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IACM-Bulletin of 04 August 2019

Science/Human: Cannabis use in adolescence is not associated with structural brain changes in adulthood

According to a large longitudinal study “adolescent cannabis use is not associated with structural brain differences in adulthood.” Data for research from the Department of Psychology of Arizona State University in Tempe, USA, came from the Pittsburgh Youth Study - a longitudinal study of ˜1000 boys. Boys completed self-reports of cannabis use annually from age 13-19. A subset of 181 boys underwent structural neuroimaging in adulthood, when they were between 30-36 years old on average.

Researchers identified four kinds of adolescent cannabis users: non-users/infrequent users, desisters/dropouts, escalators, and chronic-relatively frequent users. Authors investigated 14 brain regions and concluded that boys in different subgroups “did not differ on adult brain structure in any subcortical or cortical region of interest.”

Meier MH, Schriber RA, Beardslee J, Hanson J, Pardini D. Associations between adolescent cannabis use frequency and adult brain structure: A prospective study of boys followed to adulthood. Drug Alcohol Depend. 2019 Jul 19;202:191-199. [in press]

Science/Human: Cannabis use reduced cancer risk in patients with Crohn’s disease

In a study with 6002 patients with Crohn’s disease and 1481 patient with ulcerative colitis cannabis use was associated with a lower risk for the development of colorectal cancer, anaemia and need for hospitalisation. However, some other health outcomes were negatively associated with cannabis use and effects on ulcerative colitis were less pronounced. This is the result of an investigation by Atlanta VA Medical Center in Decatur, USA. Scientists used the Nationwide Inpatient Sample datasets (2010-2014) that to identify adults with Crohn’s disease and ulcerative colitis hospitalizations.

Of the 6,002 patients with Crohn’s disease (CD) there were 2,999 cannabis users, and of the 1,481 patients with ulcerative colitis (UC) there were 742 cannabis users. In CD patients, prevalence of colorectal cancer was 0.3% in cannabis users and 1.2% in non-users. Active fistulizing disease or intraabdominal abscess formation were higher in cannabis users (9% vs. 6%). The mean hospital stay was shorter (4.2 vs. 5.0 days) with less hospital charges in cannabis users. In patients with UC, cannabis users faced the higher frequency of fluid and electrolyte disorders (45% vs. 30 %), and hypovolemia (2.7% vs. <11), but with relatively lower frequency of postoperative infections (<11 vs. 3.4%).

Desai R, Patel U, Goyal H, Rimu AH, Zalavadia D, Bansal P, Shah N. In-hospital outcomes of inflammatory bowel disease in cannabis users: a nationwide propensity-matched analysis in the United States. Ann Transl Med. 2019;7(12):252.

USA: States want cannabis to grow greener as legal cannabis expands

As more states legalize recreational and medical cannabis, they’re confronting the reality that cannabis production involves using huge amounts of pesticides, energy, and water, while generating tons of plant and packaging waste. The result is a patchwork of air, water, pesticide, and waste regulations for the industry across dozens of states, even as the substance remains illegal at the federal level.

States like Michigan, where the Marijuana Regulatory Agency will begin accepting business licenses in November, have adopted rules on issues like industrial wastewater, water resources, and land management for cannabis growers. Illinois, which legalized recreational cannabis this year, will factor environmental planning—including conservation and efficiency efforts—into its scoring of cultivation center applications. Colorado is tweaking some elements of its cannabis environmental and sustainability regulations after becoming the first state to allow recreational cannabis use in 2014.

Bloomberg Environment of 19 July 2019

Science/Human: Cannabis use is associated with reduced fasting insulin levels in obese people

Fasting insulin levels and insulin resistance were reduced in obese adults with high insulin resistance by cannabis use. This is the result of a study conducted with 65,209 obese individuals conducted by researchers of the National Public Health Institute of Quebec, Canada. For measuring insulin resistance they used HOMA-IR (homeostasis model assessment of insulin resistance). Scientists used data of the National Health and Nutrition Examination Survey (NHANES), a survey research program designed to assess the health and nutrition status of individuals in the United States.They abstracted data from NHANES 2009-2016.

From their results they concluded that cannabis use was associated with reduced fasting insulin levels and HOMA-IR score in US obese adults with HOMA-IR  above  2.13, but not in those with HOMA-IR  lower than  2.13 or  higher than  5.72. “The impact of marijuana use is the greatest after long-term exposure and is independent of BMI,” they wrote. BMI or body mass index is a measure of obesity.

