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IACM-Bulletin of 14 April 2019

Science/Human: Cannabis may improve behaviour in patients with dementia according to observational study

Ten female demented patients with severe behavioural problems showed significant improvement after a two-month administration of an oral cannabis extract. Scientists at the Department of Primary Care and Community Medicine of Geneva University Hospitals, Switzerland, published their study results in the journal Medical Cannabis and Cannabinoids. Patients received a cannabis tincture, which contained a ratio of THC to CBD of 1 to 2. According to the study results they got a mean dose of 8.8 mg THC and 17.6mg CBD after 1month, which remained stable after 2 months (average of 9 mg THC and 18 mg of CBD).

Scores of a behavior problem visual analog scale decreased by 40% after 2 months and a rigidity score by 50%. Half of the patients decreased or stopped other psychotropic medications. The staff appreciated the decrease in rigidity, making daily care and transfers easier, the improved direct contact with the patients, the improvement in behavior, and the decrease in constipation with reduced opioid doses. There was no reduction of cannabis for reasons of side effects.

Broers B, Patà Z, Mina A, Wampfler J, de Saussure C, Pautex S. Prescription of a THC/CBD-Based Medication to Patients with Dementia: A Pilot Study in Geneva. Med Cannabis Cannabinoids. 2019 Apr 4. [in press]

Science/Human: CBD may be helpful in Fragile X syndrome according to case reports

In a case series 3 patients (one child and 2 adults) with Fragile X syndrome (FXS) benefited from a treatment with oral CBD (cannabidiol) in daily doses between 32 and 64 mg. Scientists from the Department of Pediatrics of the University of Colorado School of Medicine in Aurora, USA, presented their research in the journal Cannabis and Cannabinoid Research.

All three patients exhibited functional benefit following the use of oral CBD solutions, including noticeable reductions in social avoidance and anxiety, as well as improvements in sleep, feeding, motor coordination, language skills, anxiety, and sensory processing. Two of the described patients exhibited a reemergence of a number of FXS symptoms following cessation of CBD treatment (e.g., anxiety), which then improved again after reintroduction of CBD treatment.

Tartaglia N, Bonn-Miller M, Hagerman R. Treatment of Fragile X Syndrome with Cannabidiol: A Case Series Study and Brief Review of the Literature. Cannabis Cannabinoid Res. 2019;4(1):3-9.

News in brief

USA: Improvements of medical cannabis law of New Mexico
Governor Michelle Lujan Grisham signed Senate Bill 406 into law on 4 April effectively overhauling the state’s medical cannabis law for the first time since the inception of the program 12 years ago. Among others the updated law allows school children to be administered medical cannabis while on school-grounds, adds workplace protections for patients, and lays the framework for out-of-state medical patients to access the program.
Globe Newswire of 5 April 2019.

Luxembourg: Government buys cannabis
In a joint statement, the ministries of Health and of Foreign Affairs specified that they purchased three different types of cannabis. They bought 20 kg, worth €50,000, from a Canadian supplier. Regarding recreational cannabis, Luxembourg officials are supposedly involved in discussions with the Netherlands and Canada. Even though the exact extent and content of these discussions have not yet been made public, Luxembourg's coalition government reportedly plans on bringing to life a government-run agency that will handle the distribution of recreational cannabis in the Grand Duchy.
RTL of 30 March 2019

Germany: Government agency selects three companies for domestic production of cannabis for medicinal use
Three companies were chosen by the German Cannabis Agency for the production of cannabis in the country. These are two German subsidiaries of the Canadian companies Aphria and Aurora as well as the Berlin company Demecan.
Handelsblatt of 4 April 2019

Israel: Decriminalisation of cannabis takes effect
Decriminalisation of cannabis possession took effect on 1 April. Under the new guidelines, possession of small amounts of cannabis in private homes will no longer be treated as an offense, criminal or otherwise. Possession in public is still prohibited.
Times of Israel of 31 March 2019.

USA: No limit of THC in blood at which a driver is impaired
A new report says Michigan should not set a legal driving limit for THC in the blood. Set up under former Governor Rick Snyder, a commission made up of six panel members, says there should not be a legal limit for THC. Because there is no measurable blood level at which a driver is deemed to be “under the influence of cannabis,” police in Michigan will have to prove a driver is impaired the old fashioned way.
WILX of 26 March 2019.

Guam: Cannabis use for adults legalised
Guam legalized the adult use of cannabis when Governor Lou Leon Guerrero signed the contentious recreational cannabis bill into law. The new law allows those at least 21 years old to possess up to an ounce (about 28 g) of cannabis. Adults can grow no more than six plants for their personal use.
Pacific Daily News of 4 April 2019

Science/Human: The use of synthetic cannabinoids is associated with more mental health problems compared to natural cannabis
According to an online survey with 367 users of synthetic cannabinoids and natural cannabis, those who used synthetic cannabinoids scored higher on drug abuse, sleep problems, depression, anxiety and other mental health problems.
Department of Drug Monitoring, Utrecht, The Netherlands.
Mensen VT, et al. Psychopharmacology (Berl). 2019 Apr 9. [in press]

Science/Animal: Interaction between ketamine and the endocannabinoid system
A study with mice suggests that antidepressant effects of ketamine are mediated by cannabinoid receptors.
Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Khakpai F, et al. Biomed Pharmacother. 2019 Apr;112:108717.

Science/Human: The inhalation of hemp may result in detectable THC concentrations in blood
Half an hour after the inhalation of 1 g of hemp, containing 0.16% THC and 5.8% CBD, blood concentrations varied between 7 and 11 ng/mL for THC and 30 and 56 ng/mL for CBD.
National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy.
Pacifici R, et al. Clin Chem Lab Med. 2019 Apr 8. [in press]

Science/Animal: A combination of THC and CBD may be effective in epilepsy
In a study with zebrafish researchers found a synergistic effect of THC and CBD in a ratio of 1:1 in models of hyperactivity of the nervous system. Both THC and CBD were effective, but a combination allowed to reduce the doses of both cannabinoids. Authors wrote that “reducing the level of each cannabinoid required may help to prevent off target effects that lead to side effects,“which may be relevant for the treatment of epilepsy.
Université de Montréal, Canada.
Samarut É, et al. Front Pharmacol. 2019;10:226.

Science: Steroids may interact with FAAH
In a study with six steroids (among them testosterone, hydrocortisone, oestradiol, and cortisone) researchers found an interaction with FAAH (fatty acid amide hydrolase), which is involved in the degradation of endocannabinoids. Authors wrote, that “the results point to steroids as new regulators of FAAH interaction with membranes, which may impact the biological activity of eCBs.”
Faculty of Bioscience, and Technology for Food Agriculture and Environment, University of Teramo, Italy.
Sabatucci A, et al. Cannabis Cannabinoid Res. 2019;4(1):42-50.

Science/Cells: Activation of the CB2 receptor may be beneficial in rheumatoid arthritis
In a study with rheumatoid arthritis synovial fibroblasts, cells within the joints, researchers demonstrated, that activation of the CB2 receptor by a synthetic cannabinoid (JWH-133) resulted in a reduction of the pro-inflammatory cytokine interleukin 1-beta. Authors wrote that the CB2 receptor “may serve as a potential target to manage pain and inflammation in RA [rheumatic arthritis].”
Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, USA.
Fechtner SC, et al. Clin Exp Rheumatol. 2019 Mar 18. [in press]

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