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IACM-Bulletin of 16 July 2023

Germany: Ministry of Health presents draft law on legalisation of cannabis

On 5 July, the Federal Ministry of Health presented a draft law on the legalisation of cannabis. According to the bill, the possession of up to 25 grimes of cannabis is to be allowed for persons over 18 years of age and the cultivation of a maximum of three plants for personal use. In addition, cannabis is to be allowed to be cultivated and distributed collectively in cultivation associations, also called cannabis clubs. The clubs and club members must be prepared for strict rules.

The bill could be launched in the federal cabinet in mid-August. After that, it would be discussed in the Bundestag. According to the plans, the Bundesrat does not have to agree. Federal states like Bavaria, which are against legalisation, are therefore unlikely to be able to stop the plan via the Bundesrat. The federal government hopes that legalisation will be implemented this year. At a later stage, it is planned to pass a law allowing the distribution of cannabis through sales outlets.

Ärztezeitung of 6 July 2023

Draft law from 5 July 2023

Science/Human: Cannabis may be helpful in several symptoms of cancer patients according to observational study

Cannabis use was associated with improvements in pain, sleep and cognitive function in cancer patients according to an observational study at Harvard Medical School in Boston, USA. Participants completed a baseline appointment, a two-week ad libitum cannabis use period, and an acute administration appointment that included assessments before cannabis use, one-hour post-use, and two-hour post-use.

Twenty-five participants completed all study appointments and were included in the analysis. Sustained cannabis use was associated with improvements in pain intensity, pain interference, sleep quality, subjective cognitive function, and reaction times in the Stroop task, but no change in general quality of life was observed. High levels of CBD use during the two-week ad libitum use period were associated with steeper improvements in pain intensity and sleep quality.

Giordano G, Martin-Willett R, Gibson LP, Camidge DR, Bowles DW, Hutchison KE, Bryan AD. Cannabis use in cancer patients: acute and sustained associations with pain, cognition, and quality of life. Explor Med. 2023;4:254–271.

Science/Human: US military veterans use cannabis to reduce harms experience from other medication

Using data from a cross-sectional, self-reported, anonymous survey asking US veterans about health-related issues investigators of the Cannabis Center of Excellence in Boston, USA, found out, that many participants were able to reduce harms from other medications by replacing them with cannabis.

A total of 510 veterans of US military service participated in the survey. Primary health conditions reported included chronic pain (38%), post-traumatic stress disorder (26%), anxiety (9%), and depression (5%). Many reported using cannabis to reduce the use of over-the-counter medications (30%) including antidepressants (25%), anti-inflammatories (17%), and other prescription medications. Additionally, 463 veterans (91% of respondents) reported that medical cannabis helped them to experience a greater quality of life and 105 (21%) reported using fewer opioids as a result of their medical cannabis use.

McNabb M, Durante KA, Trocchio S, Ritter DJ, MacCaffrie R, Brum A, Mandile S, White S. Self-reported Medicinal Cannabis Use as an Alternative to Prescription and Over-the-counter Medication Use Among US Military Veterans. Clin Ther. 2023;45(6):562-577.

Science/Human: Cannabis may be useful in sleep disturbance among older patients

Investigators from the University of Florida College of Medicine in Gainesville, USA, and the University of California San Diego conducted an anonymous survey to evaluate effects on sleep in patients seen at a geriatrics clinic. Of 568 participants 83 reported cannabis use within the past 3 years.

Among the cannabis users, 29% reported using cannabis for sleep disturbance. They were more likely than other users to be female, consume cannabis more frequently, use products containing THC and use cannabis to target more symptoms. Authors noted: “As cannabis use continues to grow in older populations, it is essential to delineate better how cannabis may be used safely and effectively to improve older adults' sleep health.”

Kaufmann CN, Malhotra A, Yang KH, Han BH, Nafsu R, Lifset ET, Nguyen K, Sexton M, Moore AA. Cannabis use for Sleep Disturbance Among Older Patients in a Geriatrics Clinic. Int J Aging Hum Dev. 2023;97(1):3-17.

News in brief

Ukraine: Bill on the medical use of cannabis passes first reading in Parliament

Ukraine's parliament has given its initial approval to a bill aiming to legalize medical cannabis in the country. People's deputies Iryna Herashchenko and Yaroslav Zheleznyak confirmed the successful vote, with 268 deputies supporting the legislation. However, before the bill can become law, it must pass a second reading following any necessary finalization and subsequently be sent to the president for his signature.

