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IACM-Bulletin of 31 January 2021

Science/Human: Cannabis use reduces high blood pressure in older adults

In a prospective study with 26 patients with hypertension and a mean age of about 70 years cannabis use resulted in reduced blood pressure of about 5 mmHg. The research was conducted by investigators of the Cannabis Clinical Research Institute and Clinical Research Center of Ben-Gurion University of the Negev in Beer Sheva, Israel.

At 3 months follow-up, the mean 24-hours systolic and diastolic blood pressures were reduced by 5.0 mmHg and 4.5 mmHg, respectively. The nadir for the blood pressure and heart rate was achieved at 3 hours post-administration. The proportion of those with normal pressure changed from 27.3% before treatment to 45.5% afterward. Authors concluded that “amongst older adults with hypertension, cannabis treatment for 3 months was associated with a reduction in 24-hours systolic and diastolic blood pressure values.”

Abuhasira R, Haviv YS, Leiba M, Leiba A, Ryvo L, Novack V. Cannabis is associated with blood pressure reduction in older adults - A 24-hours ambulatory blood pressure monitoring study. EUR J Intern Med. 2021:S0953-6205(21)00005-4.

Science: CBD shows antimicrobial potential against bacteria

A study reveals that CBD (cannabidiol) shows antimicrobial activity against bacteria. Researchers of the Institute for Molecular Bioscience of the University of Queensland in St. Lucia, Australia, confirm previous reports of activities against Gram-positive bacteria and expand the breadth of pathogens tested, including highly resistant Staphylococcus aureus, Streptococcus pneumoniae, and Clostridioides difficile.

Authors wrote that their research “results demonstrate that cannabidiol has excellent activity against biofilms, little propensity to induce resistance, and topical in vivo efficacy. Multiple mode-of-action studies point to membrane disruption as cannabidiol's primary mechanism. More importantly, we now report for the first time that cannabidiol can selectively kill a subset of Gram-negative bacteria that includes the 'urgent threat' pathogen Neisseria gonorrhoeae.”

Blaskovich MAT, Kavanagh AM, Elliott AG, Zhang B, Ramu S, Amado M, Lowe GJ, Hinton AO, Pham DMT, Zuegg J, Beare N, Quach D, Sharp MD, Pogliano J, Rogers AP, Lyras D, Tan L, West NP, Crawford DW, Peterson ML, Callahan M, Thurn M. The antimicrobial potential of cannabidiol. Commun Biol, 2021;4(1):7.

Science/Human: Cannabis reduced alcohol consumption in heavy drinkers in observational study

Heavy alcohol drinkers may reduce alcohol consumption by using cannabis. Investigators of the Institute for Cognitive Science of the University of Colorado in Boulder, USA, included 96 cannabis using, who were also heavy users in an observational study.

Participants drank approximately 29% fewer alcoholic drinks and were 2 times less likely to have a binge-drinking episode on days that cannabis was used compared with days that cannabis was not used. These patterns were observed in males, females and the infrequent and frequent cannabis use groups. Authors wrote that” heavy drinkers engaged in treatment to reduce their alcohol consumption who also use cannabis appear to increase their cannabis use on days when they reduce their alcohol consumption.”

Karoly HC, Ross JM, Prince MA, Zabelski AE, Hutchison KE. Effects of cannabis use on alcohol consumption in a sample of treatment-engaged heavy drinkers in Colorado. Addiction. 2021 Jan 19. [in press]

Science/Human: Cannabis use is associated with reduced hospital readmissions in patients with irritable bowel syndrome

In an analysis of 7163 patients with irritable bowel syndrome (IBS) identified in the National Readmission Database the 357 cannabis users had lower rates of readmission to hospital within 30 days. Investigators of the Department of Medicine of the Rutgers New Jersey Medical School in Newark, USA, found out that readmission rates were 1.5% in patients who reported cannabis use and 1.1% in those who did not report cannabis use.

Authors concluded from their investigation that their was “no statistically significant differences in 30-day readmission rates for IBS-specific causes when comparing patients who reported cannabis use with those who did not. However, the authors found that cannabis use was associated with reduced 30-day hospital readmission rates for all causes.”

Choi C, Abougergi M, Peluso H, Weiss SH, Nasir U, Pyrsopoulos N. Cannabis Use is Associated With Reduced 30-Day All-cause Readmission Among Hospitalized Patients With Irritable Bowel Syndrome: A Nationwide Analysis. J Clin Gastroenterol. 2021 Jan 20. [in press]

Science/Human: Cannabis use was associated with long-term pain reduction in large observational study

In an observational study with 757 pain patients about one third of patients remained on cannabis for 6 months and reported reduced pain intensity. The investigators of the Department of Anesthesiology and Pain Medicine of the University of Toronto, Canada, use data from community-based cannabis clinics in Ontario. At six and 12 months, 230 and 104 of participants were followed up, respectively.

