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IACM-Bulletin of October 4, 2015


IACM — Mark Ware elected as the new chairman

During its General Meeting on 18 September 2015 during the Cannabinoid Conference 2015 in Sestri Levante, Italy, the IACM elected a new board of directors and five patient representatives. The following board members were re-elected: Mark Ware from Canada, Kirsten Müller-Vahl from Germany, Daniela Parolaro from Italy, Roger Pertwee from the UK, Jahan Marcu from the USA, William Notcutt from the UK, Donald Abrams from the USA and Ilya Reznik from Israel. Ethan Russo from the USA and Manuel Guzman from Spain were elected as new board members. Mark Ware was elected as the first chairman and Kirsten Müller-Vahl as the second chairwoman. Franjo Grotenhermen remains the Executive Director of the IACM.

The following patient representatives were elected: Michael Krawitz from the USA, Alison Myrden from Canada, Sarah Martin from the UK, Sébastien Beguerie from France and Max Plenert from Germany, the latter two were elected for the first time. Prior to that the General Meeting changed the IACM statutes to allow for the election of up to six patient representatives.

Statutes and Board of Directors of the IACM

IACM — IACM-Awards 2015 go to Antonio Waldo Zuardi, David Robbe, Mahmoud A. Elsohly and Beat Lutz

During the Gala Dinner at the Cannabinoid Conference 2015 the IACM honoured four persons for special achievements regarding the re-introduction of cannabis and cannabinoids as medicine. The IACM Award 2015 for Clinical Research went to Antonio Waldo Zuardi, the IACM Ester Fride Award for Basic Research 2015 went to Beat Lutz, the IACM Award 2015 for Young Researchers went to David Robbe, and the IACM Special Award 2015 went to Mahmoud A. Elsohly.

Dr Antonio Waldo Zuardi is a Professor of Psychiatry at the Medical School, University of São Paulo, Ribeirão Preto, Brazil and researcher in cannabidiol since 1976. Dr Mahmoud A. ElSohly is a Research Professor at The National Center for Natural Products Research, and Professor of Pharmaceutics at the School of Pharmacy at the University of Mississippi, USA, and is the Director of the NIDA Marijuana Project. Dr David Robbe is Associate Professor at the Institut de Neurobiologie de la Méditerranée, Marseille, France. Dr Beat Lutz is a Professor for Physiological Chemistry and Head of the Institute of Physiological Chemistry at the University Medical Centre Mainz, Germany.

Science/Human — Cannabidiol may be effective in the treatment of schizophrenia

CBD (cannabidiol), a non-psychotropic plant cannabinoid, was effective in the treatment of schizophrenia in patients who had previously failed to respond adequately to anti-psychotic medications. The British company GW Pharmaceuticals announced positive results from an exploratory clinical Phase 2 trial in 88 patients with schizophrenia. In the trial, patients remained on their anti-psychotic medication and were randomized to receive CBD or placebo as adjunct therapy.

CBD was consistently superior to placebo in relevant aspects of the disease, for example for the Clinical Global Impression of Severity and for the Clinical Global Impression of Improvement. The proportion of responders on CBD was nearly three times higher than that of participants on placebo (Odds Ratio of 2.65). There were no serious adverse events and an overall frequency of adverse events very similar to placebo.

Press release by GW Pharmaceuticals of 15 September 2015

Reuters of 15 September 2015

Science/Human — Herbal cannabis safe for medical use in chronic pain

The use of herbal cannabis was associated with a higher rate of minor or moderate adverse events compared to non-using controls, but there was no difference in serious side effects at an average dose of 2.5g cannabis per day. This is a result of the COMPASS study (Cannabis for the Management of Pain: Assessment of Safety Study). This national multicentre study looked at the safety of medical cannabis use among patients suffering from chronic pain and was led by Dr Mark Ware of the McGill University Health Centre in Montréal, Canada.

The scientists found that patients with chronic pain, who used cannabis daily for one year, when carefully monitored, did not have an increase in serious adverse events compared to pain patients who did not use cannabis. The researchers followed 215 adult patients, with chronic non-cancer pain, who used medical cannabis, and compared them to a control group of 216 chronic pain sufferers who were not cannabis users. The study involved seven pain centres across Canada. The cannabis users were given access to herbal cannabis containing 12.5% THC from a licensed cannabis producer. Every month patients were asked to give information on adverse effects and underwent lung function and cognitive testing, and were asked about their pain, mood and quality of life.

