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IACM-Bulletin of October 1, 2006


Science — Nabilone reduces pain in patients with spasticity

Researchers of the University of Innsbruck, Austria, conducted a crossover study with the synthetic cannabinoid nabilone in 13 patients who suffered from chronic pain related to spasticity in chronic upper motor neuron syndrome. Participants received both 1 mg nabilone per day in one treatment phase and a placebo in another phase. 11 patients completed the study. Nabilone caused a significant decrease of pain, while spasticity, motor function and activities of daily living did not change. Side effects were generally low. Of the two patients who did not complete the study, one patient experienced moderate transient weakness of the lower limbs and one experienced an acute relapse of multiple sclerosis.

Upper motor neurons are nerve cells that originate in the brain and send fibers through the spinal cord. Their degeneration due to multiple sclerosis or other causes may result in spasticity and muscle pain. Nabilone is synthetic derivative of THC with similar pharmacological profile.

(Source: Wissel J, Haydn T, Muller J, Brenneis C, Berger T, Poewe W, Schelosky LD. Low dose treatment with the synthetic cannabinoid Nabilone significantly reduces spasticity-related pain : A double-blind placebo-controlled cross-over trial. J Neurol. 2006 Sep 20; [Electronic publication ahead of print])

Germany — An overview of the first year of activity of the Cannabis Pharmacy

According to a release by the Cannabis Pharmacy, to date 43 patients have obtained access to the Cannabis Pharmacy through recommendation by a physician working with the pharmacy. 31 persons have donated cannabis at least once to supply these patients. 15 of these donors took responsibility for the entire supply of at least one patient, two donors adopted two patients and one donor adopted three patients. 22 patients are currently waitlisted without a supplier. The Cannabis Pharmacy has been working without interference by German law enforcement.

The release says: "We still regard it as a scandal that we have to exist because politicians and authorities do not redress the suffering of severely ill people but in fact deny them the necessary medication and condemn them to avoidable pain and ailment. We realize that our project can not really address the true extent of this needless suffering but that is particularly why we must continue."

Website of the Cannabis Pharmacy: (in German only)

(Source: Personal communication by the Cannabis Pharmacy of 25 September 2006)

Science — THC reduces intraocular pressure in patients with glaucoma

British researchers investigated the effects of THC and CBD in six patients with ocular hypertension or glaucoma. In a four-way crossover study participants received 5 mg THC, 20 mg CBD, 40 mg CBD, or a placebo. The substances were applied to the mucosa of the mouth.

Two hours after sublingual administration of THC, the intraocular pressure (IOP) was significantly lower than after placebo (on average 23.5 mm Hg versus 27.3 mm Hg). The pressure returned to baseline level after the 4-hour measurement. CBD administration did not reduce the intraocular pressure, but the highest dose caused a small increase in pressure after four hours. Visual acuity were not significantly changed. One patient experienced a transient and mild paniclike reaction after THC administration. Researchers concluded that "a single 5 mg sublingual dose of Delta-9-THC reduced the IOP temporarily and was well tolerated by most patients."

(Source: Tomida I, Azuara-Blanco A, House H, Flint M, Pertwee RG, Robson PJ. Effect of sublingual application of cannabinoids on intraocular pressure: a pilot study. J Glaucoma. 2006 Oct;15(5):349-353.)

News in brief

Canada — Research program

Money that had been earmarked to pay for clinical research on the therapeutic use of cannabis will no longer be available to investigators, under budget cuts announced this week by the Canadian government. The 7.5 million dollar Medical Marijuana Research Program (MMRP) was initially established in 1999. So far, only one clinical study with smoked cannabis in chronic pain patients was ever approved by Canadian authorities. This study remains ongoing. (Source: NORML of 28 September 2006,

Science — Improgan

Improgan is a new non-opioid analgesic which does not act at known histamine or cannabinoid receptors. It is blocked by a CB1 receptor antagonist, but does not bind to the CB1 reseptor and does not cause cannabis-like psychotropic effects. New research suggests that improgan may release endocannabinoids, or activate novel cannabinoid sites. Researchers conclude that "either possibility offers the potential for developing new types of analgesics." (Source: Nalwalk JW, et al. Eur J Pharmacol. 2006 Aug 26; [Electronic publication ahead of print])