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IACM-Bulletin of 20 December 2020

IACM: 20 years of IACM: a look back and ahead

The year 2020 marks the 20th anniversary of the IACM. To mark the occasion, our journal Cannabis and Cannabinoid Research has published an article looking back at our history, work and future prospects. At this time, when a lot is happening worldwide on all continents on the topic of cannabis as medicine, an international cooperation of scientists, physicians and patients and thus an international scientific society, which has also always focused on the patients, is more valuable than ever.

At this point, we, the members of the Board of Directors, would like to express our sincere thanks to all our colleagues and supporters for their help and cooperation. We wish everyone happy holidays and a good start into the coming year during this unusual time! We look forward to continuing to work with you.

Save the date: 15 to 17 October 2021 – Free International Virtual Conference of the IACM.

Grotenhermen F, Mueller-Vahl K.Two Decades of the International Association for Cannabinoid Medicines: 20 Years of Supporting Research and Activities Toward the Medicinal Use of Cannabis and Cannabinoids. Cannabis Cannabinoid Res. 23 Oct 2020 [in press]

Science/Human: Cannabis may be useful in Parkinson’s disease according to survey

According to a survey with 1348 questionnaires sent out to patients with Parkinson’s disease 8.4% used cannabis for medicinal purposes. The study was conducted by researchers of the Department of Neurology of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Questionnaires were distributed nationwide via the membership journal of the German Parkinson Association (1123 questionnaires) and locally in a clinic (225 questionnaires).

51% of participants were aware that cannabis can prescribed by physicians, 28% of various routes of administration and 9% of the difference between THC and CBD. Reduction of pain and muscle cramps was reported by more than 40% of cannabis users. Stiffness/akinesia, freezing, tremor, depression, anxiety and restless legs syndrome subjectively improved for more than 20% and overall tolerability was good. Improvement of symptoms was reported by 54% of users applying oral CBD and 68% inhaling THC-rich cannabis. Compared to CBD intake, inhalation of THC was more frequently reported to reduce akinesia and stiffness (50% versus 35%).

Yenilmez F, Fründt O, Hidding U, Buhmann C. Cannabis in Parkinson's Disease: The Patients' View. J Parkinsons Dis. 2020 Nov 11. [in press]

Science/Human: About one third of cancer patients in Canada use cannabis

According to a survey with 4667 cancer patients, which was conducted between 2007 and 2016 cannabis use increased throughout the study and reached 34% in 2015-2016. A researcher of the Department of Oncology at the University of Alberta, Cross Cancer Institute in Edmonton, Canada, wrote that cannabis use was lower with about 28% in 2007-2008.

Cannabis use by cancer patients was higher in young people, male patients, white race, non-married status and higher income. Authors noted that “within this study cohort of Canadian adults with current cancer diagnosis, cannabis use is not uncommon.”

Abdel-Rahman O. Cannabis use among Canadian adults with cancer (2007-2016); results from a national survey. Expert Rev Pharmacoecon Outcomes Res. 2020 Nov 20. [in press]

Science/Human: Cannabis use by women with pelvic pain increased after legalisation in Canada

The use of cannabis increased among patients with self-reported moderate to severe pelvic pain after cannabis legalisation for adults in Canada. Patients were recruited from a clinic in Vancouver, Canada, in the years 2013-2019. Overall, 15% of 3426 patients were classified as current cannabis users. These results were published in Obstetrics & Gynaecology by investigators of the University of British Columbia, and the Centre for Health Evaluation & Outcome Sciences in Vancouver, Canada.

After cannabis legalization for recreational use, prevalence of current cannabis use increased from 13% to 22%. Compared with nonusers, cannabis users were younger, had lower levels of education and lower household income, were taking opioids, antiinflammatories, neuromodulators, and herbal medications more frequently. They had worse questionnaire scores for depression, anxiety, quality of life, and pelvic pain severity. Postlegalization, cannabis users were less likely to require daily opioids compared with cannabis users before legalization.

Geoffrion R, Yang EC, Koenig NA, Brotto LA, Barr AM, Lee T, Allaire C, Bedaiwy MA, Yong PJ. Recreational Cannabis Use Before and After Legalization in Women With Pelvic Pain. Obstet Gynecol. 2020 Dec 3. [in press]

Science/Human: Cannabis may be effective in the self-management of endometriosis according to a survey

According to an online survey with 213 women from New Zealand suffering from endometriosis 80% were current cannabis users and reported symptom improvements. These data were gained by investigators of NICM Health Research Institute of Western Sydney University, Australia.

The most common reason for cannabis use was improvement of pain (96%) and sleep (96%). Respondents reported that their symptom was "much better" for pain (81%), sleep (79%), and nausea or vomiting (61%). Over three-quarters (81%) indicated cannabis had reduced their normal medication usage. Over half (59%) were able to completely stop a medication, mostly analgesics.

