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IACM-Bulletin of 18 February 2024

Europe: Citizen initiative for the improvement of access to the medical use of cannabis

The European Commission agreed to register a multi-national initiative to foster access to the medical use of cannabis and promote research into the therapeutic potential of the plant. That means signature-gathering can get underway. Petitioners will have six months to start the drive, then must gather one million signatures from at least seven member countries within a year to force the European Union to consider the proposal.

One objective asks the commission to "foster access to medical cannabis and allow the transportation of cannabis and its derivatives prescribed for therapeutic purposes to ensure the full enjoyment of the right to health." Another requests that EU allocate "the necessary resources for researching cannabis for its therapeutic purposes."

European Commission of 6 February 2024

Science/Human: Cannabis may be helpful in insomnia

According to an analysis of data from 61 patients with insomnia included in the UK Medical Cannabis Registry cannabis improved their sleep quality, investigators of the Imperial College Medical Cannabis Research Group, London, UK, reported.

There was an improvement measured with the Sleep-Quality Scale from baseline at 1, 3, and 6 months. There were also improvements in quality of life and anxiety. Fewer than 15% of participants reported one or more adverse events.

Vivek K, Karagozlu Z, Erridge S, Holvey C, Coomber R, Rucker JJ, Weatherall MW, Sodergren MH. UK Medical Cannabis Registry: Assessment of clinical outcomes in patients with insomnia. Brain Behav. 2024;14(2):e3410.

Science/Human: Cannabis may improve sleep in anxious people

Thirty days of daily data on sleep quality and cannabis use were collected in 347 individuals who use cannabis for mild-to-moderate anxiety. In this study by investigators of the University of Colorado in Boulder, USA, participants self-reported both the form (flower or edible) and the ratio of THC to CBD in the cannabis used during the observation period.

Individuals who reported cannabis use on a particular day also reported better sleep quality the following night. Analyses showed that better perceived sleep after cannabis use days was stronger for respondents with higher baseline affective symptoms. Further, respondents who used cannabis edibles with high CBD concentration reported the highest perceived quality of sleep.

Bidwell LC, Sznitman SR, Martin-Willett R, Hitchcock LH. Daily associations with cannabis use and sleep quality in anxious cannabis users. Behav Sleep Med. 2024;22(2):150-167.

Science/Human: No relevant impairment of driving performance in patients using cannabis

In a semi-naturalistic laboratory study, 40 adults consumed their own prescribed medical cannabis product. Driving performance outcomes including standard deviation of lateral position, the standard deviation of speed, mean speed and steering variability were evaluated using a driving simulator at baseline and 2.5 and 5 hours after cannabis intake. The study was conducted by Investigators of the Swinburne University of Technology in Hawthorn, Australia, and Austin Health in Melbourne, Australia.

Authors summarised that this “semi-naturalistic study suggests that the consumption of medical cannabis containing THC (1.13-39.18 mg/dose) has a negligible impact on driving performance when used as prescribed.” Detectable THC concentrations were observed in oral fluid for a mean of 6-h post-dosing (range = 0-24 ng/mL).

Manning B, Arkell TR, Hayley AC, Downey LA. A semi-naturalistic open-label study examining the effect of prescribed medical cannabis use on simulated driving performance. J Psychopharmacol. 2024:2698811241229524.

News in brief

Ukraine: President signs medical cannabis law

Ukrainian President Volodymyr Zelenskiy signed into law a bill that was adopted by Parliament on 21 December 2023. It would come into force six months after it is officially published.

Reuters of 15 February 2024

Uruguay: Sales of cannabis in pharmacies doubled in 2023

During 2023, about 3,26 tonnes of cannabis were sold in pharmacies, according to data from the Institute for the Regulation and Control of Cannabis. This figure represents an all-time high and is almost double the 1,77 tonnes of legal cannabis sold in 2022.

Infobae of 2 February 2024

Science/Cells: CBD induces programmed cell death in colorectal cancer cells

CBD activates the Mitogen-activated protein kinase (MAPK) pathway to induce apoptosis (programmed cell death) and autophagy in colorectal cancer cells.

