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IACM-Bulletin of 23 April 2023

Germany: The government intends to allow private cannabis cultivation and cannabis social clubs

The German government on 12 April presented plans to legalise cannabis, presenting legislation that would allow private cultivation and distribution through non-profit groups but not widespread sales of the drug in shops.

The legislation also foresees a pilot project for a small number of licensed shops in some regions to test the effects of a commercial supply chain of recreational cannabis on public health, the protection of minors and the black market. Acquiring and possessing up to 25 grams of recreational cannabis for personal consumption would also be made legal. „The previous cannabis policy has failed. Now we have to go new ways," Health Minister Karl Lauterbach said.

Reuters of 12 April 2023

Czech Republic: The government intends to allow a regulated cannabis market

The government recently announced its intention to introduce a strictly regulated cannabis market in the Czech Republic. Despite the fact that cannabis is legalized domestically for personal use, the sale and distribution remains prohibited. The new regulation addresses its distribution.

According to the national drug coordinator Jindřich Vobořil, the aim of the proposal to regulate the market is greater consumer protection and greater control of the quality and quantity of cannabis on the market. At the same time, tax revenues for the state coffers would also increase. The plan for a regulated cannabis market will include royalties and a cannabis tax, which would work similarly to an excise tax. The alternative would be the excise tax itself.

Seznam Zpravy of 13 April 2023

Science/Human: Cannabis has no influence on the development of psychosis in a high-risk group according to a prospective study

The use of cannabis was not associated with the development of psychosis in a high-risk group in a prospective study. Investigators of the Department of Psychosis Studies at the Institute of Psychiatry, Psychology & Neuroscience of King's College London, UK, and 19 other academic institutions from Europe, South America and Australia assessed current and previous cannabis use in 334 individuals at clinical high risk of psychosis and 67 healthy controls. Participants were assessed at baseline and followed up for 2 years.

During follow up, 16.2% of the clinical high-risk sample developed psychosis. Of those who did not become psychotic, 51.4% had persistent symptoms and 48.6% were in remission. Authors noted that “there was no significant association between any measure of cannabis use at baseline and either transition to psychosis, the persistence of symptoms, or functional outcome.”

Chester LA, Valmaggia LR, Kempton MJ, Chesney E, Oliver D, Hedges EP, Klatsa E( Stahl D, van der Gaag M, de Haan L, Nelson B, McGorry P, Amminger GP, Riecher-Rössler A, Studerus E, Bressan R, Barrantes-Vidal N, Krebs MO, Glenthøj B, Nordentoft M, Ruhrmann S, Sachs G, McGuire P. Influence of cannabis use on incidence of psychosis in people at clinical high risk. Psychiatry Clin Neurosci. 2023 Apr 18 [in press].

Science/Human: Cannabis may be helpful in the treatment of acne inversa according to case reports

In the “Case in Context” section of the journal Cannabis and Cannabinoid Research investigators of Nova Institute near Cologne, Germany, and the University of Debrecen, Hungary, presented two cases of severe acne inversa, also called hidradenitis suppurativa, successfully treated with cannabis. It is a chronic, recurrent inflammatory disease, which is characterized by the development of inflamed, painful skin nodules and abscesses.

The first patient, a 30 year old man, needed 0.5 grams of cannabis flowers per day to effectively reduce the development of abscesses. Before starting treatment under the supervision of a physician he already had several years of experience with self-medication. The second patient, a 41-year-old man, needed a daily cannabis dose of 0.15 grams. He had no previous experience with cannabis before starting treatment with his doctor.

Grotenhermen F, Oláh A. Case in Context: Acne Inversa (Hidradenitis Suppurativa). Cannabis Cannabinoid Res. 2023 Apr 19 [in press].

Science/Human: Myoclonic super-refractory status epilepticus improved following nerve stimulation and CBD intake in a case report

Febrile infection-related epilepsy syndrome (FIRES) is a rare and catastrophic clinical syndrome occurring in previously healthy patients. Investigators described a case of myoclonic prolonged super refractory status epilepticus in FIRES in a patient admitted to the paediatric intensive care unit of Padova, Italy.

After failure of standard treatment, a vagal nerve stimulator was implanted and cannabidiol (CBD) administered, 43 days and 70 days after P-SRSE onset, respectively. Authors wrote: “Two days after CBD introduction, status epilepticus weaned and the girl rapidly regained complete consciousness showing a brilliant and unexpected recovery.

Bonardi CM, Furlanis GM, Toldo I, Guarrera B, Luisi C, Pettenazzo A, Nosadini M, Boniver C, Sartori S, Landi A. Myoclonic super-refractory status epilepticus with favourable evolution in a teenager with FIRES: Is the association of vagus nerve stimulation and cannabidiol effective? Brain Dev. 2023 May;45(5):293-299.

