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IACM-Bulletin of November 4, 2012

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USA — Voters in several states decide on cannabis-related issues on 6 November

On Election Day two states - Arkansas and Massachusetts - will be deciding whether to allow cannabis use for medical reasons, as 17 states have done previously. Arkansas would be the first southern state to join the group.

Washington, Oregon and Colorado could become the first to legalize recreational use of cannabis - allowing adults to possess small amounts of cannabis under a regimen of state regulation and taxation. The Oregon proposal appears to be fizzling, but the Washington and Colorado measures have led in opinion polls.

Associated Press of 30 October 2012

Science/Human — High doses of oral THC cause fast tolerance to subjective effects

According to a study at the National Institute on Drug Abuse in Baltimore, USA, with 13 healthy cannabis users high oral doses of THC resulted in fast tolerance to subjective effects over the course of six days. Participants received 20 mg of THC every 3.5 to 6 hours: 40 mg on Day 1; 100 mg on Days 2-4; 120 mg on Days 5-6.

Morning subjective intoxication ratings increased from Days 1 to 2, and then declined on Days 4 and 6. The morning THC dose increased intoxication ratings on Day 2, but had less effect on Days 4 and 6. THC moderately lowered blood pressure by 9 to 10 mm Hg and increased heart rate by 9 to 14 beats per minute over the six days. From day two on plasma THC concentrations fluctuated between about 10 and 20 ng/mL with the lowest concentrations in the morning before first dosing. Authors noted that "Six days of around-the-clock, oral THC produced tolerance to subjective intoxication, but not to cardiovascular effects."

Gorelick DA, Goodwin RS, Schwilke E, Schwope DM, Darwin WD, Kelly DL, McMahon RP, Liu F, Ortemann-Renon C, Bonnet D, Huestis MA. Tolerance to Effects of High-Dose Oral {Delta}9-Tetrahydrocannabinol and Plasma Cannabinoid Concentrations in Male Daily Cannabis Smokers. J Anal Toxicol. 2012 Oct 16. [in press]

Science/Human — Cannabidiol reduces symptoms of cannabis withdrawal in a case-report

In a study at the Ribeirão Preto Medical School of the University of São Paulo, Brazil, a 19-year-old woman with withdrawal symptoms after cessation of cannabis use profited from a treatment with cannabidiol (CBD). Cannabis cessation in heavy users is often followed by symptoms such as insomnia, loss of appetite, and irritability. Tolerance to cannabis and cannabis withdrawal symptoms are believed to be the result of the desensitization of CB1 receptors by THC.

This report describes the case of a 19-year-old woman with cannabis withdrawal symptoms treated with CBD for 10 days. Daily symptom assessments demonstrated the absence of significant withdrawal, anxiety and other symptoms during the treatment. Authors concluded that “CBD can be effective for the treatment of cannabis withdrawal syndrome.”

Crippa JA, Hallak JE, Machado-de-Sousa JP, Queiroz RH, Bergamaschi M, Chagas MH, Zuardi AW. Cannabidiol for the treatment of cannabis withdrawal syndrome: a case report. J Clin Pharm Ther. 2012 Oct 24. [in press]

News in brief

USA — Physicians who legally use cannabis for medicinal purposes are no longer allowed to practice in Colorado

Physicians who legally use cannabis for medicinal purposes to treat their own debilitating conditions such as chronic pain or nausea are considered unsafe to practice medicine in the state of Colorado, according to a policy from the Colorado Physician Health Program. "We took a conservative stance," Dr Doris Gundersen, Medical Director of the Colorado Physician Health Program, said. "We don't want to deny them treatment...but until they no longer need it, or we have better ways of correlating impairment, they can't practice." She said Colorado is the first state to come up with such a policy. This means an occupational ban for certain physicians with chronic diseases due to a medical treatment.

Medscape Today of 25 October 2012

Holland — Government decides not to introduce membership cards for coffee shops

The incoming government has ditched plans for a national "weed pass" that would have been available only to residents and that would have effectively banned tourists from cannabis cafes. However, under a provisional governing pact unveiled recently, it is up to the cities how they deal with foreigners. The pact says that it wants only Dutch residents to have access to cannabis cafes, but leaves enforcement up to cities. Amsterdam opposes a ban, which would hurt tourism.

Associated Press of 30 October 2012

Science/Animal — CBD reduces cognitive impairment following bacterial meningitis

In a study with adult rats suffering from meningitis caused by the bacterium Streptococcus pneumoniae daily injections with CBD for 9 days prevented memory impairment and reduced signs of inflammation.

Universidade do Extremo Sul Catarinense, Criciúma, Brazil.

Barichello T, et al. Eur J Pharmacol. 2012 Oct 16. [in press]

Science/Human — Changes in the endocannabinoid system of sperm from infertile men

Researchers compared the endocannabinoid system of fertile and infertile men. They found a marked reduction of the endocannabinoids AEA (anandamide) and 2-AG (2-arachidonoylglycerol) in seminal plasma of infertile men. Seminal plasma is the fluid secreted by male sexual glands in which the sperms swim.

School of Medicine, Centre for Public Health, Queen's University Belfast, United Kingdom.

Lewis SE, et al. PLoS One. 2012;7(10):e47704.

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