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IACM-Bulletin of 13 May 2018

Zimbabwe: The government issues licences to grow cannabis for medical purposes

Zimbabweans can now apply for licences to grow cannabis for medical and research purposes, the government said, making Zimbabwe the second country in Africa to legalize cultivation of the plant. Lesotho last year announced the continent’s first license to grow cannabis legally. Until now, it has been illegal to grow, possess or use cannabis in Zimbabwe, with offenders facing up to 12 years in jail.

Health Minister David Parirenyatwa published new regulations, allowing individuals and companies to be licensed to cultivate cannabis, known locally as mbanje. The five-year renewable licences will allow growers to possess, transport and sell fresh and dried cannabis as well as cannabis oil. Applications should include plans of the growing site, quantity to be produced and sold and the production period.

Reuters of 28 April 2018

Science/Human: THC may improve symptoms of anorexia nervosa

THC may be effective in treating psychological symptoms in patients suffering from anorexia nervosa. This is the result of a small clinical study conducted by researchers of Hebrew University in Jerusalem and Haifa University, Israel. Nine female subjects with a mean age of 45 years and a mean body mass index (BMI) of 16.1 participated. Underweight is defined as a Body Mass Index der below 20 or 19. Severe underweight is defined as a BMI below 16.

They were treated with 1 mg THC per day for one week and 2 mg per day for 3 weeks. Significant improvements were found in self-reported body care, sense of ineffectiveness, asceticism and depression. There were no significant changes in BMI.

Avraham Y, Latzer Y, Hasid D, Berry EM. The Impact of Δ9-THC on the Psychological Symptoms of Anorexia Nervosa: A Pilot Study. Isr J Psychiatry Relat Sci. 2017;54(3):44-51.

Science/Human: A CBD-rich cannabis extract may be effective in children with autism

A cannabis extract with high cannabidiol and low THC concentrations may be effective in behavioural problems of children with autism spectrum disorder. Scientists of the Shaare Zedek Medical Center in Jerusalem, Israel, investigated the effects of a cannabis extract in 60 autistic children with a mean age of 11.8 years (range: 5–18 years). They were treated with oral CBD and THC at a ratio of 20:1. The dose was up-titrated according to effect with a maximal CBD dose of 10mg per kilogram bodyweight and a maximal THC dose of 0.5mg/kg. Tolerability and efficacy were assessed with standard scales, including the Home Situations Questionnaire–Autism Spectrum Disorder (HSQ-ASD) and the Autism Parenting Stress Index (APSI).

Following the cannabis treatment, behavioural outbreaks were much improved or very much improved in 61% of patients. The anxiety and communication problems were much improved in 39% or very much improved in 47%. Disruptive behaviours were improved by 29%. Parents reported less stress as reflected in the APSI scores, changing by 33%. Authors concluded that this “preliminary study supports the feasibility of CBD based medical cannabis as a promising treatment option for refractory behavioural problems in children with ASD [autism spectrum disorder].”

Aran A, Cassuto H, Lubotzky A. Cannabidiol Based Medical Cannabis in Children with Autism- a Retrospective Feasibility Study. Neurology. 2018 April 10, [in press]

Science/Human: CBD may be helpful in tobacco dependency

In a study with 30 dependent cigarette smokers administration of a single CBD dose of 800 mg reduced the pleasantness of cigarette cues, compared with placebo, after overnight cigarette abstinence. It was conducted by British researchers of the University College London, King’s College London, University of Exeter and the University of Bristol and published in the journal Addiction.

Tobacco abstinence overnight increased attention towards pictures of tobacco cues. CBD reversed this effect, such that automatic attention was directed away from cigarette cues. Compared with placebo, CBD also reduced pleasantness of cigarette images. CBD did not influence tobacco craving or withdrawal.

Hindocha C, Freeman TP, Grabski M, Stroud JB, Crudgington H, Davies AC, Das RK, Lawn W, Morgan CJA, Curran HV. Cannabidiol reverses attentional bias to cigarette cues in a human experimental model of tobacco withdrawal. Addiction. 2018 May 1. [in press]

News in brief

IACM: Roundtable discussion on the role of cannabis in the opioid crisis in the CCR, the partner journal of the IACM
“Expert Roundtable Discussion on Cannabis and the Opioid Crisis" with Daniele Piomelli, Susan Weiss, Graham Boyd, Rosalie Liccardo Pacula, Ziva Cooper.

Science/Human: About half of oncologists in the USA recommend the use of cannabis to their patients
A survey of a representative random sample of 400 medical oncologists in the USA revealed that 80% conducted discussions about cannabis with their patients, and 46% recommended the medical use of cannabis. It was viewed by 67% as a helpful adjunct to standard pain management strategies, and 65% thought cannabis is equally or more effective than standard treatments for anorexia and cachexia.
Dana-Farber Cancer Institute, USA.
Braun IM, et al. J Clin Oncol. 2018 May 10. [in press]

Science/Human: Cannabis does not increase the risk of liver fibrosis in patients co-infected with HIV and HCV
Researchers analysed data of 690 patients, who were positive both for hepatitis C and HIV, in a prospective study. At the beginning of the study 53% had smoked cannabis in the past 6 months, consuming a median of 7 cannabis cigarettes per week. They found no evidence for an association between cannabis smoking and significant liver fibrosis progression in this population.
McGill University, Montreal, Canada.
Brunet L, et al. Clin Infect Dis. 2013;57(5):663-70.

Science/Human: Effects of cannabis on cognitive performance in adolescents are small
Scientists conducted a literature review examining cannabis and cognitive functioning in adolescents and young adults. They concluded that “associations between cannabis use and cognitive functioning in cross-sectional studies of adolescents and young adults are small and may be of questionable clinical importance for most individuals. Furthermore, abstinence of longer than 72 hours diminishes cognitive deficits associated with cannabis use.”
Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Scott JC, et al. JAMA Psychiatry. 2018 Apr 18. [in press]

Science/Cells: CBD and radiotherapy may act synergistically in killing cancer cells
The combination of cannabidiol and radiotherapy showed enhanced efficacy in the killing of pancreatic and lung cancer cells.
Brigham and Women's Hospital, Boston, USA.
Yasmin-Karim S, et al. Front Oncol. 2018;8:114.

Science/Animal: A combination of morphine and a CB2 receptor agonist acts synergistically in pain treatment
Scientists investigated the effects of co-administration of AM1241, which selectively activates the CB2 receptor, and morphine on pain perception in mice. They concluded that a combination “of a CB2 agonist and morphine may provide a new strategy for better treatment of acute and chronic pain, and prevention of opioid tolerance and dependence. This may also provide a clue for the treatment of opioid tolerance and dependence in clinic.”
Cancer Hospital of Harbin Medical University, China.
Zhang M, et al. J Pain. 2018 May 2. [in press]

Science/Cells: Beta-caryophyllene may protect against toxicity to nerve cells
Parkinson’s disease results from death of certain nerve cells in the brain region substantia nigra. The chemical MPP+ (1-methyl-4-phenylpyridinium) exerts toxic effects on these nerve cells, and beta-caryophyllene may protect from this toxicity, which may be of relevance for prevention and treatment of Parkinson’s disease.
Liaocheng People's Hospital, China.
Wang G, et al. Biomed Pharmacother. 2018;103:1086-1091.

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