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IACM-Bulletin of July 8, 2018


Switzerland — The government intends to ease access to the medical use of cannabis

Switzerland, which permits low potency cannabis with THC concentrations of up to 1 % but bans cannabis with high THC content for recreational use, aims to allow pilot studies on ways to relax its laws, its government said on 4 July. It also proposed making it easier for people to access cannabis for medical use.

For medical cannabis use or use of THC, the law requires users to obtain an exemption from the federal health ministry. The government says this makes it difficult for the roughly 3,000 patients who now use the drug to get a treatment. It asked the Interior Ministry to come up with a proposal by next summer to streamline the process, and the Health Ministry to examine how to resolve insurance reimbursement issues for treatment with medical cannabis.

Reuters of 4 July 2018

USA — Health authority approves CBD-rich cannabis extract for the treatment of epilepsy

The U.S. health regulator for medicinal drugs approved GW Pharmaceuticals epilepsy cannabis-based drug on 25 June for the treatment of certain forms of epilepsy, making it the first cannabis-based drug to win approval in the country. “This approval serves as a reminder that advancing sound development programs that properly evaluate active ingredients contained in marijuana can lead to important medical therapies,” said Scott Gottlieb of the Food and Drug Administration.

The drug’s approval permits its use in patients aged two years and older with Dravet Syndrome and Lennox-Gastaut Syndrome, rare childhood-onset forms of epilepsy that are among the most resistant to treatment. The drug, Epidiolex, contains cannabidiol (CBD) and less than 0.1% of THC.

Reuters of 26 June 2018

Luxembourg — The country will legalise the medical use of cannabis

The parliament unanimously passed a bill that will legalize the use of cannabis for medicinal purposes. Passed on June 28, the new law allows that doctors can prescribe cannabis for patients suffering from chronic pain, chemotherapy-related nausea and muscle spasm as a result of multiple sclerosis. While the original draft of the medical cannabis law allowed only specialists to prescribe the treatment, the final version permits accredited general practitioners to offer patients a cannabis therapy.

The cannabis product will be imported from Canada in the form of oils and capsules, and will be available only by prescription from pharmacies located within a hospital. As the new law will certify only four hospitals within the 2600-square-kilometer nation to provide the treatment, some legislators have criticised the legislation for being too restrictive, pointing out that rural residents without access to delivery resources may have difficulty receiving the medicine.

Sputnik International of 1 July 2018

USA — Oklahoma becomes the 30th state to legalise the medical use of cannabis

Voters in Oklahoma on 26 June elected to legalize the medical use of cannabis, which makes the state the 30th state of the USA to allow the use of cannabis for medicinal purposes. The law allows individuals 18 and older to obtain a medical marijuana license. Minors can get a license but will require the approval of two physicians and their parent or legal guardian.

A new office in the Oklahoma State Department of Health will enforce regulations, including licensing for dispensaries, growers, and processors. The measure does not tie the medical use of cannabis to any specific qualifying conditions, which will likely make it easier, compared to many other states, to obtain cannabis for medicinal uses.

Vox of 27 June 2018

Science/Human — Cannabis reduces pain in multiple sclerosis

In a study conducted by researchers of the Central Hospital of Bolzano, Italy, with 19 patients suffering from multiple sclerosis a cannabis extract reduced pain. Patients underwent examinations before and after one month of treatment with the cannabis spray Sativex.

There was a significant increase in cold pain threshold by hand stimulation and a significant reduction in abnormal cold perception thresholds following cannabis treatment. Authors wrote that their investigation indicates “that Sativex therapy provides pain relief in MS patients and suggests that it might modulate peripheral cold-sensitive TRP channels.”

Turri M, Teatini F, Donato F, Zanette G, Tugnoli V, Deotto L, Bonetti B, Squintani G. Pain Modulation after Oromucosal Cannabinoid Spray (SATIVEX®) in Patients with Multiple Sclerosis: A Study with Quantitative Sensory Testing and Laser-Evoked Potentials. Medicines (Basel). 2018;5(3).

Science/Human — Cannabis tea effective in the treatment of chronic pain

Cannabis improved pain intensity, anxiety and depression in 338 pain patients was treated in the Santa Chiara University Hospital of Pisa, Italy. They received a decoction of dried cannabis flowers with 19 % THC for 12 months, in addition to their pharmacological therapy.

Pain intensity, pain disability, anxiety and depression symptoms showed a statistically significant reduction. Authors concluded that the study suggests “that Cannabis therapy, as an adjunct to a traditional analgesic therapy, can be an efficacious tool to make more effective the management of chronic pain and its consequences on functional and psychological dimension.“

Poli P, Crestani F, Salvadori C, Valenti I, Sannino C. Medical Cannabis in Patients with Chronic Pain: Effect on Pain Relief, Pain Disability, and Psychological aspects. A Prospective Non randomized Single Arm Clinical Trial. Clin Ter. 2017;168(3):e102-e107.

News in brief

IACM — Medical Cannabis and Cannabinoids

The new online journal Medical Cannabis and Cannabinoids offers publication of the first 25 articles free of charge for authors.

Medical Cannabis and Cannabinoids

UK — Further steps on the way to ease access to the medical use of cannabis

Britain moved a step closer to legalizing the medicinal use of cannabis after a report concluded there are benefits for patients. Professor Sally Davies, chief medical officer for England, said in the report there is conclusive evidence that cannabis can help certain patients. Britain’s interior ministry ordered a review into the medical use of cannabis last month.

