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IACM-Bulletin of 27 January 2013

Science/Israel: The medicinal use of cannabis may provide dramatic relief for sufferers of chronic illnesses

A treatment with cannabis can improve appetite, ease chronic pain, and more, say researchers of Tel Aviv University. “Though controversial, medical cannabis has been gaining ground as a valid therapy, offering relief to suffers of diseases such as cancer, post-traumatic stress disorder, ALS and more,“ says a report by Tel Aviv University's American Friends reprinted in Science Daily.

In the Hadarim nursing home, 19 patients between the ages of 69 and 101 were treated with medical cannabis over the course of a year for conditions such as pain, lack of appetite, and muscle spasms and tremors. During the study, 17 patients achieved a healthy weight. Muscle spasms, stiffness, tremors and pain reduced significantly. Almost all patients reported an increase in sleeping hours and a decrease in nightmares. There was a notable decline in the amount of prescribed medications taken by patients, such as antipsychotics, Parkinson's treatment, mood stabilizers, and pain relievers, researchers found, noting that these drugs have severe side effects. By the end of the study, 72% of participants were able to reduce their drug intake by an average of 1.7 medications a day.

It's True: Medical Cannabis Provides Dramatic Relief for Sufferers of Chronic Ailments

2013/01/130124123453.htm">Medical Cannabis Provides Dramatic Relief for Sufferers of Chronic Ailments, Israeli Study Finds

Science/Human: A recent epidemiological study suggesting a link between adolescent cannabis use and reduced intelligence may have come to wrong conclusions

A landmark study suggesting a link between cannabis use by adolescents and reduced intelligence may not have analysed the data correctly, with any falls in intelligence more likely due to lower socioeconomic status than cannabis, according to a Norwegian study. The new article was published in the journal PNAS, Proceedings of the National Academy of Sciences of the United States of America. "My study essentially shows that the methods used and analyses presented in the original research are insufficient to rule out other explanations (for lower IQ)," said Ole Rogeberg, an economist at the Frisch Centre for Economics Research in Oslo, to Reuters.

The Dunedin Study is an on-going report produced by New Zealand's University of Otago, monitoring 1,037 New Zealand children born between April 1972 and March 1973. The study followed them for 40 years. The participants were periodically tested for IQ and other indices including drug taking, and in 2012 clinical psychologist Madeline Meier produced a study saying there was a link between teenage cannabis use and a lower IQ. In his article Rogeberg concluded: “A simulation of the confounding model reproduces the reported associations from the Dunedin cohort, suggesting that the causal effects estimated in Meier et al. are likely to be overestimates, and that the true effect could be zero. (…) Although it would be too strong to say that the results have been discredited, the methodology is flawed and the causal inference drawn from the results premature.”

Rogeberg O. Correlations between cannabis use and IQ change in the Dunedin cohort are consistent with confounding from socioeconomic status. Proc Natl Acad Sci U S A. 2013 Jan 14. [in press]

2013/01/23/australia-cannabis-idUSL4N0AJ8IH20130123">Reuters of 23 January 2013

Science/Human: CBD may be helpful in anxiety disorders according to an experimental study

In an experiment with 48 healthy participants who underwent a fear-conditioning test CBD (cannabidiol) enhanced consolidation of subsequent extinction learning and thus may be helpful in anxiety disorders. The scientists of the Clinical Psychopharmacology Unit of University College London, UK, conducted an experiment of classical conditioning. A neutral stimulus, in this case a coloured box, was followed by a second (unpleasant) stimulus, in this case electric shocks. Later, the first (neutral) stimulus provoked a physical reaction, since the subject expected electric shocks to follow. In extinction learning this learned response to the first stimulus was eliminated when this stimulus was presented in the absence of the shocks. Extinction learning is a first-line approach to treat anxiety disorders.

Participants received 32 mg of CBD either following before or after extinction in a double-blind, placebo-controlled design. Successful conditioning and extinction were found in all three treatment groups. CBD given post-extinction enhanced consolidation of extinction learning. No acute effects of CBD were found on extinction. Authors concluded that “these findings provide the first evidence that CBD can enhance consolidation of extinction learning in humans and suggest that CBD may have potential as an adjunct to extinction-based therapies for anxiety disorders.”

