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IACM-Bulletin of 15 February 2009

Germany: First patients to receive cannabis from the pharmacy

On 7. February the first patient has received cannabis herb as a medicine from a pharmacy. The Head of the Federal Office for Opium Affairs at the Federal Institute for Pharmaceuticals and Medical Products of the the Federal Health Ministry in Bonn, Dr. Winfried Kleinert, stated that to date seven patients have received such a permission and are now receiving their first deliveries of cannabis from the Netherlands where it is available in pharmacies. Another 27 patients received an exemption for the use of cannabis extract that is produced from the Dutch cannabis.

The seven patients suffer from chronic pain, multiple sclerosis, Tourette’s syndrome and other severe illnesses. The cost of cannabis are approximately EUR 15 (about 19 US Dollars) per gram of cannabis with a dronabinol content of 18 per cent, approximately twice the cost charged by the Dutch pharmacies. Currently, the application for an exemption is rather extensive since the patient’s physician needs to produce an expertise justifying the need for a cannabis therapy. In a recent expert opinion by Dr. Lorenz Boellinger, a professor of law at the University of Bremen and Dr. Harald Hans Koerner, senior public prosecutor from Frankfurt and a well-known commentator on the German narcotics law, the authors recommend that the application process be made easier as to accommodate the patients’ need for an expeditious alleviation of their suffering.

More information at:
www.aachener-zeitung.de/sixcms/detail.php?template=az_druckversion&id=809829&_wo=Lokales:Euregio

The legal expert opinion is available at:
www.cannabis-med.org/german/gutachten_boe-koe.pdf

(Sources: personal communication, Expertise by Prof. Boellinger and Dr. Harald Hans Koerner, dpa 14. February 2009)

USA: Change in federal medical cannabis policy expected

It is expected that the federal policy is about to change when it comes to medical cannabis. "The president believes that federal resources should not be used to circumvent state laws, and as he continues to appoint senior leadership to fill out the ranks of the federal government, he expects them to review their policies with that in mind," said White House spokesman Nick Shapiro, repeating past statements.

On 6 February officials of the Drug Enforcement Administration (DEA) in Washington declined to comment at all on the subject. In California the previous week, DEA agents raided four cannabis dispensaries in Los Angeles. "I think the basic concept of using medical marijuana for the same purposes and with the same controls as other drugs prescribed by doctors, I think that's entirely appropriate," Obama told journalists in March 2008. At another occasion he said: "I would not have the Justice department prosecuting and raiding medical marijuana users." The new president is unlikely to make any official change in policy before he has a new DEA chief and drug commissioner in place. Yet experts believe it is already clear the Obama administration will change the strategy.

More at:
- hosted.ap.org/dynamic/stories/O/OBAMA_MEDICAL_MARIJUANA?SITE=FLTAM&SECTION=HOME&TEMPLATE=news_generic.htm
- www.washingtontimes.com/news/2009/feb/05/dea-led-by-bush-continues-pot-raids/

(Source: Associated Press of 7 February 2009)

Canada: Supreme Court of British Columbia rules that medical cannabis program is unconstitutional

A Supreme Court justice of British Columbia has endorsed a recent federal court decision saying the national cannabis program is unconstitutional. Justice Marvyn Koenigsberg gave the federal government a year to fix the medical-cannabis access regulations so that cannabis clubs or producers can get together and run a common cannabis-growing operation.

At the moment, the federal government restricts any licensed grower to supplying only one licensed user and prohibits more than three growers from pooling resources. Both those restrictions are unconstitutional, Koenigsberg said. The ruling was made in the case of Mathew Beren of Victoria, who was found guilty of illegally trafficking and producing cannabis. But the judge gave him an absolute discharge and showed sympathy for his action. The lawyers of Mr. Beren argued he should not be convicted because he was providing a needed service, as the marijuana regulations erected an unreasonable barrier to patients' access to needed medication.

