IACM-Bulletin of December 24, 2006

Switzerland — Parliament adopts the possibility of certificates of exemption for the medical use of cannabis

According to a proposal by the Health Committee of the parliament (Nationalrat) of 4 May 2006 the Swiss Parliament decided on 20 December to relax prohibition of the medical use of natural cannabis products. The decision allows the Health Ministry to issue exemptions for the medical use of cannabis and the approval of cannabis-based medicines .

The proposal of the Health Committee says: "The committee suggests that with a certificate of exemption by the BAG [Federal Department of Health, Health Ministry] a limited medical use of narcotics of the type cannabis should be made newly possible in individual cases. At the same time, the substance can be subjected to the pharmaceutical evaluation by the Swiss Pharmaceutical Institute, once a corresponding narcotic will be used as an active agent in a medicine, which possesses an approval by the Swiss Pharmaceutical Institute. Physicians then can prescribe this drug for the approved indication."

Parliamentary Initiative for a partial revision of the narcotics law of 4 May 2006:

http://www.admin.ch/ch/d/ff/2006/8573.pdf

(Source: Protocol of the parliament's session of 20 December 2006, Parliamentary Initiative by the Health Committee of 4 May 2006)

Science — Nabilone improves pain and other symptoms in cancer patients

According to research presented on 15 December at the San Antonio Breast Cancer Symposium the synthetic cannabinoid nabilone improved pain, nausea, appetite, anxiety and depression in cancer patients. The effects of nabilone are similar to those of THC. Dr. Vincent Maida of the University of Toronto and his colleagues retrospectively collected data from the charts of patients, who participated in a special palliative medicine program between 1 May 2005 and 30 June 2006. Data from a total of 139 patients were reviewed, of which nabilone was prescribed to 82.

Mean duration of follow-up was similar between the two groups (nabilone: 53 days, non-nabilone: 52 days). Compared with participants, who received no cannabinoid, the nabilone participants experienced significant reductions in pain. Drowsiness, tiredness, appetite, and well-being remained stable in the nabilone group but deteriorated in the non-nabilone group. While subjects in the nabilone group had significantly greater nausea at baseline, they experienced a significant reduction of this symptom, in contrast to non-cannabinoid subjects. Depression and anxiety were significantly more prevalent in the nabilone group at baseline. However, reductions in both symptoms were significant with use of the cannabinoid. Conversely, anxiety and depression increased in the non-cannabinoid group. Nabilone appeared also to be effective in improving insomnia, night sweats and distress.

The researchers concluded that despite the limitations of the study "nabilone, when added to standard of care and taken longer-term, appears to offer significant alleviation of several symptoms in cancer patients, including pain, nausea, depression and anxiety, insomnia, fever/night sweats, and overall distress."

The abstract is available at:

http://www.abstracts2view.com/sabcs06/view.php?nu=SABCS06L_1211

and in the database on clinical studies on the IACM-website at:

http://www.cannabis-med.org/english/nav/home-science.htm

(Source: Maida V. The synthetic cannabinoid nabilone improves pain and symptom management in cancer patients. Abstract of the San Antonio Breast Cancer Symposium on 15 December 2006.)

News in brief

Science — Intestinal pain

In a study by French researchers the oral administration of lactobacillus acidophilus, a bacterium commonly found in yogurt, induced the formation of opioid and cannabinoid receptors in intestinal cells, and mediated pain relieving functions in the gut, which are similar to the effects of morphine. They concluded that these results suggest that the microbiology of the intestinal tract influences our perception of the belly, and "suggest new approaches for the treatment of abdominal pain and irritable bowel syndrome." (Source: Rousseaux C, et al. Nat Med. 2006 Dec 10; [electronic publication ahead of print])

USA — California

Merced County will begin issuing identification cards for medical cannabis users after a state judge recently confirmed the lawfulness of California's medical cannabis law. The county joined the lawsuit, brought by San Diego and San Bernardino Counties, which sued California over a state requirement that counties issue identification cards for medical cannabis users. The San Diego County and the San Bernardino County decided to appeal the ruling. (Sources: Associated Press of 12 December 2006, Merced Sun-Star of 16 December 2006)

USA — Drug use by adolescents

According to a report by the Marijuana Policy Project (MPP) the cannabis laws for adults have no effect on drug use by adolescents. It cites independent studies by RAND Europe and the U.S. National Research Council, which have reported that cannabis prohibition appears to have little or no impact on rates of use. Another report by MPP says that the value of cannabis production in the USA with an estimated production of 13.8 billion US dollars (about 10.5 billion Euros) exceeds the value of the production of any other agricultural product. (Source: www.mpp.org)

Science — Pain

Oral administration of the non-psychoactive cannabinoid cannabidiol (CBD) to rats reduced neuropathic and inflammatory pain, Italian researchers demonstrated. (Source: 2006 Nov 10; [electronic publication ahead of print])

Science — Parkinson's disease

According to a review by scientists of the University of Frankfurt, Germany, cannabinoids possess a therapeutic potential in Parkinson's disease. They may alleviate some symptoms (levodopa-induced dyskinesia) and due to their neuroprotective properties might slow the progression of the disease. (Source: Lastres-Becker I, Fernandez-Ruiz J. Curr Med Chem. 2006;13(30):3705-18.)