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IACM-Bulletin of 03 July 2022

Switzerland: The medical use of cannabis will be legal from August 2022 on

The Swiss government on 22 June decided to lift the ban on cannabis for medical use from 1 August. Patients who are medically prescribed the drug will no longer need to seek exceptional permission from the health ministry. The sale and consumption of cannabis for non-medical purposes will remain prohibited.

Parliament backed amending the law in March 2021. "The decision to use a cannabis-based medicine for therapeutic purposes will rest with the doctor, in consultation with the patient," the government said. Demand for cannabis-based treatments has risen sharply, with the health ministry issuing 3,000 exceptional authorisations in 2019. The law change will also mean that the cultivation, processing, manufacture and trade of cannabis for medical use will be subject to the Swissmedic regulatory authority, just as with other narcotics for medical use such as cocaine, methadone and morphine.

Barrons of 22 June 2022

Science/Human: The use of cannabis is associated with a lower risk of liver cancer

Liver cancer (hepatocellular carcinoma) is one of the most common malignancies worldwide and the fourth leading cause of cancer deaths in the world. According to a data analysis of about 101 million patients those with a diagnosis of cannabis abuse were 55% less likely to have liver cancer. The study was conducted by investigators of scientific institutions in Cleveland, Washington DC, Springfield and Phoenix.

A total of 101,231,036 patients were included in the study. Out of the total, 996,290 patients (1%) had the diagnosis of cannabis abuse versus 100,234,746 patients (99%) in the control group without cannabis abuse. Patients with cannabis use had more hepatitis B, hepatitis C, liver cirrhosis, and smoking, but had less obesity and gallstones. After adjusting for potential confounders, patients with cannabis abuse were 55% less likely to have liver cancer.

ElTelbany A, Khoudari G, Al-Khadra Y, McCullough A, Alkhouri N. Lower Rates of Hepatocellular Carcinoma Observed Among Cannabis Users: A Population-Based Study. Cureus. 2022;14(4):e24576.

Science/Human: Palmitoylethanolamide reduced acute mania according to controlled study

Palmitoylethanolamide (PEA) is an endocannabinoid-like substance. In a placebo controlled study with 63 patients with acute mania at the Roozbeh Hospital of Tehran University of Medical Sciences, Iran PEA improved symptoms. Patients in acute phase of mania were assigned into two parallel groups given either lithium and risperidone 3 mg plus PEA 600 mg or placebo twice per day for 6 weeks.

A total of 63 patients (32 in PEA and 31 in placebo groups) completed the trial. There was a significant greater decrease in symptoms in the PEA group compared to the placebo group. Authors concluded that their “findings provide preliminary evidence that PEA is an effective adjunctive medication that improves manic symptoms and overall clinical status in acute episodes of mania.”

Abedini T, Hosseyni R, Ghannadi F, Sanjari Moghaddam H, Khodaei Ardakani MR, Talaei A, Akhondzadeh S. Efficacy and safety of palmitoylethanolamide as an adjunctive treatment for acute mania: a randomized, double-blind and placebo-controlled trial. Psychiatry Clin Neurosci. 2022 Jun 23. [in press].

News in brief

UN: Call for the end of the war on drugs
UN human rights experts have called on the international community to bring an end to the so-called “war on drugs” and promote drug policies that are firmly anchored in human rights. Ahead of the International Day Against Drug Abuse and Illicit Trafficking on 26 June 2022, the experts issued a statement.
Press release by the UN on 24 June 2022

Pakistan: Plans for the regulation and facilitation of farming and use of cannabis
Ministry of Science and Technology has decided to form an authority to regulate and facilitate the farming and usage of cannabis (Bhang). According to details, the authority would issue licences to producers and farmers to produce cannabis (Bhang) for medical and industrial usage. The authority would issue five different kinds of licences including an industrial, medical, processing, research and development license. The Science and Technology ministry would forward the policy to the cabinet for approval.
ARY News of 26 June 2022

Economy: Large differences in prices for medical cannabis in different countries
The current price for medicinal cannabis is about NIS 24.5 per gram (6,90 US dollars, 6,65 EURos) on average in Israel, in Canada the price in the recreational market is about 5.55 Canadian dollars (4.80 US dollars, 4.63 EURos). For comparison: in Dutch pharmacies the price is about 6 to 7 EURos (6 to 7 US dollars), in German pharmacies about 10 to 20 EURos (10 to 20 US dollars).
Cannabis of 26 June 2022

Science/Human: Many Canadian patients substitute cannabis for other medications
According to a survey with about 2700 registered cannabis patients those who spoke with their family physician (82%) about 39% said that their physician has very good or excellent knowledge about medical cannabis. Overall, 47 % of participants reported substituting cannabis for pharmaceuticals or other substances (e.g., alcohol, tobacco/nicotine).
Chronic Pain and Fatigue Research Center, Anesthesiology Department, University of Michigan, USA.
Holman A, et al. J Cannabis Res. 2022(1):32.

