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IACM-Bulletin of 27 August 2023
The 13th IACM Conference on Cannabinoids in Medicine will be held in Aberdeen, Scotland, from
11-13 April 2024. The Conference is dedicated to Professor Roger Pertwee, who turned 80 last year and worked at the University of Aberdeen for many decades. We also want to celebrate the life's work of Professor Raphael Mechoulam, who passed away this spring. The two worked closely together, including on the discovery of the first endocannabinoid that they named anandamide in 1992. Both are outstanding pioneers in cannabis research and both have served as past chairs of the IACM Board of Directors.
Focus areas of discussion at the IACM 2024 conference will be:
11 April: What we know: reviews and education
12 April: What we discuss: controversies
13 April: Where we go: future directions
The Scientific Committee of the meeting consisting of Daniel Piomelli, Manuel Guzman, Ken Mackie, Raquel Peraube, Jose Crippa, Debra Kimless, Ziva Cooper, Carola Perez, and Franjo Grotenhermen is working on the programme. We are open for suggestions of possible speakers and topics. The call for abstracts will be published at a later stage in autumn.
Germany's cabinet passed a contentious bill on 16 August to legalize recreational cannabis use and cultivation, one of the most liberal cannabis laws in Europe that could potentially provide further momentum for a similar worldwide trend. The legislation, which still has to pass parliament, would allow adults to possess up to 25 grams of the drug, grow a maximum of three plants, or acquire cannabis as associates of non-profit cannabis clubs.
The centre-left government of Chancellor Olaf Scholz hopes the law will curb the black market, protect consumers against contaminated cannabis and reduce drug-related crime. A key pillar of the plan, which removes the taboo around cannabis use, is also a campaign to raise awareness about the risks, which should ultimately curb consumption, said Health Minister Karl Lauterbach, of Scholz's Social Democrats (SPD).
Parliament has passed the Narcotics and Psychotropic Substances (Control) Bill, 2023 which now allows the licenced farming and use of cannabis strictly for medical use, and sets harsh penalties for a multitude of offences related to substances abuse.
The bill follows three grueling sittings in which Members of Parliament had lengthy deliberations on its provisions. If assented to by the President, Clause 1 gives the Bill an immediate enforceability, in what the Chairperson of the Committee on Defence and Internal Affairs, Hon. Wilson Kajwengye, said was the urgency to plug loopholes in the regulation of narcotics and psychotropic substances. “The committee posits that all licences and permits to be issued under this Act should centrally be issued by the Ministry responsible for Health since the permission to use narcotic drugs and psychotropic substances is restricted to only medical purposes; the Ministry of Internal Affairs should remain the enforcement arm of the Government,” he said.
According to a placebo-controlled study with 54 gynaecologic cancer patients a cannabis extract helps to reduce chemotherapy-induced nausea and vomiting. The study was conducted at the Gynecologic Oncology Units, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Bangkok, Thailand, in 2022. Participants received either a cannabis extract containing THC and CBD in equal parts or a placebo.
The nausea score of the cannabis and placebo groups were 2.11 and 2.99, respectively. More than half of the participants (36/54) reported dizziness and sedation side effects. Dry mouth, confusion, anxiety, and palpitation of both groups were comparable.
Sukpiriyagul A, Chartchaiyarerk R, Tabtipwon P, Smanchat B, Prommas S, Bhamarapravatana K, Suwannarurk K. Oral Tetrahydrocannabinol (THC):Cannabinoid (CBD) Cannabis Extract Adjuvant for Reducing Chemotherapy-Induced Nausea and Vomiting (CINV): A Randomized, Double-Blinded, Placebo-Controlled, Crossover Trial. Int J Womens Health. 2023;15:1345-1352.
In a placebo-controlled crossover study with 12 patients CBD enhanced the efficacy of standard treatment of blepharospasm, causing abnormal contractions of the eyelid muscle. In this study by Silkiss Eye Surgery, San Francisco, USA, and other US institutions all patients underwent routine maximal botulinum toxin therapy and experienced breakthrough symptoms. Participants received their standard botulinum toxin treatment every 3 months.
All 12 patients completed the study without adverse events. CBD decreased median eyelid closure amplitude by 19.1%, decreased median eyelid closure duration by 15.8%, and increased the maximum eyelid closure velocity by 34.8%.
