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IACM-Bulletin of 24 October 2021

Luxembourg: The government wants to make the country the first in EURope to legalise the growing of cannabis

Adults in Luxembourg will be permitted to grow up to four cannabis plants in their homes or gardens under laws that will make it the first country in EURope to legalise production and consumption of the drug. The announcement on 22 October by Luxembourg’s government was said to deliver fundamental changes in the country’s approach to recreational cannabis use and cultivation in light of the failure of prohibition to deter use.

Trade in seeds will also be permitted without any limit on the quantity or levels of THC. The government said it would be possible to buy seeds in shops, to import them or buy them online. There is also the intention to allow for the domestic production of seeds for commercial purposes but plans for both a national production chain and state-regulated distribution have been delayed by the Covid pandemic. Justice minister Sam Tanson described the change to the law on domestic production and consumption as a first step. “We want to do everything we can to get more and more away from the illegal black market.”

The Guardian of 22 October 2021

Switzerland: The country wants to legalise the use of cannabis for medicinal and recreational purposes

Switzerland will draw up a draft law for the legalisation of cannabis usage, after a parliamentary commission ruled the drug should no longer be banned. The production, cultivation, trade and consumption of cannabis will no longer be banned in Switzerland after a commission investigating the drug said the laws should be changed.

The Social Security and Health Commission of the Council of States (SGK-S) said cannabis should be regulated in Switzerland in order to control the “cannabis market for better youth and consumer protection”. The aim of the SGK-S is to eliminate the black market for the drug in Switzerland. A draft law will now be drawn up in Swiss parliament. Importantly, it appears that not only will medical use be allowed, but recreational use will also be approved.

The Local of 19 October 2021

Costa Rica: Congress approves legalization of cannabis for medicinal use

Costa Rica's Congress on 19 October approved the legalization of cannabis for medicinal purposes, despite opposition from conservative groups and President Carlos Alvarado who still needs to put his stamp of approval on the law. The law allows for the production and processing of cannabis, but does not regulate its recreational use.

Independent lawmaker Zoila Volio, who backed the law and called the move a milestone, said it would not open the floodgates to increased drug use in Costa Rica. "I trust that President Alvarado has understood that and will not veto it," said Volio. If Alvarado vetoes the law, lawmakers would need to again vote on it and approve it with a qualified majority.

Reuters of 19 October 2021

Science/Human: Many ADHD patients use cannabis to treat their symptoms

According to an online survey with 1738 students by investigators of Washington State University in Pullman, USA, many people with ADHD use cannabis to self-medicate for many of their symptoms. The survey contained measures of ADHD symptoms, cannabis use, perceived effects of cannabis on ADHD and medication side effects.

Participants with ADHD who have used cannabis reported that cannabis has acute beneficial effects on many symptoms of ADHD, including hyperactivity and impulsivity. Further, they perceived cannabis to improve most of their medication side effects including irritability and anxiety. Authors concluded that the results suggest that “people with ADHD may be using cannabis to self-medicate for many of their symptoms and medication side effects and that more frequent use may mitigate ADHD-related executive dysfunction.”

Stueber A, Cuttler C. Self-Reported Effects of Cannabis on ADHD Symptoms, ADHD Medication Side Effects, and ADHD-Related Executive Dysfunction. J Atten Disord. 2021 Oct 11:10870547211050949.

Science/Human: A combination of CBD and THC may be helpful in lung cancer according to a case report

According to a case report by investigators of Watford General Hospital and Basildon and Thurrock University Hospitals, UK, a patient in her 80s with lung cancer, who declined conventional treatment, improved following the intake of THC and CBD. Without the knowledge of her doctors, she chose to self-administer an extract containing 21% CBD and 20% THC 2 to 3 times daily.

Serial CT scans showed that her cancer reduced in size progressively from 41 mm to 10 mm over a period of 2.5 years. Authors noted that “the use of cannabinoids as a potential cancer treatment justifies further research.”

