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IACM-Bulletin of 31 December 2023

Ukraine: Parliament backs the legalisation of cannabis for medical use, but the bill is blocked by an opposition party

Ukraine’s Batkivshchyna (Fatherland) parliamentary faction has blocked the signing of a bill legalizing the use of medical cannabis, which was approved by the 248 deputies of the Ukrainian Verkhovna Rada, the Ukrainian parliament, on 21 December. The bill will remain blocked until mid-January when it may potentially be unblocked by the parliament and signed by the president. "And since the law will come into force only in six months, it will start working around July 2024," Member of Parliament Jaroslav Zalizniak wrote on Telegram.

The leader of Batkivshchyna, Yulia Tymoshenko, who has consistently opposed the initiative, said that the party intends to appeal to the Constitutional Court to cancel the results of the vote because "the amendments to the bill were considered in a half-empty chamber.” The co-chair of European Solidarity, the second opposition party, Irina Herashchenko claimed that the text of the bill was more about industrial production than medical cannabis and lacked clear state regulation. On 21 December the Ukrainian parliament supported the bill on medical cannabis at second reading. It will regulate the circulation of cannabis exclusively for medical, industrial, and scientific activities.

Yahoo News of 22 December 2023

Reuters of 21 December 2023

Science/Human: THC may improve cognitive function in cancer patients receiving palliative care

According to a small study with 8 adult advanced cancer patients oral THC may improve cognitive function. Patients suffered from severe pain refractory to conventional treatment and received palliative care. The study was conducted by investigators of the Centre for Clinical Research of the North Denmark Regional Hospital in Hjørring, Denmark.

Two patients discontinued THC therapy, one due to a complaint of dizziness and another critical progression of cancer disease, respectively. The remaining six patients were successfully treated with a daily dosage of 12.5 mg THC. Besides reducing pain cognitive function improved in this group of patients.

Buchwald D, Schmidt C, Buchwald D, Winter KI, Nielsen IB, Klostergaard K, Melgaard D, Fagerberg SK, Leutscher PDC. Impact of Low-Dose Dronabinol Therapy on Cognitive Function in Cancer Patients Receiving Palliative Care: A Case-Series Intervention Study. Palliat Med Rep. 2023;4(1):326-333.

Science/Human: Cannabis may be combined with opioids to further reduce pain and reduce opiate toxicity

According to a a single-arm study with 66 hospice inpatients at The Connecticut Hospital, USA, adding cannabis to opioid treatment may improve outcome. Patients received opioids for pain and were administered oral CBD-rich cannabis, 40 mg CBD/1.5 mg THC or 80 mg CBD/3 mg THC. Average age was 68 years and cancer was the most common diagnosis.

The cannabis/opioid combination showed a significant longitudinal reduction in pain intensity and a non-significant trend toward lower opioid doses. Well-being, appetite, nausea, and respiratory function showed non-statistically significant changes.

Zanker T, Sacco J, Prota J, Palma M, Viola Lee KA, Wang RR, Liang Y, Cunningham J, Mackary M, Ovchinnikova P. Medical Marijuana for Pain Management in Hospice Care as a Complementary Approach to Scheduled Opioids: A Single Arm Study. Am J Hosp Palliat Care. 2023:10499091231213359.

Science/Human: Cannabis may improve sleep in patients with anxiety

According to a study with 347 patients with intentions to use cannabis to cope with anxiety cannabis may improve sleep. They reported their cannabis and alcohol use in the previous 24 h and their previous nights' sleep quality for 30 consecutive days to investigators of the School of Public Health at the University of Haifa, Israel.

Compared to non-use, participants reported better sleep after cannabis-use-only and after co-use, but not after alcohol-use-only. People who more frequently use alcohol and cannabis reported sleeping better after cannabis-use-only days compared to those who use cannabis and alcohol less frequently.

