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IACM-Bulletin of 21 February 2016

Science/Human: Cannabis use was associated with improved outcome after bleeding in the brain

In patients with spontaneous bleeding in the brain (intracerebral haemorrhage, ICH) those, who had used cannabis, showed less disability when leaving hospital. This is the result of an analysis of an international, multicentre, observational database of 725 patients with spontaneous bleeding in the brain conducted by scientists of the Neurological Service, San Camillo de' Lellis General Hospital in Rieti, Italy.

Within this cohort of 725 patients, urine screening was positive for cannabinoids in 8.6%. Cannabinoids-positive patients had lower median disease scores on admission, than those who were cannabinoids-negative. Cannabinoid positive patients also showed a trend towards better disease outcome. Authors wrote that “although there was no relationship between cannabis use and specific ICH characteristics, CB+ patients had milder ICH presentation and less disability at discharge.”

Di Napoli M, Zha AM, Godoy DA, Masotti L, Schreuder FH, Popa-Wagner A, Behrouz R; from the MNEMONICH Registry. Prior Cannabis Use Is Associated with Outcome after Intracerebral Hemorrhage. Cerebrovasc Dis 2016;41(5-6):248-255.

Science/Human: Cannabis reduced pain and opioid use in a clinical study

Cannabis reduced pain severity and opioid consumption in 274 treatment-resistant chronic pain patients. This is the result of an open clinical study conducted at the Pain Relief Unit of Hadassah-Hebrew University Medical Center in Jerusalem, Israel. The primary outcome was change in pain symptom score on the S-TOPS (Treatment Outcomes in Pain Survey - Short Form) questionnaire at 6 months follow-up.

274 subjects were approved for treatment; complete baseline data were available for 206 and complete follow-up data for 176 subjects. At follow-up, pain symptom score significantly improved from median 83.3 to 75.0. Pain severity score improved together with most social and emotional disability scores. Opioid consumption at follow-up decreased by 44%. Serious adverse effects led to treatment discontinuation in two subjects. Authors concluded that “the results suggest long-term benefit of cannabis treatment in this group of patients.”

Haroutounian S, Ratz Y, Ginosar Y, Furmanov K, Saifi F, Meidan R, Davidson E. The Effect of Medicinal Cannabis on Pain and Quality of Life Outcomes in Chronic Pain: A Prospective Open-label Study. Clin J Pain. 2016 Feb 17. [in press]

News in brief

Macedonia: Health committee supports the medical use of cannabis
Macedonian parliament's health committee approved the amendment of the law on control of drugs and psychotropic substances, that would allow the use of cannabis products for medicinal purposes. Stojanco Stojkovski, State Secretary in the Macedonian Ministry of Health, who proposed the changes to the law, declared that "The need to change this law comes from the requests of patients who want to have the option to use naturally derived cannabis products, under strict supervision."
Shanghai Daily of 10 February 2016

Australia: Bill to legalize cultivation of medical cannabis introduced in parliament
Australia is expected to legalize the cultivation of cannabis for medical or scientific purposes with a bill introduced to parliament on 8 February -- the first step towards doctors eventually prescribing it to patients with severe diseases.
Reuters of 9 February 2016

Canada: Bedrocan is reducing prices of medical cannabis
Bedrocan Canada is lowering the price of all varieties to 5 Canadian dollars (about 3.25 EURos) plus taxes per gram. The newsletter says: “Why are we lowering all of our prices? Because we can. Because we should. Because medicine must be affordable.”
Bedrocan Canada of 1 February 2016

Science/Animal: Activation of the CB2 receptor and the PPAR-Gamma receptor inhibits scleroderma
Scleroderma is a group of rare diseases associated with inflammation and fibrosis affecting the skin and multiple internal organs. In a mouse model of dermal fibrosis the cannabinoid VCE-004.8, a synthetic derivative of CBD (cannabidiol), inhibited fibrosis of the skin induced by bleomycin. This effect was mediated by activation of the CB2 and the PPAR-Gamma receptors.
University of Córdoba, Spain.
Del Río C, et al. Sci Rep 2016;6:21703.

