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IACM-Bulletin of 16 October 2016

Science/Human: In states of the USA with medical cannabis laws there is a greater workforce participation and an improvement in overall health of older individuals

States that passed medical cannabis laws saw a significant boost to older Americans' workforce participation, according to a new working paper from researchers at Johns Hopkins and Temple University (USA). States with medical cannabis laws also saw improvements in overall health for older men, although the health effects for older women were more mixed. The study compared what happened in medical cannabis states before and after the passage of medical cannabis provisions, and compared them to trajectories in similar states that did not implement medical cannabis. The data come from the Health and Retirement study, a long-running survey of the health and economic well-being of older American adults.

The study found that, among individuals age 50 and older, “passage of [a medical marijuana law] leads to a 9.4 percent increase in the probability of employment and a 4.6 percent to 4.9 percent increase in hours worked per week.” The reason is that overall health appeared to be better in states with medical cannabis laws. In those states, older men were 5% more likely to say they were in “very good” or “excellent” health. And part of the reason men rated their health better is because they were in less pain: the passage of a medical cannabis law led to roughly a 10% drop in the percent of men saying they experienced pain. However, in women the probability of reporting pain increased by 3.8%, while as with men they were about 5% more likely to report “very good” or “excellent” health after the passage of medical cannabis.

Nicholas LH, Maclean JC. The Impact of Medical Marijuana Laws on the Labor Supply and Health of Older Adults: Evidence from the Health and Retirement Study. NBER Working Paper No. 22688. National Bureau of Economic Research, USA, September 2016.

Washington Post of 4 October 2016

Science/Human: Cannabis improves pain and movement in patients with Parkinson’s disease in open clinical study

Cannabis use improved pain and movement in 20 patients with Parkinson’s disease according to an open study conducted by scientists Rabin Medical Center in Petach Tikva and the Sackler Faculty of Medicine at Tel Aviv University, Israel. Symptoms were assessed before and 30 minutes after cannabis inhalation and again after long-term use. Motor function was assessed with the Unified PD Rating scale (UPDRS) and pain with the Pain Rating Index (PRI) and a Visual Analogue Scale (VAS).

There was a significant improvement from baseline to 30 min after cannabis consumption in mean motor scores (38.1 to 30.4), pain according PRI (27 to 9.7) and pain VAS score (6.4 to 3.6). Authors concluded that cannabis “improved motor scores and pain symptoms in PD patients.” They wrote that “peripheral and central pathways are probably modulated by cannabis.”

Shohet A, Khlebtovsky A, Roizen N, Roditi Y, Djaldetti R. Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease. EUR J Pain. 2016 Oct 10. [In press]

Science/Human: Cannabidiol may be effective in the treatment of epilepsy due to tuberous sclerosis

In an open study with 18 children at the Massachusetts General Hospital in Boston, USA, cannabidiol (CBD) was shown to be effective in the treatment of epilepsy due to Tuberous sclerosis complex. Tuberous sclerosis complex (TSC) is a genetic disorder with the most common neurologic manifestation being epilepsy. Eighteen of the 56 patients who have been enrolled in a study of cannabidiol for patients with treatment-resistant epilepsy carry a diagnosis of TSC. The initial dose of 5 mg/kg body weight per day was increased by 5 mg/kg/day every week up to a maximum dose of 50 mg/kg/day, if tolerated.

The median weekly seizure frequency during the baseline period was 22.0, which decreased to 13.3 after 3 months of treatment with CBD. In patients taking clobazam concurrently with CBD (n = 12), the responder rate after 3 months of treatment was 58.3%, compared to 33.3% in patients not taking clobazam (n = 6). Authors wrote that “although double-blind, placebo-controlled trials are still necessary; these findings suggest that cannabidiol may be an effective and well-tolerated treatment option for patients with refractory seizures in TSC.”

Hess EJ, Moody KA, Geffrey AL, Pollack SF, Skirvin LA, Bruno PL, Paolini JL, Thiele EA. Cannabidiol as a new treatment for drug-resistant epilepsy in tuberous sclerosis complex. Epilepsia. 2016;57(10):1617-1624.

News in brief

Science/Human: Sativex is useful in everyday clinical practice for the treatment of multiple sclerosis
In the MOVE-2-EU study 433 patients with multiple sclerosis mainly from Italy, who received Sativex, were followed for three months. After 3 months 281 still used the medication with a mean dose of six sprays per day. Spasticity, spasms, fatigue, pain, sleep quality and bladder dysfunction were significantly improved.
University of Lille, France.
Vermersch P, et al. EUR Neurol. 2016;76(5-6):216-226.

Science/Human: Reduced sleep increases levels of the endocannabinoid 2-AG
Compared to normal sleep restriction of sleep (4.25 hours of sleep) resulted in 80% higher concentrations of 2-AG (2-arachidonoylglycerol) in blood plasma of 16 healthy men 1.5 hours after awakening. The endocannabinoid level also increased after exercise (ergometer cycling).
Department of Neuroscience, Uppsala University, Sweden.
Cedernaes J, et al. Psychoneuroendocrinology. 2016;74:258-268.