Sznitman SR, Martin-Willett R, Ma W, Karoly HC, Bidwell LC. Daily diary study of associations between alcohol, cannabis, co-use and sleep quality in individuals with intentions to use cannabis to cope with anxiety. Drug Alcohol Rev. 2023;1-11.

News in brief

Science/Human: The legalisation of cannabis for adults may not cause increased use by young adults

According to an analysis of 2 cohorts of 18 to 20 year old cannabis users in California legalisation of the drug for adults frequency of cannabis use (days or hits per day)” was not influenced by legalisation.

Dornsife School of Public Health, Department of Community Health and Prevention, Drexel University, Philadelphia, USA.

Fedorovaa EV, et al. J Psychoactive Drugs. 24 November 2023.

Science/Cells: Essential oils from cannabis may reduce inflammation in the nervous system

In studies with microglial cells essential oils of cannabis were shown to reduce inflammation. “The sesquiterpenes (E)-caryophyllene, α-humulene, and caryophyllene oxide were identified as the main contributors to the essential oils' anti-inflammatory activity.”

Department for Life Quality Studies, Alma Mater Studiorum-University of Bologna, Rimini, Italy.

Barbalace MC, et al. Int J Mol Sci. 2023;24(23):16601.

Science/Cells: Amyloid beta evoked toxicity to the nervous system may be mitigated by alpha and beta pinenes

It is thought that the formation of amyloid beta causes neurotoxicity in Alzheimer’s disease. New research shows that the terpenes alpha pinenes and beta pinenes may mitigate this effect.

Discipline of Pharmacology, School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Australia.

Laws JS 3rd, Smid SD. Neurotoxicology. 2023;100:16-24.

Science/Cells: Certain proteins may enhance the anticancer effects of CBD

In a study with human colorectal cancer cells metallothionein family proteins synergistically enhance the anticancer effects of CBD.

Department of Biological Sciences, College of Natural Sciences, Kangwon National University, Chuncheon, Kangwon, Republic of Korea.

Kwon IS, et al. Int J Mol Sci. 2023;24(23):16621.

Science/Cells: Cannflavins of the cannabis plant may be used against SARS-CoV-2

Cannabis contains cannflavin A, B and C. “In silico ADMET studies indicated favourable drug-like properties for all three compounds, suggesting their potential as anti-SARS-CoV-2 agents.”

National Center for Natural Products Research, School of Pharmacy, University of Mississippi, USA.

Wanas AS, et al. Nat Prod Res. 2023:1-14.

Science/Human: Moderate cannabis use may be associated with a better vascular response of the penis to prostaglandin injections

In study with 4800 men with sexual dysfunction, “mild cannabis consumption may be associated with a more favorable anthropometric and lipid profile and with a better penile arterial vascular response to intracavernous prostaglandin injection.”

Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, Coppito, L'Aquila, Italy.

Barbonetti A, et al. Andrology. 2024;12(1):9-19.

Science/Human: THC and CBD increase the level of sex hormones

“Anandamide, N-palmitoyl ethanolamide, androgens, estradiol and sex hormone binding globulin levels were all higher in cannabis users, particularly in chronic, recent and cannabidiol-positive consumers. (…) In addition, cannabis users had a more basic semen pH and a higher percentage of spermatozoa with progressive motility. However, the two latter observations seem to be related to a shorter period of sexual abstinence in this group rather than to the use of cannabis.”

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

Zufferey F, et al. Andrology. 2024;12(1):56-67.

Science/Cells: CBD stimulates the production of anti-inflammatory mediators in the immune system

In studies with human macrophages CBD was shown to stimulate the production of so-called SPMs (specialised pro-resolving mediators) and suppress the biosynthesis of pro-inflammatory eicosanoids.

Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich Schiller University, Jena, Germany.

Peltner LK, et al. Cell Chem Biol. 2023;30(12):1508-1524.e7.

Science/Human: Cannabis use may be associated with an increased risk of experiencing cardiovascular diseases

“Canadian adults with cannabis use disorder appear to have an approximately 60% higher risk of experiencing incident adverse cardiovascular disease events than those without cannabis use disorder.”

