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IACM-Bulletin of 26 April 2020

Science/Human: Cannabis alleviates opioid withdrawal symptoms

According to a survey with 200 people, who used cannabis and opiates within the past month and experienced opiate withdrawal symptoms cannabis alleviates opiate withdrawal symptoms in most patients and increases them in a few. The study was conducted by researchers of Johns Hopkins University School of Medicine in Baltimore, USA.

62.5% (125 individuals) of 200 participants had used cannabis to treat withdrawal. Participants most frequently indicated that cannabis improved anxiety, tremors, and trouble sleeping. A minority of participants (6.0%, 12 individuals) indicated cannabis worsened opioid withdrawal, specifically symptoms of yawning, teary eyes, and runny nose. Across all symptoms, more participants indicated that symptoms improved with cannabis compared to those that indicated symptoms worsened with cannabis. Women reported greater relief from withdrawal with cannabis use than men.

Bergeria CL, Huhn AS, Dunn KE. The impact of naturalistic cannabis use on self-reported opioid withdrawal. J Subst Abuse Treat 2020;113:108005

Science/Human: Beneficial effects of cannabis on blood brain barrier function in HIV

Researchers from the University of California in San Diego, USA, studied 45 people with HIV and 30 HIV- individuals who had used cannabis recently. They found that cannabis may have a beneficial impact on HIV-associated injury of the blood-brain barrier. They assessed two biomarkers of blood-brain barrier permeability.

Among HIV positive participants without cannabis these two biomarkers were higher in cerebrospinal fluid compared to those, who also used cannabis. Authors concluded that “cannabis may have a beneficial impact on HIV-associated BBB injury. Since BBB disruption may permit increased entry of toxins such as microbial antigens and inflammatory mediators, with consequent CNS injury, these results support a potential therapeutic role of cannabis.”

Ellis RJ, Peterson S, Cherner M, Morgan E, Schrier R, Tang B, Hoenigl M, Letendre S, Iudicello J. Beneficial Effects of Cannabis on Blood Brain Barrier Function in HIV. Clin Infect Dis. 2020 Apr 16 [in press]

Science/Human: Cannabis use is associated with increased testosterone levels in men

An analysis of 5146 men revealed that cannabis use was associated with an increased testosterone level compared to never users. This is the result of research conducted at the Department of Urology of the University of Chicago, USA. They used data of the National Health and Nutrition Examination Survey (NHANES) from the years 2011-2016. Among the 5146 men who met inclusion, 3027 had used cannabis at least once in their life (ever-user). Nearly half of the cannabis ever-users (49.3%) were considered regular THC users.

Researchers found “a small but statistically significant increase in testosterone among regular THC users at any measured level of use, compared to non-regular THC users (non-users).” Medium THC consumption was associated with the greatest increase in testosterone. Cannabis users using two-three times per month demonstrating the greatest increase in testosterone over non-users. Authors concluded that “THC use is associated with small increases in testosterone. This increase in T appears to decline as THC use increases, but nevertheless, T is still higher with any amount of regular use when compared to T in non-users.”

Fantus RJ, Lokeshwar SD, Kohn TP, Ramasamy R. The effect of tetrahydrocannabinol on testosterone among men in the United States: results from the National Health and Nutrition Examination Survey. World J Urol. 2020 Feb 17 [in press]

Science/Human: Cannabis access may reduce the demand for opioids in people with pain

According to an online survey with 155 pain patients conducted by researchers of John Hopkins University School of Medicine in Baltimore, USA, access to cannabis may reduce opioid use in pain patients. Adults reporting current use of opioids for pain management and past 30-day cannabis exposure completed two hypothetical purchase tasks in which only grams of cannabis or units of participants' opioids were available for purchase, and two hypothetical tasks in which both were concurrently available and the price of one drug increased whereas the other was kept constant.

Demand intensity was significantly reduced and demand elasticity was significantly increased for both cannabis and opioids when the alternate commodity was available, although the reductions in cannabis consumption were more pronounced than they were for opioid consumption in the presence of the alternate commodity. Authors concluded that their “data provide behavioral economic evidence that cannabis access may modestly reduce demand for opioids in persons who have pain.”

