IACM-Bulletin of December 4, 2011

Science — Cannabis improves symptoms of inflammatory bowel disease in an open clinical study

At a Department of Gastroenterology belonging to Tel Aviv University, Israel, 13 patients with inflammatory bowel disease (IBD) were included in a pilot prospective study to investigate the effects of a treatment with inhaled cannabis. Several parameters were assessed before treatment and after three months of treatment including the Harvey-Bradshaw index, which provides information on disease activity in Crohn's disease, including general well-being, abdominal pain, number of liquid stools and complications.

After 3 months' treatment, patients reported improvement in general health perception, social functioning, ability to work, physical pain and depression. A schematic scale of health perception showed an improved average score from 4.1 to 7. Patients had an average weight gain of 4.3 kg and an average rise in BMI (body mass index) of 1.4. The average Harvey-Bradshaw index was reduced from 11.36 to 5.72. Authors concluded that "three months' treatment with inhaled cannabis improves quality of life measurements, disease activity index, and causes weight gain and rise in BMI in long-standing IBD patients."

(Source: Lahat A, Lang A, Ben-Horin S. Impact of Cannabis Treatment on the Quality of Life, Weight and Clinical Disease Activity in Inflammatory Bowel Disease Patients: A Pilot Prospective Study. Digestion. 2011;85(1):1-8.)

USA — Medical cannabis laws reduce number of traffic deaths due to lower alcohol consumption

A new study shows that laws legalizing the medical use of cannabis have resulted in a nearly nine percent drop in traffic deaths and a five percent reduction in beer sales. "Our research suggests that the legalization of medical marijuana reduces traffic fatalities through reducing alcohol consumption by young adults," said Daniel Rees, professor of economics at the University of Colorado in Denver who co-authored the study with D. Mark Anderson, assistant professor of economics at Montana State University.

The researchers collected data from a variety of sources including the National Survey on Drug Use and Health, the Behavioral Risk Factor Surveillance System, and the Fatality Analysis Reporting System. The study is the first to examine the relationship between the legalization of medical cannabis and traffic deaths. Anderson noted that traffic deaths are significant from a policy standpoint. "Traffic fatalities are an important outcome from a policy perspective because they represent the leading cause of death among Americans ages five to 34," he said. The economists analyzed traffic fatalities nationwide, including the 13 states that legalized medical cannabis between 1996 and 2009. "Although we make no policy recommendations, it certainly appears as though medical marijuana laws are making our highways safer," Rees said.

The study also examined cannabis use in three states that legalized medical cannabis in the mid-2000s, Montana, Rhode Island, and Vermont. Cannabis use by adults increased after legalization in Montana and Rhode Island, but not in Vermont. There was no evidence that cannabis use by minors increased.

More in: "Medical Marijuana Laws, Traffic Fatalities, and Alcohol Consumption":

- http://www.iza.org/en/webcontent/publications/papers/viewAbstract?dp_id=6112

- http://www.eurekalert.org/pub_releases/2011-11/uocd-ssm112911.php

(Source: Eurekalert of 29 November 2011)

News in brief

USA — Governors for cannabis reclassification

The governors of Washington state and Rhode Island filed a petition with the U.S. Drug Enforcement Administration on 30 November that would allow doctors to legally prescribe cannabis as a medical treatment. Democrat Christine Gregoire of Washington and independent Lincoln Chafee of Rhode Island are asking the DEA to reclassify cannabis as a schedule 2 drug from schedule 1 which would make it legal for doctors to recommend its use and pharmacists to supply it. Washington and Rhode Island are two of 16 U.S. states that allow the medical use of cannabis. (Source: Reuters of 1 December 2011)

Europe — Sativex

The British company GW Pharmaceuticals announced that it intends to expand approvals for Sativex to up to 10 additional European countries in 2012. Sativex is already available in the UK, Germany, Spain and Denmark and approved in the Czech Republic. Further approvals are expected in Italy, Sweden and Austria with expected launches in 2012. (Source: Press release by GW Pharmaceuticals of 28 November 2011)

Science — Bone loss

It is known that a treatment with glucocorticoids (cortisone) increases the risk of osteoporosis. Researchers from Taiwan demonstrated that this effect was mediated by the CB1 receptor. A CB1 receptor antagonist blocked this effect. Authors concluded that "modulation of CB1 signalling has therapeutic potential for preventing glucocorticoid-induced osteopenic disorders." (Source: Ko JY, et al. Arthritis Rheum. 2011 Nov 29. [in press])

Science — Eye blink

According to research at the University of Leiden, The Netherlands, regular cannabis use decreases eye blink rates. Eye blink rates correlated negatively with years of cannabis exposure, monthly peak cannabis consumption, and lifetime cannabis consumption. (Source: Kowal MA, et al. PLoS One 2011;6(11):e26662.)

Science — Inflammation of the bowel

According to animal research at the University of South Carolina in Columbia, USA, a synthetic cannabinoid reduced inflammation of the bowel (colitis) by inducing apoptosis in activated T cells, reducing the numbers of activated T cells, and suppressing induction of further white blood cells (mast cells, natural killer cells, and neutrophils) at sites of inflammation. These effects were mediated by the CB2 receptor. (Source: Singh UP, et al. Toxicol Appl Pharmacol. 2011 Nov 18. [in press])

Science — Stroke

Animal research of Takeda Pharmaceutical Company in Kanagawa, Japan, shows that activation of the CB1 and CB2 receptor by a synthetic cannabinoid (TAK-937) reduced the consequences of temporarily reduced blood supply to the brain. Scientists concluded that "TAK-937 may be useful for treatment of acute ischemic stroke." (Source: Suzuki N, et al. Brain Res. 2011 Nov 4. [in press])

Science — Rhythm disturbance of the heart

Cannabidiol (CBD) and a CB1 receptor antagonist were shown to stabilize the rhythm of the heart by different mechanisms of action. Researchers at Robert Gordon University in Aberdeen, UK, showed that a CB1 receptor antagonist and CBD acted synergistically. They suggest that there is a "cross-talk between CB1 and other CB receptors in the heart during ischaemia." (Source: Hepburn CY, et al. Heart 2011;97(24):e8.)

Science — Heart attack

According to animal research at Shanghai Jiaotong University, China, activation of the CB2 receptor protects the heart from reduced blood supply, offering a possible treatment for acute heart attack. (Source: Wang PF, et al. J Cardiovasc Pharmacol. 2011 Nov 21. [in press])

Science — Atherosclerosis

According to research at Geneva University, Switzerland, with tissue from human arteries (carotid artery) and with animals the CB2 receptor is down-regulated in unstable plaques of atherosclerotic arteries. Authors suggest that CB2 receptor activation "might selectively reduce carotid vulnerability in humans." (Source: Montecucco F, et al. Eur Heart J. 2011 Nov 22. [in press])

Science — Physical exercise

According to research at the University of Munich, Germany, the endocannabinoid system is activated in humans in strenuous exercise. The blood concentrations of anandamide more than doubled in 12 trained healthy volunteers after strenuous hiking. This effect was further increased by reduced oxygen concentration at high altitude in the mountains. (Source: Feuerecker M, et al. Eur J Appl Physiol. 2011 Nov 19. [in press])

Science — Cannabis use

According to research at Columbia University in New York, USA, cannabis use is nearly twice as high in states with medical cannabis laws compared to states without such laws. They included about 68,000 individuals in the study. They wrote that the association may be due to "an underlying common cause, such as community norms supportive of the legalization of medical marijuana and of marijuana use." (Source: Cerdá M, et al. Drug Alcohol Depend. 2011 Nov 16. [in press])