IACM-Bulletin of May 9, 2010

Science — Nabilone reduces spasticity in patients with spinal cord injury in small clinical study

At the University of Manitoba in Winnipeg, Canada, the effects of nabilone were investigated in 12 subjects with spinal cord injury (SCI) and spasticity. Nabilone exhibits a similar spectrum of action as the natural cannabinoid dronabinol (THC). In a double blind, placebo-controlled crossover study participants received either nabilone or placebo during the first 4-week period. After 2-week washout period they were crossed over to the other medication. Patients started with 0.5 mg nabilone once a day with the option to increase to 0.5 mg twice a day.

One subject dropped out during the placebo phase, and 11 subjects completed the study. In comparison with placebo, nabilone caused a significant decrease of spasticity measured by the Ashworth Scale in the most involved muscle, as well as a significant decrease in the total Ashworth score. There was no significant difference in other measures. Side effects were mild and tolerable. Authors concluded that "nabilone may be beneficial to reduce spasticity in people with SCI. We recommend a larger trial with a more prolonged treatment period and an option to slowly increase the dosage further."

(Source: Pooyania S, Ethans K, Szturm T, Casey A, Perry D. A randomized, double-blinded, crossover pilot study assessing the effect of nabilone on spasticity in persons with spinal cord injury. Arch Phys Med Rehabil 2010;91(5):703-7.)

Science — Cannabidiol reduces the appetite-enhancing effects of THC in cannabis users

According to a study with 94 cannabis users at the University College London, UK, the effects of the drug vary according to the ratio of cannabidiol (CBD) and THC. Participants were tested 7 days apart, once while non-intoxicated and once while acutely under the influence of their own chosen smoked cannabis on the appetitive and reinforcing effects of the drug. A sample of cannabis was collected from each user and analysed for levels of cannabinoids. On the basis of CBD : THC ratios in the cannabis, individuals with a comparatively high and a low ratio were directly compared.

When under the influence of cannabis, smokers of cannabis with a comparatively high CBD content showed reduced liking for drug and food stimuli compared with smokers of cannabis with a low CBD : THC ratio. Those smoking higher CBD : THC strains also showed lower self-rated liking of cannabis stimuli on both test days. Researchers concluded that their "findings suggest that CBD has potential as a treatment for cannabis dependence."

(Source: Morgan CJ, Freeman TP, Schafer GL, Curran HV. Cannabidiol Attenuates the Appetitive Effects of Delta(9)-Tetrahydrocannabinol in Humans Smoking Their Chosen Cannabis. Neuropsychopharmacology 2010 Apr 28. [in press])

Germany — Expert committee on narcotics recommends re-classification of cannabis for medicinal purposes in the federal narcotics law

At its meeting on 3 May the German expert committee for narcotics recommended to the government the reclassification of "Cannabis (marijuana, plants and parts of plants belonging to the species cannabis)" from Annex I to Annex II of the narcotics law, as long as they "are intended for the production of preparations for medicinal purposes." The committee also recommended to add the following item to Annex III of the narcotics law: "Cannabis extract (extract obtained from plants and parts of plants belonging to the species cannabis)" and only "in preparations approved as medicines."

Annex I of the German narcotic law includes substances that cannot be prescribed and are not marketable, such as heroin, cocaine, LSD and cannabis. The re-classification of cannabis intended for the manufacturing of preparations for medicinal purposes into Annex II makes these substances marketable, which means, that pharmacies can handle them without a special permission. So far, pharmacies that want to deliver cannabis imported from the Netherlands to patients with a permission for the medical use of cannabis must apply for a permit. The inclusion of cannabis extract in Annex III of the narcotics law refers to the expected approval of Sativex, a cannabis extract of the British company GW Pharmaceuticals. In general, the federal government follows the recommendations of this expert committee.

(Source: News of the Federal Association of the Pharmaceutical Industry of 4 May 2010)

Belgium — The first Cannabis Social Club of Belgium brought in house the first harvest of cannabis

According to a press release by "Trekt Uw Plant", a Belgian Cannabis Social Club, the group brought their first harvest of their collective cannabis plantation in house on 10 April. After almost 4 years of work the association could present the first legally grown cannabis plants in Belgium to its members. Since 2005, a ministerial guideline is applied in Belgium according to which the possession of a maximum of 3 grams of cannabis and 1 female plant is not persecuted. The cannabis can not be confiscated without the consent of the owner.

During the past years Trekt Uw Plant has tested this guideline. At two occasions in 2006 and 2008, a collective cannabis plantation was presented in public. Both times, the plantation was confiscated and the board members of the association were arrested and persecuted. Both times, the association was convicted by the local judge, the first time because of cannabis possession, the second time because of "incitement to drug use". And both times the association appealed against this decision and finally was acquitted, on 26 June 2008 and on 25 February 2010. From this acquittal, Trekt Uw Plants draws the conclusion that its method fits completely within the intention of the Belgian lawmakers.

More at:

http://www.encod.org/info/TREKT-UW-PLANT-BRINGS-FIRST.html

(Source: Press release of Trekt Uw Plant of 26 April 2010)

News in brief

Science — Schizophrenia

A study at the Edmundston Regional Hospital in New Brunswick, Canada, with 8 men suffering from schizophrenia asked for their reasons for current or past cannabis use. The findings indicate "that cannabis is used as a means of satisfying the schizophrenia-related need for relaxation, sense of self-worth, and distraction." (Source: Francoeur N, et al. Can J Nurs Res 2010;42(1):132-49.)

Science — Cancer of the bile duct

According to cell experiments at the Rangsit University in Patumthani, Thailand, THC exhibits cancer-inhibiting effects in cancer cells of the bile duct. This natural cannabinoid inhibited proliferation, migration and invasion, and induced cell apoptosis. It reduced tumour cell survival. The cells were taken from patients with this cancer and possessed cannabinoid receptors. (Source: Leelawat S, et al. Cancer Invest 2010;28(4):357-63.)

Science — Sleep apnoea

In a study at the University of Leipzig, Germany, with 20 patients suffering from sleep apnoea and 57 healthy control subjects serum concentrations of the endocannabinoids anandamide (AEA), 2-arachidonyl-glycerol (2-AG) and oleoylethanolamide (OEA)were determined. In patients with sleep apnoea OEA serum concentrations were doubled compared to controls. Researchers concluded that high OEA concentrations "could be interpreted as a neuroprotective mechanism against chronic oxidative stressors and a mechanism to promote wakefulness in patients with nocturnal sleep deprivation and daytime hypersomnolence." (Source: Jumpertz R, et al. Exp Clin Endocrinol Diabetes 2010 Apr 28. [in press])

Science — Diabetes

Italian researchers investigated the level of several endocannabinoids (anandamide, 2-AG, OEA and PEA) in the subcutaneous fat of subjects with both obesity and type 2 diabetes. As compared to healthy normal weight persons the levels of anandamide, OEA and PEA levels were significantly elevated (2-4.4-fold) and 2-AG levels were 2.3-fold reduced. (Source: Annuzzi G, et al. Lipids Health Dis 2010;9(1):43.)