IACM-Bulletin of September 14, 2003

IACM — Dr. Raphael Mechoulam elected as new chairman

The General Meeting on 11 September in Cologne, Germany elected Dr. Raphael Mechoulam, professor at Hebrew University in Jerusalem, discoverer of THC in 1964 and anandamide in 1992, as new chairman. Dr. Franjo Grotenhermen of the Cologne based nova-Institute remains the executive director. As proposed by the Italian ACT (Associazione per la Cannabis Terapeutica) Dr. Vincenzo Di Marzo was elected as a new member of the IACM Board of Directors, which comprises 10 members now.

Under the impression of threats to doctors who recommend cannabis to their patients or discuss it as a therapeutic option in several countries and currently notably in the US the IACM General Meeting adopted a resolution wording "It is the right of doctors to be able to discuss the medicinal use of cannabis with their patients."

On the Meeting of the Board of Directors it was decided to change from bi-annual to annual scientific meetings and to have the 3rd IACM Conference on Cannabinoids in Medicine in late September or early October 2004. Possible Places are the UK, The Netherlands and Spain.

UK — Government intends to liberalize recreational cannabis use

Smoking cannabis will no longer be against the criminal law under new government plans. Beginning January 2004, recreational users of the drug will be free from prosecution. Home Secretary David Blunkett handed Parliament a draft order to downgrade the drug from Class B to the low-risk Class C to allow police to focus resources on hard drugs like heroin.

"After reclassification, most offences of cannabis possession by adults will result in a police warning and confiscation of the drug," Blunkett said. No further action will be taken unless there are complaints, evidence of repeated possession or the smoking in public. However, people smoking near schools and playgrounds will face arrest.

Police chiefs urged their officers to take a more relaxed approach to cannabis in line with the new policy. Andy Hayman, drugs spokesman for the Association of Chief Police Officers said the rationale for existing drug laws – that people who tried cannabis were often led on to harder drugs – had been disproved. "The theory of gateway drugs doesn't stand up," he said.

(Sources: UPI of 12 September 2003, Reuters of 12 September 2003)

IACM — News at the 2nd IACM Conference on Cannabinoids in Medicine (I)

About 120 people participated in the conference on 12-13 September at the Medical School of the University of Cologne organized by the IACM in cooperation with the Department of Psychiatry and Psychotherapy and the Department of Anaesthesiology of the University of Cologne. The directors of both departments, Dr. Joachim Klosterkoetter and Dr. Walter Buzello participated as chairs of the reviews by Dr. Mechoulam on the neuroprotective properties on cannabinoids and by Dr. Di Marzo on the possible use of endocannabinoid-based drugs against tumour growth.

Some lectures presented at the meeting:

* THC effective in spasticity in spinal cord injury

At the REHAB in Basel 15 patients with spinal cord injury and severe spasticity underwent a double-blind placebo controlled trial with oral and rectal THC. Medium daily doses were 31 mg with the oral dose. THC resulted in a significant reduction of spasticity after a single dose of 10 mg THC and over a course of 6 weeks with individual dosing. (Lecture by Ulrike Hagenbach)

* Smoked Cannabis reduces neuropathic pain in HIV

A pilot study with 16 subjects with persistent painful HIV associated peripheral neuropathy despite treatment with opioids was conducted at the University of California in San Francisco. 10 of the 16 participants experienced a more than 30% reduction in pain after seven days of treatment with smoked cannabis. A placebo-controlled trial with a target sample size of 50 subjects is under way. (Lecture by Donald Abrams)

* Derivatives of cannabidiol (CBD) may be effective in inflammatory bowel disease

Analogues of CBD were tested in mice on there possible therapeutic effects in inflammatory bowel disease. CBD itself and several analogues inhibited intestinal motility. Researchers conclude that "CBD analogues devoid of central effects show therapeutic potential as anti-inflammatory drugs for the GI [gastro-inestinal] system, with application in conditions such as Inflammatory Bowel disease and Crohn’s disease." (Lecture by Ester Fride)

* Cannabinoids influence bone formation

According to research results at Hebrew University of Jerusalem endocannabinoids are involved in bone remodeling. Precursors of bone forming cells (osteoblasts) show progressive increase in CB2 but not of CB1 receptors. In addition normal mice systematically treated with the endocannabinoid 2-AG or with a specific CB2 agonist showed a dose dependent increase in bone formation. The researcher assumes that "endocannabinoids stimulate bone formation." (Lecture by Raphael Mechoulam)

* Successful use of dronabinol in children with severe neurological disorders

Eight case reports of children between 3 and 14 years of age were presented, suffering from sever neurological disorders including spasticity, dystonia (movement disorder) and seizures. They were successfully treated in private practice with dronabinol (THC). (Lecture by Ruediger Lorenz)

(Source: Reader of the IACM 2nd Conference on Cannabinoids in Medicine,

www.cannabis-med.org/meeting/cologne2003/home.htm)

Belgium — Belgium may follow the Netherlands in making cannabis available for patients

The Belgian government said on 3 September it would have no objection to following the Dutch move to make cannabis available from pharmacies on prescription. Minister for Health Rudy Demotte confirmed Belgium could be the next European country to legalise the sale of cannabis in pharmacies.

