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IACM-Bulletin of 17 July 2022

Science/Human: Very low doses of a THC-rich cannabis extract improved memory in a patient with Alzheimer's disease

Investigators of the Federal University for Latin American integration in Foz do Iguaçu, Brazil, and Johns Hopkins University in Baltimore, USA, presented a case report of a 75-year-old man in an early stage of Alzheimer’s disease, who profited from very low doses of THC rich cannabis. He presented with main symptoms of memory deficit, spatial and temporal disorientation, and limited daily activity. The treatment was carried out for 22 months with microdoses of a cannabis extract containing THC and CBD. The patient received it daily for 22 months with the daily dosage never exceeding 1 mg of THC per day.

Investigators reported that the patient exhibited “rapid” and “robust” symptom amelioration and wrote that “cognitive and memory enhancement lasted for more than one year following the start of treatment and remained stable while we progressively evaluate/follow up with the patient, for more than one year after the official report ended.” Authors concluded “that cannabinoid microdosing could be effective as an Alzheimer's disease treatment while preventing major side effects.”

Ruver-Martins AC, Bicca MA, de Araujo FS, de Noronha Sales Maia BHL, Pamplona FA, da Silva EG, Nascimento FP. Cannabinoid extract in microdoses ameliorates mnemonic and nonmnemonic Alzheimer's disease symptoms: a case report . J Med Case Rep. 2022;16(1):277.

Science/Human: Cannabis may be helpful in the treatment of fatigue according to and app-based survey

According to a study with 1224 people, who recorded 3922 sessions of cannabis self-administration with an app, the use of cannabis flowers may improve fatigue. The study was conducted by investigators of the Department of Economics of the University of New Mexico, in Albuquerque, USA, and sessions took place between 2016 and 2019.

On average, 92% of people experienced decreased fatigue following cannabis use with an average symptom intensity reduction of 3.5 points on a 0-10 visual analogue scale. Plant phenotypes (C. indica, C. sativa, or hybrid) as well as THC and CBD content did not differ in symptom improvement. Authors concluded that their “findings suggest that the majority of patients experience decreased fatigue from consumption of Cannabis flower.”

Li X, Diviant JP, Stith SS, Brockelman F, Keeling K, Hall B, Vigil JM. The Effects of Consuming Cannabis Flower for Treatment of Fatigue. Med Cannabis Cannabinoids. 2022;5(1):76-84.

Science/Human: Cannabis use does not reduce motivation

Scientists of the School of Psychological Science at Oregon State University in Corvallis, USA, investigated, whether cannabis use reduces motivation and increases apathy to test the hypothesis that cannabis may cause a so-called amotivational syndrome. Cannabis users, who use cannabis 3 times per week or more often over the past year, and none using controls completed the Apathy Evaluation Scale and the Effort Expenditure for Rewards Task.

Researchers concluded from the results that “cannabis users exhibit a greater likelihood of exerting more effort for reward, suggesting enhanced motivation relative to healthy controls. Thus, the current results do not support amotivational syndrome in adult frequent cannabis users. Despite some harms of long-term cannabis use, amotivation may not be among them.”

Vele KC, Cavalli JM, Cservenka A. Effort-based decision making and self-reported apathy in frequent cannabis users and healthy controls: A replication and extension. J Clin Exp Neuropsychol. 2022:1-17.

Science/Human: Cannabis use was associated with less short-term medical complications after spinal surgery

Researchers from scientific institutions in New York and Rhode Island used the New York Statewide Planning and Research Cooperative System (SPARCS) database to investigate the effects of cannabis use on outcomes after spinal surgery. 352 baseline cannabis users and 352 non-users with comparable age and sex distribution, who underwent thoracolumbar spinal fusion for spinal deformity, were compared.

Isolated baseline cannabis use, in the absence of any other diagnosed substance abuse disorders, was not associated with increased odds of 90-day surgical complications or readmissions or two-year revisions, though its use was associated with reduced odds of 90-day medical complications when compared to non-users.

Shah NV, Lavian JD, Moattari CR, Eldib H, Beyer GA, Mai DH, Challier V, Passias PG, Lafage R, Lafage V, Schwab FJ, Paulino CB, Diebo BG. The Impact of Isolated Baseline Cannabis Use on Outcomes Following Thoracolumbar Spinal Fusion: A Propensity Score-Matched Analysis. Iowa Orthop J. 2022;42(1):57-62.

Science/Human: Cannabis is perceived helpful by patients with Parkinson’s disease

According to a survey, patients suffering from Parkinson’s disease from Norway perceived cannabis as beneficial and non-users were interested in cannabis use. Investigators of the Norwegian Centre for Movement Disorders at the University of Bergen, Norway, conducted a survey with 530 patients, of whom 59 (about 11%) reported previous or current use of cannabis.

Cannabis use was associated with increased disease duration, but not age or gender. Improvement in motor function (70%), sleep (53%), and pain (37%) was the most frequently perceived benefits of cannabis use, with benefits more frequently reported by current than previous users. Authors noted that one in 20 patients with Parkinson’s disease “reports cannabis use, and non-users report widespread interest in cannabis. The use of cannabis is often not reported and unknown for health care professionals.”

