IACM-Bulletin of August 5, 2001

Canada — New rules on medical use of marijuana take effect

Canadians suffering from terminal illnesses and chronic conditions can legally grow and smoke cannabis, or designate someone else to grow it for them, under regulations that took effect on 30 July. About 300 patients are currently exempted from cannabis prohibition. More than 500 new applications are pending, and more are expected.

The new rules permit drug possession for (1) the terminally ill with a prognosis of death within one year; (2) those with symptoms associated with specific serious medical conditions, among them severe arthritis, cancer, HIV/AIDS, epilepsy and multiple sclerosis; and (3) those with other medical conditions who have statements from two doctors saying conventional treatments have not worked.

The regulations includes a government-approved supply of marijuana, now being grown in a former copper mine in northern Manitoba. The first marijuana harvest is expected this fall. It will be supplied by the government to eligible patients and used for research on therapeutic effects.

The new health regulations were drawn up after a court ruling last year that gave the government until 31 July to create a way for people requiring marijuana for medicinal purposes to legally obtain it.

(Source: Associated Press of 30 July 2001)

Science — Study with smoked cannabis in pain funded by Canadian government

Health Minister Allan Rock, and Dr. Alan Bernstein, President of the Canadian Institutes of Health Research, announced on 26 July a Government of Canada contribution of $235,000 to fund a clinical study that will examine the therapeutic uses of cannabis.

This is the first clinical trial related to the medical use of marijuana to be funded by Health Canada. Researchers at the Pain Centre of McGill University will conduct a one-year pilot study of smoked cannabis for chronic neuropathic pain at the General Hospital of Montreal.

The study will also be the world's first peer-reviewed clinical trial examining the effects of smoked cannabis in a non-HIV or multiple sclerosis population. While other studies have tested the effects of cannabis constituents on pain, this will be the first trial in which participants will smoke the substance as outpatients.

"The McGill Pain Centre has designed this study to mirror, as much as possible, the real-life conditions under which patients can currently use cannabis," said lead researcher Dr. Mark Ware, an assistant professor of anaesthesia at McGill University.

(Source: CNN Newswire via COMTEX of 26 July 2001)

News in brief

Science — Study in long-term users

Four recipients of federally provided medical marijuana in the USA were examined for the health effects of their long-term cannabis use. Minor changes in pulmonary function were found in two of the four. No other negative functions were discovered. The study was headed by Montana neurologist Dr. Ethan Russo and Virginia nurse Mary Lynn Mathre. Results will be published in the Journal of Cannabis Therapeutics in January 2002.

Science — Modulation of FAAH

The enzyme fatty acid amide hydrolase (FAAH) plays a major role for the degradation of the endocannabinoid anandamide. Decrease of FAAH level leads to an increase of anandamide levels, resulting in possible therapeutic effects, e.g. analgesia. Thus, modulation of FAAH levels may be interesting for therapeutic purposes. (Cravatt BF, et al. Proc Natl Acad Sci U S A 2001;98(16):9371-9376)

USA — San Mateo County study

So far only one AIDS patient has met the strict criteria required for enrolment into a San Mateo County study. The county has been recruiting for its pioneering medicinal marijuana study for three weeks, since the arrival of the cannabis from a federal farm in Mississippi. (Source: Contra Costa Times of 25 July 2001)

Science — Opiate withdrawal

Findings of a study in mice suggest that in morphine dependence, upregulation of cannabinoid CB1 receptors occurs. Thus, CB1 receptor agonists may have potential as therapeutic drugs for opiate withdrawal symptoms. (Source: Yamaguchi T, et al. Brain Res 2001;909(1-2):121-126)

Science — Brain tumours

Local administration of a selective CB2 receptor agonist induced a considerable regression of malignant gliomas in mice. The results support a therapeutic approach for the treatment of this brain tumour without psychotropic side effects. (Source: Sanchez C, et al. Cancer Res 2001;61(15):5784-5789)

Science — Amyotrophic lateral sclerosis

Cannabis has many properties that may be applicable to the management of amyotrophic lateral sclerosis (ALS). These include analgesia, muscle relaxation, bronchodilation, saliva reduction, appetite stimulation, sleep induction, and neuroprotection. (Source: Carter GT, Rosen BS. Am J Hosp Palliat Care 2001;18(4):264-270)

Science — Effects on circulation

Cannabinoids elicit dilation of coronary and brain arteries in rats by direct activation of cannabinoid CB1 receptors of blood vessels. (Source: Wagner JA, et al. Eur J Pharmacol 2001;423(2-3):203-210)

UK — Decriminalisation

A BBC survey showed that at least 81 Labour members of parliament would be prepared to vote for decriminalisation of cannabis if it was recommended by a Royal Commission, against 31 who said they would oppose it. (Source: PA News of 19 July 2001)