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IACM-Bulletin of 23 December 2018

WHO: Review on cannabis will be kept under lock

A much anticipated release of findings of two year scientific assessment of cannabis leaves, the “Critical Review on Cannabis”, was not published as expected on 7 December at the UN headquarters in Vienna during the CND meeting (Commission on Narcotic Drugs). The last assessment by WHO in 1954 fuelled global prohibition under the UN drug control Treaty framework.

When the time came to release the findings to the packed audience, all were stunned to watch, in person, the spokesperson for WHO announce that the outcome on Cannabis was kept confidential, but did not announce any date for the release. Speakers of NGOs criticised that the WHO did not obey their own rules and guidelines.

Press Release by FAAAT of 7 December 2018

Science/Human: Cannabis is effective in spasticity due to amyotrophic lateral sclerosis

In a placebo-controlled study with 59 patients suffering from spasticity due to amyotrophic lateral sclerosis or primary lateral sclerosis a cannabis extract (Sativex) decreased spasticity without serious side effects. The study was conducted at 4 centres in Italy and published by researchers of Vita-Salute San Raffaele University of Milan, Italy, in Lancet Neurology. Sativex contains THC and CBD in a ratio of about 1 to 1 and was given up to a maximum dose of 32.4 milligrams of THC. Participants self-titrated their dose within 14 treatment days and then maintained the dose for 4 weeks. 29 patients received Sativex and 30 placebo.

Spasticity according to the modified Ashworth Scale improved by a mean of 0.11 in the cannabis group and deteriorated by a mean of 0.16 in the placebo group. Cannabis was well tolerated and no participants withdrew from the study.

Riva N, Mora G, Sorarù G, Lunetta C, Ferraro OE, Falzone Y, Leocani L, Fazio R, Comola M, Comi G, CANALS Study Group. Safety and efficacy of nabiximols on spasticity symptoms in patients with motor neuron disease (CANALS): a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial. Lancet Neurol. 2018 Dec 13. [in press]

New Zealand: Medical cannabis will be widely available

New Zealand’s government has passed a law that will make medical cannabis widely available for thousands of patients over time, after years of campaigning by chronically ill New Zealanders who say the drug is the only thing that eases their pain. The legislation will also allow terminally ill patients to begin smoking cannabis immediately without facing the possibility of prosecution.

The health minister, David Clarke, said thousands of New Zealanders were living with chronic and end-of-life pain and the evidence that marijuana could safely help ease their suffering was sound. The law would also pave the way for New Zealand companies to manufacture medicinal cannabis products for both the local and international market. Legislation comes ahead of a referendum on recreational cannabis use in 2020.

The Guardian of 11 December 2018

South Korea: Cannabis will be made available for certain patients

Patients with epilepsy and other rare diseases will be able to get medical cannabis in the country as soon as early 2019, the Ministry of Food and Drug Safety said on 29 November. As the National Assembly passed a bill to amend the Act on the Management of Narcotic Drugs on 23 November the sale, import and export of cannabis for medical purposes will soon become legal.

When the amendment comes into effect, medicinal cannabis can be imported from countries such as the United States or those in EURope. However, the import and use of cannabis that has not been approved for medical use in foreign countries will be strictly banned. To obtain an approval for the use of cannabis-based pharmaceutical drugs from the government, patients must show their medical records and a physician’s note stating that there is no alternative treatment in Korea.

Korea Herald of 29 November 2018

News in brief

Science/Human: CBD may be beneficial in the post-traumatic stress disorder according to case series
In a retrospective analysis of 11 patients with post-traumatic stress disorder treated with CBD 10 patients experienced a decrease in symptom severity. Mean daily dose of CBD was about 49 mg (range: 2-100 mg). CBD also offered relief in a subset of patients with frequent nightmares.
Rocky Vista University, Parker, USA.
Elms L, et al. J Altern Complement Med. 2018 Dec 13. [in press]

Science/Human: Cannabis reduces the risk for alcohol-associated gastritis
In an analysis of 316,916 patients with a diagnosis of risky alcohol use those who also used cannabis had a lower risk to develop gastritis. The risk for hospitalisation due to gastritis was reduced from 1.7% to 1.3%, which is a 25% decreased probability of alcoholic gastritis.
North Shore Medical Center, Salem, Massachusetts, USA.
Adejumo AC, et al. Alcohol Clin Exp Res. 2018 Dec 10. [in press]