Department of Science in Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

Kim NY, et al. J Cell Biochem. 2024 Feb 15. [in press]

Science/Cells: Cannabinoids may inhibit the production of amyloid beta in patients with Alzheimer’s disease

The plant cannabinoids CBC (cannabichromene), CBG (cannabigerol) and CBN (cannabinol) significantly inhibit amyloid beta-evoked toxicity to nerve cells and changes in nerve cell morphology. Amyloid beta is produced in Alzheimer’s disease.

Discipline of Pharmacology, School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Australia.

Magno LAV, et al. Osteoporos Int. 2024 Mar;35(3):391-399.

Science/Animal: Endocannabinoids exhibit anxiolytic effects

An increase of endocannabinoids by inhibition of their degradation reduced anxiety in mice. Authors concluded that results of their study “suggest the feasibility of targeting the endocannabinoid system for the treatment of various mental disorders.”

Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China.

Zhang J, et al. iScience. 2024;27(2):108919.

Science/Animal: CBD exerts anti-inflammatory effects in inflammation of the brain induced by a high-fat diet

In a study with rats receiving a high-fat diet the administration of CBD caused anti-inflammatory effects in early stages of brain inflammation. “This can raise hopes for the future use of this cannabinoid for therapeutic purposes since it is a substance lacking lasting and severe side effects,” authors wrote.

Department of Physiology, Medical University of Bialystok, Poland.

Opęchowska A, et al. Toxicol Appl Pharmacol. 2024:116856.

Science/Animal: Endocannabinoids modulate the sensitivity to external sensory inputs

In a study with mice blockade of the CB1 receptor changes odor perception. Endocannabinoids were shown to reduce “the sensitivity to external sensory inputs.”

Univ. Bordeaux, CNRS, Interdisciplinary Institute for Neuroscience, France.

Terral G, et al. Nat Commun. 2024;15(1):1230.

Science/Cells: Bone formation may be inhibited or stimulated by CBD and THC

In studies with osteoblasts, cells that produce bone mineral, THC and CBD dose-dependently inhibited or stimulated bone cells. Authors noted “that potential unfavorable effects of cannabinoids on bone cells and bone health is a complex matter.”

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

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

Science/Human: Cannabis use is not associated complications following colon surgery

According to an analysis of a large number of patients undergoing elective colectomy cannabis use had no effect on complications.

Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.

Lo BD, et al. World J Surg. 2024 Feb 11. [in press]

Science/Animal: Depressive -like symptoms may be improved by inhibition of endocannabinoid degradation

In a study with rats “social stress-induced depressive-like symptoms and changes in gut microbial and lipidomic profiles are prevented by pharmacological inhibition of FAAH activity in male rats.” Inhibition of FAAH (fatty acid amide hydrolase) increases the concentration of the endocannabinoid anandamide.

Stress Physiology Lab, Department of Chemistry, Life Sciences, and Environmental Sustainability, University of Parma, Italy.

Barbetti M, et al. Prog Neuropsychopharmacol Biol Psychiatry. 2024:110963.

Science/Cells: Delta-9-tetrahydrocannabiorcol (THCO) has neuroprotective properties

(-)-trans-delta-9-tetrahydrocannabiorcol belongs to the delta-9-THC group of cannabinoids in the cannabis plant. It showed neuroprotective effects in cell models.

Natural Product & Medicinal Chemistry Division, CSIR-Indian Institute of Integrative Medicine, Jammu, India.

Anand R, et al. J Nat Prod. 2024 Feb 14. [in press]

Science/Human: Cannabis use has no effect on carious development

Using data of a large group of patients researchers found that “there was no significant association between marijuana-smoking and dental caries experience.” However, the combination with tobacco had some negative effect.

Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.

Samman M, et al. Int Dent J. 2024:S0020-6539(24)00033-9.

Science/Review: Cannabis use during pregnancy

“Prenatal cannabis use appears to be associated with lower birth weight, preterm birth and neonatal intensive care unit admission in newborns, but there is little evidence that prenatal cannabis exposure adversely impacts behavioral or cognitive outcomes in early childhood, with the exception of attention and externalizing problems.”

Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Canada.

Sorkhou M, et al. Addiction. 2024;119(3):411-437.

Science/Review: No clear effect of cannabis on bone mineral density

Two studies showed that cannabis exposure decreased bone mineral density , while the other 2 indicated no alteration.

Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Faculdade Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, Brazil.

Magno LAV, et al. Osteoporos Int. 2024;35(3):391-399.