Many patients with ulcerative colitis after ileoanal pouch anastomosis report improvement of pouchitis with the use of cannabis. Nine patients with chronic pouchitis used 1 g cannabis daily: 7 of the 9 patients were male with average age 51 years. The study was conducted by investigators of the Institute of Gastroenterology and Hepatology at Meir Medical Center in Kfar Saba, Israel, and other scientific institutions from Israel.
Average partial pouchitis disease activity index were 11 before cannabis treatment, 6 after 8 to 12 weeks and 5 after 52 weeks. Average bowel movements per day were 14, 8, and 10. Quality of life increased from 72 before start of the treatment to 90 after 8 to 12 weeks and 97 after 52 weeks.
Naftali T, Bar-Lev Schleider L, Kayless H, Bromberg Z, Dotan I, Broide E. Cannabis Improves Clinical Outcomes and Quality of Life in Patients With Chronic Pouchitis. ACG Case Rep J. 2023;10(8):e01131.
In a study with 100 patients receiving medical cannabis investigators of the Department of Nursing at the University of West Attica in Athens, Greece observed an increased quality of life. The majority of patients who received medical cannabis to treat their neurological disorders (58%) reported decrease in their symptoms (96%), better energy and vitality (68%), ability to perform their professional duties (88%), and an improvement in sleeping and appetite (79% and 71%, respectively) after receiving medical cannabis.
Participants exhibited very few restrictions in activities due to emotional difficulties, a moderate general health status as well as moderate vitality and energy. Participants, who reported a longer period of receiving medical cannabis, reported statistically significant more energy and vitality, but also better mental and general health status.
Investigators of Canopy Growth Corporation in Smiths Falls, Canada, found some sex differences between the effects of oral THC-rich cannabis in a placebo-controlled study with healthy adults. They received placebo, low-dose THC (2.5 or 5 mg per dose), or high-dose THC (7.5 or 10 mg per dose) twice daily for 7 days. There were 38 males (8 placebo, 17 low-dose THC, 13 high-dose THC) and 46 females (8 placebo, 17 low-dose THC, 21 high-dose THC).
In the placebo and low-dose THC groups, there were no sex differences in the relative rate of adverse events. In the high-dose THC group, females versus males reported 3.1 times as many adverse events. There were no significant interactions of sex×low-dose THC group for any subjective effect. In the high-dose THC group, females versus males reported greater "relaxed" ratings, whereas in the placebo group, males versus females reported greater ratings of "liking the effect."
MacNair L, Eglit GML, Mosesova I, Bonn-Miller MO, Peters EN. Sex Differences in the Safety and Subjective Effects of Two Oral Δ9-Tetrahydrocannabinol-Containing Cannabis Products over Multiple Doses Among Healthy Adults. Cannabis Cannabinoid Res. 2023 Aug 11. [in press]
Using the 2010-2021 state-level U.S. private health insurer financial data from the National Association of Insurance Commissioners investigators of the Department of Economics at Bowling Green State University, USA, found out that the implementation of medical cannabis laws resulted in the reduction of health insurer premiums by more than $1500 per year.
Seven years after the implementation of Medical Cannabis laws, researchers observed lower health insurer premiums in the individual market. They found a reduction of 1663 dollars for states which implemented medical cannabis laws compared to the control group, a reduction of 1542 dollars in year 8, and a reduction of 1626, in year 9. Authors wrote: “As healthcare costs continue to rise, our findings suggest that households that obtain their health insurance on the individual (i.e., not employer sponsored) market in states with medical cannabis laws appreciate significantly lower premiums.”
Half of Americans (50%) say they have tried cannabis at some time, a new high point for this behaviour that has been inching up over the past quarter century. While essentially unchanged from the 49% and 48% readings in 2021 and 2022, respectively, the new figure is statistically higher than the 45% in 2017 and 2019.
CBD enhanced the induction of apoptosis (programmed cell death) by the chemotherapeutic agent cabozantinib in liver cancer cells (hepatocellular carcinoma).
Natural Products Research Center, Korea Institute of Science and Technology.
In experiments with skin cells (keratinocytes) the natural cannabinoids CBD (cannabidiol) and CBG (cannabigerol) both cannabinoids prevented healthy cells from damage by UVA-radiation “without significantly reducing the therapeutic effect of UV radiation used to treat skin diseases such as psoriasis.”