Erga AH, Maple-Grødem J, Alves G. Cannabis use in Parkinson’s disease—A nationwide online survey study. Acta Neurologica Scandinavica, 2022;145:6:692-697

Science/Human: Cannabis may reduce pain in musculoskeletal disorder according to a survey

According to a survey with 184 patients with musculoskeletal problems conducted by investigators of the Department of Orthopaedic Surgery at the University of Puerto Rico in San Juan cannabis use is associated with reduced pain.

This study showed an average pain reduction score of 4.0 points on the Numeric Rating Scale among all participants. Authors noted that those with musculoskeletal conditions reported a notable average pain reduction score of 4.5 points. In addition, 89% of the participants considered medical cannabis to be more effective than opioids for adequate pain management.

Mangual-Pérez D, Tresgallo-Parés R, Ramírez-González M, Torres-Lugo N, Rivera-Dones A, Rivera-Rodríguez G, Claudio-Marcano A, Lojo-Sojo L. Patient Experience and Perspective on Medical Cannabis as an Alternative for Musculoskeletal Pain Management, JAAOS: Global Research and Reviews, 2022 July; 6: 7- e22.00055.

News in brief

USA: District of Columbia allows self-certification of patients
Mayor Muriel Bowser from Washington DC has signed a law removing the requirement that adults seeking to purchase cannabis products from licensed Washington DC medical cannabis dispensaries must obtain a recommendation from a licensed physician. The measure permits individuals age 21 or older to “self-certify … that they are utilizing cannabis for medical purposes” when they register with local regulators for a medical cannabis identification card.
NORML of 7 July 2022

Bosnia and Herzegovina: Cannabis may soon be used for medicinal purposes
Cannabis may be used medicinally soon in Bosnia and Herzegovina. In order to finally legalize the use of cannabis for medicinal purposes, it is only necessary for the Commission for the Suppression of Narcotic Drug Abuse to submit a proposal to the Council of Ministers, which would make a simple decision at its session.
Sarajevo Times of 6 July 2022

Thailand: More than 120,000 citizens have registered to cultivate hemp
More than 120,000 individuals have registered to cultivate hemp after new rules for cannabis went into effect last month in Thailand, according to the country’s Food and Drug Administration. According to the new law, which is in effect since June 2022, private growers must only register their intentions, and need not seek further permission, allowing them to cultivate and process cannabis with less than 0.2% THC for health aids and traditional medicines, and hemp for industrial applications.
Hemp Today of 8 July 2022

Science/Human: Beta-caryophyllene had no effect on food addiction in controlled study
In a study with 52 obese women, who either received 100 mg beta-caryophyllene daily or a placebo for 8 weeks, there was no significant effect on body composition, appetite, eating behaviour, dietary intake and physical activity level.
Department of Cellular and Molecular Nutrition, Tehran University of Medical Sciences, Iran.
Alizadeh S, et al. Appetite. 2022;178:106160.

Science/Animal: THC improves dysfunction of arteries induced by high intake of fructose
Regular intake of fructose by rats leads to increased insulin levels and dysfunction of arteries, which is ameliorated by THC.
Department of Medical Pharmacology, Istanbul University-Cerrahpasa,Turkey.
Seven T, et al. Int J Med Biochemi. 2021;4:1.

Science/Animal: Beta-caryophyllene improves metabolic problems in obesity
Regular supplementation with beta-caryophyllene can improve relevant metabolic and immunological processes in obese mice.
Department of Pharmacobiology; Pharmaceutical Research and Development Laboratory, University of Guadalajara, Mexico.
Franco-Arroyo NN, et al. J Med Food. 2022 Jul 6. [in press].

Science/Animal: Cannabis may improve bacterial composition in the gut of animals fed a high fat diet
In a study with mice the addition of specific cannabis extracts to a high fat diet results in more favorable modifications of gut bacteria.
Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
Zandani G, et al. Evid Based Complement Alternat Med. 2022;2022:7964018.

Science/Cells: THC and CBD disrupt cellular energy production
The combination of THC and CBD in a 1:1 ratio is associated with a disruption of cellular energy metabolism in glioma cells, and this is caused by affecting mitochondrial respiration.
Institute of Pharmacology and Toxicology, Rostock University Medical Centre, Germany.
Rupprecht A, et al. Cancers (Basel). 2022;14(13):3129.

Science/Animal: Low doses of THC may improve memory in Alzheimer’s disease
In a mouse model of Alzheimer’s disease low doses of THC counteracted alterations in disease-related cognitive performance.
Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, USA.
Fihurka O, et al. Int J Mol Sci. 2022;23(8):4253.

Science/Human: CBD does not improve restless legs syndrome
Six patients with Parkinson’s disease were randomized to receive CBD in doses of 75-300 mg, and 12 received placebo capsules. They were followed up for 14 weeks. CBD showed no reduction in the severity of restless legs syndrome.
School of Health Sciences, State University of Amazonas, Manaus, Brazil.
de Almeida CMO, et al. Cannabis Cannabinoid Res. 2022 Jun 24 [in press].

