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IACM-Bulletin of 19 June 2022

Brasil: Superior Court of Justice authorised 3 patients to grow cannabis for medical treatment

A top court in Brazil on 14 June authorized three patients to grow cannabis for medical treatment, a decision that is likely to be applied nationwide in similar cases. A five-judge panel of the country’s Superior Court of Justice unanimously agreed that the three patients can grow cannabis and extract its oil for use in pain relief. Brazilian law currently limits the medical use of cannabis derived products to imported goods.

Brazil’s health ministry is yet to regulate home cultivation of cannabis for medical use, which puts anyone doing it at the risk of arrest. Judge Rogério Schietti said the top court’s panel acted because the government had failed to take a scientific position on the issue. “The discourse against this possibility is moralistic. It often has a religious nature, based on dogmas, on false truths, stigmas,” Schietti said. “Let us stop this prejudice, this moralism that delays the development of this issue at the legislative, and many times clouds the minds of Brazilian judges.”

Alvares D. Brazil court approves home grown cannabis for medical use. Times union 14 of june 2022

USA: Rhode Island becomes 19th state to legalize cannabis for adults

Governor Dan McKee has signed a bill that legalizes the personal use and licensed sale of cannabis. Provisions in the law permitting adults to possess and home cultivate cannabis took effect upon signing. The new allows adult Rhode Islanders age 21 and up to possess up to one ounce in public or up to 10 ounces at home, home-cultivate of up to six plants, and purchase limited amounts of cannabis.

It also facilitates the automatic review and expungement of past criminal records. Rhode Island is the 19th state to legalize cannabis for adults. Voters in several additional states, including Maryland and Missouri, will decide on the issue in November.

Rhode Island Becomes 19th State to Legalize Marijuana for Adults. Norml of 26 May 2022.

Science/Human: Successful treatment of cutaneous squamous cell carcinoma with topical CBD

A 64-year-old woman with a history of multiple squamous cell carcinomas who presented with skin lesions on her bilateral dorsal hands is reported by investigators of the University of California Riverside School of Medicine, USA.

Her skin biopsies showed lichen simplex chronicus on her left hand and squamous cell carcinoma on her right hand. Both lesions resolved with topical application of 20% CBD (cannabidiol).

Laborada J, Cohen PR. Cutaneous Squamous Cell Carcinoma and Lichen Simplex Chronicus Successfully Treated with Topical Cannabinoid Oil: A Case Report and Summary of Cannabinoids in Dermatology. Cureus. 2022;14(4):e23850.

Science/Human: Cannabis may be beneficial in anxiety and depression according to a large retrospective study

A retrospective study of patients utilizing medical cannabis who received their medical cannabis documentation and allotment from a Harvest Medicine clinic in Canada analysed the impact of cannabis on anxiety and depression. Patients included in the study were at least 18 years of age with completed validated questionnaires for anxiety (Generalised Anxiety Disorder 7) and depression (Patient House Questionnaire 9) at their initial evaluation and at least one follow-up visit. There were 7,362 patients included in the sample, of which the average age was 50 years, and 53% were female.

There were statistically significant improvements between baseline and follow-up scores for both standardised measures for anxiety and depression, with larger improvements seen for patients who were actively seeking medical cannabis to treat anxiety or depression. From 12 months on, those reporting anxiety had an average decrease in scores that was greater than the minimum clinically important difference of 4, and the same was seen for patients reporting depression from 18 months on. Authors concluded that their “study provides some evidence to support the effectiveness of medical cannabis as a treatment for anxiety and depression.”

Sachedina F, Chan C, Damji RS, de Sanctis OJ. Medical cannabis use in Canada and its impact on anxiety and depression: A retrospective study. Psychiatry Res. 2022;313:114573.

Science/Human: Many Canadian pain patients use cannabis for symptom control

According to an analysis of data of 1344 patients suffering from chronic pain, who participated in a web-based questionnaire in 2019 cannabis was used by nearly one third for symptom management. The study was conducted by investigators of the University of Québec in Montréal and other cities.

Among the participants who completed the cannabis use section of the questionnaire, the overall prevalence of cannabis use for pain management was 30.1%. Differences were found between age groups, with the highest prevalence among participants aged 26 years our younger (36.5%) and lowest for those aged 74 years or older (8.8%). Researchers noted that cannabis “is a common treatment” for the management of chronic pain, especially in younger generations.

