International Association for Cannabis as Medicine

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IACM-Bulletin of 27 April 2008
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* Science: Cannabis was effective in the treatment of neuropathic
pain in clinical study
* Science: Nabilone reduced pain, use of opioids and nausea in
patients with advanced cancer
* Science: Cannabinoids may be helpful in the treatment of side
effects of anti-viral medications in patients with hepatitis C
* Science: Anandamide effective against impotence in diabetic rats

1.

Science: Cannabis was effective in the treatment of neuropathic
pain in clinical study

In a placebo-controlled, clinical study with 38 patients (mean age:
46 years) at the University of California, USA, smoking of cannabis
was effective in reducing neuropathic pain of different origin
(diabetes, spinal cord injury, multiple sclerosis and other causes).
Participants received either cannabis of two different strengths (3.5
per cent or 7 per cent) or placebo cannabis without THC at three
different occasions, which were separated by at least three days.
In each session, patients took the same number of puffs from the
cannabis cigarette, following a standardized procedure to ensure
uniformity of the dose received at each strength.

All participants had experience with cannabis, but discontinued the
administration of cannabis or THC (Marinol) 30 days before start of
the study. 31 patients used opiates and continued their use
throughout the study. Both doses of cannabis significantly reduced
pain and this decline remained for several hours. There was no
significant difference in pain reduction between the two cannabis
varieties. Researchers noted, that "psychoactive effects were
minimal and well-tolerated, but neuropsychological impairment was
problematic, particularly with the higher concentration of study
medication."

(Source: Wilsey B, Marcotte T, Tsodikov A, Millman J, Bentley H,
Gouaux B, Fishman S. A randomized, placebo-controlled,
crossover trial of cannabis cigarettes in neuropathic pain. J Pain.
2008 Apr 8 [Epub ahead of print])

2.

Science: Nabilone reduced pain, use of opioids and nausea in
patients with advanced cancer

A prospective observational study was conducted at the University
of Toronto, Canada, on the efficacy of the synthetic THC derivative
nabilone in advanced cancer patients, who suffered from chronic
pain. 47 patients who received nabilone were compared to 65
cancer sufferers who did not receive the cannabinoid.

Nabilone treated patients had significantly lower pain scores and
lower use of opioids. There was also a significant improvement in
nausea, anxiety and overall distress. When compared with those
not taking nabilone, patients using this cannabinoid had a lower
rate of starting non-steroidal anti-inflammatory agents, tricyclic
antidepressants, the pain medication gabapentin, the cortisone
preparation dexamethasone, and the anti-emetics metoclopramide
and ondansetron and a greater tendency to discontinue these
drugs.

(Source: Maida V, Ennis M, Irani S, Corbo M, Dolzhykov M.
Adjunctive nabilone in cancer pain and symptom management: a
prospective observational study using propensity scoring. J Support
Oncol 2008;6(3):119-24.)

3.

Science: Cannabinoids may be helpful in the treatment of side
effects of anti-viral medications in patients with hepatitis C

According to researchers of the University of Ottawa, Canada, the
use of cannabinoids may be helpful in the treatment of appetite
loss and nausea observed in patients with hepatitis C, who undergo
an anti-viral treatment. The medical records of all hepatitis C
patients, who received a treatment with ribavirin and interferon
between August 2003 and January 2007, were reviewed. Of the 191
patients identified, 25 received oral cannabinoid containing
medications. Cannabinoid treatment was initiated at a median time
of seven weeks after initiation of anti-viral treatment. The main
reasons for cannabinoid treatment were appetite loss (72 per cent)
and nausea (32 per cent).

64 per cent of all patients who received cannabinoids experienced
subjective improvement in symptoms. The median weight loss
before this therapy was 4.5 kg. Weight loss stabilized one month
after cannabinoid initiation. Interferon dose reductions were rare
and did not differ between patients who received cannabinoids
compared to those not using cannabinoids. The proportions of
patients completing a full course of anti-viral hepatitis C therapy
and achieving a sustained virological response were greater in
cannabinoid recipients compared to the control group.

(Source: Costiniuk CT, Mills E, Cooper CL. Evaluation of oral
cannabinoid-containing medications for the management of
interferon and ribavirin-induced anorexia, nausea and weight loss in
patients treated for chronic hepatitis C virus. Can J Gastroenterol
2008;22(4):376-80.)

4.

Science: Anandamide effective against impotence in diabetic rats

According to a study by the Department of Pharmacology at the
University of Tehran, Iran, the endocannabinoid anandamide
improved the relaxation of the spongy tissue (corpus cavernosum)
of the penis in diabetic rats. The animals were killed and their
spongy bodies were isolated. In a solution the spongy bodies were
treated with various substances. Compared to the spongy tissue of
healthy animals the ability of the tissue of diabetic rats to relax
when exposed to an electric field was impaired. Both the
administration of anandamide and the administration of arginine
improved that ability to relax. The combined use of both
substances resulted in considerably improved relaxation.