Science/Human: Cannabis use not associated with structure of the brain’s cortex
In a study with 141 cannabis users of different intensity and 120 controls there was no effect of cannabis on key characteristics of the brain’s cortex, including thickness of the cortex. Authors concluded that their “results revealed that cortical morphology was not associated with cannabis use, dependence, or onset age.”
Monash University, Melbourne, Australia.
Chye Y, et al. EUR Neuropsychopharmacol. 2018 Dec 14. [in press]

Science/Human: Cannabis use does not increase conduct problems in young people
According to a longitudinal study with 364 adolescents with a mean age of 13.5 years at the beginning of the study cannabis use did not lead to greater conduct problems compared to non-users apart from pre-existing conduct problems. Adolescents, who “have increasing levels of conduct problems are more likely to use cannabis, and this cascading chain of events appears to predict cannabis use disorder in emerging adulthood.”
Annenberg Public Policy Center, The University of Pennsylvania, Philadelphia, USA.
Defoe IN, et al. Addiction. 2018 Nov 20. [in press]

Europe: Review of the medical use of cannabis by Monitoring Centre for Drugs
The EURopean Monitoring Centre for Drugs and Drug Addiction published a report on the situation of medical cannabis and cannabinoids in EURopean countries.
Medical use of cannabis and cannabinoids

France: Further move towards the medical use of cannabis
The scientific committee, which was asked by the government to do a review on the medical potential of cannabis, came to the conclusion that cannabis may be helpful in certain conditions, including epilepsy, cancer and multiple sclerosis.
Vie Publique of 18 December 2018

Caribbean islands: Two islands legalise the medical use of cannabis
Saint Vincent and the Grenadines (SVG) is the first OECS (Organisation of Eastern Caribbean States) Member State to allow the use of cannabis for medical purposes and scientific research, the production of cannabis under a tightly controlled framework.
Pressroom OECS of 12 December 2018

Luxembourg: Cannabis will be legalised for recreational use
During a press conference held by the three coalition parties – Democratic Party, Luxembourg Socialist Workers’ Party (LSAP) and The Greens – political leaders said that cannabis will be legalised. It will also be commercially distributed, as was confirmed by Deputy Prime Minister Etienne Schneider.
International High Life of 30 November 2018

Science/Human: CBD effective in treatment-resistant schizophrenia according to a case report
Additional treatment with CBD in a dose of 2×750 mg considerably improved positive and negative symptoms in a 57 year old woman with otherwise treatment-resistant schizophrenia. Authors noted that “CBD might be particularly suitable for those patients being resistant to antipsychotics due to its different mode of action.”
Department of Psychiatry and Psychotherapy, University of Leipzig, Germany.
Makiol C, et al. ANZJP. 2018 Dec 13. [in press]

Science/Human: Long-term observation of children with epilepsy treated with CBD
In a study with 26 children, who started CBD treatment between April 2013 and December 2014 authors concluded that “over a 4-year period, cannabidiol was effective in 26.9% of children with otherwise refractory epilepsy. It was well tolerated in about 20% of patients, but 80.8% had adverse events, including 23.1% with serious adverse events. Decreased appetite and diarrhea were frequent along with weight loss that became evident only later in the treatment.”
Department of Neurology, Columbia University, New York, USA.
Sands TT, et al. CNS Drugs. 2018 Nov 20. [in press]

Science/Human: The risk for traffic accidents caused by cannabis is low
In a review of studies investigating the effects of cannabis use on accident risk the increased risk of a culpable traffic accident was estimated to be 1.42. Authors noted that risks found in culpability studies “exaggerate risk increases and parameter uncertainty […]. The increased crash risk associated with THC-positive drivers in culpability studies is low.”
Frisch Centre, Norway.
Rogeberg O. Accid Anal Prev. 2018;123:69-78.

Science/Human: Negative effects of cannabis use on cognition in young people is lower in those with good physical fitness
A study was conducted with 79 young adults, of whom 37 were cannabis users, aged 16 to 26 years to investigate cannabis effects on memory and psychomotor speed. Investigations were done after 3 weeks of abstinence. Cannabis use was associated with decreased performance on working memory and psychomotor tasks. High aerobic fitness of cannabis users was associated with better performance compared to low-fit users.
Department of Psychology, University of Wisconsin-Milwaukee, Wisconsin, USA.
Wade NE, et al. J Int Neuropsychol Soc. 2018:1-12.