Science/Cells: THC protects heart cells from toxicity caused by a chemical
In a study with heart cells of rats THC attenuated toxic effects caused by phosphine gas by reducing toxicity to the mitochondria and reduction of oxidative stress.
Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran.
Salimi A, et al. Pestic Biochem Physiol. 2022;184:105117.

Science/Animal: THC administration may reduce insulin levels and inflammation
The administration of large amounts of fructose to rats increased the levels of insulin. THC given together with fructose reduced the insulin levels in blood and attenuated inflammation.
Department of Medical Biology, Faculty of Cerrahpasa Medicine, Istanbul University, Turkey.
Beydogan AB, et al. J Pharm Pharmacol. 2019;71(3):408-416.

Science/Cells: Activation of cannabinoid receptors reduces inflammatory activity of microglia
New research shows “that activation of CB1 or CB2 receptors interfered with the pro-inflammatory activity of microglia in a manner that also reduced secondary damage to neurons” (nerve cells).
Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.
Young AP, et al. Brain Behav Immun. 2022;105:29-43.

Science/Human: Celecoxib does not have the potential to reduce craving after cannabis cessation
In a placebo-controlled study with 15 cannabis users celecoxib, which inhibits COX-2, improved subjective measures of sleep but did not affect mood in the participants, who stopped cannabis use.
New York State Psychiatric Institute, New York, USA.
Haney M, et al. Addict Biol. 2022;27(4):e13183.

Science/Human: Cannabis use may reduce the risk for age-related macular degeneration
According to an analysis of data from the UK biobank cohort the use of cannabis in the past for more than 100 times was associated with a lower risk of the development of age-related macular degeneration.
Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA.
Lehrer S, et al. J Fr Ophtalmol. 2022:S0181-5512(22)00132-2.

Science/Animal: Olive oil was most effective among vegetable oils in increasing the bioavailability of CBD
Researchers investigated the efficacy of sesame, sunflower, peanut, soybean, olive and coconut oils to function as vehicles in promoting CBD lymphatic transport and bioavailability. They found that olive oil “led to the highest concentration of CBD in the lymphatic system and in the systemic circulation in comparison to the other natural vegetable oils following oral administration in rats.”
School of Pharmacy, University of Nottingham, UK.
Feng W, et al. Int J Pharm. 2022 Jun 23:121947. [in press].

Science/Cells: THC and CBD have favourable effects on the tumour microenvironment
THC and CBD may have favourable effects on the tumour environment. Authors wrote that “the results presented here reinforce the usefulness of cannabinoid agonists for the treatment of some relevant aspects of lung cancer pathology.”
Department of Pathology, Faculty of Medicine and Dentistry, Universitat de València, Spain.
Milián L, et al. Int J Mol Sci. 2022;23(12):6766.

Science/Cells: CBD may decrease the efficacy of cisplatin and increase the efficacy of mitoxantrone in melanoma cells
CBD reduces the viability and proliferation of melanoma malignant cells and exerts additive interactions with the chemotherapeutic agent mitoxantrone. However it reduced the efficacy of the chemotherapeutic agent cisplatin.
Department of Pathophysiology, Medical University of Lublin, Poland.
Marzęda P, et al. Int J Mol Sci. 2022;23(12):6752.

Science/Cells: CBD and CBG inhibited the growth of bile duct cancer
CBD (cannabidiol) and CBG (cannabigerol) were shown to cause cell death in bile duct cancer cells and reduced their capability of migration, thus reducing their capability of metastasis.
School of Biological Sciences, University of Northern Colorado, USA.
Viereckl MJ, et al. Biomolecules. 2022;12(6):854.

