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IACM-Bulletin of 19 November 2022

USA: Voters in Maryland and Missouri approved the legalisation of cannabis for use by adults

On 8 November residents of five U.S. states voted on whether to legalize cannabis for adults. A growing number of states have legalized cannabis in recent years despite the drug remaining illegal under federal law. The proposals passed in Maryland and Missouri.

In Maryland voters approved an amendment to the state's constitution allowing the use of cannabis for adults over 21 beginning in July 2023. In Missouri voters approved Constitutional Amendment 3, allowing the use of cannabis by adults over 21. Voters rejected similar initiatives in Arkansas, North Dakota and South Dakota.

Reuters of 10 November

Science/Human: Cannabis may improve quality for life in treatment-resistant fibromyalgia women

In a prospective cohort study involving 30 women diagnosed with fibromyalgia, cannabis treatment improved quality of life. Investigators of Wolfson Medical Center in Holon, Israel, asked participants to fill a questionnaire before treatment initiation and one months following treatment.

Cannabis treatment for 30 days showed a marked improvement in general quality of life, general health, physical health, and psychological domain. Authors wrote that their results “suggest a potentially significant role of Cannabis in treatment-resistant Fibromyalgia women.”

Hershkovich O, Hayun Y, Oscar N, Shtein A, Lotan R. The role of cannabis in treatment-resistant fibromyalgia women. Pain Pract. 2022 Nov 4. [in press].

Science/Human: Cannabis may improve quality of life in Tourette’s syndrome according to a survey

According to results of a survey with 70 patients suffering from Tourette’s syndrome cannabis may improve quality of life and comorbidities. The study was conducted by scientists of Sackler School of Medicine, Tel-Aviv University, Israel. Patients were recruited from a registry of patients. Questionnaires were answered before and after 6 months of treatment.

The THC and CBD mean daily dose was 123 and 51 mg, respectively. Sixty-seven percent and 89% of patients with obsessive-compulsive disorder and anxiety comorbidities, respectively, reported an improvement. No significant improvement was identified for motor tics and vocal tics. Authors concluded that “reports from TS patients suggest that medical cannabis may improve their quality of life and comorbidities.”

Barchel D, Stolar O, Ziv-Baran T, Gueta I, Berkovitch M, Kohn E, Bar-Lev Schleider L. Use of Medical Cannabis in Patients with Gilles de la Tourette's Syndrome in a Real-World Setting. Cannabis Cannabinoid Res. 2022 Nov 7. [in press].

Science/Human: Cannabis may improve pain and reduce inflammation

According to a questionnaire answered by 56 patients suffering from chronic pain cannabis use was associated with a reduction of pain and blood analyses suggest a reduction in inflammation. Investigators of the University of Toronto, Canada, analysed blood samples for the presence of cannabinoids and cytokines/chemokines.

The majority of patients (96%) self-reported effective pain management and 76% reported a significant decrease in analgesic medication usage. Blood CBD levels were associated with lower vascular endothelial growth factor concentrations, and THC-COOH was a factor related to decreased pro-inflammatory cytokines, namely tumour necrosis factor alpha and IL-12p70.

Ajrawat P, Yang Y, Wasilewski E, Leroux T, Ladha KS, Bhatia A, Singh M, Thaker S, Kapoor M, Furlan AD, Kotra LP, Clarke H. Medical Cannabis Use and Inflammatory Cytokines and Chemokines Among Adult Chronic Pain Patients. Cannabis Cannabinoid Res. 2022 Nov 4. [in press].

Science/Human: CBD may reduce mood and sleep in patients with anxiety disorder

In an open study with 14 patients suffering from moderate to severe anxiety CBD improved mood, sleep and quality of life. Researchers from several institutions in Massachusetts, USA, investigated tolerability and efficacy of a high-CBD sublingual solution given three times daily over a course of four weeks. Participants received a solution containing about 10 mg/mL CBD and 0.2 mg of THC.

Clinically significant treatment response was achieved and maintained as early as week 1 in most patients and all patients had benefits within 3 weeks. Authors wrote that these results “provide preliminary evidence supporting efficacy and tolerability of a full-spectrum, high-CBD product for anxiety. Patients quickly achieve and maintain symptom reduction with few side effects.“

Dahlgren MK, Lambros AM, Smith RT, Sagar KA, El-Abboud C, Gruber SA. Clinical and cognitive improvement following full-spectrum, high-cannabidiol treatment for anxiety: open-label data from a two-stage, phase 2 clinical trial.Commun Med (Lond). 2022;2(1):139.

Science/Human: Patients with treatment refractory chronic pain may profit from cannabis

In a retrospective observational study with chronic pain patients treated in different Danish pain centres oral cannabis extracts where mildly effective. Among 826 eligible patients about 64% were included for data analysis at first follow- up (median 56 days from baseline) and 26% for second follow-up (median 126 days from first follow up.