Science/Human: Cannabis use is associated with a reduced risk for alcohol-associated pancreatitis
In a large study with hundreds of thousands US citizens concomitant cannabis use and abusive alcohol use was associated with a reduced incidence of acute pancreatitis (reduction by 50%) and chronic pancreatitis (reduction by 23%) compared to abusive alcohol users without cannabis use.
Department of Medicine, North Shore Medical Center, Salem, USA.
Adejumo AC, et al. Alcohol Clin Exp Res. 2018 Dec 20. [in press]

Science/Human: The number of people using pharmaceutical cannabinoids increased in Canada
The number of people using pharmaceutical cannabinoids, mainly nabilone (96%), increased from 0.022 % in 2004/2005 to 0.16 % in 2014/2015.
Memorial University of Newfoundland, St. John's, Canada.
Alkabbani W, et al. CMAJ Open. 2018;6(4):E637-E642.

Science/Human: Euphoric feeling from running is associated with endocannabinoids and other neurotransmitters
In a study with 25 runners, researchers found changes in the activity of genes implicating endorphins, endocannabinoids and GABA in those experiencing a so-called runners high.
Marist College, Department of Biology, Poughkeepsie New York, USA.
Hicks SD, et al. Med Sci Sports Exerc. 2018 Dec 14. [in press]

Science/Animal: Hemp seeds contain compounds, which protect nerve cells
In mice phenylpropionamides of hemp seed prevented nerve damage induced by inflammation.
Shandong University, Jinan, China.
Zhou Y, et al. ACS Omega. 2018;3(11):15988-15995.

Science/Animal: Tobacco smoke can disturb the endocannabinoid system in early life
In a study with mice exposure to tobacco smoke during days 3 to 14 after birth caused disturbance of the endocannabinoid system in the brain stem and striatum, regions that are involved in sudden infant death syndrome.
University of São Paulo, Brazil.
Torres LH, et al. Toxicol Lett. 2018 Dec 13. [in press]

Science/Animal: High levels of endocannabinoids reduce craving for methamphetamine
In a study with rats, who were dependent from methamphetamine, treatment with a synthetic drug, which increases the level of the endocannabinoid 2-AG (2-arachidonoylglycerol) reduced methamphetamine-seeking behaviour and anxiety -like behaviour.
Nagasaki International University, Japan.
Nawata Y, et al. Int J Neuropsychopharmacol. 2018 Nov 27. [in press]

Science/Animal: Treatment with CBD during puberty may prevent schizophrenia
In a rat model of schizophrenia treatment with CBD prevented schizophrenia -like behaviour. Authors wrote that “the appearance of schizophrenia -like deficits” may be prevented by “early treatment with cannabidiol.”
Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Stark T, et al. Neuropharmacology. 2018;146:212-221.

Science/Cells: Number of CB1 receptors is increased in stomach cancer
The number of CB1 receptors is increased in cancer cells of the stomach. Authors conclude that a treatment, which targets the CB1 receptor, may represent a therapeutic strategy for the treatment of stomach cancer.
Qingdao University, Yantai, China.
Xian X, et al. Onco Targets Ther. 2018;11:7503-7512.

Science/Animal: Cannabis may be beneficial in malaria
In a study with mice infected with malaria a diet, which included cannabis, improved survival. Authors concluded, that “C. sativa displayed mild antimalarial activity in vivo. There was evident reduction in symptomatic manifestation of malaria disease.”
University of Ilorin, Nigeria.
Akinola O, et al. Cannabis Cannabinoid Res. 2018;3(1):219-227.

Science/Human: Many patients with multiple sclerosis use cannabis, if it is legal
In a survey among patients with multiple sclerosis conducted in Colorado, USA, where cannabis is legal for adults, 38% used cannabis, of whom 57% categorised their use as strictly medical.
University of Colorado School of Medicine, Aurora, USA.
Weinkle L, et al. Mult Scler Relat Disord. 2018;27:383-390.

