IACM-Bulletin of January 8, 2006

USA — Rhode Island became the 11th state to legalise the medical use of cannabis

On 3 January Rhode Island became the 11th state to legalize medical cannabis. The state House of Representatives voted 59-13, with one abstention, to override a veto by Governor Don Carcieri, allowing people with illnesses such as cancer and AIDS to grow up to 12 cannabis plants or buy 2.5 ounces (about 70 grams) of marijuana to relieve their symptoms. The law requires them to register with the state and get a photo identification card.

Federal law prohibits any use of cannabis, but Maine, Vermont, Alaska, California, Colorado, Hawaii, Montana, Nevada, Oregon and Washington passed state laws that allow it to be grown and used for medicinal purposes. Rhode Island's medical cannabis law is the third to be enacted by a state legislature. The other eight states passed ballot initiatives on this issue.

Rhode Island lawmakers passed their medical cannabis bill on 7 June 2005. Carcieri vetoed it, but the state Senate voted the next day to override his veto. An override of a governor's veto requires votes from three-fifths of the lawmakers in both chambers. Now the House followed, allowing the law to take effect immediately.

(Source: Associated Press of 3 January 2006)

UK/USA — GW received approval to conduct clinical studies the United States

GW Pharmaceuticals has received approval from U.S. regulators to conduct a Phase III study into its cannabis extract Sativex as a treatment for cancer pain, the British company said on 4 January.

GW expects to start testing the product, which is sprayed into the mouth, in U.S. patients with advanced cancer later this year. The randomised clinical trial will involve 250 people and is likely to last between 24 and 36 months, suggesting Sativex will not be ready for launch in the U.S. marketplace until towards the end of the decade.

Geoffrey Guy, GW's executive chairman, said the acceptance of the Phase III study application by the U.S. medicines control agency (Food and Drug Administration) was a significant achievement for the company that would compress the overall length of time needed to win U.S. approval by avoiding the need for earlier-stage trials.

(Source: Reuters of 4 January 2006)

News in brief

USA — Oregon

On 1 January a law took effect that increases the number of cannabis plants and the amount of dried cannabis that registered medical cannabis patients are allowed to possess in Oregon. Cardholders will now be allowed to grow up to six mature plants and 18 seedlings and to possess 24 ounces (about 700 grams) of dried cannabis. (Source: Associated Press of 26 December 2005)

Switzerland — Signatures for reform

On 13 January an initiative for the reform of the drug laws intends to hand in to the government 135,000 signatures in support of a referendum. 100,000 valid signatures are needed. The initiative aims at legalising possession, purchase and cultivation of cannabis for personal use. Furthermore, the lawmaker shall enact regualtions for the cultivation and trade with cannabis. The referendum is expected to be held in about two years. (Source: www.projugendschutz.ch)

Science — Postoperative pain

A clinical study at the University of Ulm, Germany, with 100 patients who underwent surgery (removal of the prostata) investigated possible synergistic effects of the opioid piritramide and THC in postoperative pain. Patients received either eight oral doses of 5 mg THC or placebo from the evening before the operation until the morning of the second day after surgery. Patients who received THC needed a median of 54 mg of the opioid compared to 74 mg in the placebo group. This difference was not statistically significant. Researchers concluded that they found "neither a synergistic nor even an additive" interaction between THC and the opioid in acute postoperative pain. (Source: Seeling W, et al. Anaesthesist. 2006 Jan 3, [electronic publication ahead of print])

Science — Pain

Researchers of the University of Virginia in Richmond found a synergistic effect of THC and morphine in the reduction of pain in healthy subjects. All participants received the following four treatments at four different times: 5 mg oral THC or placebo and 90 minutes later 0.02 mg/kg morphine intravenously or placebo. 15 minutes later subjects rated the pain associated with the application of thermal stimuli to the skin. While there was no effect of the combination of THC and morphine on the sensory component of pain (pain intensity), there was a significant reduction on the affective component, the stress associated with pain. (Source: Roberts JD, et al. Eur J Pharmacol 2005 Dec 20; [elctronic publication ahead of print])

Science — Inflammation of the brain

German researchers demonstrated that during inflammation of the brain the level of the endocannabinoid anandamide is elevated and protects nerve cells from damage by its effect on microglial cells. Microglial cells are immune cells in the nervous system. Their activity was reduced and controlled by anandamide. (Source: Eljaschewitsch E, et al. Neuron 2006;49(1):67-79)

Science — Alzheimer's disease

Italian researchers investigated the mechanism by which cannabidiol (CBD) inhibits the toxicity of amyloid-beta peptide on certain cells (PC12 cells). A massive accumulation of amyloid-beta is regarded to play a causal role in Alzheimer's disease (AD). Researchers note that their results "provide new molecular insight regarding the neuroprotective effect of cannabidiol and suggest its possible role in the pharmacological management of AD." (Source: Esposito G, et al. J Mol Med 2005 Dec 31, [electronic publication ahead of print])