A newsletter about cannabis and cannabinoids as medicine

2008
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    IACM-Bulletin of December 21, 2008

    🏷️ Science — THC reduces reflux of acid from the stomach

    Researchers of the Academic Medical Centre of Amsterdam, the Netherlands, investigated the effects of THC (dronabinol) on relaxations of the lower oesophageal sphincter (the muscular ring at the lower end of the oesophagus) and reflux of acid from the stomach into the oesophagus (gastro-oesophageal reflux) in dogs and humans. In dogs, dronabinol dose-dependently reduced relaxations of the lower oesophageal sphincter and acid reflux rate, which was reversed by a CB1 receptor antagonist (SR141716A), indicating that this THC effect is mediated by the CB1 receptor.

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    IACM-Bulletin of December 7, 2008

    🌐 Germany — First Patients receive herbal cannabis from the Dutch Cannabis Program

    On 27. November 2008 four patients were notified by the Federal Institute for Pharmaceuticals and Medical Products (BfArM) of the Federal Ministry of Health that they will receive medical cannabis, produced under the Dutch cannabis program, beginning in early 2009. Since July 2007 some 30 patients have received permission from the BfArM to use medical cannabis. However, the permission generally refers to a liquid cannabis extract produced by a German firm from Dutch cannabis. This extract did not offer a satisfactory solution for a number of these patients.

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    IACM-Bulletin of November 23, 2008

    🏷️ Science — Why cannabis smokers may have a lower cancer risk than tobacco smokers

    Eleven scientists from the USA and Taiwan summarized data from basic research and a re-evaluation of an epidemiological study by Sidney and colleagues from 1997. Their investigation indicates that cannabis smoke may not increase or even decrease the incidence of cancers associated with tobacco smoke. While cannabis smoke contains higher levels of carcinogenic polycyclic aromatic hydrocarbons (PAH) than in tobacco smoke, this may not mean that cannabis smokers are at a higher cancer risk than tobacco smokers, since the level of PAHs is less important than the influence of substances on PAH activation by certain enzymes in the liver. "Not surprisingly, spiking tobacco tar with delta-9-THC markedly reduced carcinogenic activity" in experiments with cancer cells, scientists wrote in an article for the Journal of Psychoactive Drugs.

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    IACM-Bulletin of November 9, 2008

    🌐 USA — Michigan becomes the thirteenth state to legalize the medical use of cannabis

    Voters in Michigan overwhelmingly approved a measure on the medical use of cannabis on 4 November, making it the 13th state to allow severely ill patients to use the drug for medicinal purposes. The measure was supported by 63 percent of voters. It removes state penalties for registered patients to buy, grow and use small amounts of cannabis. Of the 12 other states with medical cannabis laws, eight stemmed from ballot initiatives as in Michigan; four were enacted by state legislatures. Alaska, Arizona, California, Colorado, Hawaii, Maine, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington have legalized the medical use of cannabis.

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    IACM-Bulletin of October 26, 2008

    🌐 Germany — Experts unanimously acknowledge the medical value of dronabinol and cannabis

    At a 15. October 2008 public hearing of the Health Committee of the German Parliament all participating experts agreed on the proven medical value of dronabinol (THC) and cannabis for a range of illnesses. All medical and legal experts further declared that the current situation was unsatisfactory for patients. Only the representative of the health insurance industry insisted that the medical benefits of a dronabinol therapy remained to be proven and thus health insurance should not be obligated to pay for such treatment.