Science/Human: No effect of THC on pain in patients with abdominal pain in controlled clinical study
In a study with 65 patients with chronic abdominal pain THC given as a tablet up to 3x 8mg daily or a placebo for 50-52 days there was no significant difference between THC and placebo in their effect on pain scores.
Radboud University Medical Center, Nijmegen, The Netherlands.
de Vries M, et al. Clin Gastroenterol Hepatol. 2016 Oct 5. [In press]

Science/Human: The stress response in patients with posttraumatic stress disorder and alcohol dependence is modulated by genetic variants of FAAH
In 49 patients with posttraumatic stress disorder and alcohol dependence their response to stress depended on the genetic variants of FAAH (fatty acid amide hydrolase), which is responsible for the degradation of the endocannabinoid anandamide. Authors concluded that “these findings point to the eCB pathway as a promising target for future antistress therapeutics.”
National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, Maryland, USA.
Spagnolo PA, et al. Alcohol Clin Exp Res. 2016 Sep 26. [In press]

Science/Animal: CBD may alleviate the behavioural effects of THC
In a study with six monkeys CBD, which was given at the same dose of THC, had no effects on certain behavioural patterns caused by THC. If CBD was given in a three-fold higher dose it attenuated the THC effects.
Preclinical Pharmacology Laboratory, Northeastern University, USA.
Jacobs DS, et al. Exp Clin Psychopharmacol. 2016;24(5):320-330.

Science/Animal: CBD may be useful in Parkinson’s disease and tardive dyskinesia
Repeated administration of reserpine in rodents induces motor impairments that are accompanied by cognitive deficits, and has been applied to model both tardive dyskinesia and Parkinson's disease. CBD (0.5 and 5 mg/kg) attenuated the increase in catalepsy behaviour and in oral movements in rats induced by reserpine. CBD (0.5 mg/kg) also ameliorated the reserpine-induced memory deficit. Authors wrote that CBD may be useful in the “pharmacotherapy of Parkinson's disease and tardive dyskinesia.”
Department of Psychiatry, Federal University of São Paulo, Brazil.
Peres FF, et al. Front Pharmacol. 2016;7:343

Science/Animal: Palmitoylethanolamide reduces itching and other features of contact allergic dermatitis
Palmitoylethanolamide (PEA) was injected into mice with contact allergic dermatitis. The treatment reduced the number of ear scratching, infiltration by mast cells and other features of this allergy.
Department of Pharmacy, University of Naples Federico II, Italy.
Vaia M, et al. EUR J Pharmacol. 2016 Oct 5. [In press]

Science/Animal: The endocannabinoid system is altered in spinocerebellar ataxia type-3
In a mouse model of spinocerebellar ataxia type-3 (SCA-3) the endocannabinoid system was dysregulated “suggesting that a pharmacological manipulation addressed to correct these changes could be a promising option in SCA-3.”
Facultad de Medicina, Universidad Complutense, Madrid, Spain.
Rodríguez-Cueto C, et al. Neuroscience. 2016 Oct 4. [In press]

Science/Animal: Activation of the CB2-receptor may be useful in the treatment of complex regional pain syndrome type 1
Complex regional pain syndrome type 1 (CRPS-I) remains one of the most clinically challenging neuropathic pain syndromes. In a rat model of CRPS-1 a synthetic cannabinoid (MDA7), which selectively activates the CB2-receptor, reduced pain and inflammation in this syndrome.
Department of Pain Management, Cleveland Clinic, USA.
Xu J, et al. EUR J Neurosci. 2016 Sep 26. [In press]

Science/Cells: Cannabidiol modulates genes linked with amyotrophic lateral sclerosis
Using human cells researchers demonstrated that cannabidiol (CBD) considerable changed the expression of genes connected with the pathology of amyotrophic lateral sclerosis, oxidative stress, mitochondrial dysfunction, and excitotoxicity.
IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.
Soundara Rajan T, et al. J Cell Biochem. 2016 Oct 7. [In press]

Science/Animal: CBD may improve brain damage up to 18 hours after the insult
In new-born mice, which experienced brain damage from reduced blood supply, CBD was beneficial up to 18 hours after the insult. Authors wrote that the therapeutic time window for neuroprotective treatment with CBD was broader than previously reported.
Hospital Clínico San Carlos - IdISSC, Madrid, Spain.
Mohammed N, et al. CNS Neurol Disord Drug Targets. 2016 Sep 27. [In press]

Science/Human: Cannabiniods may prevent chemotherapy-induced diarrhoea
In a study with rats diarrhoea, which was induced by the chemotherapeutic agent 5-fluoruracil, was prevented by a synthetic cannabinoid (WIN 55,212-2).
Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.
Abalo R, et al. Neurogastroenterol Motil. 2016 Sep 30. [In press]

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