It is known that in diabetics the neurogenic ability of spongy tissue
to relax, and thus its erection potential, may be impaired. It is
assumed, that the impairment results from a reduced production of
nitric oxide. Nitric oxide elicits a process, that results in muscle
relaxation in the spongy tissue, which enables the influx of blood
and thus erection. The amino acid arginine is a nitric oxide donor
and increases the concentration of this molecule in blood.
Anandamide exerts its effects on erection by activation of the CB1
receptors and the vanilloid receptors. It has not been investigated
so far, whether THC may cause similar effects.

(Source: Ghasemi M, Sadeghipour H, Dehpour AR. Anandamide
improves the impaired nitric oxide-mediated neurogenic relaxation
of the corpus cavernosum in diabetic rats: involvement of
cannabinoid CB1 and vanilloid VR1 receptors. BJU Int
2007;100(6):1385-90.)

5.

News in brief

***Science: Gateway theory
A study with twin pairs by scientists of the Pennsylvania State
University, USA, does not support the gateway theory. They write,
that "rather than supporting the interpretation that earlier marijuana
use 'triggers' later hard drug use, these results suggest that the
longitudinal pattern of drug use that has been interpreted as the
'gateway effect' might be better conceptualized as a genetically
influenced developmental trajectory." (Source: Cleveland HH
&Wiebe RP. Dev Psychopathol 2008;20(2):615-32.)

***Spain/Austria: Sativex
Sativex is now available all over Spain under the administrative
status of compassionate use when other medications have failed.
This is a consequence of the results of a study with Sativex in
Catalonia. For a short time, Sativex is also available on prescription
in Austria. (Sources: Personal communications by Marta Duran
and Kurt Blaas)

***Cyprus: ICRS conference
On 1-4 May 2008 the ICRS (International Cannabinoid Research
Society) will hold a conference on the therapeutic potential of
cannabinoids in Cyprus. The program with abstracts is available at:
http://www.cannabinoidsociety.org/SYMPOSIUM.2008/2008.Limass
ol/Program/2008.Limassol.Satellite.Program.pdf (Source: ICRS)

***Argentine: Acquittal
A court of appeal in Buenos Aires declared unconstitutional the
prohibition of the possession of drugs for personal use and
acquitted two defendants from illegal possession of small
amounts of cannabis and ecstasy. The Argentinean Supreme
Court will review the case. According to a newspaper report the
government supports decriminalisation of drug use. (Source: El
Financiero of 23 April 2008)

***Science: Brain damage
Researchers of the University of Oxford, UK, investigated brain
structures of heavy cannabis users who started their use at an
early age. They found abnormalities in the corpus callosum, which
may underlie cognitive consequences of long term heavy cannabis
use by young people. The corpus callosum connects the left and
right hemisphere of the brain. (Source: Arnone D, et al.
Neuroimage 2008 Mar 14 [Electronic publication ahead of print])

***Science: Inflammation of the endometrium
The endometrium is the inner membrane of the uterus.
Researchers of the University of Naples, Italy, found out, that an
inflammation of the endometrium (endometritis) is associated with
an increase of CB2 receptors in the uterus. They assume that this
increase improves the possibility for endocannabinoids to exert anti-
inflammatory effects by binding to these receptors. (Source: Iuvone
T, et al. J Cell Mol Med 2008;12(2):661-670.)

***Science: Arthritis
The presence of cannabinoid receptors and endocannabinoids was
investigated in the knees of 45 patients with arthritis, who
underwent surgery. The endocannabinoids anandamide and 2-AG
were present in the joint fluid of patients, but not in the joint fluid of
healthy controls suggesting that cannabinoids might be helpful in
treating pain and inflammation in arthritis. (Source: Richardson D,
et al. Arthritis Res Ther 2008;10(2):R43.)

***UN: Antonio Costa
During the annual conference of the Committee on Narcotic Drugs
(CND) of the United Nations in March the head of the UN Office on
Drugs and Crime (UNODC), Antonio Costa, was asked, how he
explains the fact, that the Netherlands have no higher user rates of
cannabis compared to the surrounding countries. As he did before,
Mr. Costa was avoiding to answer this question. A film of the
question and the reaction by Mr. Costa is available at:
http://www.youtube.com/watch?v=fe208nLLEwk (Source:
http://www.youtube.com)

6.

ONE YEAR AGO:
- World: The Commission on Narcotic Drugs of the United
Nations decided against reclassification of dronabinol (THC)
due to political reasons
- Science: THC promotes weight gain in elderly subjects
suffering from appetite and weight loss
- Science: Vaporization of cannabis is an effective method to
deliver THC according to a clinical study
- Science: THC reduces cancer growth and spreading to other
organs in lung cancer in an animal study

TWO YEARS AGO:
- USA: Medicinal drug agency FDA looses credibility after a
statement on the medical value of cannabis
- Germany: No association between criminal prosecution and
extent of cannabis use

(More at the IACM-Bulletin archives: http://www.cannabis-
med.org/)

International Association for Cannabis as Medicine (IACM)
Am Mildenweg 6
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Germany
Phone: +49 (0)2952-9708571
Fax: +49 (0)2952-902651
Email: info [at] cannabis-med.org
http://www.cannabis-med.org

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