Ware MA, Wang T, Shapiro S, Collet JP; COMPASS study team. Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS). J Pain. 2015 Sep 15. [in press]

Science Daily of 29 September 2015

Science/Human — Use of cannabis by adolescents decreased in the USA despite legalization of medical use in many states

Many states of the USA have passed cannabis decriminalization laws and more than 20 states have legalized the use of cannabis for medicinal purposes. But, according to two new studies, use of cannabis by adolescents has fallen over that same period. "Despite considerable changes in state marijuana policies over the past 15 years, marijuana use among high school students has largely declined," concludes one of the papers, published in Drug and Alcohol Dependence. The study looks at cannabis use among all high school students in the United States, as measured every two years by the National Youth Risk Behavior Survey. In 1999, 47.2 percent of high schoolers had reported ever using cannabis in their lifetime. That number plummeted to 36.8 percent in 2009. It crept back up to 40.7 percent by 2013, but the study's authors found that that uptick is, so far, not statistically significant.

The other study, published in the American Journal of Drug and Alcohol Abuse, suggests one reason behind the downward trend in use: strong disapproval of cannabis use among younger adolescents is up sharply from where it was even 10 years ago. That study looked at a different set of data -- attitudes toward cannabis and use of the drug as reported in the National Survey on Drug Use and Health. These numbers also show a decrease in cannabis use rates between 2002 and 2013. Disapproval is up sharply among teens age 13 and 14.

Johnson RM, Fairman B, Gilreath T, Xuan Z, Rothman EF, Parnham T, Furr-Holden CD. Past 15-year trends in adolescent marijuana use: Differences by race/ethnicity and sex. Drug Alcohol Depend 2015;155:8-15.

National Youth Risk Behavior Survey

Washington Post of 21 December 2015

Science/Human — Successful therapy of treatment resistant adult ADHD with cannabis in a case series with 30 patients

Adult ADHD patients, who are treatment-resistant to conventional pharmacological therapies (methylphenidate, atomoxetine and amphetamine or amphetamine derivatives), may experience an improvement of a variety of symptoms by cannabis flowers, including improved concentration and sleep, and reduced impulsivity. The anonymized medical certificates of 30 patients with adult ADHD from the medical practice of Dr Franjo Grotenhermen in Rüthen, Germany, were analysed by Dr Eva Milz, Medical Practice for Psychiatry and Psychotherapy, Berlin, Germany.

All patients were granted approval to use cannabis flowers between 2012 and 2014. In Germany, patients independent of medical condition may apply to a body (Bundesopiumstelle) of the Federal Health Ministry for an approval to use cannabis flowers from the pharmacy if standard therapies of a certain disease or symptom are not efficient or associated with severe side effects. Mean age of patients [28 male, 2 female] at first visit was 30 years [range: 21 to 51]. In 63% of cases ADHD was diagnosed only during adulthood. In all patients diagnosed in childhood [between 6 and 13 years of age] had previously been treated with methylphenidate. Further pharmacological treatment was atomoxetine, deexamphetamine, lisdexamphetamine and amphetamine juice. Medication was usually discontinued due to side effects and often due to ineffectiveness. Eight patients continued to take stimulants and combined them with cannabis, but 22 patients used it only.

Milz E, Grotenhermen F. Successful therapy of treatment resistant adult ADHD with cannabis: experience from a medical practice with 30 patients. Abstract book of the Cannabinoid Conference 2015, September 17-19, Sestri Levante, Italy, page 85.

Science/Human — Cannabis reduces symptoms of a large variety of medical conditions according to large survey

In a survey with 1331 participants, who used cannabis for medical purposes and responded between December 2013 and December 2014 an average symptom improvement of 3.96 on a scale of -5 (worsening) to +5 (improving) was reported across conditions. Lead author Dr Michelle Sexton from the Center for the Study of Cannabis and Social Policy in Seattle and Bastyr University Research Institute in Seattle, USA, presented these data of an ongoing survey at the Cannabinoid Conference 2015 in Sestri Levante, Italy.

Individuals from anywhere in the world could participate in the anonymous survey by recruitment at Washington State cannabis dispensing facilities and via internet. The majority of participants were male (55%). The most common symptoms for which participants used cannabis were pain, anxiety, depression, headache/migraine, and arthritis. Inhalation was the preferred route of administration. The majority of participants consumed between 3 to 7 grams of cannabis per week.

Sexton M, Finnell J, Stefano J, Mischley LK. An international survey of medical cannabis use: use patterns and health effects. Abstract book of the Cannabinoid Conference 2015, September 17-19, Sestri Levante, Italy, page 38.

To participate in the survey please visit the website.

News in brief

Science — Special issue on cannabis by Nature

A special issue by the journal Nature on cannabis is available for six months for free.


USA — Cannabis for recreational use available in Oregon

Cannabis sales for recreational use began in Oregon on 1 October. Oregon joined Washington State and Colorado in allowing the sale of the drug that remains illegal under U.S. federal law. Oregon residents 21 years and older can buy up to a quarter-ounce (seven grams) of dried cannabis at roughly 200 existing cannabis dispensaries.

