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IACM-Bulletin of April 28, 2019

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Science/Human — MS patients taking cannabis were able to reduce intake of opioids and benzodiazepines

According to a retrospective chart review of 77 patients diagnosed with multiple sclerosis treatment with cannabis allowed one third to reduce the intake of other medications, including opioids. Scientists of Dent Neurologic Institute Amherst in New York, USA, published their study results In the Journal Neurology.

Subjective improvement endorsed by patients was extensive, with alleviation of pain (71%), spasticity (43%), and sleep (42%). In addition, 34% of patients were able to decrease or discontinue other medications including opioids, stimulants, and benzodiazepines. A low rate of discontinuation (14%) was observed, most frequently due to cost (36%) and lack of efficacy (36%).

McCormack K, Lewandowski e, Rainka M, Aladeen T, Westphal E, Mazhari A, Mechtler L. Multiple Sclerosis and Use of Medical Cannabis: A Retrospective Review Evaluating Symptom Outcomes. Neurology Apr 2019, 92 (15 Supplement) P5.2-106;

Science/Human — Cannabis motivates to do more exercise

According to an online survey with 605 people living in states with full legal access to cannabis, users reported engaging in more minutes of aerobic and anaerobic exercise per week. Researchers of the University of Colorado in Boulder, USA, noted that the study represents an important step in clarifying cannabis use with exercise among adult users in states with legal cannabis markets, and provides guidance for future research directions.

Results indicated that the majority (81.7%) of participants endorsed using cannabis concurrently with exercise, and those who did tended to be younger and more likely to be males. In addition, the majority of participants who endorsed using cannabis shortly before/after exercise reported that doing so enhances their enjoyment of and recovery from exercise, and approximately half reported that it increases their motivation to exercise.

YorkWilliams S, Gust C, Mueller R, Cinnamon L, Hutchison K, Gillman A, Bryan A. The New Runner’s High? Examining Relationships Between Cannabis Use and Exercise Behavior in States with Legalized Cannabis. Public Health. 2019 Apr 19. [in press]

News in brief

Science/Human — The endocannabinoid system shows a reduced activity in patients with post-traumatic stress disorder

In a study with 20 patients suffering from post-traumatic stress disorder and healthy controls researchers investigated blood levels of the endocannabinoids anandamide (AEA), 2-AG (2-arachidonoylglycerol) and olelylethanolamide following exercise and psychosocial stress. Only healthy controls exhibited a significant increase in the levels of 2-AG following exercise and psychosocial stress. Researchers wrote, that these data provide preliminary evidence that the endocannabinoid system “is hypoactive in PTSD following exposure to physical and psychosocial stressors.”

Department of Kinesiology, University of Wisconsin-Madis markiert rasch, on, USA.

Crombie KM, et al. Biol Psychol. 2019;145:1-7.

Science/Human — Endocannabinoids contribute to the mood improving effects of exercise in patients with major depression

Blood was taken from 17 women with major depressive disorder before and 10 minutes after exercise. There were significant elevations in anandamide and oleoylethanolamide levels and there were negative associations between changes in anandamide and mood states. Researchers concluded that the endocannabinoid system “contributes to the mood-enhancing effects of prescribed acute exercise” in major depressive disorder.

Department of Kinesiology, Iowa State University, Ames, USA.

Meyer JD, et al. Med Sci Sports Exerc. 2019 Apr 8. [in press]

France — Conference on cannabis in medicine

The 8th Conference on Cannabis in Medicine by UFCM-I Care will take place on 28 June in Strasbourg.

Conference website

Holland — Trial on legal growth of cannabis for adult users

The Dutch government is to press ahead with experiments in regulated cannabis production involving 10 licenced growers, according to the detailed plans. The long-awaited experiment with regulated growing is supposed to remove the gray area between the sale of cannabis in council-licenced coffee shops and the illegal cultivation and supply. The plans, which were put out to consultation last year, state that the 10 growers will all have to produce at least 10 different types of cannabis product and the THC content will have to be clearly marked on the packaging. In addition, ministers have confirmed a minimum of 6 and maximum of 10 local authority areas will take part in the trials, which will run for at least four years.