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    IACM-Bulletin of October 12, 2008

    🌐 Germany — Declaration in support of the medical use of cannabis products by medical organizations

    In the run-up to a public hearing by the Health Committee of the German Bundestag on 15 October leading medical associations and patients organizations demand a facilitation of the use of cannabis products for medicinal purposes. For this purpose, the organizations composed a conjoint statement. The "Berlin Declaration on the medical use of Cannabis Products" says:

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    IACM-Bulletin of September 28, 2008

    🌐 Holland — Supreme court allows cannabis cultivation for therapeutic use

    Facing a lack of fresh cannabis for use in traditional Ayurvedic medical preparations, the Ministry of Indigenous Medicine this month announced a plan to grow 4,000 kg a year of cannabis. The ministry wants to be excepted from laws that have made cannabis illegal in Sri Lanka. "We are interested in getting some approval to grow some cannabis with government sponsorship, but there must be controls. It is under study," Asoka Malimage from the Ministry, said.

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    IACM-Bulletin of September 14, 2008

    🏷️ Science — Cannabis extract effective against neuropathic pain of MS patients in long-term study

    According to a press release by the British company GW Pharmaceuticals, Sativex was effective in 42 patients with multiple sclerosis and central neuropathic pain who had previously been in a phase III study and who continued to take Sativex for 12 weeks. They were then randomised to a treatment with Sativex or placebo for a further 4 weeks in a double-blinded manner. Sativex is a cannabis extract containing equal amounts of dronabinol (THC) and cannabidiol (CBD), which is administered as a spray into the mouth. During this four-week period, patients were not permitted to adjust their dose.

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    IACM-Bulletin of August 31, 2008

    🏷️ Science — Nabilone effective in the treatment of night sweats of four patients with advanced cancer

    A researcher at a Division of Palliative Medicine of the University of Toronto, Canada, presented four cases of successful treatment of night sweats in advanced cancer with nabilone, a synthetic derivative of dronabinol. The four patients had been referred to the hospital and identified night sweats as one of their most significant symptomatic concerns. On an 11-point scale with 0 indicating absence of night sweats and 10 indicating worst possible severity, mean baseline score was 7.75. Two patients received 1 mg nabilone daily taken at bedtime and two patients, who also suffered from severe pain, nausea and appetite loss received 1 mg nabilone twice daily. All patients reported improvement within 48 hours. Two days after treatment onset night sweat scores decreased to a mean of 2.75 and after 14 days to a mean of 2.00. No relevant side effects occurred.

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    IACM-Bulletin of August 17, 2008

    🏷️ Science — Smoked cannabis effective against neuropathic pain of HIV patients

    Researchers at the University of California in San Diego, USA, investigated the effects of smoked cannabis in HIV patients suffering from neuropathic pain. All patients experienced pain despite receiving pain medication. Of 34 subjects included, 28 completed the placebo controlled study. Participants received both cannabis cigarettes with a dronabinol content between 1 and 8 per cent four times daily for five days and placebo cigarettes. Both treatment phases where interrupted by two weeks of no medication. On the first day of each treatment phase the appropriate dose was determined by starting with a cannabis cigarette containing 4 per cent dronabinol and then gradually decreasing or increasing according to side effects and pain relief. The 34 patients continued to use their current pain medication during the whole study, 22 using opioids and 21 using anticonvulsants.

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    IACM-Bulletin of August 3, 2008

    🌐 USA — New Mexico is working on rules for manufacturing cannabis for medical use

    The Department of Health of New Mexico announced on 24 July that it will hold a public hearing on 8 September to take comments on regulations that would set up rules for patient identification cards and a regulated system for licensing, distributing and manufacturing medical cannabis. The state law that took effect in July 2007 allows the medical use of cannabis for serious illnesses. So far, the department has approved 169 people for medical cannabis.

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    IACM-Bulletin of July 20, 2008

    🏷️ Science — Sativex improves objective neurophysiological marker of pain intensity in a clinical study

    Researchers of the University of Rome, Italy, investigated changes in the so-called flexion reflex in a group of 17 patients with multiple sclerosis, who received either the cannabis extract Sativex or placebo. The flexion reflex or nociceptive withdrawal reflex is a reflex intended to protect the body from damaging stimuli. The classic example is when you touch something hot and withdraw your body part from the hot object. The flexion reflex is a widely used technique to assess the pain threshold and to investigate neurotransmitter systems involved in pain control. It consists of an early response (RII reflex) and a late response (RIII reflex). The RIII reflex threshold is thought to correspond to the pain threshold and the reflex size is related to the level of pain perception.

