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IACM-Bulletin of 05 November 2022

Science/Human: Cannabis may be helpful in the treatment of emotionally unstable personality disorder according to a case series

Six out of 7 patients diagnosed with emotionally unstable personality disorder showed symptom improvement with cannabis-based medicines. They were treated at Zerenia clinics in the United Kingdom and Colombia receiving either cannabis extracts or cannabis flowers with varying THC and CBD content. Patients had trialled at least one medication and one form of psychotherapy.

Participants were given an initial assessment and followed up one month after cannabis prescription. Improvement in symptoms was assessed by the completion of ratified rating scales by the participant and psychiatrist. Authors wrote: there results indicate that cannabis-based medicines “were effective and well tolerated, as six participants reported a noticeable improvement in their symptoms and functioning.”

Sultan W, Mathew A, Brown MRD, Gálvez-Flórez JF, Moreno-Sanz G. Cannabis-Based Medicinal Products in the Management of Emotionally Unstable Personality Disorder (EUPD): A Narrative Review and Case Series. Brain Sciences. 2022;12(11):1467.

Science/Human: The use of cannabis is associated with a lower risk of metabolic disorders in people infected with the hepatitis C virus

Cannabis use may be associated with a lower risk of developing hypertension and metabolic disorders in patients infected with the hepatitis C virus (HCV). Investigators from INSERM in Marseille, France, and other French institutions investigated a dataset of 6364 people of the French cohort.

Both former and current cannabis use were associated with a lower risk of hypertension and fewer metabolic disorders. These results were independent of central obesity. Cannabis use was not associated with dyslipidemia.

Barré T, Bourlière M, Ramier C, Carrat F, Di Beo V, Protopopescu C, Marcellin F, Bureau M, Cagnot C, Dorival C, Zoulim F, Zucman-Rossi J, Duclos-Vallée JC, Fontaine H, Carrieri P, The Anrs/Afef Hepather Study Group. Cannabis Use Is Inversely Associated with Metabolic Disorders in Hepatitis C-Infected Patients (ANRS CO22 Hepather Cohort). J Clin Med. 2022;11(20):6135.

Science/Human: Cannabis use improves quality of life according to an observational data review

An analysis of data from the UK project Twenty21, which allows the medical use of cannabis extracts and cannabis flowers for certain patients in the UK there was a significant increase in quality of life. Investigators of Khiron Life Sciences Spain in Madrid analysed data from 344 patients, who were administered the cannabis law variety Khiron 20/1, which was the most prescribed cannabis flower in the project.

The inhalation of cannabis flowers was associated with a marked increase in self-reported quality of life, general mood and sleep. Pain patients showed a significant improvement in chronic pain. Patients with anxiety disorders also showed significant improvement.

Moreno-Sanz G, Madiedo A, Lynskey M, Brown MRD. "Flower Power": Controlled Inhalation of THC-Predominant Cannabis Flos Improves Health-Related Quality of Life and Symptoms of Chronic Pain and Anxiety in Eligible UK Patients. Biomedicines. 2022;10(10):2576.

Science/Human: The inhalation of THC rich cannabis flowers but not the intake of the CBD extract reduces chronic low back pain

In a study with 24 patients suffering from chronic low back pain intake of a CBD-rich sublingual extract had no pain relieving effects, while the inhalation of a THC-rich cannabis flower resulted in significant pain reduction. In the study by investigators of Hasharon Hospital of Rabin Medical Center Petah Tikva, Israel, participants first received the CBD extract for 10 months and after one month wash out THC-rich smoked cannabis for 12 months.

Three patients dropped out of extract therapy treatment but resumed study participation to receive THC rich smoking therapy. Authors wrote that “pain reduction was not significant during the extract treatment part of the study; however, pain reduction was significant during the inhaled therapy part of the study. “

Robinson D, Ritter S, Yassin M. Comparing Sublingual and Inhaled Cannabis Therapies for Low Back Pain: An Observational Open-Label Study. Rambam Maimonides Med J 2022;13 (4):e0026.