Pain reduction according to a numeric rating scale was significantly different at both follow-up consultations compared with baseline. Clinically relevant pain reduction was reported by 17% at first follow up and 10% of patients at second follow-up. Authors concluded that “oral cannabinoid therapy seems to be safe and mildly effective” in patients with treatment resistant pain.

Horsted T, Lichon Hesthaven K, Leutscher PDC. Safety and Effectiveness of Cannabinoids to Danish Patients with Treatment Refractory Chronic Pain - A Retrospective Observational Real-world Study. . EUR J Pain. 2022 Nov 17. [in press].

News in brief

Science/Human: CBD was effective in a patient with autism
A CBD rich cannabis extract was effective in the treatment of a nine year old child with autism. “There was an improvement in social interactions, concentration, and emotional stability. A combination of high CBD and low-dose THC oil was demonstrated to be an effective treatment option for managing symptoms associated with autism, leading to a better quality of life for both the patient and the caregivers.”
Engineering Science, University of Toronto, Canada.
Ma L, et al. Cureus. 2022;14(8):e28442.

Science/Human: Cannabis caused a dramatic improvement in a patient with hypophosphatasia and severe pain
In a patient with hypophosphatasia and concomitant degenerative changes of the lumbar spine and an average pain intensity of 8.5 on a numerical rating scale of 0 to 10 showed a dramatic improvement in symptoms after treatment with a CBD-predominant cannabis extract. Pain reduced to an average of 2.5.
Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Germany.
Fischer JM. et al. Complement Med Res. 2022 Nov 15. [in press].

Czech Republic: The government intends to legalise cannabis use for adults
“The Czech center-right governing coalition has now started drafting legislation to fully legalize products containing THC. In the future, they would be considered similar to alcohol or cigarettes.” The government wants to coordinate the step with the German government.
Deutsche Welle of 2 November 2022

Colombia: Parliament may legalise cannabis for adult use
“Colombian legalization of adult-use cannabis is on track, following the Chamber of Representatives’ overwhelming vote of support for a bill introduced by a multiparty group led by Liberal Party deputy Juan Carlos Losada.”
Harris Bricken of 3 November 2022

Science/Animal: CBD exerts neuroprotective effects in the subacute phase of stroke
Studies with mice “indicate that the neuroprotective effects of CBD may occur in the subacute phase of ischemia, and reinforce its strong anti-inflammatory property.”
Molecular Physiology, Center for Integrative Physiology and Molecular Medicine, University of Saarland, Homburg, Germany.
Meyer E, et al. Int J Mol Sci. 2022;23(21):12886.

Science/Cells: Cannabis causes programmed cell death in colorectal cancer cells
Research demonstrates the inhibitory effect of a cannabis extract on proliferation and metastasis of colorectal cancer cells.
Wonkwang-Oriental Medicines Research Institute, Wonkwang University, Iksan, Jeonbuk, Korea.
Mun JG, et al. Nutrients. 2022;14(21):4548.

Science/Human: CBD did not reduce psychedelic effects of THC in a placebo-controlled study
In a placebo-controlled study with 46 healthy infrequent cannabis users, who received four different cannabis preparations with different CBD:THC ratios for inhalation at four different occasions “there was no evidence of CBD modulating the effects of THC on other cognitive, psychotic, subjective, pleasurable, and physiological measures.“
National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
Englund A, et al. Neuropsychopharmacology. 2022 Nov 16. [in press].

Science/Human: Cannabis users reported similar positive effects after ingestion of cannabis with different CBD:THC ratios
In a study with 99 regular cannabis users, who received edible cannabis products with different ratios of CBD and THC “findings suggest that experienced users who consumed a THC+CBD product reported similar levels of positive and psychotomimetic effects relative to those who consumed a THC-only product, despite consuming less THC and displaying lower plasma THC concentrations.”
Department of Psychology and Neuroscience, University of Colorado Boulder, Colorado, USA.
Gibson LP, et al. Cannabis Cannabinoid Res. 2022 Nov 15. [in press].

Science/Human: Cannabis legalisation had no effect on past year cannabis use in adolescents
According to a study conducted in Oregon, Washington and New York “youth who spent more of their adolescence under legalization were no more or less likely to have used cannabis at age 15 years than adolescents who spent little or no time under legalization.”
Social Development Research Group (SDRG), School of Social Work, University of Washington, Seattle, USA.
Bailey JA, et al. Am J Prev Med. 2022:S0749-3797(22)00491-3.

