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IACM-Bulletin of 04 March 2018

IACM: The Ambassadorship Program is open for applications

On behalf of the IACM Network Committee, we are happy to announce that the Ambassadorship Program of the IACM has been relaunched. The aim of this program is to create a network of representatives around the world, who on the one side like to get support from the IACM for their work in their country and on the other side would like to support the aims and activities of the IACM. The IACM Board of Directors would like to invite people that are active in this field to apply for becoming an ambassador.

Applications are open both for professional ambassadors and for patient ambassadors. Professional ambassadors may be scientists, physicians, other healthcare providers, or anyone whose profession is actively related with cannabis or cannabinoids as medicines. Patient ambassadors may be patients or patients' relatives or caregivers – who are active in their countries in support of legal access to cannabinoid medicines. Please send a short CV (Curriculum Vitae) to the IACM (about half a page) that includes a summary of your current and prospective activities in this field.

The IACM Network Committee is consisting of Milton Raff (South Africa), Raquel Peyraube (Uruguay), Minoru Arakaki (Japan), Hanka Gabrilova (Czech Republic), Ilya Reznik (Israel), Jahan Marcu (USA), Sébastien Béguerie (France), Ethan Russo (USA), Kirsten Müller-Vahl (Germany), and Franjo Grotenhermen (Germany).

The IACM network and ambassador programme is coordinated by Yuval Zolotov. Please send your application together with your short CV to network@cannabis-med.org.

Science/Human: Heavy cannabis use in patients with HIV is associated with improved immune function

In a study with 198 patients with HIV, who are treated with antiretroviral medication (ART), heavy use of cannabis was associated with reduction in systemic inflammation and immune activation. This is the result of research by scientists of the University of Washington and other universities across the USA. The study investigated the impact of cannabis use on immune cell frequency in the blood, their activation, and function.

Authors reported, that they “found that heavy cannabis use ... in HIV-infected, ART-treated individuals was associated with lower frequencies of activated CD4 and CD8 T cells compared to frequencies of these cells in non-cannabis using individuals. This novel finding is important given that elevated levels of T-cell activation have been associated with lower CD4 T-cell gains following ART (anti-retroviral therapy) and with mortality in this population."They concluded from their work, that “while the clinical implications are unclear, our findings suggest that cannabis use is associated with a potentially beneficial reduction in systemic inflammation and immune activation in the context of antiretroviral-treated HIV infection.”

Manuzak JA, Gott TM, Kirkwood JS, Coronado E, Hensley-McBain T, Miller C, Cheu RK, Collier AC, Funderburg NT, Martin JN, Wu MC, Isoherranen N, Hunt PW, Klatt NR. Heavy Cannabis Use Associated With Reduction in Activated and Inflammatory Immune Cell Frequencies in Antiretroviral Therapy-Treated Human Immunodeficiency Virus-Infected Individuals. Clin Infect Dis. 2018 Feb 17. [in press]

Science/Human: Cannabis is effective in alleviating symptoms of cancer patients

A group of Israeli scientists analysed data of 2970 cancer patients treated with medical cannabis between 2015 and 2017 and found beneficial effects across many symptoms. Average age was 59.5 years and 54.6% were women. About one quarter (26.7%) had previous experience with the drug. The most frequent types of cancer pertained to breast (20.7%), lung (13.6%), pancreas (8.1%) and bowel (7.9%).

After six months of follow up, 902 patients died and 682 stopped the treatment. Of the remaining, 1211 (60.6%) responded and 95.9% reported an improvement in their condition from the use of cannabis, 45 patients (3.7%) reported no change and four patients (0.3%) reported deterioration in their medical condition. The main symptoms were sleep problems (78%), pain (78%), weakness (73%), nausea (65%) and lack of appetite (49%). Authors concluded that cannabis “as a palliative treatment for cancer patients seems to be a well tolerated, effective and safe option to help patients cope with the malignancy related symptoms.”

Bar-Lev Schleider L, Mechoulam R, Lederman V, Hilou M, Lencovsky O, Betzalel O, Shbiro L, Novack V. Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer. EUR J Intern Med. 2018;49:37-43.

