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IACM-Bulletin of 26 May 2019

Science/Human: CBD reduces craving in drug-abstinence individuals with heroin dependency according to clinical study

CBD in a dose of 400 or 800 mg once daily reduced craving in patients with heroin dependency according to a placebo-controlled study. Of 42 patients 15 received a placebo, 14 received 400 mg of CBD and 13 received 800 mg of CBD. The study assessed the acute (1 hour, 2 hours, and 24 hours), short-term (3 consecutive days), and protracted (7 days after the last of three consecutive daily administrations) effects of CBD administration. It was conducted at the Department of Psychiatry and Department of Neuroscience and the Department of Population and Health Sciences, Icahn School of Medicine at Mount Sinai in New York, USA.

Acute CBD administration, in contrast to placebo, significantly reduced both craving and anxiety. CBD also showed significant protracted effects on these measures 7 days after the final short-term (3-day) CBD exposure. In addition, CBD reduced the drug cue-induced physiological measures of heart rate and salivary cortisol levels. There were no significant effects on cognition, and there were no serious adverse effects.

Hurd YL, Spriggs S, Alishayev J, Winkel G, Gurgov K, Kudrich C, Oprescu AM, Salsitz E. Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial. Am J Psychiatry. 2019 May 21:appiajp201918101191. [in press]

USA: North Dakota decriminalises the use of cannabis for adults - so far 10 states have legalised cannabis use by adults

North Dakota becomes the 11th state to legalise or decriminalise the recreational use of cannabis. This legislation means that first-time offenders possessing half an ounce or less of cannabis will be fined up to 1,000 dollars, with no jail time. The bill will also reduce penalties for possession of greater amounts of cannabis. The bill goes into effect from 1 August 2019.

At present, the medicinal use of cannabis (with a doctor's recommendation) is legal in 33 states. The recreational use of cannabis for adults is legal in 10 states: Alaska, California, Colorado, Maine, Michigan, Nevada, Oregon, Vermont, Washington, and Washington D.C.

Latestly of 12 May 2019

Greece: Six licenses for companies to cultivate cannabis

It’s still unlawful in Greece – apart from medical use – to use cannabis but the cannabis industry is set to take off after the government authorized six licenses for companies to cultivate the product. Some 50 applications for licenses have been submitted, some further of which are in the final stages of approval.

The new industry could create 3,500 jobs. With a far-left government and a youthful population known for disdaining the law, Greece is seen by companies investing in the future of cannabis as the perfect place to cultivate customers too. “It’s the EURopean California,” James Ickes, Managing partner for Devcann, an Ohio-based company that is investing €12 million ($13.7 million) to cultivate, process and export medical and industrial cannabis in the country told The Wall Street Journal.

The National Herald of 13 May 2019

Science/Animal: CBD is of moderate efficacy in reducing seizures in dogs with epilepsy according to a controlled clinical trial

In a controlled clinical trial, where 26 dogs with epilepsy either received CBD (12 dogs) or a placebo (14 dogs) CBD reduced seizure frequency. It was conducted at Flint Animal Cancer Center of the University of Colorado in Aurora, USA. CBD was given at a dose of 2.5 mg/kg bodyweight in an oily solution twice daily for 12 weeks.

2 dogs in the CBD group developed ataxia and were withdrawn from the study. After other exclusions, 9 dogs in the CBD group and 7 in the placebo group were included in the analysis. Dogs in the CBD group had a significant (median change: 33%) reduction in seizure frequency, compared with the placebo group. However, the proportion of dogs considered responders to treatment (at least 50% decrease in seizure activity) was similar between groups. Plasma CBD concentrations were correlated with reduction in seizure frequency.

McGrath S, Bartner LR, Rao S, Packer RA, Gustafson DL. Randomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy. J Am Vet Med Assoc. 2019;254(11):1301-1308.

News in brief

WHO/UN: The list of countries voting on the status of cannabis published
In March 2020 the United Nations might terminate its half-Century of ban on Cannabis medicines by drug conventions. The process that started in 2016 will finish with a vote planned in March 2020. The list of the 53 countries that will take part in this historic voting has been made public. WHO has been undergoing a silent but powerful process among the last couple of years: an unprecedented scientific assessment of cannabis, cannabinoids and cannabis derivatives.
Knowmad Institut

Science/Cells: CBD produces synergistic anti-tumour effects with anti-cancer medication in colorectal cancer cells
Researchers found that the combination of cannabidiol and TNF-related apoptosis-inducing ligand (TRAIL) produces synergistic antitumor effects. They wrote that CBD enhances TRAIL-induced apoptosis, a form of programmed cell death, which “suggests that cannabidiol is a novel agent for increasing sensitivity to TRAIL.”
Division of Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Kim JL, et al. Cancers (Basel). 2019;11(5).

UK: Advisory body on drug misuse to provide framework on medical cannabis by the end of 2019
The Advisory Council on the Misuse of Drugs (ACMD) has been asked to provide an outline framework on medical cannabis by the end of 2019, with the aim of having an initial view by the end of 2020.
The Pharmaceutical Journal of 9 May 2019

World: Review on the status of cannabis worldwide
The Edison group has published a review on the status of cannabis in the world. Where are we and where we are going?
Edison of 30 April 2019

St Kitts: Supreme Court rules that it is legal for Rastafaris to use cannabis
The Eastern Caribbean Supreme Court has ruled that parts of country's drug laws regarding cannabis unconstitutionally infringe on citizens' privacy and religious freedom rights. The ruling makes it legal for Rastafaris to use cannabis for religious purposes. The ruling says that “the means used by the State to deal with cannabis impair the Claimant’s fundamental right and freedom more than is necessary to accomplish the objective of protecting public health, public order and public safety.”
Ruling by the Supreme Court of 3 May 2019

