IACM-Bulletin of March 30, 2008

USA — Acquittal of a medical cannabis user in Texas

A man charged with illegal cannabis possession needed to use the drug to treat symptoms of his HIV infection, a jury of a Texas court has found. Jurors deliberated less than 15 minutes on 25 March before reaching a not guilty verdict for Tim Stevens, 53. His attorney used the defence that cannabis use was a necessity to treat nausea and vomiting of his client. It is believed that this is the first successful use of the necessity defence in a Texas cannabis case. Texas does not belong to the twelve states of the USA that have legalized the medical use of cannabis.

Stevens, who was diagnosed with HIV in 1986, suffers from nausea and cyclical vomiting syndrome, a condition so severe that it has required hospitalization in the past. He was arrested in October sitting on a front porch of a house smoking cannabis. Among the witnesses for the defence was Dr. Steve Jenison, medical director of the Infectious Diseases Bureau for New Mexico's health department. He testified that Stevens needed to use the cannabis to ease his symptoms.

The whole article is available at:

http://www.elpasotimes.com/ci_8718541

(Source: Associated Press of 27 March 2008)

Canada — Medical doctors increased the dosage of cannabis for medical purposes in recent years

Canadian doctors have been increasing daily dosages of cannabis for patients using cannabis for medical purposes in recent years, Health Canada reports. The increase in prescribed dosages is noted in a recent report on the views of physicians regarding the use of cannabis. The study found physicians were unclear about the health ministry's maximum dosage recommendation. For most doctors, the report said, overdose or dosage beyond an "optimal" limit was not a concern or even a consideration.

The study found unanimous agreement and even "enthusiastic support" among doctors for the health ministry to begin supplying dried cannabis to pharmacists trained to dispense it to patients. However, they suggested that the quality be improved and the price be reduced while insuring that medical insurance programs cover the cost. The reporting of the trend follows the health ministry's campaign last summer to keep doses below five grams.

The whole article is available at:

http://www.canada.com/ottawacitizen/news/story.html?id=327d46d2-9cc8-4fe2-a333-10a11f85169f

(Source: Ottawa Citizen of 18 March 2008)

News in brief

Holland — Smoking ban

The upcoming smoking ban in Dutch bars and restaurants does not apply to cigarettes made solely of cannabis. Health Minister Ab Klink wrote this in a letter to the Parliament. (Source: NIS-News Bulletin of 27 March 2008)

Science — Effect of prohibition

In a review for the journal Current Opinion in Psychiatry research is presented that the legal status of cannabis has only low effects of the amount of cannabis use. The author states that "almost all previous reviews on this issue reach the same conclusion: decriminalization of cannabis does not lead to a substantial increase in cannabis consumption rates." (Source: van den Brink W. Curr Opin Psychiatry 2008;21(2):122-6.)

Science — Migraine

Italian researchers found out that the activity of proteins responsible for the degradation and uptake of the endocannabinoid anandamide into cells were decreased in the platelets of patients suffering from migraine and medication overuse headache. They concluded, that these changes "may reflect an adaptative behaviour induced by chronic headache and/or drug overuse." (Source: Cupini LM, et al. Neurobiol Dis. 2008 Feb 1 [Electronic publication ahead of print])

Science — Epilepsy

There is increasing evidence that the perturbation of the endocannabinoid system leads to development of epileptic seizures, thus indicating that endocannabinoids play a protective role in suppressing pathologic neuronal excitability. New research shows that the CB1 receptor was downregulated to one third in the hippocampus of patients suffering from epilepsy compared to healthy subjects. (Source: Ludányi A, et al, J Neurosci 2008;28(12):2976-90.)

Science — Mode of action

It was shown that several natural cannabinoids of the cannabis plant, including cannabidiol (CBD) and dronabinol (THC), do not only interact with cannabinoid receptors, but also with several subtypes of so-called transient receptor potential channels (TRP), the vanilloid type 1 TRP (TRPV1), the ankyrin-type 1 TRP (TRPA1) and the melastatin-type 8 TRP (TRPM8). The interaction with these ion channels may explain some of the effects of cannabinoids. (Source: De Petrocellis L, et al. J Pharmacol Exp Ther. 2008 Mar 19 [Electronic publication ahead of print])

Science — Withdrawal

US researchers conducted telephone survey to compare withdrawal severity in 67 daily cannabis users and 54 daily tobacco cigarette smokers who made quit attempts during the prior 30 days. Severity of withdrawal symptoms were similar in both groups, except craving for the drug and sweating, which were slightly higher for tobacco. (Source: Budney AJ, et al. J Subst Abuse Treat. 2008 Mar 12 [Electronic publication ahead of print])

Science — Driving

A French group analysed 10,000 accident reports involving over 17,000 drivers. The relative risk to be responsible for the accident was 1.7 for the whole population, 2.3 for cannabis alone (THC > 1 ng/mL), 9.4 for alcohol alone (blood alcohol concentration > 0.05 per cent), and 14.1 for the alcohol-cannabis combination. Researchers concluded: "Alcohol remains the major risk at any age. Young drivers consuming alcohol and cannabis represent a priority target for prevention." (Source: Biecheler MB, et al. Traffic Inj Prev 2008;9(1):11-21.)