Science/Human: Cannabis may have a beneficial effect on patients with fibromyalgia

In a study with 26 patients with fibromyalgia, who had been treated at two hospitals in Israel (Laniado Hospital in Kiryat Sanz and Nazareth Hospital in Nazareth) cannabis improved their symptoms. Their mean age was 37.8 years and mean dosage of cannabis was 26 g per month. All participants completed a questionnaire for the assessment of fibromyalgia severity (Revised Fibromyalgia Impact Questionnaire).

After commencing treatment with cannabis , all the patients reported a significant improvement in every parameter on the questionnaire, and 13 patients (50%) stopped taking any other medications for fibromyalgia. Eight patients (30%) experienced very mild adverse effects.

Habib G, Artul S. Medical Cannabis for the Treatment of Fibromyalgia. J Clin Rheumatol. 2018 Feb 14. [in press]

Science/Human: Cannabis enhances the pain reducing effects of the opioid oxycodone according to experimental study

According to an experimental study with healthy cannabis users the combination of the opioid oxycodone and cannabis reduced pain assessed using the Cold-Pressure Test. Participants received either 2.5 or 5 mg of oxycodone or a placebo together with smoked cannabis with 5.6 % THC or no THC and immersed one hand in cold water. Researchers of the New York State Psychiatric Institute and Department of Psychiatry of the Columbia University, USA, measured the time to report pain (pain threshold) and to withdraw the hand from the water (pain tolerance).

Alone, 5.0 mg oxycodone increased pain threshold and tolerance. Although active cannabis and 2.5 mg oxycodone alone failed to elicit analgesia, combined they increased pain threshold and tolerance. authors concluded that “cannabis enhances the analgesic effects of sub-threshold oxycodone, suggesting synergy.”

Cooper ZD, Bedi G, Ramesh D, Balter R, Comer SD, Haney M. Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability. Neuropsychopharmacology. 2018 Feb 5. [in press]

News in brief

Science/Human: The legalisation of cannabis for medical use in the USA did not increase cannabis use in adolescents
According to a review of 11 studies, which examined the relationship between the implementation of medical cannabis laws in many states of the USA and cannabis use, there was no increase of use in adolescents.
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA.
Sarvet AL, et al. Addiction. 2018 Feb 22. [in press]

Science/Human: Cannabis use is associated with a not statistically significant increase in traffic accidents according to a meta-analysis
In a meta-analysis of 24 studies on the effects of cannabis on traffic accidents authors concluded that their “analysis suggests that the overall effect size for DUIC [driving under the influence of cannabis] on UTEs [unfavourable traffic events] is not statistically significant.“
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Hostiuc S, et al. Front Pharmacol. 2018;9:99.

Science/Human: Morphine reduces the production of endocannabinoids
In a study with 42 patients, who received intrathecal morphine due to surgery, the opioid reduced the level of endocannabinoids, “suggesting that potent analgesics may reduce the stimulus for production of peripheral endocannabinoids.”
Stony Brook University, New York, USA.
Kaczocha M, et al. BMC Anesthesiol. 2018;18(1):27.

Science/Animal: Cannabinoids prevent depressive-like symptoms following acute stress
In a rat model of post-traumatic stress disorder the administration of cannabinoids or the increase of endocannabinoid levels prevented depressive-like symptoms, including anxiety.
School of Behavioral Science, The Academic College Tel-Aviv-Yaffo, Israel.
Burstein O, et al. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84(Pt A):129-139.

Science/Cells: CBD induces cell death in endometrial cancer
In cell experiments CBD and the endocannabinoid anandamide reduced cell viability and increased apoptosis (programmed cell death) in endometrial cancer cells by activation of the vanilloid 1 receptor (TRPV1).
Faculdade de Farmácia, Universidade do Porto, Portugal.
Fonseca BM, et al. J Physiol Biochem. 2018 Feb 13. [in press]

Science/Animal: Endocannabinoids protect the stomach against alcohol induced injury
Increase of endocannabinoid levels by reducing their degradation resulted in protection of the stomach against alcohol-induced injury of the mucosa. Authors wrote that their “findings might suggest that central endocannabinoid system may play a role in gastric mucosal defense and maintenance of mucosal integrity.”
Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Tóth VE, et al. Brain Res Bull. 2018 Feb 10. [in press]

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