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IACM-Bulletin of 09 October 2022

USA: President Joe Biden pardons thousands of people with federal offenses for simple cannabis possession

President Joe Biden took steps to overhaul U.S. policy on cannabis on 6 October by pardoning thousands of people with federal offenses for simple cannabis possession and initiating a review of how the drug is classified. He said thousands of people with prior federal convictions could be denied employment, housing or educational opportunities and his executive action would relieve such "collateral" consequences.

Nearly 40 U.S. states have legalized cannabis use in some form, but it remains completely illegal in some states and at the federal level. Reclassification would be a first step toward wider legalization, a move backed by a majority of Americans, and usher in sweeping changes for companies and law enforcement and impact millions.

Reuters of 6 October 2022

Science/Human: CBD-rich cannabis oil reduced agitation related to dementia in a placebo-controlled study

In a placebo-controlled trial conducted in Israel with 52 patients aged at least 60, with a diagnosis of major neurocognitive disorder and associated behavioural disturbances CBD-rich cannabis oil improved symptoms. They received either "Avidekel," a broad-spectrum cannabis oil (30% cannabidiol and 1% tetrahydrocannabinol or a placebo oil three times a day for 16 weeks.

From 60 randomized patients with a mean age of 79 years 52 completed the trial. There was a statistically significant difference in the proportion of subjects who had a Cohen-Mansfield Agitation Inventory score reduction of at least 4 points at week 16 and a statistically significant difference in the proportion of subjects who had a Cohen-Mansfield Agitation Inventory score reduction of at least 8 points at week 16. There was significantly more improvement in the cannabis group compared to the control group at weeks 14 and 16.

Hermush V, Ore L, Stern N, Mizrahi N, Fried M, Krivoshey M, Staghon E, Lederman VE, Bar-Lev Schleider L. Effects of rich cannabidiol oil on behavioral disturbances in patients with dementia: A placebo controlled randomized clinical trial. Front Med (Lausanne). 2022;9:951889.

Science/Human: Medical cannabis patients report health improvements and reductions in opioid use

According to a survey with 2183 patients from medical cannabis dispensaries in Florida reported improvements in health functioning and reductions in opioid use. The survey with 66 items was conducted by investigators of Emerald Coast Research in Tallahassee, USA. Commonly reported ailment groups were Pain and Mental Health combined (48%), Mental Health (29%) or Pain (9%).

Health domains of bodily pain, physical functioning, and social functioning improved while limitations due to physical and emotional problems were unchanged. Most patients rated medical cannabis as being important to their quality of life. Many (61%) reported using pain medications prior to medical cannabis, 93% of these reported a change in pain medication after medical cannabis. The majority of participants (79%) reported either cessation or reduction in pain medication use following initiation of medical cannabis.

Pritchett CE, Flynn H, Wang Y, Polston JE. Medical Cannabis Patients Report Improvements in Health Functioning and Reductions in Opiate Use. Subst Use Misuse. 2022:1-10.

Science/Human: Medical cannabis is usually well tolerated by older adults

In an observational study with 201 older adults with 65 years of age or older cannabis was well tolerated and associated with reduced pain. They started a treatment with cannabis and completed a 3-month follow-up. The study was conducted by Canopy Growth Corporation in Toronto, Canada.

The most common symptoms for which medical cannabis was authorized were pain (85.0%) and insomnia (4.8%). At baseline and at the 3-month follow-up, CBD-dominant products were authorized most frequently (54%), followed by balanced products (42%), and then THC-dominant products (4.4%). There were significant reductions in worst pain, average pain, and overall pain severity, but not pain right now or least pain. Authors wrote that “results suggest medical cannabis was safe, well-tolerated, and associated with clinically meaningful reductions in pain in this sample of older adults.”

MacNair L, Kalaba M, Peters EN, Feldner MT, Eglit GML, Rapin L, El Hage C, Prosk E, Ware MA. Medical cannabis authorization patterns, safety, and associated effects in older adults. J Cannabis Res. 2022;4(1):50.

Science/Human: Cannabis use is associated with a lower rate of persistent opioid use after total joint arthroplasty.