Godbout-Parent M, Nguena Nguefack HL, Angarita-Fonseca A, Audet C, Bernier A, Zahlan G, Julien N, Pagé MG, Guénette L, Blais L, Lacasse A. Prevalence of cannabis use for pain management in Quebec: A post-legalization estimate among generations living with chronic pain. Can J Pain. 2022;6(1):65-77.

Science/Human: Cannabis use is associated with lower corpulence in people with hepatitis C

Investigators from several renowned scientific institutions in France, among them from Paris, Marseille and Montpelier, analysed data of hepatitis C patients in France and found beneficial effects on metabolic risk factors in cannabis users. Among the 6348 participants in the study population, 55% had central obesity, 13.7% had obesity according to their BMI (body mass index), and 12.4% were current cannabis users.

Current cannabis use was associated with lower risk of central obesity, BMI-based obesity, and overweight. This was also true for former use, but to a lesser extent. Former and current cannabis use were inversely associated with waist circumference and BMI.

Barré T, Carrat F, Ramier C, Fontaine H, Di Beo V, Bureau M, Dorival C, Larrey D, Delarocque-Astagneau E, Mathurin P, Marcellin F, Petrov-Sanchez V, Cagnot C, Carrieri P, Pol S, Protopopescu C; ANRS/AFEF Hepather study group. Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: results from the ANRS CO22 Hepather cohort. J Cannabis Res. 2022;4(1):31.

Science/Human: Cannabis intake with a new metered dose inhaler is effective in the treatment of chronic pain

Investigators of Syqe Medical in Tel-Aviv, Israel, presented preliminary data on the effectiveness of the Syqe inhaler in the treatment of chronic pain. In an observational study with 143 patients significant pain reduction was achieved. Pain intensity was evaluated using a numeric pain scale from baseline to 120 days after treatment initiation.

Most participants (72%) were diagnosed with chronic neuropathic pain. The stable daily dose, after a mean 26 days of titration was 1,5 mg aerosolized THC. Significant pain reduction, ranging from 23% in the whole group to 28% in those with a pain intensity of at least 8 points on a scale between 0 and 10. About 92% of participants reported an improved quality of life.

Aviram J, Atzmony D, Eisenberg E. Long-term effectiveness and safety of medical cannabis administered through the metered-dose Syqe Inhaler. Pain Reports 2022;7(3): p e1011

News in brief

Science: ICRS Symposium 2022
Registration for online attendance at the forthcoming Annual Symposium on the Cannabinoids of the International Cannabinoid Research Society (ICRS) remains open until 25th June 2022.
ICRS

Thailand: Legalization of cultivation and use of cannabis (hemp) with less than 0.2% THC
Thailand legalised the growing of cannabis with less than 0.2% THC and its consumption in food and drinks on 9 June, the first Asian country to do so, with the aim of boosting its agriculture and tourism sectors but smoking cannabis in public can still violate public health laws.
Reuters of 9 June 2022

Germany: The government has started with expert hearings on its plans to legalise cannabis use for adults
The German government is setting in motion plans to legalize the sale of cannabis for recreational purposes, aiming to have a proposal for a law ready later this year. The Health Ministry said 13 June that it will start holding expert hearings on various aspects. It said that more than 200 representatives from the medical, legal and other fields will take part, along with officials from various levels of government and unidentified international experts.
U.S.News of 23 June 2022

Africa: Several African countries passed laws to legalise the production of cannabis for medical use
Many African states that persecuted citizens for cannabis related offences for years are now promoting legal cannabis production. Over the past five years 10 countries have passed laws to legalise production for medical and scientific purposes. These include Lesotho, Zimbabwe, South Africa, Uganda, Malawi, Zambia, Ghana, Eswatini, Rwanda and Morocco. South Africa has also legalised the private growing of cannabis plants by adults for their own personal consumption.
All Africa of 30 May 2022

Israel: Scientists developed a technique to increase the concentration of THC and CBG in cannabis plants
Israeli researchers have used advanced technology to grow an enhanced strain of cannabis that contains higher levels of THC and CBG. They were able to successfully engineer and grow a cannabis plant with close to 17 percent higher levels of THC and 25% higher levels of CBG (cannabigerol).
The Times of Israel of 1 June 2022

Science/Animal: CBD prevents inflammation in a modell for epilepsy
In a mouse model of epilepsy CBD decreased inflammation in the central nervous system.
Molecular and Cellular Pharmacology Graduate Program, Department of Pharmacological Sciences, Stony Brook University, Stony Brook, USA.
Victor TR, et al. Neuroscience. 2022 :S0306-4522(22)00304-9.

