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IACM-Bulletin of 01 March 2020

Science/Human: THC may reduce opioid dose after traumatic injury

In a study with 66 patients, who were admitted to hospital to the St. Anthony Hospital and Medical Campus in Lakewood, Colorado, USA, for traumatic injury additional use of THC (dronabinol) reduced opioid dose. There were 66 patients included: 33 cases and 33 matched controls. Dronabinol was initiated 55 (28–107) hours from admission.

THC resulted in a nine fold greater reduction in opioid consumption for cases versus controls. Authors wrote that the results “suggest adjunctive dronabinol reduces opioid consumption following traumatic injury. The opioid-sparing effect of dronabinol may be greater in patients who are marijuana users.”

Schneider-Smith E, Salottolo K, Swartwood C, Melvin C, Madayag RM, Bar-Or D. Matched pilot study examining cannabis-based dronabinol for acute pain following traumatic injury. Trauma Surg Acute Care Open 2020;5(1):1-6.

Science/Human: Cannabis modulates blood concentrations of hormones associated with appetite

In a placebo-controlled study with 20 participants cannabis modulated blood concentrations of hormones related to appetite and metabolism. Participants underwent a crossover study with 4 sessions of oral cannabis, smoked cannabis, vaporised cannabis and placebo.

Glucagon-like peptide-1 was he lower under cannabis compared to placebo. Ghrelin concentrations during oral cannabis were higher than after smoked and vaporised cannabis. The spike in blood insulin concentrations observed in the placebo (probably due to the intake of brownie) was not seen with cannabis intake. Authors wrote that “cannabis administration in this study modulated blood concentrations of some appetitive and metabolic hormones, chiefly insulin, in cannabis users."

Farokhnia M, McDiarmid GR, Newmeyer MN, Munjal V, Abulseoud OA, Huestis MA, Leggio L. Effects of oral, smoked, and vaporized cannabis on endocrine pathways related to appetite and metabolism: a randomized, double-blind, placebo-controlled, human laboratory study. Transl Psychiatry. 2020;10(1):71.

News in brief

Malawi: Legalisation of cannabis for medicine and industrial fibres
Malawi has become the latest country in southern African to relax laws against growing and selling cannabis, making it legal for use in the production of medicines and hemp fibres used in industry. Malawi’s parliament passed a bill that makes it legal to cultivate and process cannabis for those two uses, but stops short of decriminalising recreational use.
Reuters of 27 February 2020

USA: Cannabis use increased by 75% in seniors
In research published in JAMA Internal Medicine, the number of U.S. adults over 65 who reported using cannabis nearly doubled over a three-year period, from 2.4 percent in 2015 to 4.2 percent in 2018 -- an increase of 75 percent. "We don't think increases in use are due to legalization, although increasing social acceptability in general might have helped drive these increases," co-author Joseph J. Palamar, an associate professor of population health at New York University Langone Medical Center. "I think a lot of older people are hearing more and more about potential medical uses and many of these people are willing to try it out to see how it works."
UPI of 24 February 2020

Israel: Prime Minister to explore cannabis legalization
Israeli Prime Minister Benjamin Netanyahu said his government is exploring the legalization of cannabis for recreational use, following a model similar to Canada's. Justice Minister Amir Ohana "has begun work on the issue, and he will head a committee including professionals and Oren Leibovich, chairman of the [pro-legalization] Green Leaf Party, that will investigate importing the Canadian model for regulation of a legal market in Israel," Netanyahu tweeted in Hebrew.
Reason of 24 February 2020

Australia: The country expects cannabis prescriptions will more than double to 70,000 this year
That’s more than double the 30,000 approvals through the end of 2019, which the health ministry says roughly equates to the number of prescriptions. “Even if there were no increase to the current rates of prescribing, by the end of 2020, about 70,000 prescriptions are anticipated to have been written in Australia,” the Department of Health wrote in a submission to a Senate committee studying Australia’s medical cannabis access.
Marijuana Business Daily of 10 February 2020

Poland: Demand for medical use of cannabis is constantly growing
Due to increased demand medical cannabis is sold out in Poland. According to a recent report cannabis flowers are currently not available in pharmacies.
Gazety Pomorskiej of 6 February 2020

Science/Human: Cannabis use is associated with ADHD
In a sample of 1008 participants, cannabis use severity was associated with hyperactivity ADHD symptoms. Authors wrote that the “current findings provide evidence for a link between current cannabis misuse and both have active and inattentive ADHD symptoms in general.” But there was no relationship between cannabis use and other cognitive domains.
Peter Boris Centre for Addictions Research and Department of Psychology, Neuroscience, and Behaviour, McMaster University, USA.
Petker T, et al. Exp Clin Psychopharmacol. 2020 Feb 27. [in press]

Science/Animal: Genetic variations in the endocannabinoid system associated with increased vulnerability to THC
In animal studies endocannabinoid genetic variation enhanced vulnerability to THC reward in adolescent female mice.
Division of Pediatric Neurology, Department of Pediatrics, Weill Cornell Medicine, New York, USA.
Burgdorf CE, et al. Sci Adv. 2020;6(7):eaay1502.

