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IACM-Bulletin of 14 October 2018

UK: Cannabis will be made available for medical use in November 2018

Medical cannabis will be made available to UK patients via prescription from November on, after a long battle with spotlight on children and other patients whose conditions were eased by the substance. Until now, the drug has been listed in schedule 1 – the strictest schedule possible – under UK law, limiting medical cannabis to be allowed in only exceptional circumstances and requiring a Home Office license.

The new regime, which moves the drug to schedule two, will apply to cannabis oil that contains THC. Cannabis extracts with CBD and without THC are already legal in the UK. The decision to reschedule cannabis comes after a long battle between medical cannabis campaigners and a Conservative Party government. The fight came to a head earlier this year, after tireless campaigning by mothers of children suffering from rare forms of epilepsy, who found that medicinal cannabis proved the best course of treatment for their children’s conditions.

RT News of 7 October 2018.

UNO: In March 2019 countries will vote on recommendations by the WHO on the classification of cannabis

The ECDD (Expert Committee on Drug Dependence) of the WHO has acknowledged the inconsistency of the scheduling of the cannabis plant in Schedule IV of the 1961 Convention. On 31 May the ECDD held a hearing on this issue. During the 41st meeting of the ECDD on 12 to 16 November 2018 the final part of the new assessment of cannabis, the so-called critical review, will be done.

The definitive step will happen in March 2019, when the countries will vote on the WHO recommendations during the Commission on Narcotic Drugs, an organ of the United Nations. The 53 countries appointed to vote will need to be convinced to adopting the recommendations of WHO. It will be essential to pressure governments at the national level to allow changes of cannabis within the schedules of the Convention.

Presentation for the 40th ECDD Meeting in Geneva on 31 May 2018 by the IACM

Voting countries at the 62nd CND in March 2019

Science/Human: Cannabis use is associated with significant reduction in occurrence of diabetes

The risk of diabetes was reduced by 19% in people, who have ever used cannabis, and by 49% in those, who have used it within the past 12 months. This analysis was published by investigators of the Institute of Medical Science of the University of Toronto, Canada. Data were obtained from the Canadian National Epidemiologic Survey on Alcohol and Related Conditions.

The corresponding odds ratios of diabetes were 0.81 and 0.51 for lifetime and 12-month cannabis use, respectively. Authors concluded that a “decreased likelihood of diabetes for cannabis users versus non-users was indicated after accounting for a range of potential confounders, including mental health disorders. Before the protective effects of cannabis use for diabetes can be suggested, further epidemiological studies are needed.”

Imtiaz S, Rehm J. The relationship between cannabis use and diabetes: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III. Drug Alcohol Rev. 2018 Oct 4. [in press]

Science/Human: Cannabis is effective in Tourette syndrome according to a survey

According to interviews done with 42 patients suffering from Tourette syndrome, who used cannabis for medicinal purposes, the drug was effective in symptom control of most patients. The study was conducted by the Neurological Institute of Tel Aviv Medical Centre and the Sackler School of Medicine of Tel Aviv University, Israel. A total of 33 males and 9 females with a mean age of 34.5 years were interviewed.

The total global impression score of efficacy was 3.85 out of a total 5 possible points. Patients reported during the free discussion part of the interview about reduction in tic severity, better sleep and improved mood. Thirty-eight patients reported any kind of benefit from treatment while 10 patients with more than one year of consumption elected to stop treatment with cannabis for various reasons including severe side effects as psychosis in one patient.

Thaler A, Arad S, Schleider LB, Knaani J, Taichman T, Giladi N, Gurevich T. Single center experience with medical cannabis in Gilles de la Tourette syndrome. Parkinsonism Relat Disord. 2018 Oct 1. [in press]

Science/Human: Cannabidiol may be useful in the treatment of cancer according to an observational study

In an observational study with 119 patients with advanced cancer, of whom 28 were given CBD as the only treatment, doctors were able to document improvements in a few patients. Investigators work at The Old Brewery and the St George’s University of London, UK. They analysed the data routinely collected, as part of their treatment program over a 4-year period. The main cancers were breast cancer (39 cases), prostate cancer (16 cases) and colorectal cancer (13 cases).

Authors noted that eight patients “clearly improved” by using CBD suffering from prostate cancer, brain tumours, breast cancer, oesophageal cancer and lymphoma. They presented two “impressive cases”, of which one was a 5-year-old male patient with a certain brain tumour (anaplastic ependymoma) and the other a 50-year-old patient with tanycytic ependymoma, another brain tumour. In both cases there was a decrease in tumour volume, for which CBD was made responsible. Due to the character of the study no clear conclusions can be drawn.

