IACM-Bulletin of November 28, 2004

USA — Bill to protect medical marijuana patients introduced into the US senate

On 17 November Senators Richard Durbin (Illinois), Patrick Leahy (Vermont) and Jim Jeffords (Vermont) have introduced the first-ever Senate bill to ensure that jurors of federal court hear the full story when medical marijuana patients and providers, operating legally under state law, are tried on federal marijuana charges.

This bill (S. 2989) is similar to the "Truth in Trials Act", introduced into the House of Representatives last year. This bill was in part inspired by the case of Ed Rosenthal. In January 2003, Rosenthal was found guilty of illegal marijuana cultivation by a jury that was not allowed to consider that the cannabis was for medical use by seriously ill patients and was grown with the authorization of the city of Oakland, California.

When they learned the truth, jurors who convicted Rosenthal publicly repudiated their own verdict and apologized to him, feeling they had been duped into convicting an innocent man. In his statement introducing the bill, Durbin noted, "This is a narrowly-tailored bill ... Under this legislation, defendants in the ten states with medicinal marijuana laws could be found not guilty of violating federal law if their actions are done in compliance with state law."

(Source: Marijuana Policy Project of 18 November 2004)

Italy — Difficulties to obtain cannabis-based medicines

While cannabis is still listed in the Italian Pharmacopoeia, there are no cannabis-based medicines available in Italy. Patients with multiple sclerosis or other conditions where cannabis or derivatives might offer some benefit, must obtain a special import permit from the Health Ministry for each prescription of their physician.

Drugs registered in other countries, such as Nabilone or Dronabinol (Marinol) or cannabis available in Dutch pharmacies, can be prescribed by Italian doctors, but the procedure to import them is very complicated. Since these drugs are controlled drugs (narcotics) a single prescription cannot be issued for more than 30 daily doses. Moreover, such drugs cannot be obtained through an ordinary pharmacy, but only through the pharmacy of the “local health agency” (ASL), usually the nearest hospital. Furthermore, Italian physicians are very reluctant to prescribe such a controversial drug.

To the knowledge of the Italian Association for Therapeutic Cannabis (Associazione per la Cannabis Terapeutica, ACT) there are only a few patients in Italy obtaining nabilone (most of them for MS), and probably one only with the permit to import medical cannabis from The Netherlands. Many of them have not been able to follow their therapy regularly due to the problems described above.

(Source: Associazione per la Cannabis Terapeutica, www.medicalcannabis.it)

News in brief

UK — Conference on cannabis and mental health

An international conference on cannabis and mental health will be held on 2-3 December 2004 at the Institute for Psychiatry in London. There will be a debate at the end of the conference with the motion “This house believes the legalization of cannabis would reduce the risk of mental illness”. The conference is organized by Drs Zerrin Atakan, Robin Murray and Jim van Os. Among the speakers will be Raphael Mechoulam, Wayne Hall, Don Liszen, Richard Doll, Nadia Solowij, Les Iversen and many others. More information at: http://www.iop.kcl.ac.uk/iopweb/events/?event=136

USA — Texas

A strong majority of Texans favour legalizing the medical use of marijuana, according to a new poll. 75 per cent said people with cancer and other serious illnesses should be allowed to use cannabis for medical purposes as long as their doctor approves, according to a Scripps Howard Texas poll question commissioned by Texans for Medical Marijuana. 19 per cent said they would oppose such a bill. (Source: Houston Chronicle of 18 November 2004)

USA — Vermont

About 30 Vermonters have shown interest in using cannabis to treat medical conditions since the state started taking applications on 28 October 2004. The Department of Public Safety mailed out roughly 30 applications to those who wish to use the drug legally to alleviate symptoms of chronic diseases. Last spring, the Legislature passed a medical marijuana bill making Vermont the ninth state to legalize the medical use of cannabis. The law exempts people with debilitating medical conditions from prosecution or arrest for using a small amount of marijuana. The patient and a caregiver must register with the department and pay $100 to apply. (Source: Times Argus of 13 November 2004)

Science — Gastric acid secretion

It has been shown previously that cannabinoids reduce a gastric acid secretion. New animal research of Italian scientists shows that mainly the activation of peripheral cannabinoid-1-receptors are responsible for this effect. (Source: Adami M, et al. Brain Res Bull 2004;64(4):357-61)

Science — Stress

New research shows that endocannabinoids or the augmentation of endocannabinoid concentration may serve as a novel approach to the treatment of anxiety-related

disorders. Endocannabinoids reduce stress-induced activation of a functional unit called hypothalamic-pituitary-adrenal axis. Cannabinoids that bind to the CB1 receptor reduced blood corticosterone levels in stressed mice while a CB1 receptor antagonist increased corticosterone levels. (Source: Patel S, et al. Endocrinology 2004;145(12):5431-8)

Science — Cannabis and pain

The study by Berman and his colleagues on 48 patients with neuropathic pain from damage of the brachial plexus already published as an abstract in the journal Anaesthesia in 2003 was now published as an article in the journal Pain. Patients had received two different cannabis extracts in a double-blind crossover trial consisting of three 2-week periods. Both extracts decreased pain and improved sleep. The effects were moderate although mostly statistically significant. (Source: Berman JS, et al. Pain 2004; 112(3):299-306)

Science — Echinacea acts on cannabinoid receptors

Swiss researchers found that compounds of the Echinacea plant, so-called alkylamides, modulate the synthesis of tumour necrosis factor alpha (TNF-alpha). This effect was mediated by CB2 receptors. TNF-alpha is a compound produced by the body which plays an important role in the immune system. (Source: Gertsch J, et al. FEBS Lett 2004;577(3):563-9)