Kyiv Post of 13 July 2023

 Brazil: Government intends to regulate cannabis growing in the country for medicinal use

The government intends to regulate the planting of Cannabis for medicinal purposes in Brazil, replacing the importation of products, says the national secretary of Policies on Drugs and Asset Management of the Ministry of Justice, Marta Machado.

Folha de S.Paulo of 12 July 2023

Science/Human: Adolescents experience similar acute effects from cannabis as adults

According to a study with 24 adolescents and 24 adults who used cannabis 0.5-3 days per week adolescent cannabis users are neither more resilient nor more vulnerable than adult cannabis users to the acute psychotomimetic, verbal memory-impairing or subjective effects of cannabis. Furthermore, in adolescents and adults, vaporised CBD does not mitigate the acute harms caused by THC.

Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.

Lawn W, et al. Addiction. 2023;118(7):1282-1294.

Science/Human: Cannabis may be helpful in multiple sclerosis and chronic pain

According to an analysis of data from 242 multiple sclerosis patients with chronic pain participants experienced symptom improvement. Data were taken from a controlled trial comparing mindfulness-based cognitive therapy, cognitive-behavioural therapy, and usual care for chronic pain.

Of all participants 65 (27%) reported the use of cannabis for pain management. The most common route of administration was oil/tincture (reported by 42%), followed by vaped (22%) and edible (17%) products.

Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, USA.

Link K, et al. Mult Scler Relat Disord. 2023;75:104742

Science: The measured concentrations of CBD in products purchased in the UK often differ from advertised concentrations

CBD concentrations were measured in 13 aqueous tinctures, 29 oils, 10 e-liquids and 11 drinks, which were purchased online in the UK. Authors noted that “similarly to previous studies, few products had measured CBD concentrations within 10% of advertised concentrations, with most falling below advertised concentrations. All individual product types deviated from advertised concentrations, with oils deviating least.

School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK.

Johnson DA, et al. J Cannabis Res. 2023;5(1):28.

Science/Human: Cannabis use influences motility of the oesophagus

In patients undergoing high-resolution oesophageal manometry regular cannabis use is “associated with decreased weak swallows and reduced prevalence of ineffective esophageal motility.” “In patients referred for dysphagia, chronic cannabis use is associated with increased integrated relaxation pressure and lower esophageal sphincter resting pressure, though not to levels above the normal range.”

Case Western Reserve University, School of Medicine, Cleveland, USA.

Ugwuegbu O, et al. J Clin Gastroenterol. 2023 Jun 29. [in press]

Science/Animal: Cannabis shows anti-cancer effects in liver cancer

In a rat model of hepatocellular carcinoma cannabis extracts showed anticancer effects. Authors wrote that the “anticancer potential is mediated through antiangiogenic, proapoptotic, cycle arrest, and anti-inflammatory mechanisms.”

Department of Biochemistry, Phyto-chemistry and Bio-computing Research Laboratory, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria.

Akinloye DI, et al. J Cannabis Res. 2023;5(1):27.

Science/Animal: Cannabis roots may reduce abdominal pain in dysmenorrhoea

In a mouse model of dysmenorrhoea a cannabis root extract exhibited “an antidysmenorrheic effect both alone and in association with drugs, reducing abdominal contortions in female mice without generating organ enlargement in the animals.”

Central for Analysis of Drugs, Medicines and Food (CAFMA), Federal University of Vale do São Francisco, Pernambuco, Brazil.

Araújo TCL, et al. J Ethnopharmacol. 2023:116891.

Science/Cells: Cannabinoids disturb energy production in MRSA bacteria

“Exposure to cannabinoids showed antibiotic activity against MRSA (Methicillin-resistant Staphylococcus aureus) , and differential proteomics revealed reduced levels of proteins involved in the energy production.”

Department of Chemistry and Bioscience, Aalborg University, Denmark.

Poulsen JS, et al. J Nat Prod. 2023 Jul 6. [in press]

Science: CBDA shows antiviral activity against SARS-CoV-2

“In the present study, the antiviral activity of cannabinoids isolated from Cannabis sativa L. was assessed in vitro against a panel of SARS-CoV-2, indicating cannabidiolic acid (CBDA) was the most active.”

