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IACM-Bulletin of 13 March 2022

Costa Rica: The medical use of cannabis is now legal

On 2 March medicinal cannabis was legalized in Costa Rica with the president’s signing of a law passed a day earlier by congress. The law also legalizes the cultivation and industrial production of hemp. Recreational marijuana use continues to be prohibited. The law is similar in allowing medicinal use to laws passed in other countries in the region, including: Argentina, Chile, Colombia, Ecuador, Mexico, Paraguay, Peru and Uruguay. Uruguay also legalized recreational use.

President Alvarado signed the bill in the waning days of his administration. Two presidential candidates José María Figueres and Rodrigo Chaves, who will compete in a runoff election April 3, have both spoken in favour of recreational use of marijuana.

Associated Press of 2 March 2022

Science/Human: Three further studies confirm the evidence, that cannabis use by pain patients may reduce the need for opioids

In a study with 40 patients suffering from chronic osteoarthritis pain the average daily intake of opioids measured as morphine milligram equivalents decreased from 18 to 10 within 6 months. The investigators of the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, USA, also found, that 38% drop their opioid use to 0.

Using data from the Norwegian Prescription Database, a study investigated the individual level effect of a cannabis extract (Sativex) in prescription opioid users on their opioid use in the following year. Looking at all those filling a prescription for the extract, opioid use was only marginally lowered in the follow-up period. But the investigators of the Norwegian Institute of Public Health in Oslo, Norway, noted that “some Sativex® users, however, filled more prescriptions for Sativex® and were able to reduce their opioid use substantially.”

In a retrospective observational study with patients treated with cannabis oils followed for 3 years the number of opioid non-users increased from 32% to 55%, while no significant differences were found in the distribution of anticonvulsant, antidepressant, and benzodiazepine users. The authors of the Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy, concluded that “opioid-sparing medications represent a crucial aspect of the pain treatment process.”

Renslo B, Greis A, Liu CS, Radakrishnan A, Ilyas AM. Medical Cannabis Use Reduces Opioid Prescriptions in Patients With Osteoarthritis. Cureus. 2022 Jan 24;14(1):e21564.
Bramness JG, Hjellvik V, Stubhaug A, Skurtveit S. Possible opioid-saving effect of cannabis-based medicine using individual-based data from the Norwegian Prescription Database. Basic Clin Pharmacol Toxicol.2022;130:84–92.
Nunnari P, Ladiana N, Ceccarelli G, Notaro P. Long-term Cannabis-based oil therapy and pain medications prescribing patterns: an Italian observational study. EUR Rev Med Pharmacol Sci 2022; 26 (4): 1224-1234.

News in brief

WHO: First scientific review of the medicinal value of cannabis and cannabinoids
A new article describes the process to scientifically review the medical value of cannabis by the World Health Organisation (WHO) on 2 December 2016. Finally, the UN Commission on Narcotic Drugs on 2 December 2020 withdrew “cannabis” and “cannabis resin” from Schedule IV.
Emerald insight

France: The government allows the cultivation of cannabis for medical use
The French government issued a decree in February that authorizes the cultivation of medical cannabis and the development of its industry. Although the decree entered into force on March 1, 2022, regulators need to implement it.
Forbes of 7 March 2022

Marocco: Morocco allows cannabis cultivation in northern regions
Growing cannabis for medical and industrial purposes is now allowed in Morocco, but only in three northern states and under strict control by authorities. During a weekly cabinet meeting on 10 March, Interior Minister Abdelouafi Laftit presented and adopted a draft decree amending parts of the country’s cannabis law. The law was adopted last August and established a regulatory body. It allows farming, export and sale of cannabis for industrial and medical purposes, but prohibits adult use.
Mugglehead of 12 March 2022

Science/Animal: Endocannabinoids may counteract lung injury
Inhibition of endocannabinoid degradation by an FAAH inhibitor reduced lung injury in mice induced by a chemical substance.
Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy.
Genovese T, et al. Int J Mol Sci. 2022;23(5):2781.

Science/Animal: Low doses of THC may be beneficial in Alzheimer’s disease
In a mouse model of Alzheimer’s disease low doses of THC (0.2 to 0.02 milligrams per kilogram bodyweight) showed beneficial effects “suggesting low-dose THC is a safe and effective treatment for AD,” authors wrote.
Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, USA.
Wang Y, et al. Int J Mol Sci. 2022;23(5):2757.

Science/Animal: CBD inhibits tumour growth in non-small-cell lung cancer
In a study with mice CBD showed anti-cancer effects against cisplatin resistant non-small-cell lung cancer (NSCLC). Authors wrote that their “findings identify CBD as a novel therapeutic agent targeting TRPV2 to inhibit the growth and metastasis of this aggressive cisplatin-resistant phenotype in NSCLC.”
Department of Pathology, The Ohio State University, Columbus, USA.
Misri S, et al. Cancers (Basel). 2022;14(5):1181.