Science/Human: Cannabis use in people living with HIV was associated with increased physical activity

In a cross-sectional analysis 187 people living with HIV reported on their substance use and physical activity. In this multicentre study from the USA investigators examined the relationships of self-reported substance use (alcohol, cannabis, and nicotine use), gender, and age with self-reports of walking, moderate physical activity, and vigorous physical activity.

Women reported less walking, vigorous activity, and total physical activity compared to men. Individuals who used cannabis reported more vigorous physical activity relative to those who did not use cannabis. Authors pointed out that “these findings were partially accounted for by substance use*gender interactions: men using cannabis reported more vigorous activity than all other groups, and women with alcohol use reported less walking than men with and without alcohol use.”

Cherenack EM, Stein MD, Abrantes AM, Busch A, Pinkston MM, Baker JV, Uebelacker LA. The relationship between substance use and physical activity among people living with HIV, chronic pain, and symptoms of depression: a cross-sectional analysis. AIDS Care. 2022:1-12.

Science/Human: Cannabis may be very effective against headache according to a survey

According to a survey with 200 patients, who presented with any headache disorder to a headache clinic in Calgary, Canada, 60% perceived an improvement in headache severity. Active cannabinoid users comprised 34% of respondents. Approximately 40% of respondents using cannabinoids engaged in very frequent use (at least 300 days per year). Of cannabinoid modalities, liquid concentrates were most popular (39%), followed by smoked cannabis (33%).

Patients endorsed cannabinoid use for both prevention and acute therapy of headaches, often concurrently. Sixty percent of respondents felt cannabinoids reduced headache severity, while 29% perceived efficacy in reducing the number of headaches.

Melinyshyn AN, Amoozegar F. Cannabinoid Use in a Tertiary Headache Clinic: A Cross-Sectional Survey. Can J Neurol Sci. 2022;49(6):781-790.

News in brief

Germany: The government plans to legalise the use of cannabis for adults
On 26 October, the government approved the plans of Federal Health Minister Karl Lauterbach to legalise cannabis. His key points on the planned law provide for the acquisition and possession of up to a maximum amount of 20 to 30 grams of recreational cannabis for personal consumption in private and public spaces to be exempt from punishment. Private cultivation will be permitted to a limited extent. The opposition in the German Bundestag already declared to fight against legalisation. According to a recent poll about two third of Germans support the plans of the government.
gesundheit.de of 26 October 2022
Gesundheitsstadt Berlin of 4 November 2022

Science/Human: Cannabis may be helpful in hyperhidrosis
Doctors “present the case of a refractory generalized hyperhidrosis treated with cannabinoids. We found a remarkable reduction in the volume of sweat and an improvement to the patient's quality of life using this novel low-cost and low-impact approach.”
Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany.
Kaemmerer T, et al. J Dermatolog Treat. 2022:1-3.

Science/Human: Cannabis with a balanced THC:CBD ratio induce less anxiety than THC-dominant cannabis
In a placebo-controlled study with 26 healthy cannabis users vaporised cannabis with a balanced CBD/THC ratio induce less anxiety than THC rich cannabis.
Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, Netherlands.
Hutten NRPW, et al. Psychopharmacology (Berl). 2022;239(11):3731-3741.

World/Hong Kong: The possession of CBD may be punished by jail
Hong Kong intends to ban cannabis compound CBD with up to 7-year jail term for possession. The ban – which will see the addition of CBD to the Dangerous Drugs Ordinance – will come into effect on 1 February next year. CBD will join over 200 substances listed in the ordinance, among them fentanyl, cocaine, heroin, ketamine and methamphetamine.
Bangkok Post of 20 October 2022

Science/Animal: CBD and THC reduce chemotherapy induced neuropathic pain
In a mouse model of chemotherapy induced neuropathic pain pure CBD had little impact on hypersensitivity, whereas THC had a good effect.
Department of Pharmacology, Penn State College of Medicine, Hershey, USA.
Sepulveda DE, et al. Biomedicines. 2022;10(10):2548.