Kenyon J, Liu W, Dalgleish A. Report of Objective Clinical Responses of Cancer Patients to Pharmaceutical-grade Synthetic Cannabidiol. Anticancer Res. 2018;38(10):5831-5835.

News in brief

Science/Cells: Cannabinoids may increase the efficacy of bortezomib in bone cancer
In studies with osteosarcoma cells investigators demonstrated that the efficacy of the anticancer drug bortezomib may be increased by molecules, which activate the cannabinoid-2 receptor and the TRPV1 receptor. There were synergistic effects on apoptosis (programmed cell death), cell cycle progression and migration of the bone cancer cells.
Università degli Studi della Campania "Luigi Vanvitelli", Italy.
Punzo F, et al. Pharmacol Res. 2018;137:25-33. [in press]

Science/Human: The status of legalisation in US states has no effect on problematic cannabis use
In an analysis of 329 frequent cannabis users from different US states scientists “did not find an association between US state legalisation and problematic cannabis use or impulsivity.”
Monash University, Melbourne, Australia.
Destrée L, et al. Drugs Context. 2018;7:212541.

Science: Considerable increase of publications on medical cannabis in scientific journals
Between 2000 and 2017 the number of publications on cannabis increased 4.5-fold and the number of publications on medical cannabis increased almost 9-fold in major scientific databases.
Clalit Health Services, Southern District, Israel.
Treister-Goltzman Y, et al. Popul Health Manag. 2018 Oct 6. [in press]

Science/Human: Men have more cannabinoid-1 receptors in the brain than women
In a study with 11 male and 11 female healthy people scientists found that availability of CB1 receptors was on average 41% higher in the brains of males compared to females. Scientists used a sophisticated technique to make visible CB1 receptor availability in different brain regions.
Turku PET Centre, Turku University Hospital, Finland.
Laurikainen H, et al. Neuroimage. 2018 Oct 5. [in press]

Science/Animal: High levels of an endocannabinoid are associated with unfavourable outcomes after heart attack
In studies with mice increased levels of the endocannabinoid 2-AG (2-arachidonoylglycerol), but not of anandamide or some other endocannabinoids was associated with increased inflammation and infarct size after heart attack.
Institute for Cardiovascular Prevention, Ludwig-Maximilians-University Munich, Germany.
Schloss MJ, et al. Cardiovasc Res. 2018 Sep 28. [in press]

Science/Animal: CBD and CBD extracts reduce symptoms in an animal model of multiple sclerosis
CBD (cannabidiol) and a CBD extract from a cannabis plant high in CBD and very low in THC reduced symptoms in mice with EAE (autoimmune encephalomyelitis), a model for multiple sclerosis.
The Hadassah Medical School, The Hebrew University of Jerusalem, Israel.
Gallily R, et al. Inflammopharmacology. 2018 Oct 5. [in press]

Science/Human: The endocannabinoid system is associated with well-being in later life
The endocannabinoid system is positively influenced by exercise and this has positive effects on well-being and quality of life in later years.
Department of Nutrition, University of California, Davis, USA.
Watkins BA, et al. Mol Aspects Med. 2018 Oct 5. [in press]

Science/Animal: CBD may be useful in cocaine dependency
In a study with mice CBD was shown to attenuate cocaine reinforcement. Investigators showed that CBD can modulate some behavioural and molecular manifestations of cocaine reinforcement.
Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
Luján MÁ, et al. Neuropharmacology. 2018;143:163-175.

Science/Human: The endocannabinoid system may be involved in a muscle disorder
Investigators demonstrated the involvement of the endocannabinoid system in Duchenne’s muscular dystrophy and propose “the role of CB1 receptors as target for potential therapies.”
Endocannabinoid Research Group, Italy.
Iannotti FA, et al. Nat Commun. 2018;9(1):3950.

Science/Human: Cannabis use may be associated with an increased risk of suicide
According to an analysis of Canadian data from 2002 and 2012 (43,466 subjects) there was a significant sex difference in the strengths of the association between cannabis use and suicidal thoughts and psychological distress. Females reported a higher level of distress and suicidal thoughts. It is unclear from the study if cannabis is used to reduce the stress or if cannabis causes distress.
McMaster University, Hamilton, Canada.
Halladay JE, et al. Can J Psychiatry. 2018 Sep 27:706743718804542. [in press]

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