IACM-Bulletin of March 18, 2007

USA — New Mexico will become the twelfth state to legalize the medical use of cannabis

On 13 March the House of Representatives approved a bill that would legalize the use of cannabis for medical purposes in New Mexico by a 36-31 vote. On 14 March the Senate, which already approved the bill some time ago, accepted a small change by the House of Representatives that would forbid the distribution of cannabis within 300 feet (about 100 meters) of any church, school or day-care center.

New Mexico's bill, which is now sent to Gouvenor Bill Richardson, who already said that he will approve the measure. It will allow patients to use cannabis to alleviate the symptoms of several debilitating medical conditions approved by the state Department of Health. Under the bill, the department would be required to create a system for distributing medical cannabis to patients by 1 October 2007. The department would issue identification cards to patients and caregivers, and also license producers to grow cannabis.

"This bill will provide much-needed relief for New Mexicans suffering from debilitating diseases while including the proper safeguards to prevent abuse," Gouvenor Richardson said in a written statement. Alaska, Arizona, California, Colorado, Hawaii, Maine, Nevada, Oregon, Rhode Island, Vermont and Washington have already legalized the medical use of cannabis.

(Source: New Mexican of 14 March 2007, Associated Press of 15 March 2007)

Science — Dronabinol as effective as ondansetron in the treatment of delayed nausea and vomiting after chemotherapy

In a clinical study at the Bethesda Memorial Hospital in Boynton Beach, USA, dronabinol was as effective as ondansetron in 61 patients who received chemotherapy in reducing delayed nausea and vomiting. A combination of both medications was no more effective than both of the single drugs.

Patients received dexamethasone (20 mg oral) and ondansetron (16 mg intravenous) on day 1. They also received either placebo or dronabinol (2.5 mg oral) before and after chemotherapy. On day 2, fixed doses of placebo, dronabinol (10 mg), ondansetron (16 mg), or combination therapy were administered. On days 3-5, patients received placebo, flexible doses of dronabinol (10-20 mg), ondansetron (8-16 mg), or dronabinol and ondansetron.

Total response to therapy was defined as nausea intensity below 5 on a visual analog scale, no vomiting or retching and no need for additional antiemetic medication. 64 patients participated and 61 were analyzed. Total response was similar with dronabinol (54 per cent), ondansetron (58 per cent), and combination therapy (47 per cent) versus placebo (20 per cent). Nausea absence was significantly greater in active treatment groups (dronabinol, 71 per cent; ondansetron, 64 per cent; combination therapy, 53 per cent) versus placebo (15 per cent). Nausea intensity and vomiting or retching were lowest in patients treated with dronabinol. All active treatments were well tolerated.

The abstract is available at:

http://www.cannabis-med.org/studies/study.php

(Source: Meiri E, Jhangiani H, Vredenburgh JJ, Barbato LM, Carter FJ, Yang HM, Baranowski V. Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting. Curr Med Res Opin 2007;23(3):533-43.)

USA — Federal court denies fundamental right to use cannabis for medical purposes

A California woman with an inoperable brain tumour may not use cannabis to ease her pain even though a Californian law permits it, a federal appeals court ruled on 14 March. The Federal Court of Appeals for the 9th Circuit found there is no fundamental right to use cannabis for medical purposes. The ruling agreed with a 2005 Supreme Court decision.

The judges expressed sympathy for some arguments by plaintiff Angel Raich. The court's decision said use of the drug for medical purposes was gaining support but federal law still banned it. "We agree with Raich that medical and conventional wisdom that recognises the use of marijuana for medical purposes is gaining traction in the law as well," the decision said. "For now, federal law is blind to the wisdom of a future day when the right to use medical marijuana to alleviate excruciating pain may be deemed fundamental."

(Source: Reuters of 14 March 2007)

News in brief

UK — Drug laws

An expert panel, the RSA Commission on Illegal Drugs, Communities and Public Policy, calls for a change of drug laws, since they are not based on scientific knowledge. In a 335-page report they state that "cannabis is likely to fall roughly in the middle of any harms index. (…) Its position on the harms index several places below both alcohol or tobacco suggests that the form this control takes might have to correspond far more closely with the way in which alcohol and tobacco are regulated." The whole report is available at: http://www.rsadrugscommission.org/ (Source: RSA report of 8 March 2007)

Science — Pain

In animal experiments it was shown that blockade of a certain protein (cyclooxygenase), for example by indomethacin, increased the pain-reducing effects of a synthetic cannabinoid (WIN55,212-2). Indomethacin is a widely-used anti-inflammatory drug. (Source: Ahn DK, et al. Pain. 2007 Feb 22; [Electronic publication ahead of print])