Science/Animal: Activation of the CB2 receptor protects the heart in diabetes
In a study with diabetic mice treatment with a synthetic cannabinoid (HU 308), which activates the CB2 receptor, produced heart protecting effects. This protective effect was also observed in non-diabetic mice subjected to high glucose levels.
Department of Rehabilitation Medicine, Zhejiang Hospital, Hangzhou, China.
Wu A, et al. Front Pharmacol. 2018;9:1292.

Science/Animal: CBD may be helpful in allergic asthma
In a study with allergic asthma CBD regardless of dosage reduced hyperresponsiveness of the airways and decreased inflammation.
Extreme University South of Santa Catarina, Criciúma, Brazil.
Vuolo F, et al. EUR J Pharmacol. 2018;843:251-259.

Science/Animal: CBD may prevent damage due to reduced oxygen supply during birth
A study with one day old piglets, whose arteries to the brain were closed for 20 minutes, showed that CBD given intravenously “offers some neuroprotective effects but the combination of cannabidiol and hypothermia shows some additive effect leading to more complete neuroprotection than cannabidiol or hypothermia alone.”
Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain.
Barata L, et al. Neuropharmacology. 2018;146:1-11.

Science/Animal: Antagonistic action at the CB2 receptor may be useful in autoimmune diseases
In a study with mice a selective inverse agonist of the CB2 receptor (JTE907) reduced disease severity of colitis by influencing the types of lymphocytes.
Department of Medicine, Section of Pharmacology, University of Perugia, Italy.
Gentili M, et al. Pharmacol Res. 2018 Dec 12. [in press]

Science/Animal: CBD opposes effects of THC on intraocular pressure
While THC is known to reduce intraocular pressure, which may be beneficial in glaucoma, CBD prevents THC from lowering ocular pressure.
Indiana University, Bloomington, USA.
Miller S, et al. Invest Ophthalmol Vis Sci. 2018;59(15):5904-5911.

Science/Human: Cannabis users have lower cortical thickness of the hippocampus in the brain
In this study the hippocampus, a certain brain region, was investigated in 50 older adults with a mean age of 67 years. There were minor differences between 24 formerly heavy cannabis users abstinent for an average of 29 years and 26 non-users. Authors concluded, that “negative effects of chronic adolescent CB use on hippocampal structure are maintained well into late life.”
Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA.
Burggren AC, et al. Cannabis Cannabinoid Res. 2018;3(1):242-251.

Science/Animal: Activation of the CB2 receptor reduces inflammation
In a rat model of acute inflammation activation of the CB2 receptor reduced peripheral inflammation of the paws by reduction of oxidative stress and effects on certain cytokines (tumour necrosis factor alpha, interleukin-1 beta).
Department of Pharmacology, Faculty of Medicine, Adiyaman University, Turkey.
Parlar A, et al. Exp Ther Med. 2018;16(6):4900-4908.

Science/Cells: Endocannabinoids show activity against resistant bacteria
The endocannabinoids anandamide and arachidonoyl serine reduced metabolic activity of the biofilm formation by MRSA (methicillin-resistant Staphylococcus aureus). Authors noted that “due to their anti biofilm action these agents could also be a promising alternative to antibiotic therapeutics against biofilm-associated MRSA infections.”
Faculty of Dental Medicine, The Hebrew University of Jerusalem, Israel.
Feldman M, et al. Sci Rep. 2018;8(1):17696.

Science/Human: Cannabis use may be associated with increased pain after surgery
In an analysis of 3793 patients, who underwent surgery, 155 were identified as using cannabinoids for recreational or medical use. Cannabis users had a higher incidence of moderate to severe pain at rest (62% versus 46%) and had lower sleep quality compared to non-users.
Department of Anesthesia, University of Toronto, Canada.
Liu CW, et al. Anesth Analg. 2018 Dec 7. [in press]

Science/Animal: Activation of the CB2 receptor ameliorates bone destruction in arthritis
In mice with collagen-induced arthritis the CB2 receptor was activated by the synthetic cannabinoid JWH133. Activation of the receptor increased the expression of the anti-inflammatory cytokine (interleukin-10) and reduced pro-inflammatory cytokines, including tumour necrosis factor-alpha, interleukin-1 beta and interleukin-6. It attenuated the formation of osteoclasts and pathologic bone destruction.
The First Affiliated Hospital of Soochow University, China.
Zhu M, et al. J Bone Miner Res. 2018 Dec 3. [in press]

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