IACM-Bulletin of July 6, 2008

Germany — Parliament debates proposals for medical use of cannabis

On 26 June, the German Bundestag (lower house of parliament) debated two similar proposals re. the medical use of cannabis submitted by the Green Party and "The Left", respectively. Speakers from all 5 parties represented in the Bundestag and the federal drug commissioner Sabine Baetzing (Social Democrats) participated. On 15 October 2008 the Health Committee of the Parliament will hold a public expert hearing on the subject.

Speeches by Detlef Parr (Free Democrats), Monika Knoche (The Left) und Dr. Harald Terpe (Green Party) included clear demands for improvements to the access to cannabis medicines and an end to criminal prosecution for the severely ill. "We have to help the victims by establishing legal security" Mr. Parr explained. The two representatives of the Social Democrats (Dr. Marlies Volkmer, Sabine Baetzing) showed compassion and understanding for the suffering of the patients but fell short of offering changes to the law. The representative of the Christian Democrats, Maria Eichhon largely missed the topic and emphasized the dangers of cannabis consumption for minors.

"None of us doubts that for many people cannabis is a helpful medicine" stated Ms. Blaetzing on behalf of the federal government. But she pointed out that a change in law to the benefit of patients is currently not an option because "the medical benefits of cannabis, except for the use of dronabinol in certain indications, had not been proven conclusively." Thus, the Federal Institute for Pharmaceuticals and Medical Products would continue to evaluate the safety of the therapeutic use of cannabis on a case-by-case basis, even though the application process for all involved is considerably more demanding than the prescription of a narcotic and could "hardly be expected" of the patients. So far, the Institute, an arm of the Federal Ministry of Health, has issued permits to use cannabis to 10 patients and rejected 32 applications.

The text of the speeches can be found at the IACM website at

http://www.cannabis-med.org/german/bundestag_2008.pdf

(Source: German Bundestag, protocol of the 172nd meeting of the 16th parliament of 26 June 2008)

Economy — Generic version of dronabinol available

On 30 June Watson Pharmaceuticals announced that, under a supply agreement with Solvay Pharmaceuticals, Watson has launched the authorized generic version of dronabinol in capsules of 2.5, 5 and 10 mg of the drug. Dronabinol is the international non-proprietary name (INN) of a natural cannabinoid of the cannabis plant. Marinol capsules of Solvay Pharmaceuticals contain synthetic dronabinol, indicated to treat nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments. Dronabinol is also indicated to treat anorexia associated with weight loss in patients with AIDS. For the year 2007 Solvay reported Marinol sales of 105 million US Dollars (about 66 million Euros).

Under the terms of the supply agreement, Solvay Pharmaceuticals will supply the dronabinol capsules to Watson Pharmaceuticals, which will market, sell and distribute the product in the United States. Solvay Pharmaceuticals will receive a share of the profits from Watson's sales of the generic product in the U.S. market. Watson Pharmaceuticals has its headquarter in Corona, California. The company develops, manufactures, markets, sells and distributes brand and generic pharmaceutical products.

More at:

http://ir.watson.com/phoenix.zhtml?c=65778&p=irol-newsArticle&ID=1170280

(Source: Press release by Watson Pharmaceuticals of 30 June 2008)

Science World — Cannabis use is not simply related to drug policy, a study by the WHO finds

According to a study, which describes data from the first 17 countries participating in the World Mental Health Survey Initiative of the World Health Organization (WHO), "drug use is not distributed evenly and is not simply related to drug policy, since countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones."

Surveys with a combined sample size of 85,052 were carried out in the Americas (Colombia, Mexico, United States), Europe (Belgium, France, Germany, Italy, Netherlands, Spain, Ukraine), Middle East and Africa (Israel, Lebanon, Nigeria, South Africa), Asia (Japan, People's Republic of China), and Oceania (New Zealand). The prevalence and correlates of a wide variety of mental and substance disorders were assessed. Cannabis use in the United States and New Zealand (both 42 per cent) was far higher than in any other country and was more than twice the rate of cannabis use in the Netherlands. The percentage of adolescents below the age of 15, who has already used cannabis, was 3.3 per cent in Italy, 7.0 per cent in the Netherlands, 8.5 per cent in Spain, 13.0 per cent in Germany, 15.3 per cent in France and 20.2 per cent in the US.

"The US, which has been driving much of the world's drug research and drug policy agenda, stands out with higher levels of use of alcohol, cocaine, and cannabis, despite punitive illegal drug policies," authors concluded. "The Netherlands, with a less criminally punitive approach to cannabis use than the US, has experienced lower levels of use, particularly among younger adults. Clearly, by itself, a punitive policy towards possession and use accounts for limited variation in nation-level rates of illegal drug use."