The proportion of cannabis users who reported using opioids decreased by half, from 40.8% at baseline to 23.9% at 12 months. Pain intensity and pain-related interference scores were reduced and quality of life and general health symptoms scores were improved compared with baseline.

Meng H, Page MG, Ajrawat P, Deshpande A, Samman B, Dominicis M, Ladha KS, Fiorellino J, Huang A, Kotteeswaran Y, McClaren-Blades A, Kotra LP, Clarke H. Patient-reported outcomes in those consuming medical cannabis: a prospective longitudinal observational study in chronic pain patients. Can J Anaesth. 2021 Jan 20. [in press]

News in brief

France: Survey by the government on legal status of cannabis
The French government wants to know how citizens think about legalisation of cannabis for medical use and for use by adults before changes of the law. They are invited to participate in a survey.

Science: New review on the production of CBD and other cannabinoids
Cologne-based Nova-Institute has prepared an extensive review on the production of CBD and other cannabinoids. IACM members get a 20% discount by sending an email to the IACM office (info@cannabis-med.org) to get a discount code.
Production of Cannabinoids via Extraction, Chemical Synthesis and Especially Biotechnology

Science/Human: CBD may be helpful in autism according to case report
According to a case report from Calgary, Canada, a 15-year-old boy with autism spectrum disorder profited from a treatment with a CBD extract in a very low dose (twice 4 mg CBD and 0.5 mg THC).
Caleo Health, Calgary, Canada.
Ponton JA, et al. J Med Case Reports. 2020;14:162.

Science/Human: A high density of cannabis dispensaries is associated with increased use of cannabis
According to an analysis from Los Angeles County the density of cannabis dispensaries was associated with cannabis use in young adults.
Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles.
Pedersen ER, et al. Am J Addict. 2020 Dec 30. [in press]

Science/Human: Several patients with myotonic dystrophy type 1 use cannabis medicinally
In a survey with 79 patients suffering from myotonic dystrophy type 1 22% currently used cannabis and 57% of them reported that they used it for symptom relief.
Pharmacology-physiology Department, Université de Sherbrooke, Saguenay, Canada.
Beauchesne W, et al. Neuromuscul Disord. 2021:S0960-8966(21)00004-3.

Science/Human: Cannabis use and post traumatic stress disorder are associated in veterans
According to the analysis of a large database of about 46,000 US war veterans there was an association between post traumatic stress disorder and cannabis use disorder. Veterans with cannabis use disorders also showed higher levels of depression, panic disorder, alcohol use, insomnia and opioid use disorder.
VA South Central Mental Illness Research, Education and Clinical Center (MIRECC), Houston, USA.
Bryan JL, et al. J Subst Abuse Treat. 2021;122:108254.

Science/Human: Increases in THC content of cannabis in the USA
An analysis of about 14,000 samples of cannabis during the past 10 years showed that mean THC concentrations increased from 9.8% in 2009 to 13.9% in 2019.
National Center for Natural Products Research, School of Pharmacy, University of Mississippi, USA.
ElSohly MA, et al. Biol Psychiatry Cogn Neurosci Neuroimaging. 2021:S2451-9022(21)00022-7.

Science/Human: A higher number of cannabis dispensaries in the US is associated with reduced mortality rates from opioid -related deaths
An analysis of mortality data from 812 counties in the United States in the 23 states that allowed legal forms of cannabis dispensaries to operate by the end of 2017 revealed that higher medical and recreational dispensary counts are associated with reduced opioid related death rates, particularly deaths associated with synthetic opioids such as fentanyl.
Graduate School of Management, University of California, Davis, USA.
Hsu G, et al. BMJ. 2021 Jan 27;372:m4957.

Science/Human: Cannabis use in adolescence is associated with a minimal decrease in intelligence
According to a review of 7 studies including 808 cannabis users and and 5308 non-using controls cannabis use in adolescence was associated with an average decline of approximately 2 IQ points.
Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Ireland.
Power E, et al. Psychol Med. 2021:1-7.