In a review of 210 cannabis users undergoing total hip or knee arthroplasty with a minimum 6-month follow-up there was a reduced rate of persistent opioid users. The study was conducted by investigators of several US universities. Patients receiving an opioid prescription after 90 days postoperatively were classified as persistent opioid users. Duration of opioid use was calculated for non-persistent opioid-users patients as the time between surgery and their last opioid prescription.

Cannabis users required the same amount of inpatient and outpatient morphine milligram equivalents. There was no difference in duration of opioid use, but there was a significant difference between cannabis users and the comparison group in persistent opioid use (1.4% vs. 9.5%).

Hegde V, Bracey DN, Johnson RM, Farsad YY, Dennis DA, Jennings JM. Self-Reported Cannabis Use Is Associated With a Lower Rate of Persistent Opioid Use After Total Joint Arthroplasty. Arthroplast Today. 2022;17:145-149.

Science/Human: CBD-rich cannabis oil was effective in adults with drug-resistant focal epilepsy

CBD-rich cannabis oil, as an add-on treatment to conventional antiepileptic drugs, was effective, safe, and well-tolerated in 44 adults with drug-resistant focal epilepsy. In this open-label, prospective cohort, single-center study by investigators of the School of Medicine of the Universidad Nacional de Colombiai n Bogotá, Colombia, patients were receiving stable doses of antiepileptic drugs.

The median daily dose of CBD was 200 mg, that of THC was 4 mg. The median number of seizures per month before CBD treatment was 11, and three months after starting CBD treatment was 2.5. A reduction in seizures of more than 50% at 12 week was achieved in 79.5% of the patients.

Navarro CE. Cannabis-based magistral formulation is highly effective as an adjuvant treatment in drug-resistant focal epilepsy in adult patients: an open-label prospective cohort study. Neurol Sci. 2022 Sep 21. [in press].

Science/Human: Cannabis-based medicines may improve symptoms in autism spectrum disorder

An analysis of 74 patients with autism spectrum disorder in the UK Medical Cannabis Registry showed improvements in general health-related quality of life, and anxiety- and sleep-specific symptoms. Patients treated with cannabis for autism-related symptoms for a minimum of 1 month were identified from the reigistry and analysed by investigators of Imperial College Medical Cannabis Research Group in London, UK. The mean age of participants was 33 years.

There were significant improvements in general health-related quality of life and sleep as assessed at 1 and 3 months. There were 180 adverse events reported by 14 participants. Authors wrote that their “study demonstrated an associated improvement in general health-related quality of life, and anxiety- and sleep-specific symptoms” following initiation of cannabis treatment.

Erridge S, Kerr-Gaffney J, Holvey C, Coomber R, Barros DAR, Bhoskar U, Mwimba G, Praveen K, Symeon C, Sachdeva-Mohan S, Sodergren MH, Rucker JJ. Clinical outcome analysis of patients with autism spectrum disorder: analysis from the UK Medical Cannabis Registry. Ther Adv Psychopharmacol. 2022;12:20451253221116240.

Science/Human: Sex differences in relief of cancer symptoms by cannabis

An analysis of data collected from 358 patients with cancer enrolled in the Quebec Cannabis Registry showed that females had better outcomes with regard to nauseas and appetite. Patients completed the questionnaire at baseline and 3-month follow-up. The study was conducted by investigators of McGill Nutrition and Performance Laboratory, Montreal, Canada.

Three months of cannabis therapy led to significant improvements in pain, tiredness, anxiety, and well-being in both sexes. Only women perceived improved drowsiness, nausea, lack of appetite, and shortness of breath.

Kasvis P, Canac-Marquis M, Aprikian S, Vigano M, Vigano A. Sex differences exist in the perceived relief of cancer symptoms with medical cannabis: results from the Quebec Cannabis Registry. Support Care Cancer. 2022;30(10):7863-7871.

Science/Human: Cannabis use was associated with reduced severe acute respiratory syndrome in corona virus 2 infection in pregnant women

In a study with 57,287 pregnant women aged 14-54 years current cannabis use was associated with a reduced risk of severe acute respiratory syndrome coronavirus 2 infection. They were enrolled in Kaiser Permanente Northern California (a healthcare system), and had not tested positive for COVID-19 prior to pregnancy onset.