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    IACM-Bulletin of July 6, 2008

    🌐 Germany — Parliament debates proposals for medical use of cannabis

    On 26 June, the German Bundestag (lower house of parliament) debated two similar proposals re. the medical use of cannabis submitted by the Green Party and "The Left", respectively. Speakers from all 5 parties represented in the Bundestag and the federal drug commissioner Sabine Baetzing (Social Democrats) participated. On 15 October 2008 the Health Committee of the Parliament will hold a public expert hearing on the subject.

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    IACM-Bulletin of June 22, 2008

    🏷️ Science — Medical use of cannabinoids does not cause an increase in serious adverse health effects

    Researchers at McGill University Health Centre, the McGill University in Montreal and the University of British Columbia in Vancouver, Canada, said that as the use of cannabinoid medications increases, so do concerns about their potential to cause "adverse events." Dr. Mark Ware of the McGill University Health Centre said that their analysis reported about 31 separate clinical studies of cannabinoid medications conducted between 1966 and 2007. Adverse events were categorized as either serious or non-serious; with serious adverse events defined as those leading to death, hospitalization or disability.

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    IACM-Bulletin of June 8, 2008

    🌐 Europe — Lawyer claims Ireland is in breach of the Schengen Agreement over cannabis use by MS patient

    A Dutch lawyer has claimed the Irish Government is in breach of its commitments to the Schengen Agreement by not allowing a multiple sclerosis patient into the country in possession of cannabis he requires for medicinal purposes. Noel McCullagh is involved in a legal battle to allow him to return to Ireland from the Netherlands in possession of his prescribed cannabis. Mr McCullagh said he has been unable to see his parents for two years because he would be arrested if found in possession of the drug by Irish officials.

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    IACM-Bulletin of May 25, 2008

    🌐 USA — Barack Obama might stop federal prosecutions in states with a medical cannabis law, if elected president

    According to a report in the San Francisco Chronicle Senator Barack Obama has become an increasingly firm advocate of ending federal intervention and letting states make their own rules when it comes to medical cannabis. His Democratic rival, Senator Hillary Clinton, is less explicit, recently softening a pledge she made early in the campaign to halt federal raids in states with medical cannabis laws. Senator John McCain of the Republican party has gone back and forth on the issue - promising a medical cannabis patient at one campaign stop that seriously ill patients would never face arrest under a McCain administration, but ultimately endorsing the Bush administration's policy of federal raids and prosecutions.

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    IACM-Bulletin of May 11, 2008

    🌐 USA — A man dies after denied a liver transplant because he used cannabis for medicinal purposes

    A man who was denied a liver transplant largely because he used cannabis with medical approval to ease the symptoms of hepatitis C has died. Timothy Garon, 56, died on 1 May, a week after a doctor told him a University of Washington Medical Center committee had again denied him a spot on the liver transplant list. The team had previously told him it would not consider placing him on the list until he completed a 60-day drug-treatment class. The case highlights an ethical consideration for those allocating organs for transplant: whether using cannabis with a doctor's blessing should be held against a dying patient in need of a transplant.

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    IACM-Bulletin of April 13, 2008

    🌐 Spain — Positive results of a study with the cannabis extract Sativex in Catalonia

    On 9 April the government of Catalonia published positive results of its pilot programme to evaluate the oral cannabis extract Sativex as a treatment in different patient groups. According to the press release almost half of the patients who received Sativex responded well by reporting improvement of their symptoms. A total of 207 patients were included with the following therapeutic indications: 32 with neuropathic pain due to multiple sclerosis, 54 with spasticity due to MS, 47 with neuropathic pain due to different medical conditions (other than MS), 41 with diagnosed anorexia-cachexia syndrome due to cancer or AIDS, and 33 with nausea and vomiting due to chemotherapy treatment.