Liew KL, Capuano E, Yung B. Lung cancer patient who had declined conventional cancer treatment: could the self-administration of 'CBD oil' be contributing to the observed tumour regression? BMJ Case Rep. 2021;14(10):e244195.

Science/Human: Many tobacco users are able to reduce the use after initiation of a treatment with cannabis

Investigators of Social Dimensions of Health of the University of Victoria, Canada, and other universities from Canada examined the impact of medical cannabis on tobacco/nicotine use. In total, the survey recruited 2102 individuals, of whom 650 were current or former tobacco users.

Following initiation of medical cannabis use 320 (49%) tobacco users self-reported reductions in use, with 160 (24.6%) reporting no tobacco use in the 30 days prior to the survey. authors concluded that results “from this retrospective survey of medical cannabis users suggest that initiation of medical cannabis use was associated with self-reported reductions and/or cessation of T/N use in nearly half of study participants.”

Lucas P, Walsh Z, Hendricks PS, Boyd S, Milloy MJ. Self-reported reductions in tobacco and nicotine use following medical cannabis initiation: Results from a cross-sectional survey of authorized medical cannabis patients in Canada. J Subst Abuse Treat. 2021;130:108481.

Science/Human: Genetic analyses do not strongly support a clear causal relationship between cannabis use and schizophrenia

A team of researchers from the USA and UK from Yale University School of Medicine in New Haven, USA, and King’s College in London, UK, and other universities suggest that “genetic liability for cannabis use disorder appears to be robustly associated with schizophrenia (…) with mixed evidence to support a causal relationship between cannabis use disorder and schizophrenia”. They used genomic structural equation modelling, latent causal variable analysis, and multivariable Mendelian randomization to examine genetic relationships between cannabis use disorder and schizophrenia, among others.

Cannabis use disorder was significantly associated with schizophrenia but researchers “found mixed evidence of a causal relationship, with the latent causal variable analysis finding no evidence of causality (…) , but the multivariable Mendelian randomization analyses suggesting a significant, risk-increasing effect” of cannabis use disorder on liability to schizophrenia.

Johnson EC, Hatoum AS, Deak JD, Polimanti R, Murray RM, Edenberg HJ, Gelernter J, Di Forti M, Agrawal A. The relationship between cannabis and schizophrenia: a genetically informed perspective. Addiction. 2021;116(11):3227-3234.

Science/Human: Many breast cancer patients use cannabis for symptom relief

More than 40% of breast cancer patients from the USA used cannabis for relief of symptoms. This is the result of an anonymous online survey by investigators from Pennsylvania, California, New York and Texas.

Of all 612 participants 42% reported using cannabis for relief of symptoms, which included pain (78%), insomnia (70%), anxiety (57%), stress (51%), and nausea/vomiting (46%). Approximately half of these participants believed that cannabis could treat cancer itself. Most participants used cannabis during active cancer treatment despite the potential for an adverse event during this vulnerable time.

Weiss MC, Hibbs JE, Buckley ME, Danese SR, Leitenberger A, Bollmann-Jenkins M, Meske SW, Aliano-Ruiz KE, McHugh TW, Larson SL, Le EH, Green NL, Gilman PB, Kaklamani VG), Chlebowski RT), Martinez DM. A Coala-T-Cannabis Survey Study of breast cancer patients' use of cannabis before, during, and after treatment. Cancer. 2021 Oct 12. [in press].

News in brief

USA: Olivia Newton-John 'feeling pretty good' amid cancer battle
The 73-year-old singer and actress gave a health update on 20 October amid her battle with stage 4 metastatic breast cancer. „Right now I'm feeling pretty good," the star said. "I have my days, I have my pains, but the cannabis that my husband grows for me has been such a huge part of my healing, and so I'm a really lucky person."
UPI of 20 October 2021

USA: A plurality of Americans prefer to reside where cannabis use is “fully legal”
Nearly half (46%) of respondents had a positive view on living in a place where cannabis is legal, while 22% had a negative view. This is according to an August 2021 Redfin survey of 1,023 U.S. residents who moved to a new home during the 18 months prior to the survey.
Redfin of 18 October 2021

