IACM-Bulletin of July 9, 2000

Germany — Petition committee of the Bundestag supports medical use of cannabis

On 28 June the petition committee of the Bundestag (German Parliament), consisting of 29 members of the parliament, supported the petition of the Self-Help Group Cannabis as Medicine in Berlin and of the ACM to allow a medical use of natural cannabis products and single cannabinoids.

For the first time an institution of the Bundestag advocated the medicinal use of cannabis products by ill persons.

The petition was supported by the committee members of the Socialists, the Greens and the Social Democrats and will be referd to the government "for consideration", since the request was substantiated and corrective necessary. It was opposed by the Christian Democrats. The Liberals stayed neutral. The committee arrived at the result, that cannabis helps many patients, "to cure or to mitigate their diseases and to live a life worth living again."

If the government does not take the petition into consideration, it is kept to give reason to its behaviour before the committee.

On 10 April 2000 a German company got the approval to make THC (dronabinol) available to pharmacies, so that corresponding medicines can be manufactured there. Until now only one pharmacy in Frankfurt could be supplied. Other pharmacies could only deliver the expensive THC preparation Marinol imported from the USA.

(Sources: Press release of the Greens of 28 June 2000, Press release of the PDS of 28 June 2000, Berliner Zeitung of 29 June 2000)

Science — News at the meeting of the ICRS

At the annual meeting of the International Cannabinoid Research Society (ICRS) from 22 to 24 June in the USA a number of interesting new research results were presented. Some are presented below and in the next issue of the ACM-Bulletin coming on 23 July.

(1) A research group from Israel found evidence that the endocannabinoid system is critical for the development of newborn mice. Endocannabinoids may be responsible for the suckling response of newborns, thereby playing a critical role in their growth and physical well-being. If the endocannabinoid system was put out of action by the researchers with a cannabinoid receptor antagonist (SR 141716A), the pups did not gain weight and died within 6-8 days after birth. A single administration of SR 141716A within the first day of life was enough to completely arrest growth. It is known that cannabinoids enhance appetite and this effect may be relevant for newborns. (Source: Abstract by Ester Fride, et al)

(2) The use of smoked marijuana by patients with HIV on protease inhibitors (PI) containing regimens appears to be clinically safe and well tolerated, according to a safety study at the University of California San Francisco. 67 patients received either smoked marijuana, dronabinol or placebo for a period of 21 days. Numerous parameters including immune functions and PI pharmacokinetics were monitored. There were four Grade II and two Grade III adverse reactions, half of each were in the marijuana group. Laboratory parameters will be analysed when all patients have completed the study. (Source: Abstract by Donald Abrams, et al)

(3) The analgesic actions of ajulemic acid (CT3) were reversed by the cannabinoid receptor (CB1) antagonist SR 141716A (and not by a CB2 receptor antagonist). Ajulemic acid is a derivative of a non-psychotropic metabolite of THC. A plausible explanation of these observations would be the existence of a novel cannabinoid receptor for which ajulemic acid is an agonist and SR 141716A an antagonist, says the research group of Brown University/USA. (Source: Abstract by Michael Walker, et al)

(4) Three different sublingual cannabis extracts, one containing predominantly THC, one containing predominantly cannabidiol, and one a ratio of THC to CBD of approximately 1:1, were administered to six healthy volunteers. They received up to 20 mg THC. Cognitive function assessment showed a slight THC-associated decrease in performance of spatial working memory. The British study showed sublingual administration of cannabis extract to result in relatively fast effects and to be well tolerated. (Source: Abstract by Geoffrey W Guy, et al)

(Source: Book of abstracts of the 2000 ICRS meeting)

Science — Cannabinoids in pain areas of the spinal cord

A British team of researchers found CB1 receptors in areas of the rat spinal cord that are relevant for pain modulation. The discovery published in the journal Molecular and Cellular Neuroscience paves the way for cannabinoid-based drugs to be developed which target the spinal cord to fight pain.

Dr Andrew Rice, a member of the team based at Imperial College, London, said: "We have achieved a really important step in terms of divorcing the psychoactive side-effects of cannabis from their pain-relieving effects." Drugs based on cannabinoids could be developed which lock onto spinal cannabinoid receptors, or they could be delivered directly to the spinal cord. In the 1970s opioid receptors were also shown to be present in the spinal cord. This led to the development of epidural pain killers.

The findings indicate that cannabinoids may have the ability to relieve a type of pain that is poorly relieved by current treatments. Pain may be classified into two types: inflammation, and painful neuropathy. There are very few drugs that combat painful neuropathy. "When you injure a nerve you lose the opioid receptors in the spinal cord. That is why morphine does not work well in those situations," said Rice.

(Sources: Reuters of 4 July 2000; PA News of 4 July 2000; Farquhar-Smith WP, Egertová M, Bradbury EJ, McMahon SB, Rice ASC, Elphick MR: Cannabinoid CB1 receptor expression in rat spinal cord. Mol Cell Neurosci 2000;15:510-521)

News in brief

USA

The state medical commission of Washington has added diseases that cause severe gastrointestinal symptoms, seizures or muscle spasms to the list of "terminal or debilitating medical conditions" for which marijuana may legally be used under a state law passed by voters in 1998. The action by the Medical Quality Assurance Commission added to the list diseases whose symptoms include nausea, vomiting, severe weight loss, cramping or appetite loss, when they are unrelieved by standard treatments or medications. The commission declined to add insomnia and post-traumatic stress disorder. (Source: Seattle Times of 27 June 2000)

Holland

On 27 June the Dutch parliament adopted a resolution to tolerate the cultivation of cannabis and to regulate the crop. Legislators from two of the three parties in the government coalition drafted the motion, which passed the 150-seat chamber by a 73-72 vote. But the vote was so narrow that Justice Ministry spokesman Victor Holtus said it was unlikely the cabinet would approve the resolution. "It sharply contradicts international agreements," he said. (Source: AP of 28 June 2000)