Science: Inhibitory effects of several cannabinoids on acetylcholinesterase and butyrylcholinesterase enzyme activities
Cannabinoids (THC, CBD, CBG, etc.) showed moderate inhibitory effects on the activities of acetylcholinesterase and butyrylcholinesterase enzymes, which may contribute to their modulatory effects on the cholinergic system.
Bioactive Botanical Research Laboratory, Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, USA.
Puopolo T, et al. Med Cannabis Cannabinoids. 2022;5(1):85-94.

Science/Human: Endometriotic lesions show high levels of cannabis receptors
Intense expression for CB1 and CB2 receptors was detected in the epithelial cells in ovarian endometriotic lesions. Compared with stroma in ovaries with endometriotic lesions, the expression of CB1 and CB2 was significantly higher in the epithelial cells in endometriotic lesions in the ovary for both receptor types. Authors noted that “these lesions may respond to cannabinoids as pain medication.”
Section of Emergency Medicine, Chicago, USA.
Allam S, et al. J Immunol Res. 2022;2022:4323259.

Science/Human: Legalisation of cannabis for medical use has reduced health expenditures related to traffic accidents in the USA
Analysing data from 2014 to 2019, researchers “estimate that existing legalization has reduced health expenditures related to auto accidents by almost $820 million per year with the potential for a further $350 million reduction if legalized nationally.”
Fox School of Business, Pennsylvania, USA.
Ellis CM, et al. J Psychopharmacol. Health Econ. 2022 Jun 12. [in press]

Science/Human: Daily users of cannabis show reduced impairment of driving relevant abilities compared to occasional users
In a car-based driving simulator study with 31 daily users and 24 occasional users those with a pattern of occasional use were significantly more likely to experience a lane departure during distraction periods after acute cannabis use relative to baseline, while those with daily use did not exhibit a similar increase. Changes in departure risk were significantly greater for the occasional use group compared to no-use, but not for the daily use group compared to no-use.
Department of Mathematics, Xavier University, Cincinnati, Ohio.
Miller R, et al. Traffic Inj Prev. 2022:1-7.

Science/Human: Mixed results on the correlation between THC in oral fluid and blood
Reviewing 18,000 paired samples of oral fluid and blood researchers found a good correlation between the presence of THC in oral fluid and presence of THC in blood (sensitivity = 71%, specificity = 98%). However oral fluid THC, at commonly used cut-off values, is less sensitive and less specific when used as a biomarker to detect people with blood THC concentrations above commonly used per se limits (such as 5 ng/mL).
University of Ottawa, Canada.
Robertson MB, et al. Accid Anal Prev. 2022;173:106694.

Science/Animal: Oestrogen dampens central CB1-mediated neuroexcitation in female rats
New findings suggest that attenuation of neuroexcitation in a certain brain region (rostral ventrolateral medulla) and oxidative stress underlies the protection conferred by oestrogen, in female rats, against the CB1R-mediated adverse cardiovascular effects.
Department of Pharmacology & Toxicology, Greenville, USA.
Yao F, et al. Biochem Pharmacol. 2022;201:115102.

Science: Classification of cannabis chemovars according to content of cannabinoids and terpenes
Israeli researchers tried to develop a comprehensive and accurate classification of medicinal cannabis cultivars, based on a large number of cannabinoids and terpenes. The chemical profiles were selected from the three major classes of medicinal cannabis that are most commonly prescribed to patients in Israel. A model “applied to the combined cannabinoid-and-terpene profile did the best job of differentiating between the chemovars in terms of misclassification error, sensitivity, specificity, and accuracy.”
Department of Food Safety, Institute for Postharvest and Food Sciences, Rehovot, Israel.
Birenboim M, et al. Phytochemistry. 2022;200:113215.

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