IACM-Bulletin of October 14, 2007

IACM — News at the IACM 2007 Conference in Cologne

On 5-6 October the IACM held its 4th Conference on Cannabinoids in Medicine. Here are some excerpts from presentations.

(1) British researchers evaluated the long-term tolerance and efficacy of a cannabis extract (Sativex) in patients suffering from rheumatoid arthritis. 38 out of 53 eligible subjects entered the long-term study. 70 per cent of patients completed more than three months treatment, and 51 per cent more than six. Improvements in pain and sleep quality similar in magnitude to those noted in the acute study were recorded, and there was no evidence of tolerance to these beneficial effects or escalation of Sativex dosage over time. (Abstract by Robson et al.)

(2) Canadian researchers conducted a pilot study comparing four potencies of herbal cannabis (0, 2.5, 6 and 9.5 per cent THC) in patients with neuropathic pain. 23 patients with chronic neuropathic pain due to trauma or surgery who were not current cannabis users received the four potencies in four five-day periods separated by nine-day periods. Researchers concluded that smoking 25mg (one puff) of 9.5 per cent THC herbal cannabis three times daily for five days has a modest analgesic effect on chronic neuropathic pain and improves sleep. The drug was well-tolerated. (Abstract by Ware et al.)

(3) Spanish researchers showed that cannabinoids prevent the development of peripheral neuropathy and alterations in gastrointestinal transit induced by chronic chemotherapy in the rat. The chemotherapeutic agent cisplatin induced a delay in weight gain and neuropathy and a delay in intestinal transit. When a synthetic cannabinoid was administered together with cisplatin, both neuropathy and delay in intestinal transit were prevented. (Abstract by Abalo et al.)

(4) Israelian researchers presented evidence that endocannabinoid and/or CB1 receptor insufficiency underlies infant failure-to-thrive in mouse models. They concluded that cannabinoid-based treatment should be considered to improve food intake and weight gain in infants with failure-to-thrive or with growth failure. (Abstract by Fride et al.)

(5) German researchers presented retrospective data on the effects of oral dronabinol (THC) in 124 patients with chronic pain. Mean pain intensity before treatment was 7.6 and was reduced to 4.2 during treatment with dronabinol. Researchers concluded that treatment of severely ill pain patients with dronabinol in advanced stages of chronicity proved to be highly effective and well tolerated. (Abstract by Konrad et al.)

(Source: Abstract book available for download on the IACM website at:

http://www.cannabis-med.org/meeting/cologne2007/reader.pdf)

IACM — IACM Awards go to Donald Abrams, Giovanni Marsicano, Mauro Maccarrone and Raphael Mechoulam

On its General Meeting on 5 October the IACM elected a new Board of Directors and a new chairwoman. During the evening dinner the IACM honoured four persons for special achievements regarding the re-introduction of cannabis and cannabinoids as medicine. The IACM Award 2007 for Clinical Research goes to Donald Abrams, the IACM Award 2007 for Basic Research goes to Mauro Maccarrone, the IACM Award 2007 for Young Researchers goes to Giovanni Marsicano, and the IACM Special Award 2007 goes to Raphael Mechoulam.

Kirsten Mueller-Vahl of the Medical School of Hannover, Germany, was elected as the first chairwoman of the IACM. Previous chairmen were Roger Pertwee (2005-2007), Raphael Mechoulam (2003-2005) and Franjo Grotenhermen (2000-2003). New Board Members are Daniela Parolaro (Italy), Marta Duran (Spain), Mark Ware (Canada) and Rudolf Brenneisen (Switzerland). The following Board Members were re-elected: Roger Pertwee (UK), Ethan Russo (USA), Willy Notcutt (UK), Franjo Grotenhermen (Germany) and Kurt Blaas (Austria). Clare Hodges (UK) was re-elected as patient representative of the IACM. The General Meeting followed the suggestion of the Board of Directors to drop the Advisory Board as a body of the IACM from the statutes.

News in brief

USA — Costs of prohibition

According to a report published on DrugScience.org cannabis prohibition costs nearly 42 billion US dollars per year in criminal justice costs and in lost tax revenues in the United States. According to the analysis law enforcement spends 10.7 billion dollars annually to arrest and prosecute cannabis offenders. In addition, prohibition would deprive taxpayers of 31.1 billion dollars annually. The report is available at: http://www.drugscience.org/bcr/index.html (Source: DrugScience.org of October 2007)

Science — Driving

An international working group of 11 experts from six countries suggests a limit of 7-10 ng/mL THC in blood serum for driving under the influence of cannabis. This would compare to a blood alcohol concentration of about 0.05 per cent. The group states that zero-limit laws, which are in effect in several countries and in several states of the USA, are not science-based and classify many non-impaired drivers as being under the influence of cannabis. (Source: Grotenhermen F. et al. Addiction 2007 Oct 4; [Electronic publication ahead of print])

Science — Attention deficit/hyperactivity disorder

Research with 760 female and 752 male twins shows that children with attention-deficit/hyperactivity disorder (ADHD) are at higher risk for nicotine dependence, and cannabis use/dependence. An earlier case report from Germany had shown that a patient with ADHD was nearly symptom-free with the use of cannabis. (Source: Elkins IJ, et al. Arch Gen Psychiatry 2007;64(10):1145-52)

Science — Psychosis

An article of a British researcher compares the research on the association between alcohol and psychosis with the research on the association between cannabis and psychosis from a historical point of view. Parallels from the research into the psychological consequences of alcohol use are drawn with the current debate around the link between cannabis and psychosis, "urging caution in too rapid an assertion that cannabis is necessarily 'causal'." (Source: Crome IB. Crim Behav Ment Health 2007;17(4):204-14.)

Science — Parkinson's disease

Research by scientists of the University of Texas showed that a synthetic cannabinoid, that activated the CB1 receptor, was able to reduce dyskinetic movements in a rat model of Parkinson's disease. Dyskinesia is a frequent side effect of medicinal drugs used in the treatment of the disease. (Source: Morgese MG, et al. Exp Neurol 2007 Aug 22; [Electronic publication ahead of print])