IACM-Bulletin of April 29, 2007

World — The Commission on Narcotic Drugs of the United Nations decided against reclassification of dronabinol (THC) due to political reasons

On its 50th meeting held in Vienna from 12-16 March 2007 the Commission on Narcotic Drugs (CND) of the UN decided against a rescheduling of dronabinol (THC), the main active principle of cannabis, from Schedule II to Schedule III of the 1971 Convention on Psychotropic Substances, as it was proposed by the Expert Committee of the World Health Organisation (WHO) at its meeting in 2006.

The WHO stated that the substance has a moderate therapeutic usefulness and as a result of continuing clinical research, its medical use is likely to increase. It found that Schedule III is more appropriate and that its present listing in Schedule II is outdated. The WHO estimated the abuse risk for dronabinol to be very low. However, in the notification process of the CND meeting several countries and in particular the US were strongly opposed to rescheduling. In addition, the International Narcotics Control Board (INCB) of the UN spoke out against the WHO recommendation in its 2006 Annual Report and at the CND plenary. According to the Board, there have been reports of its abuse in a country in which it is prescribed most, meaning the US. However, the US in its extensive written comments to the WHO on dronabinol had mentioned only "low levels of diversion and abuse".

In the oral statements only two out of 15 speakers expressed themselves in favour of the proposed rescheduling. Several speakers questioned the scientific basis of the recommendation. The lack of support was a remarkable difference with the written replies the WHO had received in past months, where 11 out of 13 countries had made clear they had no objections to the proposed rescheduling. Canada was at least honest in its rejection, commending the WHO for its "excellent expert advice", the validity of which they did not question, but making clear that for other considerations the government could not support rescheduling because it "may send a confusing message with regard to the risks associated to cannabis use".

More information on the debate on dronabinol at the CND 2007 Meeting is available in a report by the International Drug Policy Consortium at: http://www.idpc.info/docs/IDPC_Report_5.pdf

(Source: IDPC Report of the CND Meeting of March 2007)

Science — THC promotes weight gain in elderly subjects suffering from appetite and weight loss

According to research conducted at the Saint Louis University the use of THC may increase weight in elderly subjects who suffer from anorexia (loss of appetite) and weight loss. Scientists conducted a retrospective observational study on 28 patients with a mean age of 79.5 years, who received oral THC for twelve weeks.

Mean body weight at baseline was 47.9 kilogram. 15 participants (53.5 per cent) gained weight on THC, of which 10 gained more than 2.3 kg and 6 more than 4.5 kg. Residents who lost weight on THC were younger than those who gained weight (70.9 years and 90.8 years respectively). Overall, the mean weight gain on dronabinol was 1.4 kg. Eleven subjects lost weight. Of the subjects who lost weight 7 (64 per cent) died compared with 4 (26 per cent) in the subgroup who gained weight.

The whole abstract of the study is available at:

http://www.cannabis-med.org/studies/study.php

(Source: Wilson MM, Philpot C, Morley JE. Anorexia of aging in long term care: is dronabinol an effective appetite stimulant? - a pilot study. J Nutr Health Aging 2007;11(2):195-8.)

Science — Vaporization of cannabis is an effective method to deliver THC according to a clinical study

In a study conducted at the University of California by Dr. Donald Abrams and his colleagues 18 healthy subjects received three different strains of cannabis (with a THC content of 1.7, 3.4 or 6.8 per cent) by vaporization (Volcano, Storz & Bickel) as well as by smoking a cannabis cigarette. Peak plasma concentrations and bioavailability of THC were similar under the two conditions. The levels of carbon monoxide were reduced with vaporization. Researchers concluded that "vaporization of cannabis is a safe and effective mode of delivery of THC."

According to a study on interviews with cannabis users in the internet by researchers of the State University of New York the use of vaporizer is associated with decreased self-reported respiratory symptoms compared to cannabis users who smoke the drug.

(Sources: Abrams DI, Vizoso HP, Shade SB, Jay C, Kelly ME, Benowitz NL. Vaporization as a smokeless cannabis delivery system: a pilot study. Clin Pharmacol Ther. 2007 Apr 11; [Electronic publication ahead of print]; Earleywine M, Barnwell SS. Decreased respiratory symptoms in cannabis users who vaporize. Harm Reduct J 2007;4:11.)

Science — THC reduces cancer growth and spreading to other organs in lung cancer

According to a press release by the American Association for Cancer Research (AACR) an animal study by researchers at Harvard University was presented at the 2007 annual meeting of the organisation on 14-18 April in Los Angeles, which shows that THC may be useful in lung cancer.

THC was shown to reduce tumour growth in common lung cancer by about 50 per cent and significantly reduce the ability of the cancer to spread in mice treated for three weeks with the substance. "The beauty of this study is that we are showing that a substance of abuse, if used prudently, may offer a new road to therapy against lung cancer," said researcher Dr. Anju Preet.

The press release of the AACR is available at:

http://www.aacr.org/home/public--media/public-policy--legislative-affairs/press-releases--articles.aspx?d=744

(Source: Press release of the AACR of 17 April 2007)

News in brief

Canada — Medical cannabis program

Currently, 1,742 patients are authorized by Health Canada to possess dried cannabis as a medication. Of these, 1,040 are licensed to grow their own, and another 167 people are licensed to grow cannabis for the exclusive use of licensed patients. The Health Ministry buys cannabis from a licenced grower for 328.75 Canadian Dollar (216 Euros) a kilogram and sells it to patients for about 5,000 Canadian Dollars a kilogram. According to a study by the Canadian AIDS Society about one third of people living with HIV/AIDS use cannabis for medical purposes, but only a few use it with permission of the government. (Sources: Canadian Press of 17 April 2007; Belle-Isle L, Hathaway A., AIDS Care 2007;19(4):500-6.)

Science — Cannabinor in pain

According to a press release by Pharmos Corporation their synthetic cannabinoid cannabinor was effective in reducing post-operative pain in more than 100 patients undergoing tooth extraction. There were no differences in adverse effects between placebo and the three doses of cannabinor used in the study (12, 24 and 36 mg given intravenously). Cannabinor is a selective CB2 receptor agonist. The drug does not bind to the CB1 receptor and therefore does not cause psychological side effects. (Source: Press release by Pharmos of 24 April 2007)

Science — Sex

According to interviews by scientists of the University of Liverpool with 270 people aged 18-66 years subjects reported that compared to sex after alcohol, sex on cannabis, cocaine and ecstasy was more pleasurable and satisfying, with a greater perception of contact with the partner and a greater willingness to sexually experiment. (Source: Sumnall H, et al. J Psychopharmacol. 2007 Apr 19; [Electronic publication ahead of print])

Science — Function of the heart

According to a research with mice the absence of the protein that degrades the endocannabinoid anandamide results in a slowed aging of the cardiovascular system and slowed development of atherosclerosis. The higher concentration of the endocannabinoid resulted in reduced inflammation and reduced oxidative stress. (Source: Batkai S, et al. Am J Physiol Heart Circ Physiol. 2007 Apr 13; [Electronic publication ahead of print])

Italy — Symposium

There will be a symposium on the medical use of cannabis entitled "Canapa medica: le prospettive per i malati" (Medical cannabis: the perspectives for the ill) on 3-4 May 2007 at the University of Pisa. (Source: Associazione Cannabis Terapeutica, www.medicalcannabis.it)