Israel: Knesset gives preliminary okay to bill to make medical cannabis more available
The Knesset approved in a preliminary vote on 13 October a bill that would create major reforms in the medical cannabis industry in Israel, and expand its ease of access. Ra’am, the coalition’s Arab party, which previously opposed a similar bill that would have also decriminalized recreational cannabis usage, voted in favour of the legislation proposed by MK Sharren Haskel of the New Hope party.
The Times of Israel of 13 October 2021

Science/Cells: Cannabinoids induce cell death in Ewing sarcoma cells
Cannabinoids induce cytotoxicity in Ewing sarcoma cell lines, which might be a potential therapeutic target to treat Ewing sarcoma, which mainly affects bones.
Department of Pharmacology and Toxicology, University of Arkansas for Medical Sciences, Little Rock, USA.
Shoeib AM, et al. Life Sci. 2021;285:119993.

Science/Animal: Cannabichromene may be useful in acute respiratory distress syndrome
In a study with mice the plant cannabinoid CBG (cannabichromene) reduced symptoms of acute respiratory distress syndrome (ARDS). It reversed hypoxia and reduced inflammation. This effect may be mediated through transient receptor potential (TRP) cation channels, TRPA1 and TRPV1.
Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, USA
Khodadadi H, et al. J Cannabis Res. 2021;3(1):45.

Science/Animal: Beta-caryophyllene induced programmed cell death in colorectal cancer
In studies with mice beta-caryophyllene, which binds to the CB2 receptor, induced apoptosis (programmed cell death) and reduced the building of new blood vessels in colorectal cancer.
Department of Science, University of Technology and Applied Sciences, Oman.
Dahham SS, et al. Int J Mol Sci.2021;22(19):10550.

Science/Human: The effects of CBD may depend on certain genes
In 169 children and adults, who received CBD in treatment resistant epilepsy certain genes influenced efficacy. Authors wrote that these “results highlight the role of pharmacogenes in fundamental biologic processes and potential genetic underpinnings of treatment-resistance.”
Department of Neurology, University of Alabama at Birmingham, USA.
Davis BH, et al. Clin Pharmacol Ther. 2021;110(5):1368-1380.

Science/Human: Cannabichromene (CBC) shows higher plasma concentrations than THC and CBD after oral intake
In a placebo-controlled study with 43 healthy people, who received different oral doses of CBD, THC and CBC (cannabichromene) given together, CBC was shown to reach higher systemic bioavailability than THC and CBD.
Canopy Growth Corporation, Smiths Falls, Canada.
Peters EN, et al. EUR J Clin Pharmacol. 2021 Oct 18. [in press]

Science/Human: The use of cannabis is increasing in cancer patients
In a study with 1022 cancer patients and 19,702 people, were never had cancer, cannabis use was slightly lower in those without a history of cancer and cannabis use is generally increasing across cancer survivors.
Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, USA.
Do EK, et al. Cancer. 2021;127(21):4040-4049.

Science/Animal: CB1 receptor signalling ameliorates opiate withdrawal signs
CB1 receptor positive allosteric modulators (PAMs) enhance CB1 receptor signalling. In a study with oxycodone -dependent mice a PAM ameliorated withdrawal signs.
Pharmacology & Toxicology, Virginia Commonwealth University, USA.
Dodu JC, et al. J Pharmacol Exp Ther. 2021:JPET-AR-2021-000723.

Science/Human: Most paediatric oncologists in Canada recognise cannabis for symptom control in children with cancer
According to a survey of 122 paediatric oncologists and palliative care physicians “a potential role for cannabis in symptom control in children with cancer.”
Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.
Oberoi S, et al. Cancer Rep (Hoboken). 2021:e1551.