Department of Psychiatry, University of Calgary, Calgary, Canada.

Bahji A, et al. Addiction. 2024;119(1):137-148.

Science/Human: Cannabis exposure during pregnancy may have negative effects on white matter of the brain of children

According to a study with 11,530 children with a mean age of about 10 years there may be “small, yet reliable, effects” of prenatal cannabis exposure on “white matter integrity during childhood, particularly in the fornix, which plays a crucial role in emotion- and memory-related processes.”

Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA.

Evanski JM, et al. Biol Psychiatry Glob Open Sci. 2023;4(1):11-18.

Science/Human: Cannabis use in adolescence may be associated with reduced memory

According to a study with 246 adolescents aged 13 to 14 years those “who had used cannabis showed lower scores on an episodic memory task, and more cannabis use was linked to poorer performances on verbal, inhibitory, working memory, and episodic memory tasks.”

Department of Psychiatry, University of California, San Diego, USA.

Wade NE, et al. Addict Behav. 2024;150:107930.

Science/Animal: Activation of the CB2 receptor may improve contractile performance of the heart

In a study with hearts of fish (Brycon amazonicus) activation of the CB2 receptor improved cardiac contractile performance. “Hence, CB2 receptors could be considered a potential therapeutic target for modulating cardiac contractile dysfunctions.”

Department of Physiological Sciences, Federal University of São Carlos (UFSCar), São Paulo, Brazil.

Gonçalves YC, et al. Comp Biochem Physiol C Toxicol Pharmacol. 2023:109822.

Science/Animal: The combination of CBD and amitriptyline may improve reduction of inflammatory pain

In a study with mice both CBD and amitriptyline showed pain relieving effects in an inflammatory pain model. “Additionally, the combination of CBD and AT was found to have enhanced antinociceptive effects that is partially reliant of 5-HT1A receptors and supports the use of CBD within a multimodal approach to pain.”

Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, USA.

Barnes RC, et al. J Pharmacol Exp Ther. 2023:JPET-AR-2023-001855.

Science/Human: Endocannabinoid levels may be increased in patients with borderline personality disorder

In a study with 49 female patients suffering from borderline personality disorder and 32 healthy controls researchers found increased anandamide levels and by trend augmented 2-AG levels in blood. They wrote that this may relate to compensatory activity of the endocannabinoid system.

Department for Child and Adolescent Psychiatry and Psychotherapy, Ulm University Medical Centre, Ulm, Germany.

Spohrs J, et al. Int J Mol Sci. 2023;24(24):17452.

Science/Human: Cannabis use may not be associated with a higher risk of arterial fibrillation

In a study with 150,554 participants researchers did not find an increased risk of arterial fibrillation in cannabis users.

Division of Cardiology, Department of Medicine, University of California, San Francisco, USA.

Teraoka JT, et al. Heart Rhythm. 2023:S1547-5271(23)03058-8.

Science/Human: Lifetime cannabis use frequency may have limited psychological and social effects

According to a study with 4087 adults twins from the US, who were followed for more than 30 years, cannabis use had only measurable effects of 3 of 22 assessed outcomes, namely cannabis use disorder, frequency of tobacco use and illicit drug involvement. There was no effect on the other 19 assessed outcomes.

Department of Psychology, University of Minnesota, USA.

Zellers S, et al. J Psychopathol Clin Sci. 2024;133(1):115-128.

Science/Human: Cannabis use before exercise influences the subjective exercise experience

According to a study with 42 regular cannabis users “participants reported a more positive affect (p < 0.001), enjoyment (p < 0.001), and runner's high symptoms (p < 0.001) during their cannabis (vs non-cannabis) exercise appointment, they also reported more exertion (p = 0.04).”

Department of Psychology and Neuroscience, University of Colorado Boulder, USA.

Gibson LP, et al. Sports Med. 2023 Dec 26. [in press]