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    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.

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    IACM-Bulletin of March 16, 2008

    🌐 Spain — A grower of cannabis for personal medical use was found not guilty by a judge; government acknowledges the medical value of cannabis

    According to a report by Radio Praha of 4 March the high court ruled that the cultivation of cannabis for medical purposes is not a criminal offence. The court had to decide on the case of a woman, who had been convicted by a lower court but refered to the fact that she intended to use the cultivated plants for the alleviation of skin and stomach problems and not for the production of psychoactive effects. Cannabis is increasingly used for medicinal purposes in the Czech Republic.

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    IACM-Bulletin of March 2, 2008

    🌐 Holland — Echo Pharmaceuticals develops THC tablet Namisol

    According to a press release the Dutch company Echo Pharmaceuticals receives several million Euros from a foreign investor to conduct clinical research on their THC tablet Namisol. Partners of Echo Pharmaceuticals are the cannabis grower Bedrocan, as well as Farmalyse and Feyecon. The THC of Namisol is directly extracted from cannabis plants rich in dronabinol with a purity of more than 99 per cent. Farmalyse and Feyecon developed a procedure to produce a dry powder for the production of tablets. The tablets allow a good absorption of dronabinol from the mucous membranes of the mouth.

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    IACM-Bulletin of February 17, 2008

    🌐 USA — The largest American association of physicians calls for reclassification of cannabis and protection of patients who use the drug according to state laws

    The Ministry of Social Affairs and Health wants to publish guidelines on the medical use of cannabis. Just over a year ago the National Agency for Medicines granted its first special permission for medical cannabis to a man suffering from chronic pain stemming from a back injury. The Agency had initially rejected the application for the use of cannabis prescribed by a Dutch doctor. The patient appealed the case to his regional Administrative Court, which overturned the decision.

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    IACM-Bulletin of February 3, 2008

    🏷️ Science — THC effective in intractable nausea in a patient undergoing gastric bypass surgery

    Californian doctors presented a case-report of a 31-year old woman with a long history of obesity, who underwent gastric bypass surgery to reduce her food intake. Within the following weeks she developed severe nausea and inability to tolerate fluids or food and was admitted to hospital seven times. A variety of anti-emetic drugs were tried including a serotonin antagonist, which only provided limited relief. Finally, the patient asked her gastric bypass be reversed. As a last resort, oral THC was prescribed with a maximum of 15 mg per day. She noticed a significant improvement in her symptoms within 1-2 days and tolerated the medication well. Her mood and energy levels improved quickly and she began tolerating more foods and liquids by mouth. She used THC for less than 4 weeks.

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    IACM-Bulletin of January 20, 2008

    🌐 Israel — Patients may get an approval from the government for the medical use of cannabis

    A Tel Aviv medical clinic has quietly begun giving cannabis to cancer and AIDS sufferers, legally and with Health Ministry approval. The clinic began giving the drug to patients about six months ago. By Israeli law, cannabis can legally be used as a medicine if a patient obtains a special approval from the Health Ministry. The cannabis is grown in Israel.

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    IACM-Bulletin of January 6, 2008

    🏷️ Science — Daily cannabis use increases the risk of liver fibrosis in patients with hepatitis C

    According to research at the University of California at San Francisco daily cannabis use was associated with moderate to severe liver fibrosis in 204 patients with hepatitis C. Between 2001 and 2004, participants underwent interviews to assess demographic data, risk factors for HCV, and use of cannabis and alcohol. In addition, virologic testing and liver biopsy was performed. The median age of the group was 46.8 years, 69 per cent were male, 49 per cent were white. Cannabis use frequency within prior 12 months was daily in 13.7 per cent, occasional in 45.1 per cent, and never in 41.2 per cent. There was no fibrosis in 27.5 per cent, mild fibrosis in 55.4 per cent and moderate to severe fibrosis in 17.2 per cent of subjects.

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