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IACM-Bulletin of September 17, 2017

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Science/Human — Trauma patients find relief from a treatment with cannabis according to a survey

Patients with musculoskeletal trauma profit from a treatment with cannabis according to survey data. Harvard Medical School investigators asked 500 patients at two trauma centres. The majority of patients felt that cannabis could be used to treat pain (78%) and anxiety (62%). Most patients (60%) had used cannabis at least once previously, while only 14% reported using cannabis following their injury.

Of those who used cannabis during their recovery, 90% (63 of 70) said that it reduced symptoms of pain, and 81% (57 of 70) said that it reduced the amount of opioid pain medication they used. Authors concluded that “the majority of patients in this study believed that medical marijuana is a valid treatment and that it does have a role in reducing post-injury and post-operative pain. Those patients who used marijuana during their recovery felt that it alleviated symptoms of pain and reduced their opioid intake.”

Heng M, McTague MF, Lucas RC, Harris MB, Vrahas MS, Weaver MJ. Patient perceptions of the use of medical marijuana in the treatment of pain following musculoskeletal trauma. A survey of patients at two trauma centers in Massachusetts. J Orthopaedic Trauma. 2017 Aug 18 [in press].

Science/Human — About 40% of war veterans, who use cannabis, use it for medical purposes

Approximately 9% of Veterans in the US reported past year cannabis use. This is the result of research by scientists of the Addiction Center of the University of Michigan, USA. In states where medical cannabis was legal in 2014, approximately 41% of Veterans who used cannabis in the past year used medically. Those who used medically were older and less likely to engage in recent heavy episodic drinking or to meet criteria for alcohol abuse/dependence, compared to Veterans using non-medically.

Authors concluded that “compared to non-Veterans in the US general population, recent cannabis use was similar or slightly lower among Veterans. However, among those with past year use, the proportion of those using medically was more than double that of the general population. Because only non-medical cannabis use was associated with higher rates of heavy episodic alcohol use and alcohol use disorder, it may be important to address problematic alcohol consumption among this high-risk group.

Davis AK, Lin LA, Ilgen MA, Bohnert KM. Recent cannabis use among Veterans in the United States: Results from a national sample. Addict Behav. 2017;76:223-228.

News in brief

USA — Cannabis use in adolescents declined in 2016

The 2016 National Survey on Drug Use and Health report finds that 6.5 percent of respondents between the ages of 12 and 17 reports having consumed cannabis within the past 30 days - a decrease of 21 percent since 2002. The report says: ‘’Marijuana use among adolescents aged 12 to 17 was lower in 2016 than in most years from 2009 to 2014.” Cannabis use in people aged 18 to 25 years increased.

Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health

Science/Human — Legal access to cannabis may reduce the treatment with other medicinal drugs

Of 83 chronic pain patients, who were enrolled in a medical cannabis program, 28 ceased the use of all other medications within 6 months. In comparison only 1 of 42 patients not in the program stopped the other medications. Authors concluded that “legal access to cannabis may reduce the use of multiple classes of dangerous prescription medications in certain patient populations.”

Department of Economics, University of New Mexico, Albuquerque, USA.

Stith SS, et al. J Am Med Dir Assoc. 2017 Sep 9. [in press]

Science/Animal — Cannabinoid treatment may reduce development of tolerance to morphine

In mice with cancer pain, which were treated with a cannabinoid that only activates the CB2 receptor (AM1241) together with morphine, the development of tolerance to morphine was reduced.

Cancer Hospital of Harbin Medical University, China.

Zhang M, et al. Mol Med Rep. 2017 Sep 13. [in press]

Science/Animal — The terpene tingenone activates the CB2 receptor

Tingenone, a terpene, was shown to activate the CB2 receptor. This is another terpene with activity at the CB2 receptor, of which the best known is beta-caryophyllene.

Universidade Federal do Amazonas, Manaus, Brazil.

Veloso CC, et al. Inflammopharmacology. 2017 Sep 9. [in press]

Science/Cells — CBD is an activator of the GPR12 receptor

CBD (cannabidiol) was shown to be an activator of the GPR12 receptor. GPR12 has been shown to alter metastatic cancer cells.

Department of Pharmacology and Toxicology, University of Louisville School of Medicine, USA.

Brown KJ, et al. Biochem Biophys Res Commun. 2017 Sep 6. [in press]

Science/Animal — A CB1 receptor agonist potentiated the effect of an anti-epileptic medication

The CB1 receptor agonist ACEA increased the potency of the anti-epileptic drug levetiracetam, but not that of clobazam, lacosamide, phenobarbital, tiagabine or valproate in in a mouse model of epilepsy.

Department of Pathophysiology, Medical University of Lublin, Poland.

Luszczki JJ, et al. PLoS One. 2017;12(8):e0183873.

Science/Animal — Blockade of the CB1 receptor may increase fasting blood glucose levels

Rimonabant, an antagonist of the CB1 receptor, may increase fasting blood glucose levels. Authors wrote that such a blockade of liver CB1 receptors “should be avoided in the development of peripheral cannabinoid CB1 receptor-targeted weight-loss drugs.”

Beijing Institute of Pharmacology and Toxicology, China.

Chen W, et al. Eur J Pharmacol. 2017 Aug 26. [in press]

Science/Human — Cannabis use doubles the risk for fatal traffic crashes

A total of 4294 drivers killed in traffic crashes were included in an analysis. Researchers found evidence that compared with drivers negative for alcohol and cannabis, the presence of cannabis elevates crash responsibility in fatal crashes among drivers by 1.89. Additional drinking significantly increased the risk further.

Pacific Institute for Research and Evaluation, USA.

Romano E, et al. Accid Anal Prev. 2017;108:37-43.