"This is an area where public health must prevail and research has shown that cannabis can be of medicinal use," a Health Ministry statement said. Research is currently being carried out in several Belgian universities to prove the medical benefits of cannabis before the substance could be given to patients.

Since 1 September two varieties of cannabis with high dronabinol (THC) content are available in Dutch pharmacies, SIMM 18 with about 15% dronabinol and 0.7% cannabidiol produced by the Stichting Institute of Medical Marijuana at a price of 8.80 Euros a gram, and BEDROCAN with about 18% THC and 0.8% CBD produced by the company Bedrocan at a price of 10 Euros a gram. This results in a price of 0.056 Euros (about 0.05 US dollars) or 5-6 Cents for one milligram of dronabinol.

(Sources: Expatica.com of 4 September 2003, lecture by Willem Scholten at the IACM Conference)

USA — A federal court did not overrule a Californian state court in medical cannabis case

For the first time, a federal judge has made it clear that local sheriffs can't run to federal court to circumvent a state judge's order that they return seized medical cannabis to its owner.

In a groundbreaking decision, Chief U.S. District Judge Marilyn Hall Patel ruled on 29 August that federal courts have no authority to authorize seizure of cannabis controlled by a sheriff after a state judge ordered the sheriff to return the ounce of cannabis to its owner, Christopher Giauque. "Federal authorities may not muscle in on state proceedings in order to gain control over property seized by state police," Patel wrote.

"This is a landmark," said Dale Gieringer, the California coordinator of the National Organization for the Reform of Marijuana Laws. This was the first time any federal court has ever ordered the return of marijuana in a medical marijuana case, he said. Federal authorities could appeal her order to the 9th U.S. Circuit Court of Appeals.

(Source: Los Angeles Daily Journal of 2 September 2003)

News in brief

Science — Survey

A questionnaire was sent to 780 Canadians with multiple sclerosis by researchers of the University of Calgary. 62% completed questionnaires were returned. 72% of these support legalization for medicinal purposes, 43% had tried cannabis at some point in their lives, 16% for medicinal purposes. Symptoms reported to be ameliorated included anxiety/depression, spasticity and chronic pain. (Source: Page SA, et al. Can J Neurol Sci. 2003 Aug;30(3):201-5.)

USA — Re-legalisation in Alaska

The law that makes any possession of cannabis illegal in Alaska has been ruled unconstitutional by a states appeals court on 19 August. The ruling affirms a 1975 Alaska Supreme Court decision that found it legal to posses up to 112 grams of cannabis in one’s home. In 1990 Alaska voters approved a law that criminalized the possession of any amount of drug in any location. Governor Frank H. Murkowski said that he was "very concerned" about re-legalization of the drug, and that "Alaskans who use marijuana should remember that its use or possession remains illegal under federal law." (Sources: Guelph Mercury of 30 August 2003, Capital Weekly of 2 September 2003)

Science — Epilepsy

In an animal model of epilepsy THC and a synthetic cannabinoid completely abolished epileptic seizures. Seizures had been induced in the animals by pilocarpin. A cannabinoid receptor blocker (SR141716A) increased both seizure duration and frequency, suggesting that the endocannabinoid system is tonicaly active with regard to seizure activity. (Source: Wallace MJ, et al. J Pharmacol Exp Ther. 2003 Sep 3 [electronic publication ahead of print].)

Science — Colorectal cancer

Endocannabinoid levels in tissue of colorectal carcinomas were 2- to 3-fold higher than in normal colon tissue. Tissues were obtained from 21 patients by biopsy during colonoscopy. Researchers conclude that endocannabinoid levels are enhanced in colon cancer cells "possibly to counteract proliferation". (Source: Ligresti A, et al. Gastroenterology. 2003 Sep;125(3):677-87)

Argentina — Support for medical use

In an extensive interview for La Capital Aquiles Roncoroni, an emeritus professor of pneumology of the University of Buones Aires spoke out for the medical use of cannabis for several indications. Marijuana had become a victim of moral attitudes, he said. Roncoroni also spoke on the issue at a meeting of the Argentine Association of Harm Reduction. While other medicinal drugs would be available for possible indications for cannabis they would not always work or may have intolerable side effects. (Source: La Capital of 24 August 2003)