Ngueta G. Impact of lifetime marijuana use on fasting plasma insulin levels and HOMA-IR score in obese adults with and without insulin resistance. Acta Diabetol. 2019 Jul 31. [in press]

News in brief

Israel: Patients claim that upcoming regulations for medical cannabis will worsen their situation
The Israeli Medical Cannabis Unit is working these days to implement new regulations on medical cannabis, but many patients claim that these regulations are damaging their access to an optimal medical care with cannabis. Medical cannabis products are supposed to be distributed through pharmacies according to the new regulations, but pharmacies are out of stock for such products throughout the country. The new regulations are also causing a raise in the medical cannabis prices for most patients.
HATSINOR of Channel 13

Europe: EURopean panel supports GW Pharma cannabis drug for epilepsy
GW Pharmaceuticals’ CBD extract Epidyolex has won a positive recommendation for marketing approval from the EURopean Medicines Agency (EMA) panel for use as an additional treatment for two types of seizures. EMA’s human medicines committee (CHMP) cleared the cannabidiol oral solution for use with clobazam to treat seizures associated with Lennox‑Gastaut syndrome or Dravet syndrome for patients aged two and older. Final approvals are up to the EURopean Commission.
Reuters of 26 July 2019

Thailand: Cannabis among top priorities for new Thai government
Developing a medical cannabis industry is among top policy priorities for Thailand’s new government, according to a document released before the formal announcement.
Reuters of 22 July 2019

UK: Government may legalise cannabis in the long-term
Senior members of Boris Johnson’s Number 10 team want to legalise cannabis. A cross-party group of MPs has declared that the UK could legalize recreational cannabis use within five years after conducting an eye-opening visit to Canada.
Buzzfeed of 31 July 2019
Grizzle of 29 July 2019

USA: Governor Cuomo signs law decriminalizing cannabis in New York
New York Gov. Andrew Cuomo signed legislation to decriminalize possession of less than 2 ounces (about 56 g) of cannabis, and reduced the penalty for unlawful possession to a fine.
UPI of 29 July 2019

UK: Medical cannabis first for Scottish boy who has epilepsy
A mother who previously had to resort to bringing illegal cannabis oil into the country to treat her son’s epilepsy has become the first person in Scotland to be able to source the drug legally.
The National of 22 July 2019

Holland: Netherlands to hike cannabis exports to Germany by 1,000 kilograms per year
The Minister of Medical Care of the Netherlands informed the Dutch parliament that exports of medical cannabis flower to Germany will increase this year. In the letter, dated July 12, the Dutch minister explained that the request for an increase came from his German counterpart, who asked for a hike in the annual volume of medical cannabis flower shipped from the Netherlands to Germany from the current 1,500 kilograms to 2,500.
Marijuana Business Daily of 19 July 2019

Science/Human: Cannabis and physiotherapy may have additive effects in spasticity of MS
An observational study with 297 MS patients showed that physiotherapy may improve overall response and persistence to a treatment with the cannabis extract Sativex.
MS Center Sant'Andrea Hospital, Sapienza University of Rome, Italy.
Grimaldi AE, et al. PLoS One. 2019;14(7):e0219670.

Science/Cells: Cannabichromene is a CB2 receptor agonist
Research with cells shows that cannabichromene (CBC) is a CB2 receptor agonist. Authors wrote that “CBC may contribute to the potential therapeutic effectiveness of some cannabis preparations, potentially through CB2-mediated modulation of inflammation.”
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Udoh M, et al. Br J Pharmacol. 2019 Aug 1. [in press]

Science/Animal: Increase of endocannabinoids has significant effects on skin inflammation
Research with mice showed that inhibition of endocannabinoid degradation by different synthetic substances exhibited “a significant effect on skin barrier repair, epidermal proliferation/differentiation and inflammation.”
Department of Dermatology, University of Kiel, Germany.
Proksch E, et al. Exp Dermatol. 2019 Jul 27. [in press]

Science/Animal: CBD showed positive effects on cognition in a rat model of schizophrenia
New data of research with a rat model of schizophrenia “support the therapeutic benefits of CBD on recognition memory and sociability (…), and provide insight into the neurochemical changes that may underlie the therapeutic benefits of CBD.”
School of Medicine, University of Wollongong, Australia.
Osborne AL, et al. Brain Behav Immun. 2019 Jul 19. [in press]

Science/Animal: Cannabinoids had a positive effect on inflammation in an MS model by changing gut bacteria
In an animal model of Multiple Sclerosis (autoimmune encephalomyelitis) THC and CBD significantly reduced inflammation by a decrease in pronflammatory cytokines (interleukin-17, interferon-gamma). Investigations also showed a positive effect on gut bacteria. Authors wrote that THC and CBD may “suppress neuroinflammation by preventing microbial dysbiosis seen during EAE and promoting healthy gut microbiota.”
Department of Pathology, Microbiology and Immunology. University of South Carolina School of Medicine, Columbia, USA.
Al-Ghezi ZZ, et al. Brain Behav Immun. 2019 Jul 26. [in press]

Science/Animal: Activation of the CB2 receptor reduced allodynia caused by HIV
Studies with mice activation of the CB2 receptor with several synthetic cannabinoids showed that CB2 receptor agonists demonstrate acute, but not long-term, antiallodynic effects on retrovirus infection-induced neuropathic pain.
Neurovirology Laboratory, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
Sheng WS, et al. Pain Res Manag. 2019;2019:1260353.

