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IACM-Bulletin of 24 April 2022

Science/Human: Cannabis may be helpful in inflammatory bowel disease according to survey

According to a survey with 417 patients suffering from inflammatory bowel disease cannabis may be helpful in symptom management. Mean age was 41 years and about 55% suffered from ulcerative colitis, while about 43% from Crohn’s disease. 17.5% of respondents to the survey indicated that they had used cannabis for recreational purposes in the past. 7.5% said that they were currently using cannabis products either illegal or prescribed by a doctor.

The investigators of the Clinic of Saarbrücken and the Clinic for Integrative Medicine and Naturopathy in Bamberg, Germany, found out that 83% of the currently cannabis using participants noted symptom improvements, among them abdominal pain and sleeping problems. About 72% indicated that cannabis helps them to cope with anxiety and sorrow. Appetite was improved in about 67%, nausea in 61% and diarrhoea in 56%. In 50% their treating physician was not aware of their cannabis use. Among the reasons for stopping treatment were legal concerns and lack of efficacy.

Langhorst J, Häuser W. Cannabiskonsum von CED-Betroffenen in Deutschland. Bauchredner. 2022;1:82-88.

Science/Human: The legalisation of cannabis for adults may be associated with reduced prescription drug use

Using data of Medicaid prescriptions from 2011 to 2019 investigators of Jeb E. Brooks School of Public Policy of Cornell University in Ithaca, USA, found out that legalisation of cannabis by adults was associated with reduced prescription drug use in this population.

Authors noted that the “potential substitution of cannabis for prescription medication has attracted a substantial amount of attention within the context of medical cannabis laws (… ). However, much less is known about the association between recreational cannabis laws (… ) and prescription drug use.” They added that they found “significant reductions in the volume of prescriptions within the drug classes that align with the medical indications for pain, depression, anxiety, sleep, psychosis, and seizures. Our results suggest substitution away from prescription drugs and potential cost savings for state Medicaid programs.”

Raman S, Bradford A. Recreational cannabis legalizations associated with reductions in prescription drug utilization among Medicaid enrollees. Health Econ. 2022 Apr 15. [in press]

Science/Human: A cannabis extract was superior to long acting opiates in patients with neuropathic back pain

A retrospective analysis of data from the German Pain e-Registry of adult patients, who initiated either a treatment with the cannabis extract Sativex or with long acting opiates between March 2017 and March 2020 showed that the cannabis extract “was superior to and better tolerated than add-on treatment with typical oral LAO [long acting opioids] analgesics in patients with neuropathic back pain inadequately controlled by recommended/established systemic therapies.” The analysis was conducted by several German pain specialists.

655 patients were treated with the cannabis extract and 655 were treated with long acting opioids. The cannabis extract was associated with superior pain reduction and further symptoms, including physical function, improved more with the cannabis extract. With cannabis fewer patients experienced side effects or discontinued treatment because of side effects.

Ueberall MA, Vila Silván C, Essner U, Mueller-Schwefe GHH. Effectiveness, Safety, and Tolerability of Nabiximols Oromucosal Spray vs Typical Oral Long-Acting Opioid Analgesics in Patients with Severe Neuropathic Back Pain: Analysis of 6-Month Real-World Data from the German Pain e-Registry. Pain Med. 2022;23(4):745-760.

News in brief

USA: The legalisation of cannabis was associated with reduced entry of children into foster-care system
Investigators estimated that legalization of cannabis for recreational use “decreases foster-care placements by at least 10%, with larger effects in years after legalization, and for admissions for reasons of parental drug and alcohol abuse, physical abuse, neglect, and parental incarceration.”
Department of Economics, University of Mississippi, University, Mississippi, USA.
Gardner J, Osei B. Recreational marijuana legalization and admission to the foster-care system. Economic Inquiry. 2022 Apr 1. [in press]

Europe: More than half of EURopeans support cannabis legalization
More than half of the EURopean population support legalization of adult use of cannabis and around 30% of them are interested in purchasing it, according to polling data by industry consultants on 5 April. Many EURopean countries, including Germany, have legalized cannabis for limited medicinal purposes, while others have decriminalized its general use. Malta became the first EURopean country to allow limited cultivation and personal use of cannabis.
Reuters of 7 April 2022

USA: Two thirds of US citizens favour legalisation of cannabis under federal law
Two-thirds of Americans want recreational cannabis use to be legal under federal law and in their own state. As more states move to legalize cannabis, most people say they wouldn't mind if a licensed cannabis business opened in their neighborhood. Recreational cannabis use remains illegal at the federal level. The House of Representatives recently passed a bill to federally decriminalize cannabis.
CBS News of 20 April 2022

