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IACM-Bulletin of 24 June 2018

IACM: Medical Cannabis and Cannabinoids, a new partner journal of the IACM

Number 1 of the new open-access journal Medical Cannabis and Cannabinoids has just been launched, containing editorial, interviews with board members, research and review articles about basic, pre-clinical and clinical studies, as well as comments. It is a product of Karger Publishers Basel, the official journal of the Swiss Task Force for Cannabinoids in Medicine (STCM), and a new partner journal of the IACM. The Editor-in-Chief is Dr Rudolf Brenneisen, Swiss Academy of Pharmaceutical Sciences, Bern, Switzerland.

The journal offers an international forum to present and discuss recent advances in the rapidly developing and challenging field of the medical use of cannabis and cannabinoids. It seeks to bridge the gap between empirical and evidence-based clinical medicine by covering current basic and applied as well as translational research topics. In addition to original papers, reviews and mini-reviews this journal features short communications, case-reports, technical notes, letters, and conference proceedings.

Medical Cannabis and Cannabinoids

Canada: The country legalizes cannabis

Cannabis sales will become legal in Canada beginning October 17, Prime Minister Justin Trudeau said on 20 June, making it the first major economy to legalize its recreational use. The Senate voted on 19 June to approve adult use of cannabis.

The start date marks a delay by the government, which had previously said recreational use of cannabis would become legal within eight to 12 weeks of the law being passed. Canada’s 10 provinces had complained to Ottawa that that schedule was too tight for them to set up distribution and sales networks. “We’ve listened to the provinces, which have been asking us for more time to implement it,” Trudeau told legislators.

Reuters of 20 June 2018

Portugal: Parliament approves bill for the medical use of cannabis-based medicines

Portugal decriminalized the use of all drugs in 2001 to fight a heroin epidemic. Now parliament approved a bill for the medical use of cannabis. Only one party, the centre-right CDS-PP, abstained in the vote in parliament legalizing cannabis-based drugs to treat chronic pain, post-traumatic stress disorder, side effects from cancer therapy, and some other ailments.

The bill now goes to President Marcelo Rebelo de Souza to be signed into law. All cannabis medicines will need a license from regulator Infarmed, the body which last year authorized a medical cannabis plantation in central Portugal growing plants with a high content of the psychoactive ingredient THC for export.

Reuters of 15 June 2018

Science/Human: External use of CBD improves symptoms of severe skin disease in 3 children

Three children with epidermolysis bullosa profited from a treatment with CBD. Epidermolysis bullosa is a rare blistering skin disorder that is challenging to manage because skin fragility and repeated wound healing cause itching, pain, limited mobility, and recurrent infections. Researchers at Stanford University's School of Medicine and at West Virginia University's Department of Dermatology reported on the topical use of CBD in a six-month-old boy, a three-year-old girl, and a 10-year-old boy.

All 3 experienced “dramatic benefits” including faster wound healing, less blistering, and amelioration of pain with cannabidiol use. One patient was weaned completely off oral opioids.

Chelliah MP, Zinn Z, Khuu P, Teng JMC. Self-initiated use of topical cannabidiol oil for epidermolysis bullosa. Pediatr Dermatol. 2018 May 22. [in press]

UK: Government signals changes on medicinal cannabis use

The British government will look into possible changes to rules on the use of cannabis-based medicines, a minister said on 18 June, after an epileptic boy whose medication was confiscated was hospitalized. Interior minister Sajid Javid used an exceptional power on 16 June to release medicinal cannabis oil that had been taken from Billy Caldwell, 12, by customs officials at London’s Heathrow Airport.

Billy’s mother, Charlotte Caldwell, had been pleading for the medication to be given back because without it her son suffered from life-threatening seizures. “This case .. has shone a light on the use of cannabis medicine in this country and highlighted the need for the government to explore the issue further, and our handling of these issues further,” said Nick Hurd, a junior minister responsible for the work of the police. “As a first step, I can announce today that the government is establishing an expert panel of clinicians to advise ministers on any individual applications to prescribe cannabis-based medicines,” he told parliament.