Armour M, Sinclair J, Noller G, Girling J, Larcombe M, Al-Dabbas MA, Hollow E, Bush D, Johnson N. Illicit Cannabis Usage as a Management Strategy in New Zealand Women with Endometriosis: An Online Survey. J Womens Health (Larchmt). 2020 Dec 3. [in press]

News in brief

USA: No increase in cannabis use among youth despite legalisation within the past decade
Self-reported cannabis use by adolescents remained largely stable during the last decade, according to survey data of the Monitoring the Future Study released by the University of Michigan. Throughout the years , “the use of marijuana in all forms … by adolescents did not significantly change (…) for lifetime use, past 12-month use, past 30-day use, daily use,” the National Institute on Drug Abuse stated in a news release.
Monitoring the Future
Press release of the National Institute on Drug Abuse of 15 December 2020

USA: Bill by the House of Representatives facilities clinical research with cannabis
On 9 December the House of Representatives passed The Medical Marijuana Research Act, which facilitates clinical cannabis research by easing access to cannabis flowers and other products and by ending the monopoly of the University of Mississippi on cultivation of cannabis for research.
NORML of 10 December 2020

Canada: 380,000 citizens registered as cannabis patients
Health Canada’s finding show about 43,000 individuals were allowed to grow cannabis for their personal medical use by the end of September 2020, and about 380,000 citizens were registered as patients. The allowed limited amount of cannabis grown at home was 36.2 grams per month by the end of March, resulting in a mean need of 1.2 g per day.
Reuters of 18 December 2020

Science/Human: Cannabis may be effective in improving symptoms in patients with dementia according to a case series
Three cases from a dementia clinic received cannabis for the treatment of anxiety, insomnia and pain. Authors wrote that “in all cases, use of cannabinoid products showed significant improvements in behavior and in the primary indication for prescription.”
Department of Psychiatry, University of Arizona College of Medicine, Phoenix, USA.
Gopalakrishna G, et al. Neurodegener Dis Manag. 2020 Nov 16. [in press]

Science/Human: CBD may diminish tamoxifen degradation
Researchers present a case of the 58-year-old woman, were they found, that daily intake of 40 mg of CBD were associated with reduced degradation of tamoxifen, a drug used in the treatment of breast cancer. They noted, that the use of CBD may inhibit the activity of the metabolising enzymes CYE3A4 and/or CIP2D6, thus increasing tamoxifen levels.
McMaster University Medical Centre, Hamilton, Canada.
Parihar V, et al. J Pharm Pract. 2020:897190020972208.

Science/Human: THC has strong effects in people with reduced activity of a certain enzyme in the liver
The main enzyme, which degrades THC in the liver to 11-hydroxy-THC, called CYP2C9, has a reduced activity in some people (“CYP2C9 poor metabolizers”). These individuals may have a higher THC concentrations after intake than people with normal CYP2C9 activity and experience effects after lower doses.
National Center for Biotechnology Information, U.S. National Library of Medicine, Bethesda, USA.
Dean L, et al. Dronabinol Therapy and CYP2C9 Genotype.

Science/Animal: Several minor cannabinoids bind to cannabinoid receptors
The pharmacological effects of delta-9-THC, delta-9-tetrahydrocannabinolic acid (THCA), delta-9-tetrahydrocannabivarin (THCV), CBD, cannabidiolic acid (CBDA), cannabidivarin (CBDV), cannabigerol (CBG), and cannabichromene (CBC) were evaluated in cells and mice. The research revealed partial agonist activity for many of them at the classical cannabinoid receptors (CB1 and/or CB2 receptors). Authors wrote that these results “build on the growing body of literature showing cannabinoid receptor-dependent pharmacology for these less-abundant phytocannabinoids (…).”
College of Pharmacy and Nutrition, University of Saskatchewan, Health Sciences Building, Saskatoon, Canada.
Zagzoog A, et al. Sci Rep. 2020;10(1):20405.

Science/Human: Cannabis use is associated with an increased risk of cardiovascular disease mortality
According to an analysis of 14,818 adults aged 20 to 59 years followed from 2005 to 2014 cannabis use was associated with an increased risk to die from cardiovascular disease and a reduced risk to die from cancer. According to the authors the mechanisms for this association are unclear and “require future research.”
Department of Epidemiology, College of Public Health, University of Iowa, USA.
Sun Y, et al. Am J Prev Med. 2020;59(6):873-879.

Science/Human: Certain genetic variants of the CB1 receptor protect for diabetes
According to an analysis of 320 patients with type 2 diabetes mellitus and 320 patients with diabetic nephropathy a certain variant of the CB1 receptor was protective against these medical conditions.
Department of Endocrinology, China-Japan Friendship Hospital, People's Republic of China.
Zhang X, et al. Pharmgenomics Pers Med. 2020;13:591-599.