Science/Cells: Activation of cannabinoid receptors may be helpful in leukaemia
A synthetic cannabinoid (JWH-018), which activates the CB1 and the CB2 receptor, provides a therapeutic effect on the pathogenesis of leukaemia and particularly upon leukemic stem cells.
Basic Oncology Department, Ege University Health Science Institute, Izmir, Turkey.
Salcin H, et al. Cannabis Cannabinoid Res. 2022 Jul 14 [in press].

Science/Animal: CBD may be helpful in amphetamine addiction
According to studies with mice CBD may be helpful in preventing relapse in amphetamine addiction.
Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria, Brazil.
Metz VG, et al. Pharmacol Biochem Behav. 2022:173427.

Science/Human: Delta-8-THC use is increasing in the USA
In an online survey with 4.348 cannabis-using adults 16.7% reported delta-8-THC use.
Department of Epidemiology, Columbia University man School of Public Health, New York, USA.
Livne O, et al. Addict Behav. 2022;133:107374.

Science/Human: Cannabis use is associated with lower heart rate
At the year 30 examination 471 out of 3269 (14%) participants of the CARDIA study (Coronary Artery Risk Development in Young Adults) in the USA currently used cannabis. Cannabis use was associated with a lower heart rate. Authors wrote 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, University of Bern, Switzerland.
Jakob J, et al. Am J Med. 2022;135(7):871-878.e14.

Science/Animal: Endocannabinoids reduce nicotine self-administration
Increase of endocannabinoid levels by inhibition of their degradation by blocking the activity of FAAH (fatty acid amide hydrolase) reduces self-administration of nicotine in rats.
School of Pharmacy, University of Camerino, Italy.
Lunerti V, et EUR J Pharmacol. 2022;928:175088.

Science/Animal: Endocannabinoids may prevent migraine
In a rat model of migraine the inhibition of the degradation of endocannabinoids by blocking the activity of FAAH (fatty acid amide hydrolase), which degrades anandamide and other endocannabinoids, reduced symptoms.
Unit of Translational Neurovascular Research, IRCCS Mondino Foundation, Pavia, Italy.
Greco R, et al. J Headache Pain. 2022;23(1):79.

Science/Cells: Cannabis reduces the viability of liver cancer cells
Cannabis high in CBD content reduces the viability of 2 liver cancer cell lines, but did not disturb healthy liver cells.
Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran.
Tajik T, et al. Biomed Pharmacother. 2022;152:113209.

Science/Human: Transdermal CBD had no effect on epilepsy in placebo-controlled study
In a study with 188 adults suffering from focal epilepsy, who were divided into 3 groups, daily doses of either 195 or 390 mg of CBD (cannabidiol) had no effect on epilepsy.
Department of Neuroscience, The Central Clinical School, Monash University and The Alfred Centre, Melbourne, Australia.
O'Brien TJ, et al. JAMA Netw Open. 2022;5(7):e2220189.

Science/Human: The oral bioavailability of CBD and THC were increased by a new delivery system
The oral intake of CBD and THC together with the new delivery system Solutech oral enhanced the bioavailability of the cannabinoids.
New Age Ventures, New York, USA.
Berl V, et al. Cannabis Cannabinoid Res. 2022 Jul 5. [in press].

Science/Animal: Opioids and cannabinoids act synergistically in abdominal pain
“This study in mice demonstrates that cannabinoid 1 receptor (CB1R) agonists inhibit visceral sensation. Furthermore, a combination of sub-analgesic doses of µ-opioid receptor agonist and CB1R agonist markedly reduce abdominal pain without causing the side effects of high dose opioids.”
Gastrointestinal Diseases Research Unit, Queen's University, Kingston, Canada.
Yu Y, et al. J Neurosci. 2022:JN-RM-0641-22.

Science/Animal: CBD reduces pruritus in dogs with atopic dermatitis
In a placebo-controlled trial dogs suffering from atopic dermatitis either received 2 mg of CBD and CBD acid per kilogram bodyweight or a placebo for 4 weeks. The combination of CBD and CBD acid reduced pruritus but did not improve skin lesions.
Animal Dermatology and Allergy Specialists, Wayne, NJ, USA.
Loewinger M, et al. Vet Dermatol. 2022;33(4):329-e77.

Science/Human: Many patients with cancer use cannabis
According to a survey of 153 patients with solid cancer 25% reported use of cannabinoids for medicinal purposes, with 50% currently using the substance. Another 18 % of non-users considered future cannabis use.
Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, The Netherlands.
Oelen Y, et al. J Cancer Res Clin Oncol. 2022 Jul 2. [in press].

Science/Animal: CBD alleviated the damage to certain nerve cells in an animal model of Parkinson’s disease
In a mouse model of Parkinson’s disease CBD improved cognitive dysfunction and increased the number of spontaneous movement by inhibiting the programmed cell death of certain nerve cells (dopaminergic neurons) and by inhibiting and nerve cell inflammation.
Institute of Agro-food Technology, Jilin Academy of Agricultural Sciences, Changchun, China.
Wang L, et al. Neuroscience. 2022:S0306-4522(22)00339-6.

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