Reuters of 1 October 2015

Science/Human — THC was not effective in preventing nausea after surgery

In a study with 40 patients with a high risk for postoperative nausea and vomiting, 0.125 mg THC per kilogram body weight given intravenously at the end of surgery or a placebo, THC was not superior to placebo. Side effects were described as “clinically relevant” by the authors.

Bern University Hospital, Switzerland.

Kleine-Brueggeney M, et al. Anesth Analg. 2015 Sep 30. [in press]

Science/Human — Patients with inflammatory bowel disease use higher doses of cannabis

In a study with 2,084,895 subjects with inflammatory bowel disease and 2,013,901 control subjects, participants with the bowel disease had a higher incidence of ever having used cannabis. Patients with the disease were more likely to use a heavier amount per day.

Temple University Hospital, Philadelphia, USA.

Weiss A, et al. Drug Alcohol Depend. 2015 Sep 14. [in press]

Science/Human — The concentration of endocannabinoids are not altered on touch massage

In a study with 20 healthy subjects touch massage did not have any effect on the blood levels of the endocannabinoids anandamide and 2-AG (2-arachidonoylglycerol) compared to a condition, where participants just relaxed.

Department of Integrative Medical Biology, Umeå University, Sweden.

Lindgren L, et al. BMC Res Notes. 2015;8:504.

Science/Cells — Anandamide and 2-AG have different effects on bone producing cells

Studies with human osteoblasts (cells that synthesise bone) have demonstrated a clear involvement of the endocannabinoids anandamide and 2-arachidonoylglycerol in modulating the activity of human osteoblasts. However, the effects of both endocannabinoids differed.

Royal Derby Hospital, University of Nottingham, United Kingdom.

Smith M, et al. PLoS One. 2015 Sep 28;10(9):e0136546.

Science/Animal — The activation of the CB2 receptor improves blood perfusion in the capillaries of the iris

Systemic administration of a cannabinoid to rats improved blood flow in the iris of the eye. This effect is most likely mediated by activation of the CB2 receptor. Authors wrote that their “findings indicate that the iris microvasculature can serve as a model to study the microcirculation during systemic inflammation”.

Department of Pharmacology, Dalhousie University, Halifax, Canada.

Toguri JT, et al. Clin Hemorheol Microcirc. 2015 Sep 9. [in press]

Science/Human — Cannabis use during pregnancy did not caused anomalies

In a study with 6,468 pregnant women, of whom 361 were cannabis users, cannabis use did not increase the number of complications during birth and of anomalies of the new-borns. However, the risk of small new-borns was increased by 30%.

Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, USA.

Warshak CR, et al. J Perinatol. 2015 Sep 24. [in press]

Science/Animal — A peripheral CB2-receptor agonist prevents damage to the kidneys caused by cisplatin

A synthetic cannabinoid (LEI-101), which only activates the CB2-receptor in the periphery and not in the brain prevented damage to the kidneys caused by cisplatin, a medicinal drug used in chemotherapy of cancer.

National Institutes of Health, Maryland, USA.

Mukhopadhyay P, et al. Br J Pharmacol. 2015 Sep 23. [in press]

Science/Animal — A blocker of the degradation of both anandamide and 2-AG is more effective in

A blocker of the degradation of both anandamide and 2-AG is more effective in reducing pain than blockers of one endocannabinoid alone

A substance (JZL 195), which inhibits the function of two enzymes (FAAH and MAGL), which are responsible for the degradation of the two endocannabinoids anandamide and to 2-AG, is more effective in reducing neuropathic pain than inhibitors of one of these two enzymes alone.

University of Sydney at Royal North Shore Hospital, St Leonards, Australia.

Adamson Barnes NS, et al. Br J Pharmacol. 2015 Sep 23. [in press]

Science/Animal — THC administration did not increase heroin self-administration in monkeys

Rhesus monkeys were allowed to self-administer heroin by pressing a lever. Daily treatment with THC every 12 hours either had no effect on or decreased responding for heroin. Authors wrote that repeated administration of THC “likely does not increase, and possibly decreases, the positive reinforcing effects” of heroin.

The University of Texas Health Science Center at San Antonio, USA.

Maguire DR & France CP. Behav Pharmacol. 2015 Sep 21. [in press]

Science/Animal — Interactions of THC and CBD

In a study with mice, who received THC, CBD or a combination of THC and CBD showed that CBD potentiated THC-induced reductions of movements but reduced the decrease of body temperature and induction of anxiety by THC. CBD alone had no effect on these measures. THC increased brain activation in 11 of the 35 brain regions studied. CBD co-administration suppressed this activation in 6 of these brain regions.

The Brain and Mind Centre, University of Sydney, Australia.

Todd SM & Arnold JC. Br J Pharmacol. 2015 Sep 17. [in press]