Section of Microbiology, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Italy.

Tamburello M, et al. J Nat Prod. 2023 Jul 4. [in press]

Science/Cells: Cannabis extracts have antifungal and antibacterial effects

“All the extracts of the analysed cannabis varieties showed antibacterial and antifungal activities. In addition, plants belonging to the same chemotype showed different antimicrobial activity, demonstrating that the classification of cannabis strains based solely on THC and CBD content is not sufficient to justify their biological activities and that other compounds present in the extracts are involved in their action against pathogens. Cannabis extracts act in synergy with chemical fungicides, allowing to reduce its doses.”

Instituto de Investigaciones Biológicas, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata - CONICET, Mar del Plata, Argentina.

Vozza Berardo ME, et al. J Ethnopharmacol. 2023;318(Pt A):116839.

Science/Human: Cannabis legalisation may be associated with reduced mental health problems

The results indicate that shortly after a state adopts recreational cannabis legalization, “they experience a decrease in the average number of mental health treatment admissions. The findings are driven by white, Black, and Medicaid-funded admissions and are consistent for both male and female admissions.”

Indiana University, Bloomington, USA.

Ortega A. Health Econ. 2023 Jun 30. [in press]

Science/Cells: Activation of cannabis receptors influence blood vessel production

A study with human brain vessel cells “provides a new possible approach by targeting the cannabinoid receptors to control and regulate brain angiogenesis for treating a variety of angiogenesis-related diseases. This could be achieved by using different agonists or antagonists of the cannabinoid receptors based on the nature of the diseases.”

Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid, Jordan.

Al-Eitan L, Alahmad S. Gene. 2023;878:147585.

Science/Human: Legalisation of cannabis may be associated with a reduction in tobacco use

In the USA the adoption of recreational cannabis laws “is associated with a reduction in adult cigarette smoking.”

Department of Economics, Bentley University, NBER & IZA, Waltham, USA.

Dave D, et al. J Health Econ. 2023;90:102756.

Science/Animal: CBD influences brain alterations induced by alcohol withdrawal

In a study with alcohol dependent mice “CBD dose-dependently normalized the behavioral, somatic withdrawal signs and anxiety-like behaviors” after acute alcohol withdrawal.

Instituto de Neurociencias, Universidad Miguel Hernandez-CSIC, San Juan de Alicante, Spain.

Gasparyan A, et al. Neuropharmacology. 2023;233:109549.

Science/Animal: Cessation of THC use partially reversed impacts on male fertility

A new study demonstrated “that discontinuation of chronic THC use in rhesus macaques partially restores adverse impacts to male reproductive health, THC-associated sperm differentially methylated regions in genes important for development, and expression of proteins important for male fertility.”

Department of Urology, Oregon Health & Science University; Portland, USA.

Hedges JC, et al. Fertil Steril. 2023;120(1):163-174.

Science/Animal: CBD recovers nerve cell damage induced by reserpine and may be helpful in Parkinson’s disease

in a study with Caenorhabditis elegans “findings collectively provide new evidence that CBD acts as neuroprotector in dopaminergic neurons, reducing neurotoxicity and α-syn accumulation highlighting its potential in the treatment of PD” [Parkinson’s disease].

Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.

da Cruz Guedes E, et al. Neurochem Res. 2023;48(8):2390-2405.

Science/Animal: CBD and the chemotherapeutic agent doxorubicin may act synergistically in bone cancer

A study with mice suggests “that cannabidiol and doxorubicin have a synergistic anticancer effect” on osteosarcoma (OS), and their combined application may be “a promising treatment strategy for OS.”

Department of Orthopedics, The First Hospital of Nanchang, The Third Affiliated Hospital of Nanchang University, Jiangxi, China.

Li J, et al. Clin Transl Oncol. 2023;25(8):2408-2418.

Science/Human: Cannabis use may be associated with a lower risk for stroke

The 2019 National Inpatient Sample from Healthcare Cost and Utilization Project and Agency for Healthcare Research and Quality was used to evaluate the acute ischaemic stroke patients ages 25 and more. Researchers concluded from the investigation that “although the overall mortality risk seems to be lower among cannabis users, those with certain risk factors still present higher mortality risks.”

Department of Pediatrics, Shanghai Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Ramphul K, et al. Neurologist. 2023;28(4):226-230.