Science/Human: CBD rich cannabis was not effective in treatment resistant epilepsy in an observational study
In observational study with 29 patients with different forms of epilepsy aged 12 to 46 years CBD rich cannabis did not reduce seizure frequency. However, authors noted that “doses of CBD used were lower than prior studies.”
NYU Comprehensive Epilepsy Center, New York, USA.
Devinsky O, et al. Ann Clin Transl Neurol. 2022 Mar 10. [in press]

Science/Animal: The endocannabinoid 2-AG suppresses gastric emptying
Administration of the endocannabinoid 2-AG (2-arachidonoylglycerol) to mice suppressed gastric emptying via activation of CB1 receptors.
Graduate School of Agriculture, Hokkaido University, Sapporo, Japan.
Ochiai K, et al. Lipids. 2022 Mar 10. [in press]

Science/Animal: Hemp reduced markers of stress in cows
Hemp with high concentrations of CBDA (cannabidiolic acid) reduced biomarkers of stress and inflammation in a study with 16 cows, of whom 8 received CBDA rich hemp.
Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, USA.
Kleinhenz MD, et al. Sci Rep. 2022;12(1):3683.

Science/Human: Cannabis use is associated with reduced resting heart rate
In an analysis within the CARDIA study 471 of 3269 participants used cannabis. Current cannabis use was associated with lower resting heart rate. Investigators noted that this “adds to the growing body of evidence suggesting a lack of deleterious association of cannabis use at a level typical of the general population on surrogate outcomes of cardiovascular disease.”
Institute of Primary Health Care (BIHAM), University of Bern and Department of Paediatrics, University Hospital Bern, Switzerland.
Autor J, et al. Am J Med. 2022:S0002-9343(22)00132-2.

Science/Human: CBD alters some responses to aerobic exercise without impairing performance
In a placebo-controlled pilot study 9 endurance trained men took either 300 mg oral CBD or a placebo before exhausting exercise. Investigators found that “CBD appears to alter some key physiological and psychological responses to aerobic exercise without impairing performance.” One observation was that CBD increased pleasure during exercise.
Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Australia.
Sahinovic A, et al. Sports Med Open. 2022;8(1):27.

Science/Animal: CBD reduced withdrawal -induced behaviour in mice
In a study with mice CBD given 30 hours after eight-day heroin treatments reduced withdrawal -induced behavioural and molecular changes.
Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.
Navarrete F, et al. Addict Biol.
2022;27(2):e13150.

Science/Cells: CBD increased the efficacy of a chemotherapeutic agent in breast cancer
In cultures of triple negative breast cancer cells pre-treatment with CBD increased the efficacy of the chemotherapeutic agent doxorubicin.
College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, USA.
Surapaneni SK, et al. Drug Deliv Transl Res. 2022 Feb 25. [in press]

Science/Animal: CBD protects against seizures induced by a chemical in female rats
Approximately 70% of women with epilepsy experience additional challenges in seizure exacerbation during fluctuations of estrogen-progesterone levels in the menstrual cycle. CBD was shown to have partial protective effects “against PTZ-induced acute seizures in female rats during the proestrus-estrus transition.”
Departamento de Fisiologia, Laboratório de Neurofisiologia, Universidade Federal de São Paulo - UNIFESP, Brazil.
Janisset NRLL, et al. Epilepsy Behav. 2022;129:108615.

Science/Animal: CBD may have protective effects to the heart in obesity
In a rat model of high-fat diet induced obesity administration of CBD showed protective effects to the heart, namely “amelioration of de novo ceramide synthesis pathway.”
Department of Physiology, Medical University of Bialystok, Poland.
Charytoniuk T, et al. Int J Mol Sci. 2022;23(4):2232.

Science/Animal: CBD prevents depressive -like behaviours
In a study with mice administration of CBD prevented depressive -like behaviours through the modulation of neural stem cell differentiation.
State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, China.
Hou M, et al. Front Med. 2022 Feb 25. [in press]

Science/Cells: CBD induces programmed cell death in human pancreatic cells
While the standard chemotherapeutic agent gentamicin only triggers cell cycle arrest in pancreatic cancer cells CBD induces apoptosis (programmed cell death) in a human pancreatic tumour cell line.
Faculté de Pharmacie, Université de Strasbourg, Illkirch, France.
Emhemmed F, et al. Molecules. 2022;27(4):1214.

Science/Animal: The activation of the CB2 receptor reduces progression of kidney fibrosis
In a mouse model of kidney fibrosis activation of the CB2 receptor by a synthetic cannabinoid was able “to reduce kidney tissue damage and slow the fibrotic progression.”
Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Swanson ML, et al. Cannabis Cannabinoid Res. 2022 Feb 23. [in press]

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