IACM-Bulletin of February 1, 2004

UK — Relaxed cannabis law took effect

The new British cannabis law took effect on 29 January. The drug has been downgraded to the same status as anabolic steroids and anti-depressants. This means that cannabis possession will no longer lead to arrest in most cases. According to a new poll of 2,500 Britons 52 percent said they support reclassification.

Under the new law, cannabis possession will be illegal but will "ordinarily not be an arrestable offence". Instead, police will usually give a warning and the drug will be confiscated. Under certain circumstances cannabis use will still lead to arrest, among them smoking the drug in public and possession of the drug inside or near places where there are children.

Several medical groups warned that the government's decision to downgrade cannabis could endanger public health. Dr. Peter Maguire of the British Medical Association said: "The BMA is extremely concerned that the public might think that reclassification equals safe. It does not. Chronic cannabis smoking increases the risk of heart disease, lung cancer, bronchitis and emphysema."

But Sir Michael Rawlins, chairman of the Advisory Council on the Misuse of Drugs, said on 26 January that it was time to consider whether to go further. He said his members were investigating new ways of measuring the relative harmfulness of all illegal drugs.

(Sources: The Guardian of 27 January 2004, Western Gazette of 29 January 2004)

Switzerland/UK — Death was not caused by cannabis

On 20 January 2004 the newspaper Daily Telegraph reported that cannabis was blamed as cause of death of a 36 year old British man. However, a review of the toxicological data and autopsy report by a Swiss expert revealed that there is no reason to assume that the sudden death of Lee Maisey in August 2003 was due to cannabis.

Mr Maisey smoked six cannabis cigarettes a day for 11 years, which was reported in some newspapers to be "excessive". He had complained of a headache on 22 August last year and was found dead at his home next morning. Michael Howells, the local coroner, who led the investigation of the death cause, said Mr Maisey was free from disease and had not drunk alcohol for at least 48 hours. "High levels of cannabinoids" had been found in his blood. The report led to new warnings about the dangers of the drug. Dr. John Henry, a professor of toxicology at Imperial College, London, said: "I have not seen anything like this before. It corrects the argument that cannabis cannot kill anybody."

The Federal Health Ministry of Switzerland asked Dr. Rudolf Brenneisen, a professor at the department for clinical research at the University of Bern, to review the data of this case. Dr. Brenneisen said that the data of the toxicological analysis and collected by autopsy were "scanty and not conclusive" and that the conclusion death by cannabis intoxication was "not legitimate".

According to the toxicological analysis of a British laboratory (Forensic Alliance) Mr Maisey's blood contained 130 nanograms per milliliter (ng/ml) of the THC metabolite THC-COOH. THC could not be detected due to analytical problems. Dr. Franjo Grotenhermen of the nova-Institute in Cologne said: "A concentration of 130 ng/ml THC-COOH in blood is a moderate concentration, which may be observed some hours after the use of one or two joints. Heavy regular use of cannabis easily results in THC-COOH concentrations of above 500 ng/ml. Many people use much more cannabis than Mr Maisey did, without any negative consequences."

(Sources: Daily Telegraph of 20 January 2004, Neue Zuericher Zeitung of 28 January 2004, personal communications)

Science — THC reinforced the anti-emetic effects of ondansetron in animal study

The 5-HT3 antagonists, such as ondansetron, are regarded as the most effective drugs to treat cancer chemotherapy induced nausea and vomiting. The natural cannabinoids THC and CBD (cannabidiol) are also known to inhibit these symptoms. The relative and combined effectiveness of these drugs in suppressing vomiting produced by cisplatin was investigated in shrews. Cisplatin is a chemotherapeutic agent that causes severe emesis.

Researchers of the Wilfrid Laurier University in Waterloo, Canada, demonstrated that ondansetron and THC both dose-dependently suppressed cisplatin-induced vomiting and retching in shrews. Furthermore, a combined pre-treatment of doses of the two drugs that

were ineffective alone completely suppressed vomiting and retching. CBD produced

a biphasic effect, suppressing vomiting at low doses and increasing it at high doses.

In two earlier clinical studies by Artim and DiBella (1983) and Lane and colleagues (1991) THC increased the anti-emetic effect of prochlorperazine in humans who underwent chemotherapy. The new animal study shows that cannabinoids may help to suppress nausea and vomiting that are not controlled by 5-HT3 antagonists alone.

(Source: Kwiatkowska M, Parker LA, Burton P, Mechoulam R. A comparative analysis of the potential of cannabinoids and ondansetron to suppress cisplatin-induced emesis in the Suncus murinus (house musk shrew). Psychopharmacology (Berl) 2004 Jan 22, [electronic publication ahead of print])

News in brief

UK — Cannabis medicine available in summer

The cannabis based medication developed by GW Pharmaceuticals is expected to be approved for sale in Britain in spring. Alan Macfarlane, a chief inspector at the Home Office, said the results of the clinical trials for Sativex looked promising. "I'm hoping it will be dealt with in the next two to three months, and I will be surprised if it doesn't succeed," he said. GW Pharmaceuticals hopes to make the medicine available in summer. (Source: New York Times of 27 January 2004)

Science — Effect of legal status

The effect of the legal status and the price of cannabis on frequency of use was investigated by an Australian researcher. He summarized that "decriminalisation is associated with an increase in the prevalence of use by males over the age of 25. There is no evidence that decriminalisation significantly increases participation in marijuana use by either young males or females, or that decriminalisation increases the frequency of use among marijuana users." (Source: Williams J. Health Econ 2004;13(2):123-37)

Science — Cannabis and dogs

The effect of cannabis ingestion by 213 dogs in the years 1998 until 2003 was analysed by researchers of the Faculty of Veterinary Medicine in Warsaw, Poland. The amount of cannabis ingested ranged from 0.5 to 90 grams. The lowest dose at which signs of intoxication occurred was 85 milligrams per kilogram of body weight and the highest reported dose was 26.8 grams per kilogram. The signs lasted from 30 min to 96 h. All animals made full recoveries. (Source: Janczyk P, et al. Vet Hum Toxicol 2004;46(1):19-21)

Science — Cannabis and driving

According to research by British scientists a moderate amount of cannabis may actually improve driving performance. A group of 20 drivers aged 21-40 participated in a driving simulator test. Ten of them smoked the equivalent of about half a cannabis cigarette. Subjects under cannabis scored superior than the sober subjects in most of the tasks including reaction time and number of collisions. Simon Smith Wright, the director of the laboratory where the studies were conducted, said: "The results of our test clearly show that a small or moderate amount of cannabis is actually quite beneficial to someone's driving performance." (Source: Evening News of 24 January 2004)

Canada — Cannabis club of Toronto

On 28 January the federal justice department has dropped drug trafficking charges against owners of a Toronto "compassion club," a new victory for unlicensed groups that provide patients access to medical marijuana. The centre was raided by the police in August, 2002. At the time, it was providing cannabis to 1,200 patients who had a doctor's prescription. (Source: Toronto Star by 29 January 2004)

USA — California

According to a new state wide survey 75 per cent of Californian voters support the medical use of cannabis, which is considerably more than some years ago. Proposition 215, the Californian marijuana law, passed with only 56 per cent in 1996. Today the acceptance of the law is much higher than 1996. (Source: Sacramento Bee of 30 January 2004)