Activation of the CB2 receptor may improve symptoms SARS-CoV-2 infections
Researchers stated that they “hypothesize that CB2R agonists, due to immunomodulatory, antiinflammatory, and antiviral properties may show activity against COVID-19.”
Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
Nagoor Meeran MF, et al. Drug Dev Res. 2020 Nov 15. [in press]

Science/Animal: THC protects against inflammation of the bowel, while CBD has little effect
Mice with chemically induced inflammation of the bowel were treated with THC and CBD. Researchers “found that THC prevented colitis, and that CBD, at the dose tested, provided little benefit to the amelioration of colitis, or when added synergistically with THC.” THC acted on both immune cells and cells of the bowel (enterocytes).
Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, Columbia, USA.
Becker W, et al. J Crohns Colitis. 2020:jjaa253.

Science/Cells: The anti-cancer effects of CB2 receptor activation could be increased by blocking the activity of a certain enzyme
Research shows that activation of the CB2 receptor by a synthetic cannabinoid (JWH133) shows anti-tumour effects against glioma cells, certain brain tumour cells. And this effect was increased by decreasing the effect of CYP2J2, an enzyme responsible for the production of metabolites, which may increase tumour growth.
Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Lei X, et al. Front Oncol. 2020;10:574277.

Science: Cannabinoids may be helpful in tinnitus
A review of scientific data is presented, which shows that cannabinoids may have a “possible use as protective and therapeutic agents in the ear and auditory system, especially in tinnitus.”
Department of Brain and Behavioural Sciences, University of Pavia, Italy.
Perin P, et al. Front Neurol. 2020;11:505995.

Science/Animal: The bacteria in the bowel may influence depression and this effect is mediated by the endocannabinoid system
By using transportation of gut bacteria (fecal microbiota) from one mouse to another researchers showed, that these bacteria have an effect on depressive -like behaviour. And this effect was mediated by the endocannabinoid system.
Microenvironment and Immunity Unit, INSERM U1224, Institut Pasteur, Paris, France.
Chevalier G, et al. Nat Commun. 2020;11(1):6363.

Science/Animal: CBDA shows anticonvulsant activity in rats
Research shows that cannabidiolic acid (CBDA) may have anticonvulsant activity in an epilepsy model of rats.
Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, USA.
Goerl B, et al. Epilepsy Res. 2020;169:106525.

Science/Cells: Vitamins C reduces negative effects of THC on sperm
In dishes with sperm high concentrations of THC reduced their motility and this effect was reduced by the addition of vitamins C. Authors wrote that “Vitamin C ameliorates the THC-induced reduction in spermatozoa motility in-vitro by modulation of their kinematics.”
Department of Physiology, School of Medicine and Pharmacy, University of Rwanda College of Medicine and Health Sciences, Huye, Rwanda.
Alagbonsi AI, et al. BMC Nutr. 2020;6(1):59.

Science/Human: Pregnant women often have poor knowledge of potential harmful effects of cannabis
According to a survey with 1133 pregnant women most of them had poor knowledge about the potential risks of cannabis use during pregnancy. Non-smokers of tobacco were more often aware of potential risks than tobacco smokers.
Division of Complex Family Planning, Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, USA.
Ng JH, et al. J Matern Fetal Neonatal Med. 2020:1-9.

Science/Animal: CBD reduces soman-induced lethality and seizure severity
The chemical soman causes seizures and death. Pre-treatment of mice, which had received soman, with CBD improved the outcome of the treatment with the sedative midazolam. Authors wrote that “cannabidiol administration in a severe seizure model of soman exposure provide additional pre-clinical support for the benefits of cannabidiol against exposure to seizure-inducing chemical agents
and suggest cannabidiol may augment the anti-seizure effects of midazolam.”
US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, United States.
Kundrick ER, et al. Neurotoxicology. 2020;82:130-136.

Science: CBD and THC may show antiviral effects against the new corona virus
Researchers investigated the antiviral effects of several cannabinoids against the SARS-CoV-2. They wrote that there “findings suggest cannabidiol and delta-tetrahydrocannabinol are possible drugs against human coronavirus that might be used in combination or with other drug molecules to treat COVID-19 patients.”
School of Chemical Engineering, Yeungnam University, Gyeongsan, Republic of Korea.
Raj V, et al. Int J Biol Macromol. 2020:S0141-8130(20)35178-3.

Science/Animal: Beta-caryophyllene may be helpful in Parkinson’s disease
Beta-caryophyllene, a terpene which binds to the CB2 receptor, showed protective antioxidant effects in a mouse model of Parkinson’s disease. Authors concluded that “this phytocannabinoid may represent a promising pharmacological option to safeguard dopaminergic neurons and prevent the progression of PD.”
Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social, Guadalajara, Mexico.
Flores-Soto ME, et al. Neurosci Lett. 2020 Nov 30:135534.

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