Science: Several terpenes of cannabis possess anti-inflammatory potential
In a review researchers analysed the anti-inflammatory and antioxidant properties of terpenes in cannabis and wrote that given “their anti-inflammatory properties, terpenes may contribute to the effects of current cannabinoid-based therapies.”
Trinity College Dublin, University of Dublin, Ireland.
Downer EJ. ACS Chem Neurosci. 2020 Feb 24. [in press]

Science/Animal: CBD is more potent as antidepressant in adult compared to adolescent rats
In a study with rats researchers found, that CBD exerts antidepressant and appetite reducing effects in adult rats and demonstrate a decreased potential when administered in adolescent rats.
IUNICS, University of the Balearic Islands, Palma, Spain.
Bis-Humbert C, et al. Psychopharmacology (Berl). 2020 Feb 21. [in press]

Science/Human: Cannabis confirmed to be useful in the treatment of spasticity of MS patients
In a survey among people with multiple sclerosis and spasticity 54% reported ever using cannabis and 36% current use. 79% found cannabis helpful for spasticity and 26% use cannabis and prescribed oral spasticity medications. 1
Department of Neurology, Oregon Health and Science University & Portland VA Health Care System, Portland, OR, USA.
Rice J, et al. Mult Scler Relat Disord. 2020;41:102009.

Science/Human: Cannabis use is associated with increased quality of life in chronic diseases
Research of a group of patients with various chronic diseases, who used cannabis and were followed at baseline, 4, 8 and 12 months, showed that cannabis use “may help patients with chronic diseases to maintain an acceptable” quality of life.
ICEERS-International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain.
Bouso JC, et al. Phytother Res. 2020 Feb 21. [in press]

Science/Animal: CBD does not have antihypertensive effects
In a study with hypertensive rats CBD in a dose of 10 mg/kg bodyweight once a day for 2 weeks did not reduce blood pressure. Researchers observed an unexpected increase in lipid peroxidation in normotensive rats.
Department of Experimental Physiology and Pathophysiology, Medical University of Białystok, Poland.
Remiszewski P, et al. Int J Mol Sci. 2020;21(4).

Science/Animal: Cannabinoids reduce inflammatory reaction after hypoxia
Treatment with a cannabinoid, which binds to both cannabinoid receptors (WIN 55,212-2) reduced the inflammatory response after hypoxia in unborn lambs. The cannabinoids reduced the increase of the inflammatory markers tumour necrosis factor alpha, interleukin 1 beta and interleukin 6.
Department of Cell Biology and Histology, School of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Vizcaya, Spain.
Alonso-Alconada D, et al. Int J Mol Sci. 2020;21(4).

Science/Human: Cannabis effective in different severity subgroups of the spasticity in multiple sclerosis
in a study with patients belonging to different subgroups of spasticity severity the cannabis extract Sativex was effective in all subgroups. Authors summarised: “patients with severe resistant spasticity achieve significant therapeutic gains. Spasticity-associated pain often improves similarly in the same subgroups.”
Department of Neurology, Institute of Translational Neurology, University of Münster, Germany.
Meuth SG, et al. Int J Neurosci. 2020 Feb 17:1-15. [in press]

Science/Animal: Activation of the endocannabinoid system alleviates cancer induced bone pain
In a study with mice inhibition of endocannabinoids by inhibition of monoacylglycerol lipase, which is responsible for the degradation of the endocannabinoid 2-AG, reduced cancer bone pain.
University of Arizona, USA.
Thompson AL, et al. J Pharmacol Exp Ther. 2020 Feb 13. [in press]

Science/Animal: First study on the treatment possibilities of cannabis in dogs
Researchers investigated the effects of the cannabis extract Sativex in dogs by investigating physical effects and pharmacokinetic parameters. They concluded that “this study demonstrates that single or multiple dose sublingual administration of Sativex to naïve dogs results in the expected pharmacokinetic profile, with maximal levels of phytocannabinoids detected at 1-2 h and suggested progressive accumulation after the multiple dose treatment.”
Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain.
Fernández-Trapero M, et al. Biomolecules. 2020;10(2).

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