USA: About 20% of Medicare recipients acknowledge consuming cannabis for symptom relief
Twenty-one percent of Medicare recipients report consuming cannabis for therapeutic purposes, according to survey data compiled by the group MedicarePlans.com. Survey respondents were most likely to report using cannabis products to address symptoms of anxiety, chronic pain, depression, glaucoma, and HIV/AIDS.
NORML of 20 April 2022

USA: Two cannabis research bills advance in Congress
Congress is considering two acts designed to make cannabis and cannabidiol (CBD) more accessible to medical researchers. The U.S. House of Representatives’ Medical Marijuana Research Act and the Senate’s Cannabidiol and Marihuana Research Expansion Act were approved in their chambers with bipartisan support in recent weeks. They are considered a critical next step toward approval by the U.S. Food and Drug Administration of cannabis and cannabis-derived substances for medicinal use.
Phoenix New Times of 15 April 2022

New Zealand: Partnership with a company to build up a cannabis industry in the country
The New Zealand government has announced a 32 million New Zealand dollar partnership with medicinal cannabis grower Puro in a bid to build a sector that matches the country’s wine industry. The project will run from 2022 to 2027, with the government contributing 13 million dollars via the Ministry for Primary Industries’ Sustainable Food and Fibre Futures fund, and Puro the rest.
Cannabiz of 8 April 2022

Science/Human: Investigation of the pharmacokinetics of a CBD rich cannabis extract
Investigators looked at the pharmacokinetics and effects of different doses of a CBD rich cannabis oil with 20 mg/mL CBD and less than 1 mg/mL THC. Daily doses were increased up to 480 mg CBD and about 22 mg THC. A steady state of CBD concentrations in blood were reached after 7 days. Until doses of 240 mg of CBD and about 11 mg of THC there were not many side-effects.
Canopy Growth Corporation, Canada.
Peters EN, et al. J Anal Toxicol. 2022;46(4):393-407.

Science/Human: Cannabis use is common among cancer survivors in the US
An analysis of data from about 13,000 adults with cancer showed that about 9% of all cancers survivors reported current cannabis use. About 51% of them used it for medicinal purposes.
Department of Population Science and Policy, Southern Illinois University School of Medicine, USA.
Lee M, et al. J Cancer Surviv. 2022 Apr 9. [in press]

Science/Human: Cannabis legalisation in Massachusetts has resulted in increased use of cannabis
According to data from 2 medical centres in Boston investigators found increasing numbers of THC positive patients and an increasing number of cannabis use disorders.
Department of Pathology, Brigham and Women's Hospital, Boston, USA.
Tolan NV, et al. Clin Toxicol (Phila). 2022;60(5):585-595.

Science/Animal: Palmitoylethanolamide reduces inflammation in obese mice
Obesity results in chronic state of low-grade inflammation. Palmitoylethanolamide reduced inflammation of the nervous system and anxiety in obese mice. The production of pro-inflammatory cytokines, such as tumour necrosis factor alpha was reduced.
Department of Pharmacy, School of Medicine, University of Naples Federico II, Naples, Italy.
Lama A, et al. Brain Behav Immun. 2022;102:110-123.

Science/Human: About 9% of Canadians cultivated cannabis for their own in 2020
According to a survey with about 26,000 participants self cultivation of cannabis increased after legalisation from about 6% to about 9%. Authors noted that “almost one in ten Canadian cannabis consumers reported home cultivation of cannabis in 2020, with modest increases following legalization and most growing within the non-medical limit of four plants.”
School of Public Health Sciences, University of Waterloo, Canada.
Wadsworth E, et al. Addict Behav Rep. 2022;15:100423.

Science/Animal: An increased level of endocannabinoids supports sleep behaviour in mice
In a study with adolescent mice researchers found an increased level of anandamide and oleylethanolamide increased during sleep phase in a circadian manner. Inhibition of degradation of anandamide and 2-AG increased dark phase sleep. Male mice were more sensitive to the sleep promoting effects of enhanced endocannabinoid levels.
Department of Cell Biology and Physiology and the UNC Neuroscience Center, University of North Carolina at Chapel Hill, USA.
Martin SC, et al. Sleep. 2022 Apr 8:zsac083.

Science/Human: Cannabis use is associated with coronary artery disease
An analysis of about 12,500 people from the National Health and Nutrition Examination Survey revealed that cannabis users presented with an increased number of coronary artery disease.
Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, USA.
Skipina TM, et al. Am J Med Sci. 2022:S0002-9629(22)00153-7.

Science/Human: The endocannabinoid system plays a role in taste dysfunction of patients with Alzheimer’s disease
In a study with 15 patients with Alzheimer’s disease and mild cognitive dysfunction and 15 patients with Parkinson’s disease there were changes in brain regions associated with smell and taste. The endocannabinoid system was involved in these changes.
Department of Anatomy, Faculty of Medicine, Kastamonu University, Kastamonu, Turkey.
Petekkaya E, et al. J Clin Neurosci. 2022;100:52-58.

