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IACM-Bulletin of 26 March 2023

Science/Human: Cannabis is safe and effective in treating severe chronic diseases

A retrospective analysis of data from 157 Australians, who were prescribed medicinal cannabis for different diseases, showed that the medication is safe and effective. Investigators of the University of New South Wales in Sydney and other academic institutions in Sydney, Australia, published the results according to which cannabis was perceived beneficial by 53.5% of patients.

There were significant changes overtime for pain, bowel problems, fatigue, difficulty sleeping, mood, quality of life, breathing problems, and appetite. For the conditions, neuropathic pain/peripheral neuropathy had the highest rate of perceived benefit (66.6%), followed by Parkinson's disease (60.9%), multiple sclerosis (60.0%), migraine (43.8%), chronic pain syndrome (42.1%), and spondylosis (40.0%). For the indications, medicinal cannabis had the greatest perceived effect on sleep (80.0%), followed by pain (51.5%), and muscle spasm (50%).

Morris M, Chye R, Liu Z, Agar M, Razmovski-Naumovski V. A Retrospective Medical Record Review of Adults with Non-Cancer Diagnoses Prescribed Medicinal Cannabis. J Clin Med. 2023;12(4):1483

Science/Human: Delta-8-THC causes similar but weaker effects as delta-9-THC

Delta-8-tetrahydrocannabinol has emerged as a new retail cannabinoid product in the United States. Investigators of the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine in Baltimore, USA, conducted a survey with 252 participants with past year delta-delta-8-THC use. They completed given and open-ended questions related to their reasons for using and past experiences with delta-8-THC-containing retail products.

Compared to delta-9-THC, self-reported ratings for "Drug effect," "Bad effect," "Sick," "Anxiety," "Paranoia," "Irritability," "Restlessness," "Memory Problems," and "Trouble Performing Routine Tasks" were lower for delta-8-THC. Qualitative responses indicated that participants used delta-8-THC because it is perceived as legal, a substitute or similar to delta-9-THC, and/or less intense than delta-9-THC.

Bergeria CL, Strickland JC, Spindle TR, Kalaba M, Satyavolu PU, Feldner M, Vandrey R, Bonn-Miller M, Peters EN, Weerts E. A crowdsourcing survey study on the subjective effects of delta-8-tetrahydrocannabinol relative to delta-9-tetrahydrocannabinol and cannabidiol. Exp Clin Psychopharmacol. 2023;31(2):312-317.

News in Brief

Science/Human: Oral THC and CBD:THC combinations did not relieve peripheral neuropathic pain in controlled study

In a placebo-controlled study with 145 patients suffering from peripheral neuropathic pain, who had failed at least one previous evidence-based treatment for neuropathic pain THC capsules and combinations of THC and CBD did not relieve symptoms.

Department of Neurology, Odense University Hospital, Odense, Denmark.

Zubcevic K, et al. Eur J Pain. 2023;27(4):492-506.

Science/Human: CBD has minimal effects on subjective effects of alcohol

In a placebo-controlled, crossover study, participants consumed 30 mg CBD, 200 mg CBD, or a placebo before receiving a standardized alcohol dose. The cannabinoid had “minimal influence” on subjective effects of alcohol.

Department of Psychology, Colorado State University, Fort Collins, USA.

Karoly HC, et al. Psychopharmacology (Berl). 2023 Mar 20. [in press].

Science/Cells: Cannabinoids may be used for cancer immunotherapy

Data suggest that specific cannabinoids (THC, CBD, CBG) may have utility in cancer immunotherapy regimens by overcoming immune escape and augmenting cancer immune surveillance in metastatic disease. “Finally, the fundamental discovery of the ability of cannabinoids to alter epigenetic programs may help elucidate many of the pleiotropic medicinal effects of cannabinoids on human physiology. “

Michael Smith Laboratories, University of British Columbia, Vancouver, Canada.

Dada S, et al. Front Immunol. 2023;13:982082

Science/Human: CBD may interact with clopidogrel increasing bleeding risks

According to a case report of a 76-year-old man with acute myocardial infarction CBD may interact with clopidogrel increasing patient’s cardiovascular or bleeding risks.

McWhorter School of Pharmacy, Samford University, Birmingham, USA.

Brown SA, et al. Sr Care Pharm. 2023;38(4):141-147.

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

In a study with mice CBD was efficient in preventing paclitaxel-induced neuropathic pain, and this effect may involve inhibition of the 4 Toll-like receptors (TLR4) on microglia spinal with activation of the endocannabinoid system.

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

Dos Santos R, et al. J Pharm Pharmacol. 2023:rgad023.

Science/Human: Mixed effects of cannabis legalisation on opioid and benzodiazepine related deaths in the USA

An analysis of deaths involving opioids and benzodiazepines in the US in 2002-2020 showed, that the implementation of medical cannabis laws resulted in a slight increase of opioid and benzodiazepine -related deaths while legalisation for recreational use reduced death risks by opioids and benzodiazepines.

Society and Health Research Center and School of Public Health, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Chile.

Castillo-Carniglia A, et al. Epidemiology. 2023 Mar 16. [in press].

Science/Human: No association between past year cannabis use and traffic accidents in elder adults

In a study with 2,095 older drivers aged 67 to 79 years investigators “did not find a statistically significant association of past-year cannabis use with MVC [motor vehicle crashes], which may indicate limited sustained effects on driving performance from periodic use among older adults, who report rarely driving immediately after use.”

Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, USA.

Davis S, et al. Traffic Inj Prev. 2023:1-8.

Science/Human: A variant of the CB1 receptor may be associated with the susceptibility of developing depression

An analysis of the gene which encodes the CB1 receptor in 59 healthy volunteers suggests that carriers of a certain gene variant (CNR1-A allele) “may be more susceptible to developing depression.”

Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr-University Bochum, Germany.

Emons B, et al. Ann Gen Psychiatry. 2023;22(1):11.

Science/Human: The legalisation of cannabis in Canada did not impact traffic accidents

An analysis of emergency department visits in Canada from 2010 to 2021 found that “Canada's recreational cannabis legalization (RCL) did not notably impact motor vehicle and pedestrian/cyclist injury.”

Injury Prevention Research Office, Division of Neurosurgery, St. Michael's Hospital, Toronto, Canada.

Walker M, et al. Addiction. 2023 Mar 12. [in press].

Science/Human: Lessons from 20 years of medical cannabis use in Canada

After 20 years of experience with medical cannabis in Canada investigators made several interesting observations. For example: “The fraction of Canadians using cannabis daily increased again after the 2018 legalization of recreational cannabis; at the same time, participation in the medical access program declined.”

Leslie Dan Faculty of Pharmacy, University of Toronto, Canada.

Shim M, et al. PLoS One. 2023;18(3):e0271079.