Reuters of 18 June 2018

News in brief

IACM: Most read articles in Cannabis and Cannabinoid Research
Here are the most read articles published in the CCR, a partner journal of the IACM:
Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report by Reiman Amanda, Welty Mark, and Solomon Perry.
The Cannabis sativa Versus Cannabis indica Debate: An Interview with Ethan Russo, MD by Daniele Piomelli and Ethan B. Russo.
Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes by Ethan B. Russo.
Cannabis Roots: A Traditional Therapy with Future Potential for Treating Inflammation and Pain by Natasha R. Ryz, David J. Remillard, and Ethan B. Russo.
”An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies” by Kerstin Iffland and Franjo Grotenhermen,
The Use of Cannabis for Headache Disorders by Bryson C. Lochte, Alexander Beletsky, Nebiyou K. Samuel, and Igor Grant.

Uruguay: Five years after legalization only very limited available cannabis in pharmacies
Five years after legalizing cannabis, Uruguay is facing cannabis supply problems. The South American country was the first nation to legalize cannabis in 2013. But legal sales of cannabis began just last year. The law allows registered consumers to purchase up to 40 grams of cannabis at participating pharmacies each month. But so far, only 14 of approximately 1,200 pharmacies in the country have registered to sell cannabis.
High Times of 13 June 2018

France: Majority for legalization of cannabis
According to a poll by Ifop (Institut français d'opinion publique) 51% of French citizens support legalization of cannabis, while 40% are opposed and 9% undecided.
Terra Nova of 11 June 2018

Science/Human: Medical cannabis laws in the USA do not increase driving under the influence of cannabis
An analysis of US drivers involved in fatal crashes between 1993 and 2014 indicates that laws on medical cannabis had no effect on driving under the influence of cannabis. In states with cannabis dispensaries there was a small increase by 14%.
Georgia State University. Andrew Young School of Policy Studies, Atlanta, USA.
Sevigny EL.. Accid Anal Prev. 2018;118:57-65.

Science/Human: Cannabis use has no effect on suicidal attempts in psychiatric disorders
In a study with 985 people with psychiatric disorders cannabis use had no effect on the frequency of suicide attempts in men and women.
Department of Family Medicine, McMaster University, Hamilton, Canada.
Naji L, et al. Biol Sex Differ. 2018;9(1):22.

Science/Human: CBD increases connectivity between certain brain regions
The intake of 600 mg oral CBD by 16 healthy volunteers increased connectivity of nerve cells of the frontal lobe and the striatum. The intake of 10 mg oral THC had no effect. Authors suggest that this effect of CBD “might be a neural correlate of its anti-psychotic effect in patients.”
Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Germany.
Grimm O, et al. EUR Neuropsychopharmacol. 2018 Jun 7. [in press]

Science/Animal: Endocannabinoids may be beneficial in Huntington’s disease
In a mouse model of Huntington’s disease inhibition of the degradation of the endocannabinoid 2-AG (2-arachidonoylglycerol), which results in an increased concentration of 2-AG, improved motivation.
University of Maryland School of Medicine, Baltimore, USA.
Covey DP, et al. Neuropsychopharmacology. 2018 Jun 1. [in press]

Science/Animal: How cannabidiol influences sleep
CBD (cannabidiol) enhances compounds in the brain relevant for wake control, including acetylcholine in the forebrain, animal studies show.
Universidad Anáhuac Mayab, Mérida, Mexico.
Murillo-Rodríguez E, et al. Neurochem Res. 2018 Jun 6. [in press]

Science/Human: Cannabis use may cause constrictions of arteries in the brain
In 40 patients with a syndrome, that causes constriction of arteries in the brain and reduced circulation, 6 cases were attributed to cannabis use.
Department of Neurology, Swedish Medical Center, Englewood, USA.
Jensen J, et al. J Vasc Interv Neurol. 2018;10(1):32-38.