Bergeria CL, Dolan SB, Johnson MW, Campbell CM, Dunn KE. Evaluating the co-use of opioids and cannabis for pain among current users using hypothetical purchase tasks. J Psychopharmacol. 2020:269881120914211

News in brief

Europe/Canada: Covid-19 freezes EURopean GMP cannabis inspections in Canada and elsewhere
European Union Good Manufacturing Practice (EU-GMP) certification audits involving cannabis facilities in Canada and elsewhere are screeching to a halt given the travel restrictions in place in most of the world because of the coronavirus pandemic. The discontinuation of the audits has meant that some overseas medical cannabis producers can’t receive the key certification to begin exports to the EU market.
Marijuana Business Daily of 6 April 2020

Science/Human: Cannabis may be helpful in generalised anxiety disorder
In a case study with a 88-year-old female patient the use of cannabis oil reduced her generalised anxiety and symptoms of vertigo. The author wrote that “this case demonstrates how the patient drastically improved her quality of life and reinforces the need for more rigorous testing on the use of medical cannabis to support patients and better manage the symptoms associated with their medical conditions.”
Counselling and Consulting Services, Sydney, Australia.
Walkaden C. Discoveries (Craiova). 2019;7(2):e92

Science/Human: Oral CBD does not convert to THC in humans
In a study with 120 healthy human subjects (60 male and 60 female), who received 300 mg of CBD there was no THC in blood plasma and participants had no THC effects. Authors concluded that “the findings presented here are consistent with previous evidence suggesting that the oral administration of CBD in a corn oil formulation is a safe route for the administration of the active substance without bioconversion to THC in humans.”
Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Brazil.
Crippa JAS, et al. Cannabis Cannabinoid Res. 2020;5(1):89-98

Science/Human: Cannabis users have lower body mass index than non-users
Participants in this study were 401 adolescents aged 14-17 at baseline who were at risk for escalation in their use of cannabis. Researchers investigated cannabis use and body mass index (BMI). Authors wrote that results of this study “showed that baseline BMI predicted a positive and significant association with cannabis use slope. In addition, there was a significant and negative correlation between the cannabis use slope and the BMI slope.” They concluded that these results “are consistent with the adult literature that reports a negative association between cannabis use and BMI.”
Institute for Behavior Genetics, University of Colorado Boulder, USA .
Ross JM, et al. Cannabis Cannabinoid Res. 2020;5(1):81-88

Science/Animal: CBD improves survival in Dravet syndrome
In a mouse model of Dravet syndrome, a rare genetic disease, which is associated with epileptic seizures, CBD improved survival and reduced several symptoms. Authors wrote that they are “the first to demonstrate a potential disease-modifying effect of cannabidiol in animal models of Dravet syndrome.”
School of Pharmacy, University of Reading, Reading, UK.
Patra PH, et al. Br J Pharmacol. 2020 Apr 22 [in press]

Science/Animal: Mice without CB1 receptors show impaired memory at an advanced age
New findings suggest that missing CB1 receptors in certain mice lead to abnormal function of the mitochondria in nerve cells of the hippocampus, certain brain region, during ageing. Authors wrote that these mitochondrial changes might be due to the impairments in mitochondrial quality control system, which links age-related decline in CB1 activity and impaired memory.”
Faculty of Science and Engineering, Waseda University, Tokyo, Japan.
Kataoka K, et al. Brain Res Bull. 2020 Apr 12. [in press]

Science/Human: The effects of cannabis smoking are different to those of tobacco smoking according to a review
In a review scientists highlight the different consequences of cannabis and tobacco smoke. They summarised that “cannabis use is associated with increased central airway resistance, lung hyperinflation, and higher vital capacity with little evidence of airflow obstruction or impairment of gas transfer. There are numerous reports of severe bullous lung disease and pneumothorax among heavy cannabis users, but convincing epidemiological data of an increased risk of emphysema or alveolar destruction are lacking. An association between cannabis and lung cancer remains unproven with studies providing conflicting findings.”
Department of Respiratory Medicine, Waikato Hospital, Hamilton, New Zealand.
Gracie K, et al. Addiction. 2020 Apr 14. [in press]

Science: Adolescents, who use cannabis to fall asleep, may have insomnia later in life
Teenagers who use cannabis to fall asleep may be setting themselves up for insomnia later in life, a new study suggests. It is widely known that many people rely on cannabis as a sleep aid. In a 2018 survey of 1,000 cannabis users in Colorado, 74 % reported that they use it to fall asleep. In a new study, researchers analyzed the sleep habits and history of cannabis use among 1,882 teens from Colorado. The results showed that roughly one-third of the participants who started using cannabis before age 18 had insomnia later in life. Only 20 percent of the other participants -- who either never became regular cannabis users or started their use at age 18 or older -- had insomnia in adulthood.
UPI of 14 April 2020

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