Das RK, Kamboj SK, Ramadas M, Yogan K, Gupta V, Redman E, Curran HV, Morgan CJ. Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology (Berl). 2013 Jan 10. [in press]

USA: Federal court rejects a petition to reclassify cannabis

There is some evidence to back up the claims of cannabis’ health benefits, but not enough to overrule the U.S. government's judgment that the drug should be tightly controlled, a federal appeals court ruled on 22 January. The ruling means the U.S. Drug Enforcement Administration can keep marijuana (cannabis) on its list of the most dangerous, tightly controlled drugs, alongside heroin.

Medical cannabis supporters sued over the DEA's classification in 2011. But the challengers, including Americans for Safe Access, failed to show convincingly that cannabis has an effective, accepted and safe medical use, said the U.S. Circuit Court of Appeals for Washington, D.C. Without further scientific evidence, the court must defer to the DEA, wrote Judge Harry Edwards. Since 1970, the U.S. government has classified marijuana as a Schedule I drug, a category it reserves for drugs with no accepted medical use and a high potential for abuse.

2013/01/22/usa-marijuana-ruling-idUSL1N0AR6O220130122">Reuters of 22 January 2013

News in brief

Science: 6th EURopean Workshop on Cannabinoids
The 6th EURopean Workshop on Cannabinoids will take place on 18-20 April 2013 at Trinity College Dublin, Ireland.
Conference website

Science/Human: Cannabis use did not affect epilepsy severity in a survey
The use of cannabis did not affect disease severity in epilepsy, while the use of other illegal drugs resulted in seizure worsening. This is the result of a survey with 310 epilepsy patients. Of all patients 63 (20.3%) reported consuming cannabis after epilepsy was diagnosed, and 16 (5.2%) used other illicit drugs. Cannabis consumption mostly did not affect epilepsy (in 84.1% of cases).
Department of Neurology, Charité-University Hospital Berlin, Germany.
Hamerle M, et al. EUR J Neurol. 2013 Jan 11. [in press]

USA: The Mayor of San Diego ends crackdown on cannabis dispensaries
San Diego’s Mayor Bob Filner ordered civil prosecutors to "stop the crackdown on marijuana dispensaries." The announcement signals a change in dispensary prosecutions in California's second largest city. In 2011, the city attorney launched code enforcement action lawsuits against more than 100 medical cannabis dispensaries and shut most of them down.
2013/01/11/us-usa-california-marijuana-idUSBRE90A03W20130111">Reuters of 11 January 2013

Luxembourg: Physician who prescribed Bedrocan cannabis gets a mild sentence
On 10 January the judgement in the cannabis affair on the physician Jean Colombera was delivered by a court in Diekirch. Dr Colombera had prescribed cannabis of the Dutch company Bedrocan to 25 of his patients, which is not allowed in Luxembourg. According to the judge the physician infringed the law, but was guided by his intention to help his patients without any criminal attitude. The court refrained from any prison sentence or fine and the ruling was suspended for one year. He is allowed to continue his work as a physician and will be acquitted if he complies with the law during this time. (Personal communication by Jean Colombera)

Science/Animal: CBD inhibits the activity of a certain liver enzyme
The natural plant cannabinoid CBD (cannabidiol) inhibits the activity of the enzyme cytochrome P450 2C19. Enzymes of the cytochrome P450 complex are responsible for the degradation of medicinal drugs. Medicines that are degraded by the 2C19 enzyme of the complex, including many proton pump inhibitors and antiepileptics, may be degraded slower if given together with CBD.
Faculty of Pharmaceutical Sciences, Hokuriku University, Japan.
Jiang R, et al. Drug Metab Pharmacokinet. 2013 Jan 15. [in press]

Science/Human: CB1 receptor gene variants are associated with bowel movements
In a study with 455 patients with irritable bowel syndrome and 228 healthy individuals certain variants of the gene for the cannabinoid-1 receptor were associated with movements of the colon. Authors wrote: “These data support the hypothesis that cannabinoid receptors may play a role in control of colonic transit and sensation in humans and deserve further study as potential mediators or therapeutic targets in lower FGID [functional gastrointestinal disorder].”
Mayo Clinic, Rochester, USA.
Camilleri M, et al. Am J Physiol Gastrointest Liver Physiol. 2013 Jan 10. [in press]

Science/Animal: Endocannabinoids reduce withdrawal symptoms from opiates
Inhibition of degradation of endocannabinoids reduced withdrawal in morphine-dependent mice. Authors concluded that the inhibition of endocannabinoid “represents a promising approach for the treatment of opioid dependence.”
Medical College of Virginia, Virginia Commonwealth University, Richmond, USA.
Ramesh D, et al. Neuropsychopharmacology. 2013 Jan 3. [in press]

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