More at:
www.vancouversun.com/news/court+rules+medical+marijuana+program+unconstitutional/1245136/story.html

(Source: Vancouver Sun of 2 February 2009)

Science: Cannabis use by adolescents decreased in recent years

Cannabis use appears to have decreased among most EURopean and North American adolescents from 2002 to 2006, researchers in Switzerland said. Emmanuel Kuntsche of the Swiss Institute for the Prevention of Alcohol and Drug Problems in Lausanne, Switzerland, and colleagues analysed data from 93,297 15-year-old students who participated in the Health Behavior in School-Aged Children study.

Study participants from 31 countries - mostly in EURope and North America - were surveyed in 2002 and again in 2006 about cannabis use and the number of evenings per week they usually spend out with their friends, among other topics. The study found cannabis use decreased in most countries, with the most significant declines in England, Portugal, Switzerland, Slovenia and Canada. Increases were observed in Estonia, Lithuania, and Malta and among girls in Russia. "The more frequently adolescents reported going out with their friends in the evenings, the more likely they were to report using cannabis, or marijuana," the study authors said in a statement.

More at:
- archpedi.ama-assn.org/cgi/content/full/163/2/119
- www.upi.com/Health_News/2009/02/03/Marijuana_use_among_teens_down/UPI-25191233687552/

(Sources: UPI of 3 February 2009; Kuntsche E, Simons-Morton B, Fotiou A, ter Bogt T, Kokkevi A; Health Behavior in School-Aged Children Study. Decrease in adolescent cannabis use from 2002 to 2006 and links to evenings out with friends in 31 EURopean and North American countries and regions. Arch Pediatr Adolesc Med 2009;163(2):119-25)

News in brief

Science: Colitis
Researchers at the University of Erlangen-Nuremberg, Germany, studied the effects of the endocannabinoid anandamide in experimental colitis induced by a chemical in mice. Anandamide significantly reduced inflammation. (Source: Engel MA, et al. J Physiol Pharmacol 2008;59(4):673-89.)

Science: Testicular cancer
According to an epidemiological study by the Fred Hutchinson Cancer Research Center in Seattle, USA, with 369 men, who where diagnosed with testicular cancer, cannabis users were at an increased risk. Current cannabis users had an increased risk of 1.7 to develop this rather rare cancer compared to non-users. Early onset of use and frequent use increased the risk. Authors noted that additional studies will be needed to confirm the observation. (Source: Daling JR, et al. Cancer. 2009 Feb 9. [Electronic publication ahead of print])

Science: Brain morphology
According to a study at the University of Goettingen, Germany, there were no differences in brain morphology between patients with psychosis, who used cannabis, and patients without drug use. Patients with cannabis use presented with an earlier onset of psychosis, which could not be explained by brain abnormalities. (Source: Wobrock T, et al. EUR Arch Psychiatry Clin Neurosci. 2009 Feb 4. [Electronic publication ahead of print])

Science: Thyroid cancer
According to cell experiments a synthetic derivative of the endocannabinoid anandamide inhibited growth of cell lines derived from thyroid carcinomas by inducing programmed cell death. This effect was associated with the CB1 receptor. (Source: Cozzolino R, et al. Invest New Drugs. 2009 Feb 3. [Electronic publication ahead of print])

Science: Liver cirrhosis
The cannabinoid receptor antagonist rimonabant significantly delayed the development of ascites in rats with liver cirrhosis, according to research at the University of Bologna, Italy. (Source: Croci T, et al. Gastroenterology. 2009 Jan 14. [Electronic publication ahead of print])

Science: Injury risk
A study at the University of Lausanne, Switzerland, with 486 patients who were treated for different injuries showed that alcohol use in the six hours prior to injury was associated with a three-fold increased injury risk (relative risk: 3.0), while the use of cannabis reduced injury risk (relative risk: 0.33). However, the sample size for people who had used cannabis was small. (Source: Gmel G, et al. BMC Public Health 2009;9(1):40.)

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