Science/Cells: A metabolite of tamoxifen binds to the CB2 receptor
A metabolite of tamoxifen, which is used in breast cancer therapy, was shown to be an inverse agonist at the cannabinoid 2 receptor. Thus, there may be an unwanted interaction if cannabinoids and tamoxifen are used together in breast cancer patients.
College of Medicine, University of Arkansas for Medical Sciences, Little Rock, USA.
Franks LN, et al. Toxicol Appl Pharmacol. 2018;353:31-42.

Science/Animal: CBD does not cause severe detrimental effects to embryos
In a study with zebrafish cannabidiol did not induce strong detrimental effects in embryos. Authors wrote that the “present work showed early light effects induced by CBD exposure.”
University of São Paulo, Ribeirão Preto, Brazil.
Valim Brigante TA, et al. Chem Biol Interact. 2018 Jun 11. [in press].

Science/Human: The number of CB2 receptors is increased in a certain respiratory disease
By comparing patients suffering from aspirin induced asthma and healthy control subjects researchers found that the number of CB2 receptors is increased in this group of patients, probably due to the inflammation.
Emory University School of Medicine, Atlanta, USA.
Corrado A, et al. Int Forum Allergy Rhinol. 2018 Jun 13. [in press].

Science/Human: Regular cannabis use may impair episodic foresight
In a study with 57 regular cannabis users and 57 controls heavy users exhibited impairment of episodic foresight, which is the ability to imagine future events. Regular cannabis use of lower doses did not impair this capacity.
School of Psychology, Australian Catholic University, Melbourne, Australia.
Mercuri K, et al. J Psychopharmacol. 2018 Jun 1. [in press].

Science/Animal: The activation of the CB2 receptor protects blood-brain barrier permeability
In a study with rats a synthetic cannabinoid (JWH133), which selectively activates the CB2 receptor reduced inflammation of the brain and protected permeability of the blood-brain barrier.
Department of Neurosurgery, Nanchong Central Hospital, China.
Li L, et al. Brain Res. 2018 Jun 7. [in press]

Science/Human: Cannabis use by pregnant women was associated with reduced birth weight in boys, but not in girls
An analysis of 654 boys and 537 girls revealed that boys, whose mothers had used cannabis during pregnancy, had a slightly lower mean birthweight of 153 g compared to drug-free women, while there was no effect on girls.
Northwestern University Feinberg School of Medicine, Chicago, USA.
Massey SH, et al. Neurotoxicol Teratol. 2018 Jun 7. [in press]

Science: The antidepressant effect of CBD is dependent on serotonin levels in the brain
In a study with mice the combination of low CBD doses and low doses of the antidepressant fluoxetine, which increases serotonin levels in the central nervous system, was synergistic.
School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
Sales AJ, et al. Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jun 6. [in press]

Science/Animal: CBD caused antidepressant effects in diabetic rats
In rats with diabetes low doses of CBD induced a mild antidepressant-like effect.
Department of Pharmacology, Federal University of Paraná, Brazil.
de Morais H, et al. Neurosci Lett. 2018;682:62-68.

Science/Human: Fibromyalgia is associated with increased blood levels of endocannabinoids
In a study with 104 women with fibromyalgia and 116 healthy controls researchers demonstrated that the levels of 2-AG (2-arachidonoylglycerol), PEA (palmitoylethanolamide) and 2 other endocannabinoids in the blood were significantly higher in the patient group.
Pain and Rehabilitation Centre, Linköping University, Sweden.
Stensson N, et al. J Pain. 2018 Jun 6. [in press]

Science: Activation of the CB1 receptor is responsible for anti-cancer effects in leukaemia
In cancer cells of chronic myelogenous leukaemia (CML) the activation of the CB1 receptor caused attenuation of cell proliferation.
Tehran University of Medical Sciences, Iran.
Gholizadeh F, et al. Iran Biomed J. 2018 Jun 9. [in press]

Science/Human: Cannabis use by pregnant women increased the risk of miscarriage
In a study with 500 pregnant women the use of cannabis was associated with a higher risk for stillbirth or miscarriage.
Battelle Memorial Institute, USA.
Coleman-Cowger VH, et al. Neurotoxicol Teratol. 2018;68:84-90.

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