BusinessSociety of 11 April 2019

Science/Animal — The administration of THC may reduce the abuse of opioids

Rats were trained to intravenously self-administer the opioid oxycodone. If they received THC by inhalation or injection self-administered doses of the opioid were reduced. In further studies researchers observed additive effects of oxycodone and THC in reducing pain. They concluded that “these data demonstrate additive effects of THC and oxycodone and suggest the potential use of THC to enhance therapeutic efficacy, and to reduce the abuse, of opioids.”

Department of Neuroscience, The Scripps Research Institute, La Jolla, USA.

Nguyen JD, et al. Neuropharmacology. 2019;151:127-135.

Science/Human — CBD extracts may improve quality of life of patients with epilepsy without influence on seizures

In an open study patients with treatment-resistant epilepsy received the CBD extract Epidiolex starting at 5 mg/kg/day and up to 50 mg/kg per day. 53 patients completed enrollment into the study. There was a significant improvement of quality of life after one year of treatment. This improvement was not associated with changes in seizure severity.

Department of Neurology, University of Alabama at Birmingham, USA.

Gaston TE, et al. Epilepsy Behav. 2019;95:10-17.]

Science/Human — The risk for problematic use of cannabis depends on reason for use

In a study with 468 adults the main reasons for using cannabis were to heighten positive feelings (35%), habit (29%) and to cope with negative feelings (25%). Coping with negative feelings was associated with the highest risk for problematic cannabis use.

University of Barcelona, Spain.

Casajuana Kögel C, et al. Adicciones. 2019;0(0):1221.

Science/Cells — CBD extract has different effects on white blood cells compared to isolated CBD

In a study with white blood cells both a CBD extract standardised on 5% CBD and isolated CBD inhibited cell migration, the development of reactive oxygen species and the production of TNF-alpha. However, inhibition of cell migration and production of the pro-inflammatory cytokine TNF-alpha was stronger than with isolated CBD “suggesting that beyond CBD, other components of the cannabis plant may contribute to the biological effects of the extract.”

Center for Research in Medical Pharmacology, University of Insubria, Varese, Italy.

Mabou Tagne A, et al. Int J Mol Sci. 2019;20(8).

Science/Human — CBD in high doses may increase blood concentrations of tacrolimus

A patient, who received a daily dose of 2000 to 2900 mg of CBD showed an approximately 3-fold increase of tacrolimus in blood. This may be due to the same metabolic pathways of the 2 medications in the liver.

Department of Internal Medicine, University of Cincinnati College of Medicine, USA.

Leino AD, et al. Am J Transplant. 2019 Apr 23. [in press]

Science/Animal — High THC doses may damage the DNA

In a study with rats, who received THC in daily oral doses of 7 mg/kg body weight, researchers found low-level DNA damage in white blood cells and brain cells.

Institute for Medical Research and Occupational Health, Zagreb, Croatia.

Kopjar N, et al. Molecules. 2019;24(8).

Science/Animal — The endocannabinoid system modulates symptoms of schizophrenia

In a mouse model of schizophrenia, characterised by increased locomotor activity and memory impairment, increasing the levels of endocannabinoids influenced the symptoms in a dose dependent manner. A low dose of an inhibitor of endocannabinoid degradation (URB 597) reduced memory impairment, while a higher dose increased memory impairment.

Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, Poland.

Kruk-Slomka M, et al. Mol Neurobiol. 2019 Apr 19. [in press]

Science/Animal — Derivatives of CBD were developed to allow better permeation into eye tissues

In an attempt to treat diabetic retinopathy-induced pain and inflammation scientists developed CBD derivatives, which better penetrate into eye tissues of rabbits in comparison with CBD.

Department of Pharmaceutics and Drug Delivery, School of Pharmacy, University of Mississippi, Oxford, USA.

Taskar P, et al. J Ocul Pharmacol Ther. 2019 Apr 18. [in press]