Dermatological Specialized Center "DERMAL" NZOZ in Białystok, Poland.
In a mouse model of fragile X syndrome the natural cannabinoid CBDV (cannabidivarin) was able to prevent the development of neurobehavioural abnormalities of the disease. Authors highlighted “the relevance of its early administration.”
Univ. Bordeaux, France.
Science/Animals: CBD may show anti-tumour effects in colon cancer by influencing the microenvironment of the tumour
In studies with mice CBD was shown to inhibit “colorectal cancer progression by modulating the suppressive tumor microenvironment.” Authors concluded that “taken together, we provide new insights into the anti-tumor effects of CBD.”
Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing University, China.
The data of 138 children, who presented at an emergency department with cannabis intoxication were analysed. 52 were omitted to an intensive care unit, including one patient who died. Authors wrote that “young children, all of whom were exposed to edibles, were at higher risk of severe outcomes. Teenagers with severe outcomes were frequently involved in polysubstance exposure, while psychosocial factors may have played a role.”
Division of Emergency Medicine, The Hospital for Sick Children, Toronto, Canada.
In a mouse model for tibial fracture “CBD and CBG normalized pain sensitivity to all tested stimuli, and their analgesic effects were comparable to those of the NSAIDs. Interestingly, CBD and CBG promoted bone healing via multiple mechanisms during the early and late phases.”
Department of Orthopaedics and Rehabilitation, The Pennsylvania State University College of Medicine, Hershey, USA.
In studies with mice CBD alleviated inflammation and fibrosis of the liver induced by perfluorooctane sulphonate (PFOS). “Our study reveals the mechanism of PFOS-induced hepatotoxicity and provides promising insights into the protective role of CBD in this process.”
College of Veterinary Medicine, Northeast Agricultural University, PR China.
In a mouse model of diabetes beta-caryophyllene, a terpene and CB2 receptor agonist of the cannabis plant and other plants (including pepper), was shown to alleviate heart damage (cardiomyopathy).
Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Al Ain, United Arab Emirates.
Ten patients with schizophrenia were compared to non-psychiatric people and researchers “examined total CB1R levels and CB1R levels within excitatory (vGlut1-positive) and inhibitory (vGAT-positive) boutons of prefrontal cortex samples. Significantly higher total CB1R levels were found within samples from individuals with schizophrenia. Terminal type-specific analyses identified significantly higher CB1R levels within excitatory boutons in samples from individuals with schizophrenia relative to comparisons.”
Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA.
Science/Human: Blood levels of anandamide are higher in painful than in painless diabetic neuropathy
An analysis of participants of the Pain in Neuropathy Study, multicentre research project, in which painful and non-painful neuropathies were compared, showed that “serum levels of anandamide were significantly higher in the painful group, but the effect size was small.”
Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.
“We found that CBD was hydroxylated mainly by CYPs 2C8, 2C19, 2D6; CBN by 1A2, 2C9, 2C19 and 2D6; and CBG by 2B6, 2C9, 2C19 and 2D6. CBC exhibited higher susceptibility to CYP-mediated transformation than the other tested compounds, mainly with CYPs 1A2, 2B6, 2C8, 2C19, 2D6 and 3A4 being involved.”
Department of Medical Chemistry and Biochemistry, Faculty of Medicine and Dentistry, Palacky University, Czech Republic.
The effects of a synthetic cannabinoid (WIN55212-2) on blood vessels in the retina of the eye were investigated. It “dilated noradrenaline-precontracted capillaries in a concentration-dependent manner.” This effect was mediated by activation of the CB1 receptor.
Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, People's Republic of China.
Researchers found synergistic effects of beta-asarone and CBD in the formation of amyloid beta in a model of Alzheimer’s disease. They showed “that it may also slow aging, decrease the rate of paralysis, enhance learning capacity, and boost autophagy activity in C. elegans”, a nematode.
School of Chemistry and Chemical Engineering, Harbin Institute of Technology, China.
According to an analysis of 149 schizophrenia patients and 167 controls the “cannabinoid receptor gene CNR1 is downregulated in subcortical brain samples and upregulated in blood samples of individuals with schizophrenia.”
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.