Israel: Computerised interface to process applications for a medical cannabis licence for patients
Israel's Health Ministry has established a new, advanced computerized interface to process applications for a medical cannabis license. The system allows for a doctor or the patient him/herself to enter their request and accompanying documents. After the documents are processed and approved, the patient can print the license and prescription and bring them directly to a pharmacy.
Jerusalem Post of 2 May 2019

Science/Animal: THC may be more effective in reducing pain in adults compared to adolescents
In a study with rats the pain-relieving effects of THC were more pronounced in adult rats than in adolescent rats. THC was more effective in females compared to males.
Department of Psychology, Washington State University, USA.
Craft RM, et al. Exp Clin Psychopharmacol. 2019 May 23. [in press]

Science/Animal: THC reduces inflammation in a monkey model of HIV infection
In rhesus macaques infected with the SI-virus (simian immunodeficiency virus) administration of THC reduced intestinal inflammation.
Nektar Therapeutics, South San Francisco, USA.
Kumar V, et al. Front Immunol. 2019;10:914.

Science/Human: Legalisation of cannabis for medical use in the US increased cannabis use by pregnant women
A comparison between 21 states, which legalised the medical use of cannabis, and 27 states, which did not, revealed that the number of pregnant women seeking support for cannabis substance use was considerably higher in states with medical cannabis laws.
Department of Healthcare Policy & Research, Weill Cornell Medicine, New York, USA.
Meinhofer A, et al. Addiction. 2019 May 20.[in press]

Science/Human: Non-significant increase of crash risk in drivers under the influence of cannabis
In a study with 3005 injured drivers from the British Colombia, Canada, 14.4% tested positive for alcohol and 8.3% for THC. There was no increased risk of crash responsibility in drivers with THC blood concentrations below 5 ng/mL and a statistically non-significant increased risk (odds ratio of 1.74) in drivers with a THC blood concentration of 5 ng/mL or more.
Vancouver General Hospital & The University of British Columbia, Vancouver, Canada.
Brubacher JR, et al. Addiction. 2019 May 20. [in press]

Science/Animal: Memory effects of cannabinoids may be reduced by blockade of adenosine receptors
In a study with mice memory impairment by a synthetic cannabinoid (WIN52,202-2), which activates the CB1 receptor was reduced by blockade of the A2A receptor. Authors note that these results “strongly indicate that adenosine A2ARs are appropriate targets to tackle side-effects of putative therapies involving the activation of cannabinoid receptors.”
Instituto de Farmacologia e Neurocięncias, Faculdade de Medicina, Universidade de Lisboa, Portugal.
Mouro FM, et al. Neuropharmacology. 2019;155:10-21.

Science/Animal: CB2 receptors on microglia and macrophages modulate neuropathic pain responses
According to results of a study with mice researchers found “that CB2 receptors on microglia and macrophages, but not on neurons, modulate neuropathic pain responses.”
Institute of Molecular Psychiatry, University of Bonn, Germany.
Nent E, et al. Sci Rep. 2019;9(1):7468.

Science: Cannabinoids differentially activate ion channels involved in pain reduction
Researchers investigated effects of several cannabinoids on ion channels involved in pain reduction and found that they differentially activate these channels and “it may be possible to rationally design approaches to pain using single or multiple cannabinoids.”
Laboratory of Immunology and Signal Transduction, Chaminade University, Honolulu, USA.
Starkus J, et al. Channels (Austin). 2019 May 17. [in press]

Science/USA: No relevant effect on hospital admissions after legalisation of cannabis in Colorado
Compared with New York and Oklahoma there was no relevant effect of legalisation of cannabis in Colorado and hospital admissions, length of stay and costs. Motor vehicle accidents, alcohol abuse and overdose injury increased, while chronic pain admissions decreased.
University of California, San Francisco, USA.
Delling FN, et al. BMJ Open. 2019;9(5):e027432.

Science/Animal: Cannabidivarin may rescue memory deficits
In a mouse model of Rett syndrome, which is associated with problems of language, coordination and movements, CBDV (cannabidivarin) was shown to rescue memory deficits. Authors concluded that “CBDV delays neurological defects but this effect is only transient.”
Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy.
Zamberletti E, et al. J Psychopharmacol. 2019:269881119844184.

Science/Animal: THC may be helpful in damaged kidneys due to diabetes
In a study with diabetic rats and damaged kidneys THC showed “ameliorative effects on the impaired redox status of diabetic kidney and also it acts as an immunomodulator.”
Department of Medical Biochemistry, Faculty of Cerrahpasa Medicine, Istanbul University, Turkey.
Yanar K, et al. J Cell Biochem. 2019 May 13. [in press]

Science/Human: Many patients with brain cancer use cannabis
According to a survey among 73 patients with glioma, an aggressive brain cancer, in a state with legal access to cannabis one third reported using cannabis products after their diagnosis.
Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA.
Reblin M, et al. J Palliat Med. 2019 May 13. [in press]

Science/Animal: CBD may reduce alcohol consumption
Treatment with CBD reduced alcohol intake in male mice, but was not effective in females. Authors concluded that “these findings suggest that CBD may be of interest for treating binge-drinking patterns and that gender-related difference may affect the treatment outcome.”
Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Spain.
Viudez-Martínez A, et al. Addict Biol. 2019:e12765.

Science/Animal: THC may be used to treat vulvar pain
THC reduced tactile sensitivity in the vagina and accumulation of mast cells. These cells may increase in allergic sites. Authors wrote that “mast cell-targeted therapeutic strategies may therefore provide new ways to manage and treat vulvar pain potentially instigated by repeated allergenic exposures.”
Biology Department, Macalester College, Saint Paul, USA.
Boo B, et al. Int J Mol Sci. 2019;20(9).

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