Reuters of 3 July 2018

USA — Vermont has become the 9th state to legalise the recreational use of cannabis

Vermont has become the ninth state in the country to legalize recreational cannabis use. The state is the first state to enact the law through its legislature. Previous approvals in other states were accomplished through voter referenda. Vermont's new law took effect on 1 July. The law emphasizes private use and cultivation -- allowing adults to possess one ounce (about 28 g) of cannabis, and two mature and four immature cannabis plants. Just one ounce can be carried at any time, but more can be stored at home.

UPI of 2 July 2018

Science/Human — Cannabis reduces pain and increases the quality of life in pain patients

In a small retrospective analysis of 29 pain patients, who received cannabis for medicinal purposes, cannabis improved quality of life, reduced pain and opioid use. Adverse effects were reported by 10% of participants.

GPI Clinical Research, Rochester, New York, USA.

Bellnier T, et al. Ment Health Clin. 2018;8(3):110-115.

Science/Cells — Cannabigerol is a partial agonist at the CB2 receptor

Cannabigerol (CBG) is one of the major plant cannabinoids present in cannabis. Research shows that CBG is a partial agonist of CB2 receptor. The effect of CBG on the CB1 receptor was measurable but the underlying molecular mechanisms remain uncertain. Authors wrote that the “results indicate that CBG is indeed effective as regulator of endocannabinoid signalling.”

Faculty of Pharmacy, University of Barcelona, Spain.

Gemma Navarro G, et al. Front Pharmacol. 21 June 2018 [in press].

Science/Cells — A CB2 receptor agonist showed anti-cancer effects in leukaemia cells

Research demonstrates that a synthetic agonist to the CB2 receptor reduced proliferation and induced apoptosis, a form of programmed cell death, in certain leukaemia cells.

Department of Experimental Medicine, University of Rome "La Sapienza", Italy.

Capozzi A, et al. Int J Mol Sci. 2018;19(7).

Science/Animal — Cannabis extracts were more effective against breast cancer than pure THC

The anti-cancer effects of THC and cannabis were investigated in animal models of ER+/PR+, HER2+ and triple-negative breast cancer. The combination of cannabinoids with tamoxifen and lapatinib or with cisplatin produced additive anti-cancer effects in cell cultures. Combinations of these treatments in animals showed no interactions, either positive or negative.

Complutense University, Madrid, Spain.

Blasco-Benito S, et al. Biochem Pharmacol. 2018 Jun 27. [in press]

Science/Animal — Increased activity of the endocannabinoid system may be beneficial in Huntington’s disease

In a mouse model of Huntington’s disease (HD) goal-directed behaviour progressively declined with age, which was restored by increased levels of the endocannabinoid 2-AG (2-arachidonoylglycerol). Authors wrote, that “cannabinoid receptor-based therapies may benefit neuropsychiatric care for HD.”

University of Maryland School of Medicine, Baltimore, USA.

Covey DP, et al. Neuropsychopharmacology. 2018 Jun 1. [in press]

Australia — The majority of doctors are supportive or neutral with regards to the medical use of cannabis

Results of a survey completed by 640 general practitioners (response rate = 37%) on the medical use of cannabis show that the majority (61.5%) reported one or more patient enquiries about the medical use of cannabis in the last 3 months. Over half of physicians (56.5%) supported availability of cannabis on prescription.

The Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Australia.

Karanges EA, et al. BMJ Open. 2018;8(7):e022101.

Science/Human — Many cancer patients use cannabis in Canada

Of 1987 cancer patients, who responded to a survey, 18% reported cannabis use within the past 6 months. Of these 36% were new users. Their reasons for use included cancer-related pain (46%), nausea (34%), other cancer symptoms (31%), and non-cancer-related reasons (56%).

Tom Baker Cancer Centre, University of Calgary, Canada.

Martell K, et al. Curr Oncol. 2018;25(3):219-225.

Science/Human — Cannabis dependence was associated with an increased risk of suicide in war veterans

In a study with 319 war veterans, who had deployed to either Iraq or Afghanistan there was an increase in post-deployment suicide attempts in those with cannabis dependence.

Durham Veterans Affairs Medical Center , USA.

Adkisson K, et al. Arch Suicide Res. 2018:1-18.

Science/Animal — A synthetic cannabinoid ameliorates cognitive deficits in a model of vascular dementia

In a rat model of vascular dementia, which is characterised by chronic reduced blood supply to the brain and memory decline, a synthetic cannabinoid (WIN55,212-2), which activates both the CB1 and the CB2 receptor, reduced the production of inflammatory factors and improved learning and memory impairment.

Tong Ji University School of Medicine, Shanghai, China.

Wang DP, et al. Psychiatry Res. 2018;267:281-288.

Science/Cells — Cannabidiol binds to further receptors – Action against cancer and infertility

Research demonstrates that CBD (cannabidiol) is an inverse agonist for GPR3, GPR6, and GPR12. As known cannabis receptors (CB1 and CB2) they belong to the group of G protein-coupled receptors. Authors wrote that this discovery highlights these receptors “as potential new molecular targets for CBD, provides novel mechanisms of action, and suggests new therapeutic uses of CBD for illnesses such as Alzheimer's disease, Parkinson's disease, cancer, and infertility.”

University of Louisville School of Medicine, USA.

Laun AS, et al. Acta Pharmacol Sin. 2018 Jun 25. [in press]