Investigators of Kaiser Permanente Northern California in Oakland observed 6% of SARS-CoV-2 PCR tests being positive. At the start of follow-up, 7% of pregnant individuals had current cannabis use. Cannabis use was associated with lower rates of SARS-CoV-2 infection than non-use.

Young-Wolff KC), Ray GT, Alexeeff SE, Benowitz N, Adams SR, Does MB, Goler N, Ansley D, Conway A, Avalos LA. Association of Cannabis Use During Pregnancy with Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Retrospective Cohort Study. Addiction. 2022 Oct 3. [in press].

News in brief

Japan: Health panel recommends allowing import, use of medical cannabis products
A Japanese health ministry panel on 29 September recommended revising the nation's drug laws to allow for the importation and use of medicinal cannabis products. The recommendation was based on meeting medical needs and to harmonise Japan with international standards, the committee said in a report.
Reuters of 29 September 2022

France: Minister of Health announces potential extension of pilot programme on cannabis
The French Minister of Health announced the potential one-year extension of the pilot programme on cannabis for medical use in France, bringing its end to March 2024 instead of 2023, a decision deplored by patient associations but welcomed by the industry.
Practical Law

Canada: Nearly 10% of Canadian cannabis users engage in home cultivation
Cultivating your own cannabis can provide many benefits, with one of the most obvious being cost savings. If someone is knowledgeable and able, they can cultivate their own cannabis for a fraction of what it costs to purchase cannabis from retail outlets. 10% of Canadian cannabis users to so.
The Health Guild of 5 October 2022

Colombia: Lawmakers approve cannabis legalization bill in committee
As Colombia’s recently inaugurated president steps up his push for global drug policy reform, lawmakers approved a bill to legalize and regulate cannabis nationwide, advancing it through a committee with nearly unanimous support. The legislation cleared the Chamber of Representatives First Committee in a 31-2 vote.
Marijuana Moment of 4 October 2022

Science/Cells: CBD and dexamethasone exhibit similar anti-inflammatory effects
CBD and dexamethasone exhibit similar anti-inflammatory effects on macrophages but with different intracellular mechanisms. “These findings suggested that CBD may be considered a natural anti-inflammatory agent for protecting skin from immune disorders,” authors wrote.
Research and Development Department, Yunnan Baiyao Group Health Products Co, Kunming, People's Republic of China.
Wang Y, et al. Clin Cosmet Investig Dermatol. 2022;15:1959-1967.

Science/Cells: THC extracts demonstrate anti-cancer activity
In a study with 25 cannabis extracts containing high levels of THC extracts demonstrated anti-cancer activity on squamous cell carcinoma cells, while only certain selected extracts showed anti-inflammatory activity.
Department of Biological Sciences, University of Lethbridge, Canada.
Li D, et al. Molecules. 2022;27(18):6057.

Science/Animal: CBD shows anti-epileptic effects
CBD attenuates generalized tonic-clonic seizures in a genetically epilepsy-prone rats strain.
Department of Pharmacology and Physiology, Georgetown University, New Research Bldg., Washington, USA.
Lazarini-Lopes W, et al. Pharmacol Rep. 2022 Oct 4. [in press].

Science/Animal: Cannabinoids may be helpful in atopic dermatitis of dogs
Cannabinoid receptors are widely expressed in the inflammatory infiltrate of the dogs with atopic dermatitis. Based on the present findings, the endocannabinoid system “could be considered to be a potential therapeutic target for dogs with AD, and may mitigate itch and inflammation.”
Department of Veterinary Medical Sciences (UNI EN ISO 9001:2008), University of Bologna, Italy.
Chiocchetti R, et al. Front Vet Sci. 2022;9:987132.

Science/Cells: Cannabis extracts protect nerve cells
A cannabis extract was able to significantly protect nerve cells from glutamate-impaired cell viability. Authors found that the whole extract was more effective than single compounds of the extract.
Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Italy.
Borgonetti V, et al. Fitoterapia. 2022;163:105315.

Science/Human: Personality may influence the effect of cannabis use on driving
Impulsivity and other personality or individual differences may impact the effects of cannabis on driver behaviour and performance according to a study on simulated driving.
Institute for Mental Health Policy Research.
Wickens CM, et al. Exp Clin Psychopharmacol. 2022;30(5):547-559.