Science/Animal: How CB1 receptor activation causes antidepressant effects
In a study with mice researchers demonstrated that the activation of the CB1 receptor in the hippocampus, a certain brain region, mediates antidepressant-like effects of HU210, a synthetic cannabinoid.
Department of Emergency, Third Hospital of Xi'an, Shaanxi, China.
Fang G, Wang Y. Neurosci Lett. 2022;792:136953.

Science/Human: Increased white-matter coherence following medical cannabis treatment
In a study with 37 participants white-matter coherence was assessed before starting cannabis treatment and after three and six months of treatment investigators found “increased WM coherence, which contrasts with prior research examining recreational cannabis consumers, likely related to inherent differences.”
Cognitive and Clinical Neuroimaging Core and McLean Hospital Imaging Center, Belmont, Massachusetts, USA.
Dahlgren MK, et al. Cannabis Cannabinoid Res. 2022 Nov 11. [in press].

Science/Cells: Photodynamic therapy of melanoma may be enhanced by CBD
In a study with metastatic melanoma cells CBD enhanced the anti-cancer effects of photodynamic therapy.
Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, South Africa.
Nkune NW, et al. Pharmaceutics. 2022;14(11):2418.

Science/Cells: Cannabinoids act synergistically with a PARP inhibitor against ovarian cancer cells
Several cannabinoids (THC, CBC, CBG) acted synergistically with niraparib, a PARP inhibitor, against ovarian cancer cells.
The Mina and Everard Goodman, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel.
Shalev N, et al. Molecules. 2022;27(21):7523.

Science/Human: Adolescents with lower executive function may be at higher risk for frequent cannabis use
According to a prospective longitudinal study with 198 children those with lower executive function (EF) were at high risk for frequent cannabis use. “Whereas literature suggests poorer EF may be a consequence of cannabis use, these findings suggest EF should be considered prior to cannabis use initiation.“
School of Psychological Science, Oregon, USA.
Cavalli JM, et al. Psychol Addict Behav. 2022 Nov 10. [in press].

Science/Animal: An oil-in-water CBD emulsion may increase oral bioavailability of CBD
The relative oral bioavailability compared to oil solution as well as total availability of CBD were assessed in a cross-over study in rats and absorption of CBD via lymphatic system was observed. Compared to oil solution, the emulsion exhibited higher absolute oral bioavailability.
Department of Chemical Engineering, Faculty of Chemical Engineering, University of Chemistry and Technology, Prague, Czech Republic.
Jelínek P, et al. Cannabis Cannabinoid Res. 2022 Nov 4. [in press].

Science/Animal: CBD attenuates fear memory expression in rats
In a study with female rats CBD attenuated fear memory expression via hippocampal serotonin receptors but not CB1 or CB2 receptors.
Departamento de Farmacologia, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
Franzen JM, et al. Neuropharmacology. 2022;223:109316.

Science: Cannabis oil preparations may be helpful in wound dressing
Three chitosan-based films containing different concentrations of cannabis oil were prepared. “Cell culture studies revealed that the obtained materials are biocompatible and, therefore, they might be potential candidates for application in wound dressing materials.”
Department of Biomedical Chemistry and Polymer Science, Medicinal Chemistry Research Group, Faculty of Chemistry, Nicolaus Copernicus University in Torun, Poland.
Chelminiak-Dudkiewicz D, et al. Sci Rep. 2022;12(1):18658.

Science/Human: The use of recreational cannabis may not be associated with an increased risk for obesity
According to a study from the US “recreational marijuana's introduction did not lead to increased obesity rates and may have led to decreases in obesity.”
Center for the Study of Public Choice and Private Enterprise, North Dakota State University, Fargo, North Dakota, USA.
March RJ, et al. Health Econ. 2022;31(12):2609-2629.

Science/Human: Cannabinoids may be useful in periodontal therapy
According to a study with fibroblasts cannabinoids (CBD, CBG, CBVN (cannabidivarin)) may be helpful in periodontal therapy due to their anti-inflammatory profile.
College of Dentistry, The University of Tennessee Health Science Center (UTHSC), Memphis, Tennessee, USA.
Abidi AH, et al. J Periodontal Res. 2022;57(6):1127-1138.

Science/Animal: A synthetic cannabinoid protected against paraquat-induced lung injury
In a study with mice a synthetic cannabinoid (WIN55212-2) protected against paraquat-induced lung injury.
Department of Emergency, the First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Xishan District, Kunming City, China.
He Q, et al. Inflammation. 2022;45(6):2256-2267.

Science/Human: A high percentage of cancer patients believe that cannabis may help with symptoms during treatment
According to a questionnaire filled in by 63 cancer patients about 70% “actively undergoing cancer treatment believed marijuana medications would help with symptoms during treatment.“
Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Canada.
Levin M, et al. Ann Otol Rhinol Laryngol. 2023;132(1):13-18.

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