IACM-Bulletin of September 17, 2006

Science — Cannabis use improves outcome of antiviral treatment in patients with hepatitis C

Drug addicts who are infected with hepatitis C virus may continue their medication until the planned treatment end more often if they use cannabis and may have a better treatment outcome, scientists of the University of California reported in the European Journal of Gastroenterology and Hepatology. Cannabis may help them tolerate the side effects of the antivirals, which can clear the virus but often cause fevers, chills, and muscle and joint aches, the researchers said.

Dr. Diana Sylvestre and colleagues tested 71 patients given interferon and ribavirin to treat their hepatitis C. Interferon boosts the immune response and ribavirin attacks the virus. 22 of them (31 per cent) also used cannabis. 24 per cent of all patients discontinued therapy early, among them only one cannabis user but 16 non-users. About half of the cannabis users (54 per cent) were successfully treated with the medication, which means that the virus was no longer detectable, compared to only 18 per cent of the control group. And just 14 per cent of the cannabis users relapsed, compared to 61 per cent of non-users. Relapse means that the hepatitis C virus was detectable again after a while.

Researchers concluded that these "results suggest that modest cannabis use may offer symptomatic and virological benefit to some patients undergoing HCV treatment by helping them maintain adherence to the challenging medication regimen."

(Sources: Reuters of 13 September 2006; Sylvestre DL, Clements BJ, Malibu Y. Cannabis use improves retention and virological outcomes in patients treated for hepatitis C. Eur J Gastroenterol Hepatol 2006;18(10):1057-63.)

Italy — Health minister authorizes the import of medicines that contain THC

The Italian Health Minister Livia Turco has officially ordered that the import of medicines containing THC can still be authorized by the Central Narcotics Commission of the Ministry, for patients who need these medicines and have no alternatives available. The Minister's ordinance is valid until 30 November 2006.

The previous government's drug law, currently in effect, states that cannabis has no accepted medical uses, and all cannabinoids were excluded from Table II, the official list of all the narcotic and psychotropic substances accepted for medical use. Following an appeal signed by over 100 health care professionals and researchers, in the interest of patients who depended on the regular import of cannabis medicines like nabilone, dronabinol, Sativex and Bedrocan from abroad, the new government's Health Minister responded with this ordinance, while waiting for a decision by the Superior Health Council whether to include cannabinoids in Table II again.

The complete text of the ordinance (in Italian) is available at http://medicalcannabis.it.

(Source: Personal communication by the Associazione per la Cannabis Therapeutica)

News in brief

Science — Cannador

After completion of the CAMS study (Cannabinoids in Multiple Sclerosis) in 2003, a second phase III trial on the standardized oral cannabis extract Cannador started in July in 20 centres in the UK. This study is sponsored by the pharmaceutical company Weleda, Switzerland, and the Society for Clinical Research in Berlin. It is intended to include 400 patients with multiple sclerosis, who suffer from spasticity and pain insufficiently treated by available medication, into this study within the coming 15 months. As in the CAMS study the study will be headed by Dr. John Zajicek, a professor at the Peninsula Medical School, Plymouth. (Source: Personal communication by the Institute for Clinical Research, Berlin)

Europe — GW Pharmaceuticals

On 5 September GW Pharmaceuticals announced that it has filed a regulatory submission in four European countries for the cannabis extract Sativex. The filing is for the symptomatic relief of spasticity in people with multiple sclerosis. The filing has been made under the “decentralised procedure” in the UK, Spain, Denmark and the Netherlands. Under this procedure, the UK is acting as Reference Member State and will consult with the three other countries. If successful, a filing under the decentralised procedure would lead to the simultaneous approval of Sativex in these countries. (Source: Press release by GW Pharmaceuticals of 5 September 2006, http://www.gwpharm.com)

USA — Cannabis dispensaries

A 23-page report by Americans for Safe Access argues that medical cannabis dispensaries are a benefit to both patients and local communities. The report was released at a press conference in San Diego on 7 September. It details the impact of regulatory ordinances in cities around the state, based on information collected over nine months from local officials, and the benefits for patients, as described in recent work by a University of California researcher. The report is available at http://www.safeaccessnow.org/downloads/dispensaries.pdf. (Source: Americans for Safe Access)

Science — Depression

Using data of the ongoing National Longitudinal Survey of Youth of 1979 researchers of the Johns Hopkins University in Baltimore investigated the influence of cannabis use on the development of depression. A total of 8,759 adults (age range 29-37 years) interviewed in 1994 had complete data on past-year cannabis use and current depression. The risk for depression was significantly increased by 1.4 in cannabis users in comparison to the non-using group. However, after adjustment for possible influencing factors the risk was no longer increased in the cannabis group. (Source: Harder VS, et al. Addiction 2006;101(10):1463-72.)