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IACM-Bulletin of 29 October 2000

Science: THC reduces nausea and vomiting associated with HIV therapy

New study findings show that 85% (23/27) of HIV/AIDS patients who added dronabinol (THC), the most active ingredient of the cannabis plant, to their current antiretroviral therapy had a 50% improvement in symptoms of nausea and vomiting. These results were presented on 23 October at the Fifth Congress on Drug Therapy in HIV Infection in Glasgow (Scotland).

Nausea and vomiting are common side effects associated with antiretroviral medications used to treat HIV infection. The study used Marinol capsules that contain synthetic dronabinol in sesame oil.

"Marinol has been shown to be effective as an anti-nausea agent for people with cancer undergoing chemotherapy," said Dr. Roger Anderson of Anderson Clinical Research, Pittsburgh, and lead investigator of the study. "The study results we present today show that Marinol may also be useful for patients experiencing nausea and vomiting associated with their HIV treatment. This is important because side effects such as nausea and vomiting can often cause patients to miss doses of their antiretroviral medication."

The study enrolled patients who were on stable antiretroviral therapy. Twenty-seven patients were randomised to receive dronabinol 2.5 mg twice-daily within one hour of taking their antiretroviral medication (14 patients) or dronabinol 5.0 mg at bedtime (13 patients) for six weeks. At study start and at six weeks patients were assessed by questionnaire for the number of minutes they did not feel well in the previous 48 hours, the number of episodes of vomiting and the severity of nausea in the same period.

Ninety-three percent (13/14) of patients in the THC twice-daily group had a greater than 50% improvement in symptoms of nausea and vomiting, and 77% (10/13) of patients taking THC at bedtime had a greater than 50% improvement. The severity of nausea improved by at least one grade in 96% (26/27) of patients and no severe or very severe nausea was experienced in either group after six weeks.

(Source: PRNewswire of 23 October 2000)

USA: Medical marijuana registry in Oregon successful

The medical marijuana registry in Oregon registered 594 patients in its first year (May 1999 to April 2000), and since May 2000 another 474 patients have applied for a medical marijuana identification card.

In order to legally qualify for Oregon's Medical Marijuana Act, approved by voters in 1998, patients must possess a doctor's recommendation and register with the Oregon Department of Human Services Health Division (ODHSHS).

"Oregon was the first to implement a state-wide registration system for patients," said Dr. Martin Wasserman, administrator of the ODHSHS. "Our first-year review shows the system is working as it was intended. A substantial number of qualified patients and their physicians are using it, and only a very few inquiries from law enforcement officials regarding patients have occurred."

According to a report by the ODHSHS of October 2000:

(Source: NORML of 26 October 2000)

News in brief

Europe:
According to a recent report of the EURopean Union one in five EU citizens, or around 45 million people, have tried cannabis at some time in their life, while as many as 40% of the 18-year-olds in the EU have tried the drug. 3% of the Danish adults say that they have used cannabis in the past year, around 1% in Sweden, and 9% in the UK which tops the list. The EU report concluded that national drug policies appear to affect the figures less than the drug trafficking routes. (Source: M2 Communications Ltd of 28 October 2000)

Science:
Dr Steven Goldberg, a pharmacologist at the U.S. National Institute of Drug Abuse (NIDA) and his team has shown for the first time that monkeys can be trained to repeatedly self administer THC, given intravenously in a clear solution, by pressing a lever. This solution rapidly distributed THC to the brain. Goldberg's team concludes from its observations published in Nature Neuroscience that THC "has as much potential for abuse as other drugs of abuse, such as cocaine and heroin." Dr. Martin Jarvis, professor of health psychology at University College London (UK) said this would probably overstate the case. He told the British Medical Journal that misuse is "a judgment best made by looking at patterns of actual human use." (Sources: PRNewswire of 15 October 2000; Nature Neuroscience 2000;3:1073-4; British Medical Journal of 21 October 2000)

Germany:
An article in the Journal of the German Medical Association (Deutsches Aertzeblatt) calls cannabis prohibition a "collective wrong way". In the conclusion the author, Dr. Carl Nedelmann, says: "The medical arguments that where used for the maintenance of cannabis prohibition arise from findings of severe pathology. (...) [However], harms done by cannabis are subtle, infrequent and transient." (Source: Nedelmann C: Das Verbot von Cannabis ist ein "kollektiver Irrweg". Deutsches Aertzeblatt 2000;97:A2833-A2837)

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