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IACM-Bulletin of April 30, 2006

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USA — Medicinal drug agency FDA looses credibility after a statement on the medical value of cannabis

In a statement issued on 20 April the US medicinal drug agency FDA (Food and Drug Administration) said that "no sound scientific studies supported medical use of marijuana for treatment in the United States, and no animal or human data supported the safety or efficacy of marijuana for general medical use."

Many commentators in the media noted that the FDA lost credibility by this move. The New York Times reported on the issue as follows. "The Bush administration's habit of politicizing its scientific agencies was on display again this week when the Food and Drug Administration, for no compelling reason, unexpectedly issued a brief, poorly documented statement disputing the therapeutic value of marijuana. The statement was described as a response to numerous inquiries from Capitol Hill, but its likely intent was to buttress a crackdown on people who smoke marijuana for medical purposes and to counteract state efforts to legalize the practice. (…) Ordinarily, when the F.D.A. addresses a thorny issue, it convenes a panel of experts who wade through the latest evidence and then render an opinion as to whether a substance is safe and effective to use. This time the agency simply issued a skimpy one-page statement asserting that 'no sound scientific studies' supported the medical use of marijuana."

The British journal Economist wrote: "If Cannabis were unknown, and bioprospectors were suddenly to find it in some remote mountain crevice, its discovery would no doubt be hailed as a medical breakthrough. Scientists would praise its potential for treating everything from pain to cancer, and marvel at its rich pharmacopoeia—many of whose chemicals mimic vital molecules in the human body. In reality, cannabis has been with humanity for thousands of years and is considered by many governments (notably America's) to be a dangerous drug without utility." The article said that the FDA statement lacks "common sense".

Dr. Daniele Piomelli, a professor of pharmacology at the University of California, was cited by the New York Times that he had "never met a scientist who would say that marijuana is either dangerous or useless." Studies clearly show that marijuana has some benefits for some patients, Dr. Piomelli said. "We all agree on that."

(Sources: New York Times of 21 and 22 April 2006, The Economist of 27 April 2006, www.fda.gov)

Germany — No association between criminal prosecution and extent of cannabis use

According to a study by the Max-Planck-Institute for Foreign and International Criminal Law commissioned by the Federal Health Ministry there are "large differences" in the criminal prosecution of cannabis users in different states. A comparison with a survey by the Institute for Therapy Research shows that there is no association between the extent of cannabis use and the practice of criminal prosecution.

The Max-Planck-Institute investigated the practice of criminal prosecution in six of the 16 German states, in Bavaria, Berlin, Hesse, North Rhine-Westphalia, Saxony and Schleswig-Holstein. In 1994 the Federal Constitutional Court asked to abandon criminal prosecutions in case of possession of a "low amount" for personal use. However, the guidelines issued by the states show a significant difference. Thus, the upper limit that does not result in a criminal procedure is six grams in Bavaria and Saxony, ten grams in North Rhine-Westphalia, 15 grams in Berlin and Hesse, and 30 grams in Schleswig-Holstein. Further differences, for example with regard to repeated drug possession, result in a stop of the criminal prosecution without restraints in between 40 and 60 per cent in Bavaria and between 80 and 90 per cent in Schleswig-Holstein and Berlin.

The Institute for Therapy Research investigated the amount of drug use in Germany in 2003 commissioned by the Federal Health Ministry and had interviewed in written form 8,061 subjects aged 18 to 59 years. According to this survey 4.4 per cent of respondents from Schleswig-Holstein, the most liberal state concerning drug policy had used cannabis within the past 12 months. In Saxony and Bavaria, two of the most repressive states, the proportions were 4.7 and 5.5 per cent. Therefore, the Max-Planck-Institute stated that the different practices in criminal prosecution probably does not directly influence the use of illegal drugs, but points out that the insufficient empirical basis of the data do not allow a substantiated scientific conclusion on this issue.

(Source: Schäfer C, Paoli L. Drogenkonsum und Strafverfolgungspraxis [Drug use and practice of criminal prosecution]. Max-Planck-Institut, Berlin 2006)

News in brief

Science — Vaporizer

Researchers of the University of Leiden investigated the performance of the vaporizer Volcano in terms of reproducible delivery of THC. They summarized: "It was found that an average of about 54% of loaded THC was delivered into the balloon of the vaporizer, in a reproducible manner. When the vaporizer was used for clinical administration of inhaled THC, it was found that on average 35% of inhaled THC was directly exhaled again. Our results show that with the Volcano a safe and effective cannabinoid delivery system seems to be available to patients. The final pulmonal uptake of THC is comparable to the smoking of cannabis, while avoiding the respiratory disadvantages of smoking." (Source: Hazekamp A, et al. J Pharm Sci 2006 Apr 24; [electronic publication ahead of print])

Both chambers of the parliament have past a bill that would legalize the possession of small amounts of several drugs including cannabis, opioids and cocaine. The limit for cannabis is 5 grams. The office of president Vicente Fox already announced that the president will sign the law. (Sources: La Segunda of 28 April 2006, elNuevoHerald.com of 28 April 2006)

Science — Childhood cancer

Researchers of the University of North Carolina investigated a possible link between neuroblastoma, a childhood cancer emanating from the adrenal gland, and drug use during pregnancy in 538 children with neuroblastoma. Maternal use of any illegal drug almost doubled the risk to develop neuroblastoma (OR = 1.82). The risk was highest for cannabis use in the first three months of pregnancy, with a nearly fivefold increased risk (OR = 4.75). Cannabis use in the month before pregnancy did not increase the risk. The effect of cannabis was strongest in children diagnosed within age one. (Source: Bluhm EC, et al. Cancer Causes Control 2006;17(5):663-9)

Science — Cough

Basic research shows that inhibition of degradation of anandamide reduced cough in mice that was induced by capsaicin. Researchers used the anandamide transporter inhibitor VDM11. They concluded that anandamide may modulate the cough sensitivity and have antitussive effects. (Source: Kamei J, et al. Cough 2006;2(1):2)

USA — Ed Rosenthal

A federal appeals court in California on 26 April overturned the conviction of Ed Rosenthal because of jury misconduct. Rosenthal was convicted by a district court in June 2003 for cultivating hundreds of cannabis plants for a city of Oakland medical cannabis program. The jury was not allowed to hear that the cannabis was grown for medical purposes. The appeals court, however, upheld the right of the federal authorities to punish cannabis growers even if they grow the plant for medical purposes. (Source: Associated Press of 26 April 2006)