Science/Human: Cannabis may be helpful in multiple sclerosis -related bladder dysfunction according to a prospective study

In a study with 31 patients suffering from multiple sclerosis the cannabis extract Sativex ameliorated subjective perception of urinary disturbances. Investigators of the Department of Neuroimmunology and Neuromuscular Diseases of the Neurological Institute C. Besta IRCCS Foundation in Milan, Italy, and other academic institutions from Italy assessed neurological problems, spasticity and quality of life before, 1 month and 6 months after treatment start. Of 31 participants enrolled in the study, 25 reached one month and 18 reached 6 months.

Urinary disturbances measured by the International Prostatic Symptoms Score, an urodynamic test evaluating maximum pressure of the bladder pressure and other measures showed a trend to improve.

Torri Clerici V, Brambilla L, Politi PL, Viggiani F, Mercurio S, Tonietti S, Ronzoni M, Crisafulli SG, Antozzi C, Tramacere I, Redemagni C, Confalonieri P. Nabiximols oromucosal spray in patients with multiple sclerosis-related bladder dysfunction: A prospective study. Mult Scler Relat Disord. 2023;74:104711.

Science/Human: Cannabis may be helpful in the treatment of Parkinson’s disease according to an observational study

In an observational study with 69 patients suffering from Parkinson’s disease most of them exhibited an improvement in any symptom after starting treatment with a cannabis tincture with THC and CBD in a ratio of 1:1. Investigators of the Buffalo School of Pharmacy and Pharmaceutical Sciences, New York, USA, included patients in the normal course of clinical practice.

Symptoms with the highest incidence of improvement included cramping/dystonia, pain, spasticity, lack of appetite, dyskinesia, and tremor. After starting the cannabis treatment, 56% of the 14 opioid users were able to decrease or discontinue opioid use.

Aladeen TS, Mattle AG, Zelen K, Mesha M, Rainka MM, Geist T, Myers B, Mechtler L. Medical Cannabis in the Treatment of Parkinson's Disease. Clin Neuropharmacol. 2023 Apr 19 [in press].

Science/Human: Cannabis users have lower opioid demands after wrist surgery according to an observational study

Cannabis users, who had to undergo wrist surgery after distal radius fractures needed less opioids before and after surgery compared to non-users. Investigators of the University of Colorado School of Medicine in Aurora, USA, included all patients treated between 2010 and 2020.

The rates of prescription refills before and after surgery were congruent in both the case and control populations and did not show significant differences. The average morphine milligram equivalents of patients' first opioid prescription was significantly reduced in the case population compared with the control (352.26 versus 480.61 morphine milligram equivalents per prescription)

Lee N, Le ELH, Constantine R, Iorio ML. Patterns of Opioid Demand after Operative Treatment of Distal Radius Fractures. Plast Reconstr Surg Glob Open. 2023;11(4):e4901.

News in brief

Antigua and Barbuda: Rastafari are allowed to use cannabis

Antigua and Barbuda has become the first Caribbean country to grant the Rastafari community official sacramental authorisation to grow cannabis. Prime Minister Gaston Browne praised the Rastafari community for their resilience over the years and granted religious and cultural group the landmark authorising under the 2018 Cannabis Act.

The Voice of 13 March 2023

Science/Cells: Delta-8-THC may be helpful in Alzheimer’s disease

In a study with nerve cells delta-8-THC protected against amyloid beta toxicity by modulating stress to the endoplasmatic reticulum thereby reducing cell death.

IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.

Gugliandolo A, et al. Int J Mol Sci. 2023;24(7):6598.

Science/Animal: CBD may reduce inflammatory pain by activation of the endocannabinoid system

According to a study with mice treated with bacterial lipopolysaccharide (LPS) CBD treatment prevented LPS induced pain by up-regulation of endocannabinoids.

Sciences of Motricity Institute, Federal University of Alfenas, Brazil.

Dos Santos RS, et al. Basic Clin Pharmacol Toxicol. 2023 Apr 19 [in press]

Science/Animal: CBD treatment showed therapeutic efficacy in a mouse model of social transfer of pain

Acute CBD administration attenuated anxiety-like behaviour, pain hypersensitivity, and anhedonic-like behaviour in cagemates that cohabited with a pair in chronic pain. In addition, repeated CBD treatment reversed the anxiety-like behaviour induced by chronic pain.

Psychobiology Group, Department of Psychology, CECH-Universidade Federal de São Carlos-UFSCar, São Carlos, Brazil.