Science/Animal: A synthetic agonist of the CB2 receptor and antagonist at the CB1 receptor exerts antitumour effects
A synthetic activator of the CB2 receptor and blocker at the CB1 receptor called URB447 inhibited the development of liver metastasis in a model with mice.
Department of Cell Biology and Histology, Faculty of Medicine and Nursery, University of the Basque Country, Leioa, Spain.
Benedicto A, et al. Pharmaceuticals (Basel). 2022;15(10):1166.

Science/Human: Cannabis may not influence the concentration of endocannabinoids
According to a study with 15 patients aged 60 years or more, “on average, cannabis treatment for 3 months does not result in a significant change in the levels of endogenous cannabinoids and thus has a safe metabolic risk profile.”
Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Abuhasira R, et al. Life (Basel). 2022;12(10):1539.

Science/Human: CBD and THC may be administered transdermally
Healthy adults received topical application of 100 mg CBD and 100 mg of THC. CBD was absorbed at a faster rate compared with THC. No psychotropic effects were reported. Authors wrote that “transdermal cannabinoid delivery was safe and well tolerated in the population studied.”
Gefion Canada Inc, Toronto, Canada.
Varadi G, et al. Adv Ther. 2022 Oct 29. [in press]

Science/Human: Cannabis legalisation is not associated with cannabis risk perception among children
According to a study with 10,395 children aged 9 to 10 legalisation of cannabis in the USA “are not associated with differential perception of cannabis risk among children, even after controlling for demographics, trait impulsivity, and religiosity.”
Center for Addiction Medicine, Massachusetts General Hospital (MGH), Boston, USA.
Gilman JM, et al. Cannabis Cannabinoid Res. 2022 Oct 26. [in press]

Science: The degradation of THC does not impair accuracy of THC doses by a metered dose inhaler
According to a 2 year study medical cannabis powder in cartridges of the Syqe may be stored at room temperature for at least 2 years after production without affecting the aerosolized THC dose delivered to patients by more than ±25%.
Syqe Medical, Tel Aviv-Yafo, Israel.
Aviram J, et al. J Cannabis Res. 2022;4(1):55.

Science: THC binds to the glycine receptor, which may contribute to its analgesic effects
THC binds to the glycine receptor, an ion channel involved in the modulation of nervous system responses, including sensitivity to peripheral pain. Thus, the pain relieving effects of THC may partly be mediated by the glycine receptor.
Facultad de Ciencias Exactas y Naturales, Departamento de Química Biológica, Universidad de Buenos Aires, Argentina.
Alvarez LD, et al. Proteins. 2022 Oct 21. [in press]

Science/Animal: CBD may improve fish welfare
CBD mixed with fish food was offered to isolated fish for 5 weeks. The 10 mg/kg dose decreased fish's aggressiveness over time, whereas 20 mg/kg attenuated non-social stress. Authors wrote “that CBD could be used as a tool to increase non-mammal welfare, presenting a great potential to be explored in other husbandry and captivity species.”
Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, Brazil.
Camargo-Dos-Santos B, et al. Sci Rep. 2022;12(1):17650.

Science/Human: CBD did not reduce anxiety elicited by 10% CO2-enriched air
A single oral administration of CBD (150 mg, 300 mg, 600 mg) compared to placebo had no effect on self-reported fear or heart rate following a well-established administration of 10% carbon diooxide-enriched air biological challenge.
University of Arkansas, Fayetteville, USA.
Leen-Feldner EW, et al. Psychopharmacology (Berl). 2022 Oct 15.

Science/Animal: CBD protects against ultraviolet--induced DNA damage
CBD was protective against ultraviolet-B-induced DNA damage and autophagy in human keratinocyte cells and mouse skin tissue.
Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
Li Y, et al. Molecules. 2022;27(19):6740.