Science/Human: The impact of cannabis use on opioid -related problems depends on cannabis legalisation
By analysing a large data set investigators found out the type of medical cannabis policy in states with legal access to cannabis has varying effects on opioid-related hospitalizations and emergency department visits. Their findings indicate that the implementation of home cultivation is positively associated with hospitalizations and emergency department visits related to opioids.
College of Pharmacy, University of Georgia, Athens, USA.
Jayawardhana J, et al. Health Serv Res. 2021 Jan 26. [in press]

Science/Human: Cannabis use may be associated with an increased risk of falling in elder people
An experimental study with 16 older adults, split into cannabis Users and age- and sex-matched Non-Users groups, indicated a higher fall risk, worse one leg standing balance performance, and slower gait speed in Users vs. Non-Users. No significant differences in cognitive function were found.
Department of Health and Human Physiology, University of Iowa, USA.
Workman CD, et al. Brain Sci. 2021;11(2):134.

Science/Cells: Mixed results on THC and CBD against different types of brain cancer cells
Both CBD and THC reduced viability of certain brain cancer cells (medulloblastoma, ependymoma). The effect was strongest, if CBD and THC were combined. However, in animal studies the cannabinoids were less effective and cannabinoid treated animals had no improved survival.
Brain Tumour Research Program, Telethon Kids Institute, Nedlands, Australia.
Andradas C, et al. Cancers (Basel). 2021;13(2):330.

Science/Cells: CBC and THC kill cells of bladder carcinoma
Treatments with CBC (cannabichromene) + THC or CBD (cannabidiol) led to programmed cell death (apoptosis) in cells of bladder carcinoma. CBC + THC or CBD treatments inhibited cell migration.
Department of Urology, Sheba Medical Center, Ramat Gan, Israel.
Anis O, et al. Molecules. 2021;26(2):465.

Science/Human: THC and CBD accumulate in breast milk
In a study with 20 women, who consumed a mean of about 20 cannabis cigarettes per week mean THC concentration in blood plasma was 3.7 ng/mL and 27.5 ng/mL in breast milk. THC and CBD accumulate in breast milk. Breastfeeding mothers used cannabis frequently and increased use in the early period after birth.
Utah Poison Control Center, College of Pharmacy, University of Utah, Salt Lake City, USA.
Moss MJ, et al. Pediatr Res. 2021 Jan 19.

Science/Human: CBD did not reduce cocaine relapse in a clinical study
In a placebo controlled study with 78 adults with cocaine use disorder daily use of 800 mg CBD did not reduce cocaine craving relapse compared to a placebo.
Research Center, Centre Hospitalier de l'Université de Montréal, Canada.
Mongeau-Pérusse V, et al. Addiction. 2021 Jan 19. [in press]

Science/Human: Reduced endocannabinoid metabolism may be associated with heavy use of alcohol in youth
In a study with 302 young people those with a certain variant of FAAH, the enzyme which degrades anandamide, had a high risk for frequent heavy episodic alcohol drinking.
Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada.
Best LM, et al. Alcohol Clin Exp Res. 2021 Jan 18. [in press]

Science/Human: Acceptance of cannabis use has increased in the USA in recent years
Cannabis acceptance and cannabis use increased among alcohol abstainers, non-binge drinkers, and binge drinkers between 2002 and 2018 in the US. Authors noted that the “impact of cannabis disapproval on use attenuated during the study period among drinkers but not among abstainers, suggesting that the effect of anti-cannabis attitudes may be weakening among those most likely to use cannabis.”
School of Social Work, Boston College, Chestnut Hill, USA.
Salas-Wright CP, et al. Addict Behav. 2021;116:106818.

Science/Animal: A reduction of anandamide produced by inflammation of the bowel contributes to anxiety
Studies with rats with inflammation of the bowel show that this inflammation is associated with an increased activity of the enzyme FAAH (fatty acid amide hydrolase) resulting in reduced andamide levels and increased anxiety. Inhibition of FAAH activity reversed this process. Authors concluded that this offers a perspective for “pharmacological management of psychiatric comorbidities of chronic inflammatory conditions through modulation of eCB signaling.”
Neuroscience Graduate Program, University of Calgary, Canada.
Vecchiarelli HA, et al. Neuropsychopharmacology. 2021 Jan 15. [in press]

Science/Animal: The endocannabinoid 2-AG reduced inflammation of the eye retina
The endocannabinoid 2-AG (2-arachidonoylglycerol) was applied to rats showing that it is “a putative therapeutic for retinal diseases characterized by neurodegeneration and neuroinflammation, when administered exogenously or by the inhibition of its metabolic enzymes.”
Department of Pharmacology, School of Medicine, University of Crete, Heraklion, Greece.
Kokona D, et al. Neuropharmacology. 2021;185:108450.

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