Science/Human: CBD may exacerbate eyelid myoclonia in Jeavans syndrome
Jeavons Syndrome is a childhood genetic generalized epilepsy. According to two cases CBD given to treat epilepsy in this disorder may exacerbate concurrent eyelid myoclonia.
Epilepsy Center, Neurological Institute, Cleveland Clinic, USA.
Zawar I, et al. Epileptic Disord. 2021 Oct 7. [in press]

Science/Human: Cannabis use is associated with lower risks of obesity in people infected with the hepatitis B virus
In a study with 3706 patients with chronic hepatitis B virus infection (HBV) cannabis use was associated with a 59% lower risk of central obesity compared with no lifetime cannabis use.
Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
Barré T, et al. Cannabis Cannabinoid Res. 2021 Oct 13. [in press]

Science/Human: Cannabis may normalise some aberrations of nerve function in people with HIV
In a study with 81 people with HIV (PWH) magnetoencephalographic brain imaging data were collected. Authors wrote that their “results provide initial evidence that cannabis use may normalize some neural aberrations in PWH. This study fills an important gap in understanding the impact of cannabis use on brain and cognitive function in PWH.”
Institute for Human Neuroscience, Boys Town National Research Hospital, USA.
Christopher-Hayes NJ, et al. Hum Brain Mapp. 2021;42(16):5446-5457.

Science/Animal: The administration of CBD is associated with metabolic changes
Repeated CBD administration to juvenile rats induced “significant alterations in multiple metabolic markers analyzed in the adulthood. Our findings highlight the relevance of chronic CBD treatment in disturbed metabolic activity.”
Escuela de Nutrición, División Ciencias de la Salud, Universidad Anáhuac Mayab Mérida, Yucatán, Mexico.
Reyes-Cuapio E, et al. EUR J Pharmacol. 2021;910:174463.

Science/Human: Cannabis does not play a causal role in type 2 diabetes
In a large study cannabis use had no effect on the risk for the development of type 2 diabetes.
Epidemiology, LMU München, UNIKA-T Augsburg, Augsburg, Germany.
Baumeister SE, et al. Addict Biol. 2021;26(6):e13020.

Science/Animal: A deficiency of the CB1 receptor in the skin may lead to accelerated skin ageing
According to a study with mice CB1 receptor deficiency in the skin “may lead to accelerated skin aging due to the increased production of ROS, a decrease in the antioxidant defences and a higher pro-inflammatory environment.”
Center for Neuroscience and Cell Biology, University of Coimbra, Portugal.
Leal CE, et al. Exp Gerontol. 2021;154:111528.

Science: CBD may reduce the efficacy of disulfiram used in cancer treatment
New research shows that the use of CBD in cancer patients may reduce the anti-cancer effects of disulfiram.
Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
Buchtova T, et al. Mol Oncol. 2021. [in press]

Science/Human: CBD may exert anti-inflammatory effects in people with cocaine use disorder
In a placebo controlled study with 48 people with cocaine use disorder, who received either CBD (800 mg) or placebo for 92 days CBD was shown to exert anti-inflammatory effects.
Faculty of Medicine, Department of Psychiatry and Addictology, Université de Montréal, Canada.
Morissette F, et al. Neuropsychopharmacology. 2021;46(12):2101-2111.

Science/Animal: The cannabinoid receptor GPR55 may be a target for the treatment of nicotine use disorder
According to results of a study with mice the cannabinoid receptor GPR55 in a certain brain region (nucleus accumbens) “plays a specific role in blocking nicotine-CPP behavior and might be a potential target for the treatment of nicotine use disorder.”
Precision Pharmacy & Drug Development Center, Department of Pharmacy, Tangdu Hospital, Air Force Medical University, Xi'an, China.
Liu Q, et al. Psychopharmacology (Berl). 2021 Oct 14. [in press]

Science/Cells: CBD may prevent inflammation triggered by the coronavirus
A study with cells shows, that CBD may prevent epithelial damage and hyperinflammatory response triggered by SARS-CoV-2 spike protein.
Department of Physiology and Pharmacology, Sapienza University of Rome, Italy.
Corpetti C, et al. Phytother Res. 2021 Oct 12. [in press]

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