Science/Human: Cannabis relieves cancer symptoms
In an online survey with cancer patients sleep (n = 112), pain (n = 96), and anxiety (n = 82) were the most common symptoms participants using cannabis reported to be relieved-
Division of Nursing Research, Mayo Clinic, Jacksonville, USA.
Tofthagen C, et al. J Palliat Med. 2022;25(10):1563-1570.

Science/Human: Cannabis use may be associated with an overactive bladder
Regular cannabis use was associated with an overactive bladder according to data from the National Health and Nutrition Examination Survey.
Department of Urology, The First Affiliated Hospital of Nanjing Medical University, China.
Zhu S, et al. Am J Med. 2022 Sep 20:S0002-9343(22)00667-2.

Science/Animal: Cannabis may be helpful in fibromyalgia
Broad-spectrum cannabis oil ameliorated symptoms in a mouse model of fibromyalgia.
Laboratory of Autoimmunity and Immunopharmacology, Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, Brazil.
Ferrarini EG, et al. Biomed Pharmacother. 2022;154:113552.

Science/Human: Cannabis use during lactation may alter the composition of human breast milk.
Milk was collected from women who were 6-8 weeks postpartum. THC was detected in the milk of 13 women who reported cannabis use during lactation. Relative to 17 non-users, lactose levels were higher and low secretory IgA levels were significantly lower in the milk of subjects who used cannabis during lactation.
Department of Pediatrics and the Medical Science Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
Josan C, et al. Pediatr Res. 2022 Oct 4. [in press].

Science/Animal: Endocannabinoids may reduce allergies
Endocannabinoid metabolism inhibition ameliorates ovalbumin-induced allergic airway inflammation and hyperreactivity in Guinea pigs.
Hacettepe University, Faculty of Pharmacy, Department of Pharmacology, Ankara, Turkey.
Abohalaka R, et al. Life Sci. 2022;306:120808.

Science/Animal: CBD may be helpful in oral mucositis
One of the most common complications of cancer chemotherapy is oral mucositis, a serious kind of oral ulceration. CBD-loaded nanomicelles were effective in an oral mucositis mouse model-
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Liu Y, et al. Drug Deliv. 2022;29(1):1272-1281.

Science/Human: Cannabis use disorder is associated with better survival than alcohol use disorder
A study with 1136 people shows that individuals with only cannabis use disorders have a lower mortality risk compared to those with both cannabis and alcohol use disorders.
Local Health Unit of Bologna, Italian Society of Substance Abuse SITD, Italy.
Pavarin RM, et al. Psychiatry Res. 2022;316:114741.

Science/Human: Cannabis use does not increase opioid use after surgery
Preoperative cannabis use does not increase opioid utilization following primary total hip arthroplasty according to a study with 156 current and 936 never users
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, USA.
Ong CB, et al. Arch Orthop Trauma Surg. 2022 Sep 21. [in press].

Science/Animal: A CB1 receptor antagonist may be helpful in ataxia
The cannabinoid-1 receptor antagonist, AM251 attenuated ataxia related deficiencies in a rat cerebellar ataxic model.
Neuropharmacology Institute, Kerman University of Medical Sciences, Iran.
Ranjbar H, et al. Int J Neurosci. 2022:1-8.

Science/Human: Cannabis may be helpful in pain
According to a study with 16 women cannabis could improve pain management for socially marginalised populations.
Centre for Research and Information on Substance Abuse, Uyo, Nigeria.
Nelson EE, et al. Drug Alcohol Rev. 2022 Oct 3. [in press].

Science/Human: No effect of CBD on opioid-induced hyperalgesia
In a placebo controlled study with 24 healthy participants high single-oral dose of 1600 mg cannabidiol was not effective in reducing opioid-induced hyperalgesia.
Clinic for Anaesthesia, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital of Basel, Switzerland.
Dieterle M, et al. Pain. 2022;163(10):1919-1928.

Science/Human: CBD reduces the production of cytokines in immune cells
Oral inhalation of cannabidiol delivered from a metered dose inhaler alleviated cytokine production in immune cells induced by SARS-CoV-2 and pollutants.
Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Srichana T, et al. J Drug Deliv Sci Technol. 2022;76:103805.

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