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IACM-Bulletin of July 10, 2016


Science USA — Elderly patients were prescribed fewer medicinal drugs if they had access to medical cannabis

Physicians wrote significantly fewer prescriptions for painkillers and other medications for elderly and disabled patients who had legal access to medical cannabis, a new study finds. Medicare saved more than 165 million dollars in 2013 on prescription drugs in the District of Columbia and 17 states that allowed cannabis to be used as medicine, researchers calculated. Medicare is a national social insurance program of the USA. If every state in the USA legalized medical cannabis, the study forecast that the federal program would save more than 468 million dollars a year on pharmaceuticals for disabled Americans and those 65 and older.

No health insurance, including Medicare, will reimburse for the cost of cannabis. Although medical cannabis is legal today in 25 states and the District of Columbia, federal law continues to prohibit its prescription in all circumstances. The new study, published July 6 in Health Affairs, was the first to ask if there’s any evidence that medical cannabis is being used as medicine, senior author W. David Bradford told Reuters in a phone interview. The answer is yes, said Bradford, a health economist and a professor at the University of Georgia in Athens. “When states turned on medical marijuana laws, we did see a rather substantial turn away from FDA-approved medicine,” he said.

Bradford AC, Bradford WD. Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D. Health Aff (Millwood) 2016;35(7):1230-1236.

Reuters of 6 July 2016

Science/Human — A CBD extract reduced frequency of seizures in a rare form of epilepsy

The British company GW Pharmaceuticals said its CBD extract Epidiolex met the main goal to reduce frequency of seizures in a placebo-controlled phase 3 clinical study. The company said the drug significantly reduced the monthly frequency of short-term seizures in people suffering from a rare form of epilepsy called Lennox-Gastaut syndrome (LGS). The trial randomized 171 patients into two arms, where Epidiolex 20mg/kg body weight per day (n=86) or placebo (n=85) was added to current medication.

“From a physician’s perspective, the positive outcome in this trial of Epidiolex in patients with Lennox-Gastaut syndrome is very exciting. Lennox-Gastaut syndrome begins in early childhood, is particularly difficult to treat, and the vast majority of patients do not obtain an adequate response from existing therapies,” stated Dr Linda Laux, Director of the Comprehensive Epilepsy Center at Ann & Robert H. Lurie Children's Hospital of Chicago and an investigator in the trial. “These data show that Epidiolex has the potential to provide a robust and clinically meaningful reduction in seizures in this highly treatment-resistant population together with an acceptable safety and tolerability profile, which is consistent with my previous clinical experience with Epidiolex.”

Press release by GW Pharmaceuticals of 27 June 2016

Reuters of 27 June 2016

Japan — First voices in support of the medical use of cannabis

Japan prides itself on having a low tolerance for guns and drugs, but a tiny political party has become the first to support the medical use of cannabis. Japan outlaws owning and growing cannabis, despite a trend in advanced countries, such as Canada and the United States, to free up medical use. "Faced with this sharp gap between Japan and the rest of the world, the public are at a loss which to believe," said Saya Takagi of the New Renaissance Party (Shintō Kaikaku), founded by a former member of Prime Minister Shinzo Abe's ruling party.

The idea of legalising medical use finds backers among Japan's growing ranks of senior citizens, who make up just over a quarter of the population of 127 million. The government says legalising cannabis for medical use is premature, without scientific proof. "We are not saying cannabis should be freed from all restrictions," said Minoru Arakaki, the head of the Japanese Clinical Association of Cannabinoids (JCAC). "All we are saying is, let's conduct research to see what harm and benefit it can bring, and let's use it if it turns out to be useful."

Reuters of 7 July 2016

News in brief

Science Australia — The efficacy of cannabis will be tested in melanoma

Researchers at the University of Canberra will collaborate with the Israel-based company Cann Pharmaceutical to test the efficacy of medicinal cannabis in treating melanoma. The university announced a 1 million dollar deal to provide specific strains of cannabis, which will be administered to melanoma patients along with the current standard of care.

ABC News of 30 June 2016

Science/Human — Problematic use of opioids is more common in pain patients than problematic cannabis use

In a study with 888 pain patients, those who were treated with opioids showed problematic opioid use in 52.6% according to DSM-IV. Among those, who were treated with cannabis prevalence of problematic use was 21.2%.

Department of Psychology, Ariel University, Israel.

Feingold D, et al. Pain Med. 2016 Jun 26. [in press]

Science/Cells — The inflammation induced by amyloid beta in Alzheimer’s disease is blocked by THC

A study with human nerve cells shows that amyloid beta, which is highly present in Alzheimer’s disease, causes inflammation. THC was shown to stimulate the removal of amyloid beta in the nerve cells, to block the inflammatory response, and to be neuroprotective.

The Salk Institute for Biological Studies, La Jolla, USA.

Currais A, et al. Aging and Mechanisms of Disease 2016;2:16012

Science/Animal — Beta-caryophyllene modulates inflammation caused by tuberculosis bacterium

By activating the CB2 receptor beta-caryophyllene modulated the inflammation caused by Mycobacterium bovis in mice. Mycobacterium bovis is a bacterium and the causative agent of tuberculosis in cattle. Authors wrote that “these results suggest that the CB2 receptor may represent a new target for modulating the inflammatory reaction induced by mycobacteria.”

Instituto de Tecnologia em Fármacos-Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.

Andrade-Silva M, et al. Inflamm Res. 2016 Jul 5. [in press]

Science/Animal — The activation of the GPR55 receptor promotes metastasis in breast cancer

An elevated concentration of the GPR55 receptor in human tumours was shown to be associated with the aggressive triple-negative breast cancer population, higher probability to develop metastases, and therefore poor patient prognosis. Activation of GPR55 by its assumed endogenous ligand lysophosphatidylinositol promotes metastasis.

School of Biology, Complutense University, Madrid, Spain.

Andradas C, et al. Oncotarget. 2016 Jun 21. [in press]

Science/Human — In a case report the combination of paliperidone and olanzapine with cannabis caused delirium

An overdose of the antipsychotic medications paliperidone and olanzapine together with cannabis caused delirium, a confusional state, in one patient.

University Psychiatric Clinic Ljubljana, Slovenia.

Kokalj A, et al. BMJ Case Rep. 2016 Jun 22;2016.