The article is available for download at:

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050141&ct=1

Two articles by Reuters on this research are available at:

http://www.reuters.com/article/latestCrisis/idUSN01254783

http://www.reuters.com/article/reutersComService4/idUSL0320469420080704

(Sources: Reuters of 1 and 3 July 2008; Degenhardt L, Chiu WT, Sampson N, Kessler RC, Anthony JC, Angermeyer M, Bruffaerts R, de Girolamo G, Gureje O, Huang Y, Karam A, Kostyuchenko S, Lepine JP, Mora ME, Neumark Y, Ormel JH, Pinto-Meza A, Posada-Villa J, Stein DJ, Takeshima T, Wells JE. Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys. PLoS Med 2008;5(7):e141.)

Europe — The EU drugs agency releases extensive scientific monograph on cannabis

An estimated one in five European adults have tried it at some time in their lives. Over 13 million Europeans have consumed it in the past month. Globally, nearly 50 000 tonnes of cannabis herb or resin are produced for consumption every year. Little wonder, then, that cannabis has become a controversial cultural phenomenon.

A new monograph by the EMCDDA (European Monitoring Centre for Drugs and Drug Addiction) of more than 700 pages underlines the point that cannabis is not just a static, unchanging plant, but a dynamic product that is subject to gradual evolution in potency, prevalence and cultivation. In the publication, leading experts provide short, sharp insights on a range of cannabis topics while offering advice on further reading for each of them. Brief editorial notes provide concise introductions to each issue. The monograph includes a chapter on cannabis as medicine in Europe in 19th century by Dr. Manfred Fankhauser and a chapter on the re-emergence of the therapeutic use of cannabis products by Dr. John Witton.

The monograph is available for free at:

http://www.emcdda.europa.eu/publications/monographs/cannabis

(Source: Press release by EMCDDA of 26 June 2008)

News in brief

Science — Caryophyllene

Swiss researchers found out that beta-caryophyllene is a CB2 receptor agonist. This cannabinoid is not only found in cannabis but is a constituent of the essential oils of numerous spice and food plants. Beta-caryophyllene is found in the essential oils of clove, hemp and rosemary. Activation of the CB2 receptor may result in a reduction of inflammation and a slowing in the development of atherosclerosis. (Source: Gertsch J, et al. Proc Natl Acad Sci U S A. 2008 Jun 23. [Electronic publication ahead of print])

Austria — Cultivation of cannabis

The Agency for Health and Food Safety (AGES, Agentur für Gesundheit und Ernährungssicherheit) is allowed to cultivate cannabis for medicinal purposes and under supervision and control of the Health Ministry. This is made possible by an amendment of the narcotics law, approved by the Health Committee. This change allows the cultivation of cannabis for the production of substances for the manufacturing of medicinal drugs. (Source: Der Standard of 2 July 2008)

USA — Medical Students

The Medical Student Section of the American Medical Association (AMA) unanimously endorsed a resolution urging the AMA to support the reclassification of cannabis for medical use at the AMA's annual conference. The resolution will now go before the AMA House of Delegates for a final vote at its interim meeting in November 2008. More at: http://stopthedrugwar.org/chronicle/541/ama_medical_student_section_supports_medical_marijuana (Source: Drug War Chronicle of 27 June 2008)

Science — Study with Cannador

According to an interim analysis of the ongoing with Cannador in spasticity due to multiple sclerosis 200 patients have now been enroled in the study. Cannador is a capsulated cannabis extract. The internal monitoring centre (IDMC) issued the following statements. "(1) The IDMC recommends that the trial be continued. (2) The IDMC is aware of the difficulties encountered in recruiting to the trial. (3) The IDMC feels it would be advisable on statistical grounds to continue to a total of 300 patients randomised." (Source: Personal communication by Dr. Martin Schnelle, Institute for Clinical Research, Berlin)

Science — Glaucoma

In an experimental study by American scientists it was demonstrated that the endocannabinoid 2-AG (2-arachidonylglycerol) increased aqueous humor outflow in eyes. (Source: Njie YF, et al. Exp Eye Res. 2008 May 14. [Electronic publication ahead of print])

Science — Pain

In a study with 18 healthy subjects dronabinol was ineffective in reducing several forms of experimental acute pain. (Source: Kraft B, et al. Anesthesiology 2008;109(1):101-10.)

Science — Driving

Canadian researchers conducted a survey in 1021 subjects, who were treated for abuse of either cocaine or cannabis, on the effects of these drugs on driving. They concluded that "both cannabis and cocaine have detrimental but different effects on driving. The negative physical effects of cannabis may reduce the likelihood of driving under the influence of cannabis." (Source: MacDonald S, et al. Traffic Inj Prev 2008;9(3):190-4.)

Science — Pain

Low doses of cannabinoids were shown to enhance the pain reducing effects of agonists at metabotropic glutamate receptors in studies with rats. (Source: Lee MK, et al. Pain 2008 Jun 18. [Electronic publication ahead of print])