Science/Human: Oral cannabis preparations are increasingly used in the US
Oral cannabis preparations (“edibles”) are increasingly used in the US. Most participants of a survey with 172 individuals reported that they experienced negative experiences due to too high doses. Authors wrote: “Notwithstanding these uncomfortable experiences, the vast majority of the sample used cannabis edibles again, reported that the experience was at least somewhat meaningful, and did not report significant problems associated with the experience.”
Department of Psychology, State University of New York , Albany , USA.
Farmer S, et al. J Psychoactive Drugs. 2019 Jul 29:1-8.

Science/Cells: CBD shows anti-cancer effects in stomach cancer cells of humans
In a study with human stomach cancer cells CBD showed several anti-cancer effects including induction of apoptosis, a form of programmed cell death, by increasing reactive oxygen species.
School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, China.
Zhang X, et al. Biomolecules. 2019;9(8)

Science/Animal: A synthetic derivative of cannabigerol may be useful in Parkinson’s disease
in a mouse model of Parkinson’s disease a synthetic derivative (VCE-003.2) of the natural cannabinoid cannabigerol (CBG) showed neuroprotective effects and authors wrote that “this study opens the possibility to further the development of oral VCE-003.2 in the clinic.”
Facultad de Medicina, Universidad Complutense, Madrid, Spain.
Burgaz S, et al. Molecules. 2019;24(15).

Science/Human: Medical cannabis use does not lead to increased opioid misuse
According to a survey with 1295 medical cannabis users, 707 both medical and non-medical cannabis users and 18,666 non-medical cannabis users, there was an increased risk to develop a prescription opiate use disorder in non-medical cannabis users. Authors wrote: “Medical cannabis use, however, was not associated with prescription opioid use disorder.”
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, USA.
Liang D, et al. Drug Alcohol Rev. 2019 Jul 25. [in press]

Science/Human: The CB2 receptor concentration is increased in patients with irritable bowel syndrome
The concentration of CB2 receptors and certain opiate receptors was increased in the mucosa of patients with irritable bowel syndrome. Scientists wrote that their research “suggests that opioid and cannabinoid systems play an immune-related compensatory role in visceral pain in IBS patients.”
David Geffen School of Medicine, University of California Los Angeles, USA.
Dothel G, et al. Neurogastroenterol Motil. 2019 Jul 23:e13688.

Science/Human: Cannabis use was associated with adverse pregnancy outcomes in young women
In a sample of 1206 pregnant young woman (13-22 years old), of whom 17.5 % used cannabis, those who used cannabis had a high risk for preterm birth, hypertensive disorders of pregnancy and stillbirth. While 34% of women, who did not use cannabis, had some kind of negative outcome it was 46% for cannabis users.
University of Colorado School of Medicine, Aurora, USA.
Rodriguez CE, et al. BJOG. 2019 Jul 23. [in press]

Science/Human: A combination of THC and CBD were effective in reducing seizures in childhood epilepsy
In a small study with 7 participants suffering from childhood epilepsy a cannabis extract with a ratio of THC to CBD of 1 to 20 all patients tolerated the extract up to a daily dose of 10-12 mg CBD per kilogram and had improvements in seizure frequency.
Cannabinoid Research Initiative of Saskatchewan, University of Saskatchewan, Canada.
Huntsman RJ, et al. Front Neurol. 2019 Jul 3;10:716.

Science/Animal: A synthetic cannabinoid was effective in an animal model of migraine
In a rat model of migraine the synthetic cannabinoid WIN 55,212-2 was effective. Authors wrote, that their data “supported the argument that activation of CB1 and CB2 receptors by WIN 55,212-2 may be considered a new medication for migraine.”
Department of Neurology, Kashan University of Medical Sciences, Iran.
Vosough EM, et al. Life Sci. 2019 Jul 19:116670.

Science/Animal: CBD may improve recovery of learned behaviours following brain injury
In a study with songbirds administration of CBD reduced the time required to recover their specific songs after brain injury. Authors wrote that results “suggest CBD holds promise to improve functional recovery of complex learned behaviors following brain injury.”
Department of Pharmacology and Toxicology, ECU Brody School of Medicine, Greenville, USA.
Alalawi A, et al. Neuropharmacology. 2019 Jul 17:107716.

Science/Human: No relevant association between medical cannabis laws and opioid misuse
In a large investigation with 627,000 individuals from 2004 to 2014 researchers “found little evidence of an association between medical marijuana law enactment and nonmedical prescription opioid use or prescription opioid use disorder among prescription opioid users.”
Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, USA.
Segura LE, et al. JAMA Netw Open. 2019;2(7):e197216. [in press]

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