Science/Animal: Activation of the CB1 receptor may reduce toxicity of neuroleptics on the heart
The activation of the CB1 receptor reduced inflammation of the heart caused by neuroleptics and may help “to rescue cardiac side effects of antipsychotics.”
Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China.
Li L, et al. Signal Transduct Target Ther. 2022;7(1):190.

Science/Human: Cannabis use may be associated with an increased risk of arrhythmias
In a study with 1485 participants investigators found “that current marijuana use may be associated with a greater burden of arrhythmias.”
Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.
Harding BN, et al. Am J Cardiol. 2022 Jun 17:S0002-9149(22)00541-0.

Science/Human: Sex differences in the effects of cannabis on cancer symptoms
In a study with 358 cancer patients there were some sex differences in the perceived effects of cannabis, among them pain and nausea.
McGill Nutrition and Performance Laboratory, Montreal, Canada.
Kasvis P, et al. Support Care Cancer. 2022 Jun 20 [in press].

Science/Human: About 3 of 4 pregnant women do not regard cannabis use as a great risk
In a study with about 15,000 pregnant women in the US 27% perceived regular cannabis use is a great risk.
Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
Alshaarawy O, et al. Am J Prev Med. 2022:S0749-3797(22)00289-6.

Science/Human: The number of CB2 receptors is increased in the intestine of children with inflammatory bowel disease
In a study with intestinal tissue from 15 children, 5 with Crohn’s disease, 5 with ulcerative colitis and 5 without inflammation, tissues from children with inflammatory diseases presented with a higher concentration of the CB2 receptor.
Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Strisciuglio C, et al. Pediatr Res. 2022 Jun 18 [in press].

Science/Animal: Reduced levels of the endocannabinoid 2-AG may contribute to Parkinson’s disease
In an animal model of Parkinson’s disease lack of the enzyme diacylglycerol lipase beta, which is important for the synthesis of the endocannabinoid 2-AG, reduced locomotor skills. Authors wrote that their research indicates “potential benefits of 2-AG augmentation in alleviating Parkinsonism.”
Transgenic Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, USA.
Liu Z, et al. Nat Commun. 2022;13(1):3490.

Science/Human: Dried flowers remain the dominant product in Canada and the US
Survey data of several thousand participants from the years 2018, 2019 and 2020 show that “dried flower remains the dominant product in Canada and the US; however, use of processed cannabis products has increased, with the largest increases observed in legal cannabis markets.”
School of Public Health Sciences, University of Waterloo, Canada.
Hammond D, et al. Int J Drug Policy. 2022;105:103716.

Science/Human: Palmitoylethanolamide may decrease the number of days with headache in patients with migraine
In an open study with 25 patients suffering from migraine the endocannabinoid like substance palmitoylethanolamide, which was taken for 3 months, the number of days with headaches decreased from mean of 10 to a mean of 6.6 days.
Neurology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Faculty of Health Sciences, Universidad Fernando Pessoa Canarias, Spain.
Hernández AG. Clin Neurol Neurosurg. 2022;218:107282.

Science/Cells: CBD may prevent from the development of colon cancer
CBD was shown to cause programmed cell death in colon cancer cells through activation of the CB2 receptor. “Anti-proliferative activity was also observed for other non-psychoactive cannabinoid derivatives including cannabidivarin (CBDV), cannabigerol (CBG), cannabicyclol (CBL), and cannabigerovarin (CBGV). Our data indicate that CBD and its derivatives could be promising agents for the prevention of human colorectal cancer.”
Department of Nutrition and Food Science, University of Maryland, USA.
Lee HS, et al. Int Immunopharmacol. 2022;108:108865.

Science/Human: CBD may be helpful in the treatment of addiction from nicotine, cannabis and opioids
A review of “human studies showed a positive impact of CBD in the context of nicotine, cannabis, and opioid use (e.g., frequency and quantity of consumption). In contrast, CBD was not found to have an effect in human studies on cocaine or alcohol use.”
Hôpital Universitaire Paul Brousse (AP-HP), UR PSYCOMADD, Université Paris-Saclay, Villejuif, France.
Paulus V, et al. Addict Behav. 2022;132:107360.

Science/Human: Cannabis may reduce itching in lymphoma of the skin
A survey with 119 patients with cutaneous lymphoma 55% reported ever having used cannabis. 25% of current users reported using cannabis specifically to treat itch.
University of Washington School of Medicine, 1959 NE Pacific St, Seattle, USA.
Mahurin HM, et al. Complement Ther Med. 2022;67:102830.

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