Minister Mark Golding told reporters that lawmakers should make possession of 2 ounces (56 grams) or less a petty offense before the end of 2014. He also expects decriminalization for religious purposes by Rastafarians to be authorized by then.
Associated Press of 30 September 2014

Israel: Army reservists are allowed to use medical cannabis
The Israeli army has decided to allow reserve soldiers who hold a prescription for medical cannabis to continue to use the medication even while they are performing their active reserve duty. The decision affects a few hundred reserve soldiers, and the army has not published exact guidelines.
Times of Israel of 22 September 2014

Science/Animal: Cannabinoids reduce bowel inflammation
Cannabinoids alleviate experimentally induced intestinal inflammation by acting at central and peripheral cannabinoid receptors in mice.
Snyder Institute for Chronic Disease, Department of Medicine, University of Calgary, Canada.
Fichna J, et al. PLoS One 2014;9(10):e109115.

Science/Animal: Cannabigerol inhibited colon cancer
Development of colon cancer was inhibited in mouse models by cannabigerol, a natural non-psychotropic cannabinoid and this effect was mediated by antagonism of the TRPM8 (transient receptor potential M8).
Department of Pharmacy, University of Naples Federico II, Italy.
Borrelli F, et al. Carcinogenesis. 2014 Sep 30 [in press]

Science/Animal: R-flurbiprofen attenuates inflammation in a mouse model of MS
R-flurbiprofen has a similar chemical structure as the non-steroidal anti-inflammatory drug flurbiprofen, which was assessed as a remedy for Alzheimer's disease. Now it was shown that it is effective in a mouse model of multiple sclerosis. Researchers concluded that the “promising results suggest potential efficacy of R-flurbiprofen in human MS, and its low toxicity may justify a clinical trial.”
Institute of Clinical Pharmacology Goethe-University Hospital, Frankfurt am Main, Germany.
Schmitz K, et al. EMBO Mol Med. 2014 Sep 30. [in press]

Science/Animal: Nerve protecting effects of CBG in Huntington’s disease
CBG (cannabigerol) was “extremely” neuroprotective in two mouse models of Huntington’s disease. Authors wrote that these “results open new research avenues for the use of CBG, alone or in combination with other phytocannabinoids or therapies, for the treatment of neurodegenerative diseases such as HD.”
Instituto Universitario de Investigación en Neuroquímica, Universidad Complutense, Madrid, Spain.
Valdeolivas S, et al. Neurotherapeutics. 2014 Sep 25. [in press]

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