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IACM-Bulletin of 22 September 2013

USA: The Supreme Court of Washington says that people before the courts can argue they need cannabis for medical reasons

People busted for cannabis can argue they needed it for medical reasons, even if they failed to follow the requirements of the state’s medical cannabis law, the Washington Supreme Court said on 19 September. In a 5-4 opinion hailed by advocates of patients who use cannabis, the justices said voters did not get rid of the “medical necessity defense” when they passed the medical marijuana law in 1998.

The ruling means that people who don’t have the money or insurance to see a doctor to authorize them to use cannabis, or who don’t have a doctor in their community who will authorize them to use cannabis, will nevertheless be able to argue in court that they had a medical reason for using it, said Seattle lawyer Suzanne Lee Elliott, who handled the case. The state medical cannabis law allows people to use the drug for certain debilitating medical conditions, such as cancer, AIDS or intractable pain. People are required to obtain an authorization to use cannabis from an appropriate health care professional before they can avail themselves of the medical law. Chief Justice Barbara Madsen wrote for the majority that people who fail to follow the medical law can nevertheless argue in court that they needed the cannabis for medical reasons, but in order to do so, they must also show that complying with the medical cannabis law was not a viable alternative for them.

Associated Press of 19 September 2013.

News in brief

Science/UK: A cannabis extract rich in cannabidivarin will be tested in humans
GW Pharmaceuticals announced on 18 September it has commenced a Phase 1 clinical trial of product candidate GWP42006 for the treatment of epilepsy. GWP42006 is a cannabis extract rich in cannabidivarin (CBDV). Over the last five years, GW has conducted an extensive pre-clinical cannabinoid research program in the field of epilepsy in collaboration with the University of Reading in the United Kingdom. This research has led to the emergence of a number of promising cannabinoid therapeutic candidates showing anti-epileptic effects, of which a CBDV extract (GWP42006) is one of the most promising of those candidates.
Press release by GW Pharmaceuticals of 18 September 2013.

Science/Human: Good results from the clinical use of Sativex in spasticity due to MS
At a hospital in Spain treatment results with Sativex in 50 patients with spasticity due to multiple sclerosis between April 2008 and March 2012 were analysed. The reason for prescribing the drug was spasticity in a 44%, pain in 10% and both in 46%. The cannabis extract was effective in 80% of patients at a median dose of five sprays per day. Authors concluded that "THC/CBD appears to be a good alternative to standard treatments as it improves refractory spasticity in MS and has an acceptable toxicity profile."
Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Lorente Fernández L, et al. Neurologia. 2013 Sep 10. [in press].

Science/Human: People with post-traumatic stress disorder present with reduced levels of endocannabinoids
In a study 46 subjects, who were near to the World Trade Center at the time of the attack of 11 September 2001 22 did not suffer from post-traumatic stress disorder (PTSD) and 24 met criteria of PTSD. Researchers found that people with PTSD had lower levels of the endocannabinoid anandamide.
Department of Cell Biology & Anatomy and Psychiatry, University of Calgary, Canada.
Hill MN, et al. Psychoneuroendocrinology. 2013 Sep 10. [in press].

Science/Animal: Cannabidiolic acid enhances the anti-nausea effects of metoclopramide
In rats the effects of metoclopramide, a medicinal drug used in the treatment of nausea and vomiting, were increased by the natural cannabinoid CBDA (cannabidiolic acid). Scientists concluded that “CBDA could be a powerful adjunct treatment to anti-emetic regimens for chemotherapy-induced nausea.”
Department of Psychology, University of Guelph, Canada.
Rock EM & Parker LA. Pharmacol Biochem Behav. 2013 Sep 4. [in press].

Science/Animal: Endocannabinoids effective against nausea
Enhancement of the endocannabinoid system reduces anticipatory nausea in a rat model. Researchers used an inhibitor of endocannabinoid degradation (JZL195).
Department of Psychology and Neuroscience Graduate Program, University of Guelph, Canada.
Limebeer CL, et al. Psychopharmacology (Berl). 2013 Sep 17. [in press].

Science/Human: Endocannabinoids influence placebo effects
Certain variants of the gene for FAAH, which is responsible for the degradation of endocannabinoids, showed higher placebo analgesia in humans. Researchers wrote that this demonstrates the involvement of endocannabinoids in placebo effects.
Department of Psychiatry, University of Michigan, Ann Arbor, USA.
Pecińa M, et al. Mol Psychiatry. 2013 Sep 17. [in press].

Science/Cells: Anandamide effective against human cancer cells of the skin
In experiments with human skin cancer cells (melanoma) the anti-cancer effects of the endocannabinoid anandamide were investigated. Researchers summarised: "Overall, these findings demonstrate that AEA induces cytotoxicity against human melanoma cells in the micromolar range of concentrations through a complex mechanism, which involve ... CB1 activation."
Department of Pharmacy, University of Pisa, Italy.
Adinolfi B, et al. EUR J Pharmacol. 2013 Sep 13. [in press].

Science/Animal: Endocannabinoids counteract bladder over-activity
In experiments with rats a treatment with an inhibitor of FAAH (fatty acid amide hydrolase), the enzyme which degrades endocannabinoids, over-activity of the bladder was reduced.
Urological Research Institute, San Raffaele Scientific Institute, Milan, Italy.
Gandaglia G, et al. Neurourol Urodyn. 2013 Aug 29. [in press].

Science/Animal: Endocannabinoids influence effects of migraine medications
Animal research demonstrates a novel interaction between serotonergic and endocannabinoid systems in the processing of pain in the brain, “suggesting that some of the therapeutic action of triptans may be via endocannabinoid containing neurons in the vlPAG.” The vlPAG is the ventrolateral periaqueductal gray of the brainstem, a certain brain region involved in pain perception. Triptans are very effective medicinal drugs against migraine.
Department of Neurology, University of California, San Francisco, USA.
Akerman S, et al. J Neurosci 2013;33(37):14869-77..

Science/Animal: CBD reduces alcohol-induced neurodegeneration
In experiments with rodents CBD (cannabidiol) reduced degeneration of nerve cells caused by alcohol. Researches used a CBD containing gel administered to the skin of the animals. They wrote that “these results demonstrate the feasibility of using CBD transdermal delivery systems for the treatment of alcohol-induced neurodegeneration.”
College of Pharmacy, University of Kentucky, Lexington, USA.
Liput DJ, et al. Pharmacol Biochem Behav. 2013 Sep 5. [in press].

Science/Human: Stress is a major factor in relapse in opioid-dependent patients on methadone
In a study with 315 opioid dependent patients, who received methadone, the relationship between perceived stress and substance abuse was investigated. Researchers found that “stress may be a marker of patients' risk for illicit substance use, a known risk factor for illicit opiate relapse.”
Warren Alpert Medical School of Brown University, Providence, USA.
Moitra E, et al. Drug Alcohol Depend. 2013 Aug 26. [in press].

Science/Human: No relevant global disease burden by cannabis use
In a world-wide analysis of the disease burden by the use of illegal drugs no relevant effect of cannabis was found. Illicit drug dependence directly accounted for 0.8% of global disease burden. The largest risk factors were dependence of opioids, amphetamines and cocaine.
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Degenhardt L, et all. Lancet. 2013 Aug 28.[in press]

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