Science/Cells: Cannabinoids mediate anti-cancer effects by oxidative stress and autophagy
In a study with cancer gingival cells, which were treated with a cannabinoid mixture, apoptosis, autophagy, antioxidant levels and mitochondrial stress as well as DNA damage were increased.
Héma-Québec, Canada.
Loubaki L, et al. Cancers (Basel). 2022;14(19):4924.

Science: CBD may be transformed to delta-8-THC and plays a major role in the US
This review describes the emergence of an industry in the USA on delta-8-THC and other products gained from CBD and states: “American consumers are ingesting products that are mislabeled with many compounds that have never received any toxicological testing.”
Whole Health & Healing Integrative Clinic, Cherry Valley, New York, USA.
Geci M, et al. Cannabis Cannabinoid Res. 2022 Oct 19.

Science: Several natural-like compounds bind to the CB1 receptor
Using several screening methods investigators “found five natural-like compounds with submicromolar or low micromolar affinity to CB1, including one mixed partial agonist/antagonist.”
Department of Drug Chemistry, Faculty of Pharmacy, Medical University of Warsaw, Poland.
Stasiulewicz A, et al. ACS Chem Neurosci. 2022;13(20):2991-3007.

Science/Animal: A CBD containing hydrogel promoted spinal cord injury repair
An injectable in situ gelling hydrogel was developed for the local delivery of cannabidiol (CBD) through a novel method based on polyelectrolyte (PEC) interaction of sodium carboxymethylcellulose (CMC) and chitosan (CS). This hydrogel enhanced neurogenesis more than pure hydrogels.
College of Veterinary, South China Agricultural University, Guangzhou, China.
Zhang H, et al. Int J Biol Macromol. 2022;221:1259-1270.

Science/Animal: Activation of the CB2 receptor protects against chemotherapy used kidney damage
The synthetic CB2 receptor agonist, 1-phenylisatin, protects against cisplatin-induced toxicity to the kidneys in mice owing to its anti-apoptotic, anti-inflammatory, and antioxidant effects.
Egyptian Drug Authority), Giza, Egypt.
Chafik SG, et al. Life Sci. 2022 Nov 1;308:120928.

Science/Animal: CBD enhances analgesic effects of morphine
In a study with rats CBD enhanced the pain relieving effects of morphine and attenuated opioid-induced tolerance in the chronic constriction injury model, where the sciatic nerve is damaged.
Department of Pharmacology, Biological Sciences Sector, Federal University of Paraná, Curitiba, Brazil.
Jesus CHA, et al. Behav Brain Res. 2022;435:114076.

Science: CBD products are often mislabelled in the USA
“There is substantial discrepancy between the product label claims for CBD potency and the amount measured in both edible and topical products.”
University of Miami Miller School of Medicine, Miami, USA.
Gardener H, et al. Sci Total Environ. 2022;851(Pt 1):158110.

Science/Human: Beta-caryophyllene did not reduce appetite and weight in obese women
in a placebo-controlled trial women with obesity and food addiction were randomly allocated to receive a beta-caryophyllene softgel (26 individuals) (100 mg/daily with meal) or placebo (26) for 8 weeks. This terpene found in high concentrations in cannabis had no significant effect on appetite, eating behaviour.
Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran, Iran.
Alizadeh S, et al. Appetite. 2022;178:106160.

Science/Human: No effect of cannabis use during pregnancy on the risk of autism for the child
A study assessed the risk of autism spectrum disorder in children aged 30-68 months, born 2003 to 2011. 1428 children with autism were compared to 1198 children with other developmental delays/disorders and 1628 population controls. Cannabis use during pregnancy had no effect on the risk of autism.
Medical Campus, Aurora, USA.
DiGuiseppi C, et al. J Autism Dev Disord. 2022;52(11):5064-5071.

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