IACM-Bulletin of September 18, 2005

IACM — News at the IACM 2005 Conference at the University of Leiden

On 9-10 September the IACM held its 3rd Conference on Cannabinoids in Medicine. Here are some excerpts from presentations.

(1) Cannabis in multiple sclerosis: British researchers presented results of a long-term study on a cannabis extract (Sativex) in multiple sclerosis. Patients suffered from at least one of the following symptoms: spasticity, spasms, bladder problems, tremor or pain. 137 patients were included in the long-term study (average duration: 434 days, range: 21-814 days) that followed a six-week acute study with 160 patients. Average maximum daily doses were 37.5 mg THC and CBD in the acute study. 66 patients with spasticity completed 82 weeks of treatment. At entry to the acute study this group had a mean spasticity score of 69.5 on a visual analogue scale, which had reduced to 34.2 on entry into the long-term study and was 31.8 after 82 weeks. In this group average daily doses had reduced marginally from 30 mg THC to 25 mg in the course of the treatment. The study demonstrates that beneficial effects of cannabis on spasticity in multiple sclerosis seem to be maintained over long-term treatment, with no evidence of tolerance. (Abstract by Robson et al.)

(2) Cannabis in neuropathy: Researchers of the University of California presented results of a clinical study of smoked cannabis in 50 patients with HIV-related painful peripheral neuropathy. Participants smoked a cannabis cigarette or a placebo cigarette three times daily for five days. 13 of the 25 patients who had received cannabis cigarettes reported greater then 30 percent reduction in pain, compared with 6 of the 25 patients receiving placebo cigarettes. The pain reduction was greater in the group receiving cannabis (34 percent) than in the control group (16.7 percent). Researchers concluded that the magnitude of the response of the neuropathic pain is similar to what is seen with gabapentin, a widely used therapeutic intervention for HIV neuropathy. (Abstract by Abrams et al.)

(3) Cannabidiol (CBD) in schizophrenia: Researchers of the University of Cologne presented results of their study that compared the effects of CBD and amisulpride (an established antipsychotic) in 42 patients with acute schizophrenia. Half of them received 800 mg of oral CBD daily for four weeks. CBD significantly reduced psychopathological symptoms of acute psychosis, when compared to the initial status. There was no statistical difference in treatment effect compared to the control group. Cannabidiol, however, caused significantly less side effects than amisulpride. (Abstract by Leweke et al., personal communication)

(Source: Abstract book available for download on the IACM website, www.cannabis-med.org)

USA — Cannabis use by young people not increased in states that legalized the medical use of cannabis

The 10 states that approved the medical use of cannabis over the last decade have experienced sharp declines in cannabis use among teenagers, according to a new study funded and released by the Marijuana Policy Project. The authors Mitch Earleywine, a State University of New York psychology professor, and Karen O'Keefe, a legislative analyst with the Marijuana Policy Project, analyzed federal and state statistics for their report.

Although debate over medical cannabis is often shaded by concerns about

increasing drug use among young people, the report does not support this assumption. The study shows widespread reductions in cannabis use have occurred generally at the same rate among all the states, including those allowing medical use. The key findings of the study are: No state that has passed a medical cannabis law has seen an overall increase in teen cannabis use since the law's passage. The decline in teen cannabis use in states with medical cannabis laws slightly exceeds the decline seen nationally.

In the United States, compared with 1996, about 43 percent fewer 8th graders and 9 percent fewer 12th graders reported they had used the drug in the past 30 days in 2003. In California that permitted the medical use of cannabis in 1996, past-month use dropped by half among the state's 9th graders and by one-quarter among 11th graders. Other states with medical-cannabis laws also saw varying reductions in youth cannabis use.

The authors of the report noted that in contrast to widely cited prejudices teenagers may increasingly consider cannabis "a treatment for serious illness, that requires cautious and careful handling, not a toy." Tom Riley, a spokesman of the federal Office of National Drug Control Policy, said the drop in teen drug use across the nation is attributable to the federal anti-drug advertising campaign in recent years and that all Americans "should be glad that teen drug use is going down."

(Sources: United Press International of 7 September 2005, Los Angeles Times of 8 September 2005)

Canada — The health ministry wants to bring cannabis into pharmacies next year

Health Canada's long-delayed plan to sell government-certified cannabis in drugstores appears to be back on track for early next year. The pilot project would stock medicinal cannabis in some pharmacies for use by authorized patients, making Canada the second country after The Netherlands to sell cannabis in pharmacies.

The department is scouting out a handful of urban and rural pharmacies to begin the pilot project by the first quarter of 2006, said spokesman Christopher Williams. "Ideally, we'd like to run it in more than one province," Williams said in an interview. An internal document from Health Canada says it could take up to three years to implement a national pharmacy distribution program.

Currently, 943 people are authorized to possess cannabis for medical conditions, once a doctor has indicated that traditional remedies are ineffective. Of these, 695 have permission to grow the plant themselves, while Health Canada has authorized 77 growers to produce it for other patients. Several of authorized patients receive their cannabis from Health Canada. Thirty-gram bags of dried buds cost 150 Canadian Dollars (about 100 €).

(Source: Canadian Press of 13 September 2005)

News in brief

IACM — Roger Pertwee new chairman

Dr. Roger Pertwee, professor at the University of Aberdeen (Scotland), was elected as the new chairman of the IACM during the IACM General Meeting on 9 September. The chairmanship was handed over to Dr. Pertwee by Dr. Raphael Mechoulam who was chairman for the past two years.

UK — Respiratory diseases

Researchers from Imperial College London are looking for volunteers to test whether a cannabis extract (Sativex) can be used to alleviate the sensation of breathlessness caused by several respiratory diseases. The team are looking for volunteers aged between 50 and 70, who don't have breathing difficulties. The study will take a morning on two different days, during which time volunteers will be hooked up to a circuit to regulate and measure their breathing. It will be conducted at Charing Cross Hospital in west London. People who wish to take part should call 020 8846 1234 to register their interest. (Source: ScienceDaily Magazine of 4 September 2005)

USA — Medical cannabis and workplace

Courts in California and Oregon are deciding on the question whether employers have the right to fire employees who are allowed to use cannabis for medical purposes if they test positive on cannabis in drug screenings. The Oregon Supreme Court says it will review an appellate court ruling that suggests employers should tolerate workers who use medical cannabis. In contrast to this ruling a Californian court of appeal ruled on 7 September that firing an employee who tests positive for cannabis does not violate the law, even if the employee can show that he uses cannabis for medicinal purposes. (Sources: Associated Press of 15 September 2005, Metropolitan News-Enterprise of 8 September 2005)