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IACM-Bulletin of 09 July 2017

Greece: Government legalizes medical use of cannabis

Greece has become the latest EURopean country to legalise cannabis for medical purposes. Prime Minister Alexis Tsipras said that doctors will soon be able to prescribe the drug for a variety of medical conditions.

“From now on, the country is turning its page, as Greece is now included in countries where the delivery of medical cannabis to patients in need is legal.” Mr Tsipras said at a press conference, as reported by the Greek Government Gazette. Details on how the drug will be cultivated and distributed are yet to be clarified by Mr Tsipras' left-wing party. The Prime Minister also said cannabis would be downgraded from a Table A prohibited drug to a Table B drug, in which category are other drugs like methadone and opium with approved medical values

Independent of 3 July 2017

Science/Human: Cannabis effective in migraine and cluster headache in a clinical study

An Italian study presented at the Congress of the EURopean Academy of Neurology in June, has determined that cannabis is as effective as current pharmaceutical therapies for migraine prophylaxis. In a phase 2 study, 79 patients with chronic migraine were given a daily dose of either 25mg of amitriptyline or 200mg of a cannabis extract containing THC and CBD for a period of three months. The extract was made from the cannabis strain Bedrocan with 19 % THC and the strain Bedrolite with 9 % CBD. Forty-eight cluster headache patients also received either the same dose of the cannabis extract or 480mg of verapamil daily. For acute pain, an additional 200mg of the extract were administered for both types of headaches.

While the cannabis extract and amitriptyline achieved similar reduction in attacks, the severity and number of cluster headache attacks only fell slightly. In the treatment of acute pain, cannabis reduced pain intensity among migraine patients by 43.5%. The same results were seen in cluster headache patients, but only in those who had experienced migraine in childhood.

Nicolodi M, et al. Therapeutic Use of Cannabinoids - Dose Finding, Effects and Pilot Data of Effects in Chronic Migraine and Cluster Headache. 3rd EAN Congress. Amsterdam. 24 - 27 June 2017.

Apotheke Adhoc of 29 June 2017

News in brief

Spain: Catalonia legalises cannabis consumption, cultivation and distribution
The government of Catalonia has legalised cannabis. The cultivation, consumption and distribution of cannabis will be permitted for members of designated clubs after the region's parliament voted to regulate them.
Independent of 30 June 2017

Science/Human: How the medical use of cannabis saves lives
Many chronic illnesses are associated with increased suicide risks. In several of these medical conditions cannabis may be helpful and avoid suicide. Now a study with 7,736 patients demonstrated that people with Tourette's disorder or chronic tic disorder are over four times more likely to die by suicide than the general population.
Karolinska Institute, Stockholm, Sweden.
Fernández de la Cruz L, et al. Biolog Psych, 2017;82(2):111.

Science/Human: Legalisation of cannabis in certain US states had no effect on number of motor vehicle crash fatalities
Scientists investigated annual numbers of motor vehicle crash fatalities between 2009 and 2015 in Washington, Colorado, and 8 control states. They found that “three years after recreational marijuana legalization, changes in motor vehicle crash fatality rates for Washington and Colorado were not statistically different from those in similar states without recreational marijuana legalization.“
Dell Medical School, University of Texas, Austin, USA.
Aydelotte JD, et al. Am J Public Health. 2017 Jun 22:e1-e3. [in press]

Science/Human: Alcohol use but not cannabis use was associated with changes in brain structure including reduced volume of grey matter
In a group of 853 adults aged 18-55 years and a group of 439 adolescents aged 14-18 years effects of alcohol and cannabis use on the brain were investigated. Authors concluded from their research that “alcohol use severity is associated with widespread lower gray matter volume and white matter integrity in adults, and with lower gray matter volume in adolescents.” There was no effect of cannabis use.
Department of Psychology & Neuroscience, University of Colorado Boulder, USA.
Thayer RE, et al. Addiction. 2017 Jun 23. [in press]

Science/Animal: CBD reduces certain emotional aspects of pain perception
In a study with rats with allodynia the plant cannabinoid CBD (cannabidiol) reduced pain by modulating the affective dimensions of pain. Allodynia refers to pain following normally non-painful stimulation, e.g. by touching the skin.
Ribeirão Preto Medical School, University of São Paulo, Brazil.
Genaro K, et al. Front Pharmacol. 2017;8:391.

Science/Human: Cannabis use in adolescents was associated with psychotic-like experiences
In a group of 2,566 adolescents, who were followed from the age of 13 years to 16 years increased cannabis use was associated with an increased likelihood of having psychotic-like experiences. This was partly mediated by depression. Authors wrote that “there may be a preventative effect to be gained from targeting depression symptoms, in addition to attempting to prevent cannabis use in youth presenting increasing psychotic experiences.”
Centre de recherche CHU Sainte-Justine, Montreal, Canada.
Bourque J, et al. J Child Psychol Psychiatry. 2017 Jul 5. [in press]

Science/Human: Cigarette smoking may increase the risk for psychotic experiences
In a study with 1,680 people living in London daily cigarette smoking was associated with an about 50% increase in the risk of having psychotic experiences (adjusted odds ratio 1.47, 95%). Scientists found a dose-response relationship with increased tobacco use increasing the risk for psychotic experiences. In former uses the risk was as high as in non-users.
King's College London, UK.
Bhavsar V, et al. Psychol Med. 2017 Jun 28:1-9. [in press]

Science/Human: Trauma in childhood is associated with increased use of cannabis and cocaine in adulthood
In a large sample of 12,288 participants, who were interviewed at ages 11-21 years and again at ages 18-26 years traumas in childhood were associated with an increased risk of cannabis and cocaine use in adulthood and the risk increased with the number of traumas.
Department of Population Health, New York University School of Medicine, USA.
Scheidell JD, et al. Addiction. 2017 Jun 23. [in press]

Science/Human: Cannabis use was associated with reduced recreational physical activity
In a sample of 12,618 adults (20-59 years) cannabis users had a little lower prevalence of moderate physical activity than never users (current users: 51.9%, past users: 50.4%, never users: 55.3%). As the frequency of cannabis use increased, time spent on physical activity decreased.
School of Nursing and Health Sciences, University of Miami, USA.
Vidot DC, et al. Drug Alcohol Depend. 2017;178:43-48.

Science/Animal: Deficiency of polyunsaturated fatty acid during adolescence had a negative effect on cognitive performance and this effect was ameliorated by endocannabinoids
In mice deficiency in omega-3 fatty acids lasting from adolescence into adulthood resulted in strong increases in anxiety and joylessness which lead to decreases in specific cognitive functions in adulthood. Inhibition of endocannabinoid degradation, resulting in increased endocannabinoid concentrations normalized behaviours in these mice.
INSERM, Marseille, France.
Manduca A, et al. J Neurosci. 2017 Jun 19. [in press]

Science/Animal: The mechanisms by which CBD improves epilepsy remain unclear
CBD reduced seizure activity in epilepsy models of rats. This effect was not mediated by 5HT1A or 5HT2A receptors. Authors wrote that “while this work further confirms the anticonvulsant efficacy of CBD and supports its application in the treatment of human seizure disorders, additional research on CBD's mechanism of action must be conducted.”
Skidmore College, Saratoga Springs, USA.
Pelz MC, et al. Epilepsy Behav. 2017;73:111-118.

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