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IACM-Bulletin of July 5, 2009


Israel β€” Significant increase in the number of patients who are allowed to use cannabis for medicinal purposes

About 700 patients are currently allowed to use cannabis for medicinal purposes and it is expected that the number surpasses 1,000 at the end of this year. The first patients received cannabis in 1999 after the Health Ministry legalized the use of the drug by severely ill patients. "I issue 40 new prescriptions every month, with an average prescription calling for 100 grams per patient per month," says Dr. Yehuda Baruch, the head of the psychiatric hospital Abarbanel in Bat Yam. Baruch is the only physician appointed by the Health Ministry to issue approvals for cannabis. The Health Ministry committee that decided to permit the medicinal use of cannabis in 1999 stipulated that the drug be given only to patients with extreme symptoms.

Until 2005 the prescriptions for medicinal cannabis were given only to ten patients. The ministry allowed them to cultivate up to ten cannabis plants, and to possess up to 200 grams of cannabis. In addition, patients may get cannabis for free from a grower who remains anonymous and is allowed to deliver cannabis to patients. There are several volunteers who are allowed to transport the drug to patients all across the country. Today cannabis is prescribed by Baruch for a broad array of diseases, among them multiple sclerosis, chronic pain, Tourette syndrome and cancer. The producer of cannabis doesn't receive any payment from the state for the production of the cannabis, and the patients don't pay for it either. However, experts say that it is clear to everyone that this cannot continue, in light of the growing demand and the cost of production. Currently it is unclear who will have to pay for cannabis then. Baruch supposes that patients will have to pay about 5 or 10 shekel (about 0,9 to 1,8 Euros) per gram in the future.

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(Source: Haaretz of 27 June 2009)

Science β€” The development of the number of new schizophrenia cases in the UK does not support the hypothesis that cannabis use increases schizophrenia risk

According to research of scientists at Keele University in Staffordshire, UK, the incidence (the number of new diagnosed cases) of schizophrenia in the years 1996 to 2005 does not support the hypothesis that cannabis use increases the risk for the development of schizophrenia or psychosis. For this study an analysis of data from 183 practices in England, Wales, Scotland and Northern Ireland was conducted. The study cohort comprised almost 600,000 patients each year, representing approximately 2.3 per cent of the UK population aged 16 to 44. Between 1996 and 2005 the incidence of schizophrenia and psychoses were either stable or declining.

A recently published study found that cannabis use increased fourfold between 1972 and 2002 and 18-fold among people under 18 years of age. If the risk of schizophrenia is elevated 1.8-fold among light users and 3.1-fold among heavy users as suggested by another study, and assuming an elevated risk for 20 years, an increase in schizophrenia incidence of 29 per cent would have been expected between 1996 and 2005. Researchers concluded that "the causal models linking cannabis with schizophrenia/psychoses are not supported by this study" and that "the underlying causes of schizophrenia/psychoses remained stable/declined over the study period."

(Source: Frisher M, Crome I, Martino O, Croft P. Assessing the impact of cannabis use on trends in diagnosed schizophrenia in the United Kingdom from 1996 to 2005. Schizophr Res. 2009 Jun 26. [Electronic publication ahead of print])

USA β€” Measure of medicinal use of cannabis introduced to House of Representatives

Barney Frank, a member of the House of Representatives, has introduced two pieces of legislation on cannabis to the House. The first would change federal law to allow states to experiment with medical cannabis without interference from the federal government. And the second would drastically reduce penalties for "personal possession" of cannabis.

The medical cannabis bill aims to fix a problem in the classification of cannabis. Federal law always trumps state law, and federal law says that cannabis is illegal, even for medical use. Federal law also states that cannabis has no medical value, and therefore even doctors who prescribe it are at risk of legal trouble with the federal government for doing so. The first of Frank's bills, is titled "The Marijuana Patient Protection Act" and "would prevent federal authorities from prosecuting pharmacies, growers and users of medical marijuana in states where the use of the substance for medical reasons is legal."

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(Sources: Press release by Barney Frank of 19 June 2009, Huffington Post of 22 June 2009)

News in brief

Science β€” Osteoporosis

Variants within the gene that encodes the cannabinoid-2 receptor have been shown to be associated with osteoporosis and low bone mineral density. New research from the University of Bonn, Germany, shows that variations of this gene are associated with the strength of hand bones. (Source: Karsak M, et al. Hum Genet 2009 Jun 30. [Electronic publication ahead of print])

Science β€” Opiate dependence

According to animal research by a French group THC influences the vulnerability to opiate use different in normally treated rats and animals whose contact to their mother was interrupted after birth. It worsened the vulnerability to opiates in normal animals, but improved the deficits in maternal neglected rats. Authors noted that "these findings point to the self-medication use of cannabis in subgroups of individuals subjected to adverse postnatal environment." (Source: Morel LJ, et al. Neuropsychopharmacology 2009 Jun 24. [Electronic publication ahead of print])

Science β€” Macular degeneration

Age related macular degeneration is a cause of blindness and retinal pigment epithelial cells play a key role in initiating and developing of this disease. The macula is a central part of the retina. Researchers of the University of Shanghai, China, demonstrated that several synthetic cannabinoids acting on CB1 and CB2 receptors protected these cells. They concluded that the "modulation of cannabinoid receptor tone warrants consideration for future therapeutic strategies of ARMD." (Source: Wei Y, et al. Mol Vis 2009;15:1243-51.)

Science β€” Schizophrenia

Earlier animal research has shown that THC increases the rate of dopamine release in the striatum (a brain region) leading to vulnerability to psychosis. New research from the Hammersmith Hospital in London, UK, shows that the administration of 10 mg oral THC to 13 healthy volunteers did not result in a release of significant amounts of dopamine. Scientists concluded that these moderate THC doses do not result in significant dopamine release and that their observations "challenge current models of striatal dopamine release as the mechanism mediating cannabis as risk factor for schizophrenia." (Source: Stokes PR, et al. Neuroimage 2009 Jun 16. [Electronic publication ahead of print])

Science β€” Migraine

Researchers of the University of Manchester, UK, demonstrated that variations in the gene encoding the CB1 receptor predisposes to migraine. They compared 684 healthy controls with 195 migraine headache sufferers. (Source: Juhasz G, et al. Neurosci Lett 2009 Jun 17. [Electronic publication ahead of print])

Science β€” Kaposi's sarcoma

Researchers of the University of Catania, Italy, showed that a synthetic cannabinoid (WIN 55,212-2), which binds both to the CB1 and CB2 receptor decreases the viability of Kaposi's sarcoma cells. Kaposi's sarcoma is a cancer that is often observed in AIDS patients. (Source: Luca T, et al. Eur J Pharmacol 2009 Jun 17. [Electronic publication ahead of print])

Science β€” Pain

According to research at the University of Miami, USA, the pain relieving effects of the synthetic cannabinoid WIN 55,212-2 did not undergo the development of tolerance within 7 days in a rat model of neuropathic spinal cord injury pain. By contrast, the efficacy of morphine decreased over the same treatment period. (Source: Hama A, et al. J Rehabil Res Dev 2009;46(1):135-43.)