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IACM-Bulletin of 01 August 2010

Spain: Sativex receives approval in Spain and other EURopean countries are likely to follow

The cannabis extract Sativex of the British company GW Pharmaceuticals has been approved in its second EURopean market, Spain, as an add-on therapy for treating spasticity in patients with multiple sclerosis (MS). The news follow a green light in June 2010 in Britain.

GW said on 28 July it had also filed to get the medicine approved under the EURope Union's mutual recognition procedure in other selected markets, including France, Germany and Italy. Clinical trials have shown Sativex, which is sprayed under the tongue, reduces spasticity in MS in patients who do not respond adequately to existing therapies. It became the world's first cannabis medicine to win regulatory clearance when it was approved in Canada in 2005 for neuropathic pain in MS.

More at:
- www.gwpharm.com/Spanish%20Sativex%20Approval.aspx
- www.reuters.com/article/idUSLDE66R08U20100728

(Sources: Press release by GW Pharmaceuticals of 28 July 2010, Reuters of 28 July 2010)

USA: The Department of Veterans Affairs will formally allow patients to use cannabis in states where it is legal

The federal Department of Veterans Affairs will formally allow patients treated at its hospitals and clinics to use cannabis for medicinal purposes in states where it is legal. A department directive resolves the conflict in veterans facilities between federal law, which outlaws cannabis, and the 14 states that allow medicinal use of the drug.

The policy will not permit department doctors to prescribe cannabis. But it will address the concern of many patients who use it that they could lose access to their prescription pain medication if caught. Such fear has led many patients to distrust their doctors, veterans say. With doctors and patients pressing the veterans department for formal guidance, agency officials began drafting a policy last fall. "When states start legalizing marijuana we are put in a bit of a unique position because as a federal agency, we are beholden to federal law," said Dr. Robert Jesse of the Veterans Department. At the same time, Dr. Jesse said, "We didn’t want patients who were legally using marijuana to be administratively denied access to pain management programs."

More at:
-www.nytimes.com/2010/07/24/health/policy/24veterans.html?scp=1&sq=officials%20began%20drafting%20a%20policy%20last%20fall&st=cse
- www.denverpost.com/opinion/ci_15635005

(Sources: New York Times of 23 July 2010, Denver Post of 30 July 2010)

USA: Large-scale cannabis production for medicinal purposes allowed in the Californian city of Oakland

The Californian city of Oakland on 20 July legalized large-scale cannabis cultivation for medical use and will issue up to four permits for "industrial" cultivation starting next year. The move by the San Francisco Bay Area city aims to bring medical cannabis cultivation into the open and allow the city to profit by taxing those who grow it.

The resolution passed the city council easily after a nearly four-hour debate of supporters of small-scale "garden" growers against advocates of a bigger, industrial system that would become a "Silicon Valley" of cannabis. "This is going to grow as an industry. And someone is going to have a high-tech producer," Council Member Jean Quan said during the debate. Oakland already taxes sales of medical cannabis, but cultivation has existed in a legal grey area. On 26 July Oakland's city council approved a 5 percent gross receipts tax on licensed cannabis growers and on businesses selling cannabis for medical purposes, and anticipating legalization of cannabis in California a 10 percent rate on sales of cannabis used for recreational purposes.

More at:
- www.reuters.com/article/idUSTRE66Q6E620100728
- www.reuters.com/article/idUSTRE66K17320100721
- www.nytimes.com/2010/07/22/us/22oakland.html?_r=1&scp=1&sq=This%20city,%20which%20has%20been%20at%20the%20vanguard%20of%20medical%20marijuana%20legalization%20&st=cse

(Sources: Reuters of 21 and 28 July 2010, New York Times of 22 July 2010)

News in brief

USA: Washington D.C.
Medical cannabis is now legal in the District of Columbia after the Democrat-controlled Congress declined to overrule a D.C. Council bill that allows the city to set up as many as eight dispensaries where chronically ill patients can purchase the drug. The council approved the bill in May, and according to the law Congress has 30 legislative days to review laws of the council of Washington D.C. (Source: Washington Post of 27 July 2010)

Science: Stress
According to animal research at the Medical College of Wisconsin in Milwaukee, USA, chronic stress impaired the function of the CB1 receptor in the nucleus accumbens, a brain region important for feeling good. Researchers concluded that down regulation in endocannabinoid signalling in the nucleus accumbens may contribute to the development of depression. (Source: Wang W, et al. Neuropsychopharmacology 2010 Jul 21. [in press])

Science: Obesity
New research shows that a CB1 receptor antagonist largely restricted to the periphery does not affect behavioural responses mediated by the CB1 receptor in the brains of mice with genetic or diet-induced obesity, but it does cause weight-independent improvements in glucose homeostasis, fatty liver, and plasma lipid profile. (Source: Tam J, et al. J Clin Invest 2010 Jul 26. [in press])

Science: Aggregation of platelets
According to research at the UHI Millennium Institute in Inverness, UK, the endocannabinoid 2-AG activated platelet aggregation in blood samples of healthy volunteers, while THC was without effect. Platelet aggregation by 2-AG was not mediated by cannabinoid receptors and was abolished by aspirin. (Source: Keown OP, et al. Br J Clin Pharmacol 2010;70(2):180-8.)

Science: Breast cancer
THC and a synthetic cannabinoid-2 receptor agonist (JWH-133) reduced tumour growth, tumour number and amount of lung metastases in a mouse model of a certain breast cancer (ErbB2-positive breast cancer). This kind of breast cancer is very aggressive and does not respond well to standard therapies. Researchers concluded that "these results provide a strong preclinical evidence for the use of cannabinoid-based therapies for the management of ErbB2-positive breast cancer." (Source: Caffarel MM, et al. Mol Cancer 2010;9(1):196.)

Science: Depression
According to research at the University of Alicante, Spain, genetically modified mice with an over-expression of CB2 receptors presented with reduced depressive-related behaviours. Researchers concluded "that the CB2 receptor could be a new potential therapeutic target for depressive-related disorders." (Source: García-Gutiérrez M, et al. Br J Pharmacol 2010;160(7):1773-84.)

Science: Coma
Researchers of the University of California in San Diego, USA, presented a case report of a 14-month-old child with a mental status alteration of more than 2 days after the ingestion of cannabis resin (hashish). They concluded that cannabis "is capable of causing prolonged symptoms (including coma) in children." (Source: Carstairs SD, et al. J Emerg Med 2010 Jul 13. [in press])

Science: Electroacupuncture
According to research at the University of Science and Technology in Wuhan, China, electroacupuncture increases the number of CB2 receptor on cells of the skin (keratinocytes) and infiltrating inflammatory cells in inflamed skin tissues of rats. Researchers concluded that "this finding provides new evidence showing the potential role of CB2 receptors in the analgesic effect of acupuncture on inflammatory pain." (Source: Zhang J, et al. J Pain 2010 Jun 1. [in press])

Science: Loosening of implants
According to research of Chinese scientists with mice inactivation of the CB2 receptor by the cannabinoid receptor antagonist AM630 reduced bone dissolution induced by titanium particles. Scientists concluded "that CB2 inactivation by AM630 could provide a promising therapeutic target for treating or preventing aseptic loosening." Many implants are made of titanium. (Source: Geng DC, et al. J Biomed Mater Res A. 2010 Jul 8. [in press])

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