Science/Human: Cannabis use was associated with increased alcohol and tobacco use but not with mood disorders
In a study with 34,653 adults cannabis use in the years 2001-2002 was associated with a higher risk for alcohol and tobacco use disorders three years later (2004-2005), but not with any mood disorder or anxiety disorder.
National Institute on Drug Abuse, Bethesda, USA.
Blanco C, et al. JAMA Psychiatry. 2016 Feb 17. [in press]

Science/Human: According to a meta-analysis cannabis use was associated with an increased risk of psychosis
In a meta-analysis with 10 studies enrolling a total of 66,816 individuals higher levels of cannabis use were associated with increased risk for psychosis in all the included studies. The analysis gave an odds ratio of 3.90 for the risk of schizophrenia and other psychosis-related outcomes among the heaviest cannabis users compared to the nonusers. Authors wrote that “a causal link cannot be unequivocally established.”
Department of Psychosis Studies, King's College London, UK.
Marconi A, et al. Schizophr Bull. 2016 Feb 15. [in press]

Science/Human: Cannabis use was associated with an increased risk for alcohol use disorders
In a study with 27,461 adults cannabis use in the years 2001-2002 was associated with a fivefold increased risk for alcohol use disorders three years later.
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, USA.
Weinberger AH, et al. Drug Alcohol Depend. 2016 Feb 11. [in press]

Science/Human: Cannabis use did not have any impact on doses of antipsychotics in acute schizophrenia
In a study with 8,157 patients cannabis use did not significantly impact on doses of antipsychotics required during the periods of acute exacerbation in patients with schizophrenia or schizoaffective disorder.
University of Texas Harris County Psychiatric Center, Houston, USA.
Babatope T, et al. Psychiatr Q. 2016 Feb 13.[in press]

Science/Animal: Blockade at the CB2-receptor may reduce allergic reactions
Allergic airway inflammation was assessed in mouse models of acute asthma. Researches showed that antagonism of CB2 receptors may represent a novel pharmacological approach for the treatment of allergic inflammation and other disorders associated with an increased number of eosinophils, a certain form of white blood cells.
Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Austria.
Frei RB, et al. Allergy. 2016 Feb 6. [in press]

Science/Human: Higher concentrations of the endocannabinoid 2-AG are associated with lower capacity to smell
A study with 161 females obese subjects had a lower olfactory capacity (capacity to smell) than non-obese ones and elevated fasting blood 2-AG concentrations in obesity were linked to a lower olfactory capacity.
Hospital de Mar Medical Research Institute, Barcelona, Spain.
Pastor A, et al. PLoS One 2016;11(2):e0148734.

Science/Human: Activation of CB1-receptors may be helpful in atopic dermatitis and psoriasis
In a mouse model of atopic dermatitis activation of the CB1 receptor reduced inflammation.
Authors concluded from their research, that cannabinoids, which activate the CB1 receptor “may be used for relieving inflammatory symptoms mediated by mast cell activation, such as atopic dermatitis, psoriasis, and contact dermatitis.”
Department of Cosmetic Science and Technology, Seowon University, Cheongju, Korea.
Nam G, et al. Ann Dermatol 2016;28(1):22-9.

Science/Animal: Activation of the CB2-receptor was beneficial in periodontitis
In a rat model of periodontitis activation of the CB2 receptor by the synthetic cannabinoid HU-308 demonstrated anti-inflammatory, osteoprotective and pro-homeostatic effects.
Faculty of Dentistry, University of Buenos Aires, Argentina.
Ossola CA, et al. J Periodontol. 2016 Feb 5:1-17. [in press]

Science/Animal: Treatment with CBD prevents psychosis
In an animal model of schizophrenia a treatment with CBD (1mg per kg body weight, intraperitoneally) during puberty prevented psychosis. The treatment did not modify the animals’ body weight gain.
Department of Psychiatry, Federal University of São Paulo, Brazil.
Peres FF, et al. Schizophr Res. 2016 Feb 4. [in press]

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