Rodrigues Tavares LR, et al. Cannabis Cannabinoid Res. 2023 Apr 18 [ in press].

Science/Animal: CBGA ameliorates inflammation and fibrosis in kidney damage caused by cisplatin

Researchers found that CBGA (Cannabigerolic acid) protected the kidneys from cisplatin-induced kidney damage. Authors concluded that “CBGA and CBD possess reno-protective properties, with CBGA having a higher efficacy, likely due to its dual anti-inflammatory and anti-fibrotic effects paired with TRPM7 inhibition.”

Center for Biomedical Research, The Queen's Medical Center, Honolulu, USA.

Suzuki S, et al. Sci Rep. 2023;13(1):6341.

Science/Animal: CBD reduces neuropathic pain in mice

The results of a study with mice suggests that CBD produces peripheral pain reducing effects during the acute treatment of neuropathic pain and it partially involved the participation of the 5-HT1A and TRPV1 receptors.

Department of Pharmacology, Institute of Biological Sciences, UFMG, Belo Horizonte, Brazil.

Aguiar DD, et al. Biochem Biophys Res Commun. 2023;660:58-64.

Science/Animal: Magnolia officinalis may prevent gastric ulcers by involving the CB2 receptor

In a study with mice treated with a Magnolia officinalis water extract the gastric ulcer index and inflammation were ameliorated. The number of CB2 receptors increased.

Department of Veterinary Medicine, Research Center for Animal Biologics, National Pingtung University of Science and Technology, Neipu, Taiwan.

Shen KP, et al. Evid Based Complement Alternat Med. 2023;2023:7901734.

Science/Animal: The CB2 receptor may reduce alcohol -induced inflammation

Mice without CB2 receptors showed enhanced alcohol -induced inflammation and increased behavioural alterations caused by alcohol.

Department of Biology, College of Science and Health, William Paterson University, Wayne, USA.

Kibret BG, et al. Behav Brain Res. 2023:114439.

Science/Animal: THCA and CBDA may be helpful in the treatment of Alzheimer’s disease

In a mouse model of Alzheimer’s disease CBDA and THCA, the carboxylic acids of CBD and THC present in the cannabis plant, rescued memory deficits and reduced amyloid beta and tau pathology. Authors wrote that “together, CBDA and THCA may be useful therapeutic agents for treating AD.”

Department of Agricultural Biotechnology, Seoul National University, Seoul, Republic of Korea.

Kim J, et al. Int J Mol Sci. 2023;24(7):6827.

Science/Human: THC and CBD may influence sex hormones

In a study with cannabis users “anandamide, N-palmitoyl ethanolamide, androgens, estradiol, and SHBG (sex hormone binding globulin) levels were all higher in cannabis users, particularly in chronic, recent, and CBD-positive consumers. Gonadotropin levels were not significantly different in these user subpopulations, whereas prolactin and albumin concentrations were lower. In addition, cannabis users had a more basic semen pH and a higher percentage of sperm with progressive motility.”

Service of Clinical Chemistry & Toxicology, Central Institute of Hospitals, Hospital of Valais, Sion, Switzerland.

Zufferey F, et al. Andrology. 2023 Apr 12 [in press].

Science/Animal: CBD may prevent chemotherapy-induced neuropathic pain

According to a study with mice treatment with CBD prevented neuropathic pain induced by the chemotherapeutic agent paclitaxel. CBD increased spinal levels of the endocannabinoids anandamide and 2-AG.

Sciences of Motricity Institute, Federal University of Alfenas, Brazil.

Dos Santos R, et al. J Pharm Pharmacol. 2023;75(5):655-665.

Science/Animal: A synthetic derivative of CBD may be helpful in stroke

In a study with mice with ischemic stroke the synthetic CBD derivative VCE-004.8 “reduced infarct volume and improved behavioral outcomes.”

Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, USA.

Lavayen BP, et al. Neurochem Int. 2023;165:105508.

Science/Animal: CBD modulates hippocampal hyperactivity

In a study with mice CBD influenced hyperactivity in the hippocampus, a certain brain region, which adds to the knowledge of CBD’s antiepileptic effects.

Department of Neuroscience & Physiology and Neuroscience Institute, NYU Langone Medical Center, New York, USA. 6

Rosenberg EC, et al. Neuron. 2023;111(8):1282-1300.e8.

Science/Animal: Activation of the CB1 receptor may reduce itching psoriasis

A study with a mouse model of psoriasis “reveals that CB1R in sensory neurons plays a key role in psoriasiform skin inflammation and pruritus by regulating substance P expression.”

Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Liu X, et al. J Invest Dermatol. 2023;143(5):812-821.e3.