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IACM-Bulletin of 10 March 2024

Science/Human: Cannabis may improve quality of life in patients with chronic illnesses

A survey from Germany with 1030 chronically ill patients showed, that cannabis treatment improved their quality of life regardless of the underlying illness. A standardized questionnaire was presented online nationwide over a 15-week period. Recruitment was supported by pharmacies, prescribing physicians, and patient associations in Germany.

Of 1582 participants, 1030 data sets (65%) could be completely analyzed. There was a heterogeneous patient population, whose common feature was disease chronicity. The frequency distribution of symptoms showed a homogeneous pattern for the respective indications, in which the most frequent six (pain 71%, sleep disturbance 64%, stress/tension 52%, inner restlessness 52%, depressive mood 44% and muscle tension 43%) seem to have a special significance. According to subjective assessment, quality of life improved significantly in 84% of all participating patients. Authors concluded that the treatment with cannabis may “improve the quality of life of chronically ill patients, regardless of the underlying disease.”

Gastmeier K, Ihlenfeld A, Gastmeier A, Hirt G, Landschaft A, Wirz S. Patient-reported outcomes in chronic diseases under treatment with cannabis medicines. Schmerz. 2024 Mar 7. [in press]

Science/Human: Cannabis is used for the treatment of endometriosis

According to a survey with 192 participants by NICM Health Research Institute at Western Sydney University, Australia, many patients with endometriosis self medicate with cannabis. The study aimed to identify costs, modes of administration, product composition, and self-reported effectiveness for those accessing medicinal cannabis in Australia.

Most (63.5%) used a doctor specialised in cannabis treatment. Cost was a major barrier to access, necessitating reducing dosage (76.1%) and/or consuming illicit cannabis (42.9%), despite a prescription. Most (77%) medical consumers used two or more cannabis products, with THC predominant oil and flower products most frequently prescribed.

Proudfoot A, Duffy S, Sinclair J, Abbott J, Armour M. A survey of cost, access and outcomes for cannabinoid-based medicinal product use by Australians with endometriosis. Aust N Z J Obstet Gynaecol. 2024 Feb 28. [in press]

News in brief

Science/Human: No increase in psychosis after the legalisation of cannabis in Canada

Investigators reported “no increase in the proportion of ED consultations for a psychotic episode in which evidence for cannabis consumption was obtained before and after legalization.”

PPEP Capitale-Nationale, Centre Intégré Universitaire de Soins et Services Sociaux (CIUSSS) de la Capitale Nationale, Québec, Canada.

L'Heureux S, et al. Can J Psychiatry. 2024:7067437241232901.

Science/Human: Cannabis use is not associated with exercise

According to a survey with 2,591 adults cannabis users had the highest number of walking times per week, followed by non-users, e-cigarette users, and dual users there were no significant differences in strength training or general exercise between the four groups. Authors noted that these “findings challenge the stereotype that marijuana and e-cigarette users are less active than non-users.”

The University of Texas at Dallas, USA.

Boutouis S, et al. Prev Med Rep. 2024;40:102668.

Science/Animal: CBD may alleviate chronic prostatitis

In a rat model of chronic prostatitis and chronic pelvic pain syndrome CBD was shown to alleviate symptoms by activation of the CB2 receptor.

Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Piao JJ, et al. World J Mens Health. 2024 Feb 29. [in press]

Science/Human: Cannabis may reduce harm caused by alcohol and other drugs

“Research suggests there is potential to reduce alcohol and drug use related harms of more dangerous substances through substitution with cannabis. This case study is the first to document cannabis donation as a harm reduction practice in the US and suggests potential for sustainability dependent on state laws.”

RTI International, Research Triangle Park, New Jork, USA.

Duhart Clarke SE, et al. Harm Reduct J. 2024;21(1):58.

Science/Animal: CBD may be helpful in sleep deprivation-induced hyperalgesia

Hyperalgesia resulting from sleep deprivation poses a significant a global public health challenge with limited treatment options. In a rat model of sleep deprivation-induced hyperalgesia CBD reduced pain sensitivity.

Chinese Academy of Medical Sciences, Shijiazhuang, China.

Zhu K, et al. Neuropharmacology. 2024;249:109893.

Science/Cells: Renal cell carcinomas express the CB2 receptor

An analysis of 87 patients with renal cell carcinoma showed, that in 78 cases the CB2 receptor was highly expressed by cancer cells. There were no CB1 receptors.

Department of Urology, Naval Hospital of Athens, Greece.

Deligiannis D, et al. Cureus. 2024;16(2):e55121.