Science/Human: A cannabis extract reduced cannabis use in cannabis-dependent people
In a 12 week placebo-controlled study with 128 cannabis-dependent patients the cannabis extract Sativex reduced illicit cannabis use and improved comorbidity symptoms.
Drug and Alcohol Services, Northern Sydney Local Health District, Australia.
Montebello M, et al. Drug Alcohol Depend. 2022;234:109388.

Science/Human: Emergency department visits due to cannabis psychosis increased in Colorado after legalisation
With legalisation of cannabis in Colorado there was no significant association with the rate of schizophrenia emergency department visits, while the rate of psychosis visits increased by 24%.
University of Colorado Anschutz Medical Campus Children's, Hospital Colorado Department of Pediatrics, USA.
Wang GS, et al. Int J Drug Policy.2022;104:103685.

Science: CBD shows antibacterial activity against Gram-positive bacteria
CBD exerts antibacterial activity against Gram-positive bacteria. A combination of polymyxin B and CBD was more effective than CBD or polymyxin B alone. CBD was effective against Neisseria gonorrhoeae, Neisseria meningitidis, Moraxella catarrhalis and Mycobacterium tuberculosis, but not against Gram-negative bacteria.
Department of Clinical Analyses, Toxicology and Food Science (DACTB), School of Pharmaceutical Sciences of Ribeirao Preto (FCFRP), University of São Paulo, Brazil.
Abichabki N, et al. Sci Rep. 2022;12(1):6454.

Science/Animal: CBD increases lifespan in a certain nematode
In a study with the nematode C. elegans CBD induced lifespan extension and increased neuronal health.
Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, NSW, Australia.
Wang Z, et al Geroscience. 2022 Apr 20. [in press]

Science/Animal: CBD may be helpful in post-traumatic stress disorder In a study with mice
CBD in a dose of 10 mg/kg intraperitoneal produced anti-post-traumatic stress disorder-like actions and disrupted trauma-related fear memory.
Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing, China.
Han X, et al. Psychopharmacology (Berl). 2022 Apr 9. [in press]

Science/Cells: A CBD rich cannabis extract may reduce inflammation of microglial cells
A cannabis extract rich in CBD and terpenes reduced pro-inflammatory cytokines (interleukin-1 beta, interleukin-6, tumour necrosis factor-alpha) in microglial cells. Authors wrote that such extracts “could represent a novel therapeutic strategy for neuro inflammatory-related diseases.”
Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Italy.
Borgonetti V, et al. Phytother Res. 2022 Apr 8. [in press]

Science/Animal: Memory consolidation depends on anandamide levels in the hippocampus
In a study with rats investigators demonstrated that “an optimal, stable extracellular concentration of anandamide” is a necessary condition “to ensure the consolidation of a stable memory trace” in the hippocampus, a certain brain region, important for memory and emotions.
Psychobiology and Neurocomputation Lab, Biophysics Department, Bioscience Institute, Universidade Federal do Rio Grande do Sul, Agronomia, Porto Alegre, Brazil.
Scienza-Martin K, et al. Neuroscience. 2022:S0306-4522(22)00191-9.

Science/Animal: Beta-caryophyellene attenuates seizure activity
In a study with rats with status epilepticus caused by a chemical beta-caryophyellene reduced seizure activity and blood-brain-barrier breakdown.
Graduate Program in Pharmacology, Federal University of Santa Maria, Brazil.
Mallmann MP, et al. Brain Res. 2022;1784:147883.

Science/Animal: CBD may partially reverse stress induced emotional alterations
Early-life stress induces emotional and molecular alterations in female mice that are partially reversed by cannabidiol.
Neurobiology of Behaviour Research Group (GReNeC-NeuroBio), Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
Martín-Sánchez A, et al. Prog Neuropsychopharmacol Biol Psychiatry. 2022;115:110508.

Science/Animal: CBD prevented heart cells from toxicity by aluminium phosphide
In a study with rats CBD was able to restore mitochondrial function and decreased oxidative damage induced by the poison aluminium phosphide “and thus, prevented the heart cells from entering the apoptotic stage”, that is programmed cell death.
Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Hooshangi Shayesteh MR, et al. Toxicol Mech Methods. 2022;32(4):288-301.

Science/Human: There is a substantial variability of blood concentrations after CBD intake between different subjects
Using data from a clinical study with 12 patients investigators found a big variability of CBD blood concentrations. Authors concluded that the “findings of this study have important implications for drug development. The lack of a clear dose-response relationship, due to large pharmacokinetic variability, indicates that a one-size-fits-all approach to CBD dosing may not be feasible, at least with current dosing approaches.”
UniSA Clinical & Health Sciences, University of South Australia, Adelaide, Australia.
Schultz HB, et al. Cannabis Cannabinoid Res. 2022 Apr 19. [in press]

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