Science/Cells: The activity of human bone cells was influenced by THC and CBD

Human osteoclasts, bone cells that degrade bones, were dose-dependently both inhibited and stimulated by CBD and THC. “In the lower dose ranges of THC and CBD, osteoclast fusion was unaffected while bone resorption was increased. At higher doses, both osteoclast fusion and bone resorption were inhibited.”

Clinical Cell Biology, Pathology Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Nielsen SSR, et al. Bone. 2024;181:117035.

Science/Cells: CBD and THC may reduce cortisone doses

In studies with white blood cells of dogs THC and CBD increased the efficacy and thus reduced the dose of dexamethasone, a cortisone medication, to achieve anti-inflammatory effects. Dexamethasone reduced the production of pro-inflammatory cytokines, namely interferon gamma and tumour necrosis factor alpha, and this effect was enhanced by THC and CBD.

Center for Environmental Health Sciences, Department of Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, USA.

Dixon S, et al. Vet Immunol Immunopathol. 2024;269:110727.

Science/Animal: Disturbances of the endocannabinoid system impairs fear extinction

In studies with mice a reduction in the production of the endocannabinoid 2-AG resulted in an impairment of contextual fear extinction, which plays a role in post-traumatic stress disorder. “Here, we show that systemic pharmacological blockade of diacylglycerol lipase, the rate-limiting enzyme catalyzing in the synthesis of 2-AG, enhances contextual fear learning and impairs within-session extinction.”

Vanderbilt Brain Institute, Vanderbilt University, Nashville, USA.

Ramos-Medina L, Rosas-Vidal LE, Patel S. Psychopharmacology (Berl). 2024;241(3):569-584.

Science/Animal: CBD may help to reduce tobacco smoking

In studies with mice investigators “found that CBD attenuated the somatic signs of nicotine withdrawal and prevented nicotine's hyperalgesia-inducing effects. Taken together, these results demonstrate that modulation of cannabinoid signaling may be a viable therapeutic option as a smoking cessation aid.”

Department of Neurobiology and Behavior, University of California Irvine, USA.

Cheeks SN, et al. Neuropharmacology. 2024;246:109833.

Science/Animal: The CB2 receptor may be a potential target for the treatment of schizophrenia

According to a mouse model of schizophrenia there is an interaction between neuronal CB2 receptors and methamphetamine treatment, “which increases the risk of schizophrenia-like behavior in this mouse model. This finding provides evide Ichnce for further studies targeting CB2R as a potential schizophrenia therapy.”

Laboratory of Reticular Formation Physiology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.

Canseco-Alba A, et al. Prog Neuropsychopharmacol Biol Psychiatry. 2024;130:110924.

Science/Human: Cannabis use during childhood may impair memory

123 cannabis using children aged 13 to 14 years, who were compared to 123 non-cannabis users, “showed lower scores on an episodic memory task, and more cannabis use was linked to poorer performances on verbal, inhibitory, working memory, and episodic memory tasks.”

Department of Psychiatry, University of California, San Diego, USA.

Wade NE, et al. Addict Behav. 2024;150:107930.

Science/Review: No association between cannabis legalisation and cannabis use during adolescence

“For adolescents, ten studies reported no change in use prevalence associated with legalization, six reported a decrease, and seven reported an increase. Among young adults, most studies (8) showed an increase in at least one prevalence measure, four showed no change, and one showed a decrease.”

Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, USA.

O'Grady MA, et al. Eur Child Adolesc Psychiatry. 2024;33(3):701-723.

Science/Review: The metabolism of THC is altered by pregnancy

“THC and its metabolites disposition likely change during pregnancy. Hepatic CYP2C9 and CYP3A4 are induced in pregnant individuals and in vitro by pregnancy hormones. This induction of CYP2C9 and CYP3A4 is predicted to lead to altered THC and 11-OH-THC disposition and pharmacodynamic effects.”

Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, USA.

Authement AK, Isoherranen N. Expert Opin Drug Metab Toxicol. 2024:1-21.

Science/Review: Activation of the CB2 receptor may reduce morphine tolerance

“This study introduces the potential mechanism of morphine tolerance and the effect of CB2 receptor agonists on reducing morphine tolerance, which can provide new ideas for researchers studying morphine and provide beneficial effects for patients suffering from morphine tolerance.”

Department of Anesthesiology, Harbin Medical University Cancer Hospital, Harbin, China.

Cui D, Zhang Y, Zhang M. IBRO Neurosci Rep. 2023;16:43-50.