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IACM-Bulletin of March 14, 2021

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Science/Human — A high proportion of patients with Parkinson’s disease in the US use cannabis

In an anonymous survey among people with Parkinson’s disease from 49 US states 24.5% reported cannabis use within the previous 6 months. Investigators of the Parkinson's Foundation in New York, USA, distributed the survey to 7607 people with Parkinson’s disease. 1339 participated (17.6%), and 1064 completed the whole survey and were available for analysis.

Patients using cannabis were more likely to report insufficient control of their non-motor symptoms with prescription medications than non-users. Cannabis was primarily used for Parkinson’s disease (63.6%) and was most often used to treat anxiety (45.5%), pain (44.0%), and sleep disorders (44.0%). However, nearly a quarter of users (23.0%) also reported they had stopped cannabis use in the previous six months, primarily due to a lack of symptom improvement (35.5%). Three quarters of respondents (75.5%) did not use cannabis, primarily because there was a lack of scientific evidence supporting efficacy (59.9%).

Feeney MP, Bega D, Kluger BM, Stoessl AJ, Evers CM, De Leon R, Beck JC. Weeding through the haze: a survey on cannabis use among people living with Parkinson's disease in the US. NPJ Parkinsons Dis 2021;7(1):21.

Science/Human — The efficacy of CBD against epilepsy increases over time

In a study with 169 participants with treatment resistant epilepsy following standard medication, who received treatment with the CBD extract (Epidiolex) significant reduction of seizure frequency was more pronounced after 2 years of treatment than within the first month after start of the treatment. In addition, investigators of the Department of Neurology and the UAB Epilepsy Center of the University of Alabama at Birmingham, USA, found out, that this effect was more pronounced in the 80 adults than in the 89 children of the study after one year of treatment.

The percentage of children achieving at least 50% seizure frequency reduction was 44% at month 1, and 41% at year 1, and 61% reduction at year 2, while adult responder rates were 34% at month 1, 53% at year 1, and 71% at year 2. Authors wrote, that “there was a significant difference in seizure severity reduction at year 1, with adults reporting greater improvement.”

Gaston TE, Ampah SB, Martina Bebin E, Grayson LP, Cutter GR, Hernando K, Szaflarski JP; UAB CBD Program. Long-term safety and efficacy of highly purified cannabidiol for treatment refractory epilepsy. Epilepsy Behav 2021;117:107862.

Science/Human — Impairment of drug-related driving skills by cannabis may last about 7 hours

A meta analysis of 80 publications on cannabis and driving revealed, that impairment may last about 7 hours. Regular cannabis use and medicinal use were associated with lower impairment.

The University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, Australia.

S McCartney D, et al. neuroscience & Biobehavioral Reviews, 23 January 2021. [in press]

News in brief

Norway — Government wants to decriminalise the possession of cannabis

Norway's government proposed a bill aimed at decriminalising the possession and use of small amounts of narcotics, saying users should be offered treatment rather than face jail. "Decades of repression have taught us that punishment doesn't work. On the contrary, punishment can make things worse," Education Minister Guri Melby told a press conference.

France24 of 19 February 2021

Thailand — The medicines agency wants to list cannabis among essential medicinal drugs

The Food and Drug Administration (FDA) is pushing to expedite the listing of cannabis in the National List of Essential Medicines and for food product use, its deputy secretary-general Supattra Boonserm said. She said the FDA committee approved the draft of minister of public health ordinance that places cannabis on the National List of Essential Medicines as well as allowing it to be used as ingredients in food products.

Bangkok Post of 23 February 2021

Science/Human — Cannabis may improve several symptoms in cancer patients

In a small survey with 36 cancer patients 83% reported the use of cannabis, which provided relief for several symptoms, “including decreased appetite (41%), insomnia (41%), neuropathy (41%), anxiety (35%), nausea (29%), joint pain (29%), bone pain (29%), abdominal pain (25%), and depression (19%).”

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale New Haven Hospital, USA.

Webster EM, et al. Gynecol Oncol Rep 2020;34:100667.

Science — Indoor production of cannabis is associated with major CO2 emissions

Indoor production of cannabis may have a major impact on the environment through major CO2 emissions. In the US they may range “from 2,283 to 5,184 kg CO2-equivalent per kg of dried flower” depending on location.

Mechanical Engineering, Colorado State University, Fort Collins, USA.

Summers HM, et al. Nature Sustainability, 8 March 2021.[in press]

Science/Human — THC may be detectable in very low concentrations in breast milk for more than 5 weeks

In a study with 25 women, of whom 12 reported abstinence from cannabis, mean THC concentrations were 3.2 ng/mL breast milk within the first week after giving birth and starting abstinence, increased to 5.5 ng/mL in the second week and declined to 1.9 ng/mL at 6 weeks. Given an intake of 800 mL of breast milk the newborn would ingest about 0.0026 milligrams of THC per day in the first week and about 0.0015 mg per day of THC in week six.

Department of Pediatrics, University of Colorado School of Medicine, Aurora, USA.

Wymore EM, et al. JAMA Pediatr, 8 March 2021. [in press]

Science/Cells — CBD influences cell proliferation and survival in nerve cells

New research shows that CBD (cannabidiol) is involved in the regulation of cell proliferation and cell survival in nerve cells. Authors concluded that their study “sheds light on potential therapeutic cannabinoid targets that could be developed for treating neurodegenerative disorders.”

Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.

Vrechi TAM, et al. Sci Rep 2021;11(1):5434.

Science/Animal — Administration of CBD together with sesame oil increases bioavailability

In a study with rats the bioavailability of CBD was increased by coadministration with natural sesame oil. Sesame oil was superior to pre-digested lipids or purified trioleate.

School of Pharmacy, University of Nottingham, UK.

Feng W, et al. Eur J Pharm Biopharm 2021:S0939-6411(21)00057-6.

Science/Animal — The endocannabinoid anandamide reduces inflammation in sheep

A new study demonstrates that the intravenous administration of the endocannabinoid anandamide reduces the synthesis of the pro-inflammatory cytokine interleukin 1 beta. Cytokines are mediators in the immune system and influence the activity of immune cells.

The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Jabłonna, Poland.

Tomczyk M, et al. Animals (Basel) 2021;11(2):484.

Science — CBD shows activity against Candida albicans, a fungal pathogen

CBD (cannabidiol) exerts pronounced time-dependent inhibitory effects on biofilm formation as well as disruption of mature biofilm of the fungus Candida albicans. Candida albicans is usually found in the healthy human body. When the immune system is compromised it may cause health problems.

Biofilm Research Laboratory, Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University of Jerusalem, Israel.

Feldman M, et al. Microorganisms 2021;9(2):441.

Science — The cannabis compound caflanone processes antiviral potential

The major non-cannabinoid compound of the cannabis plant with medicinal properties may be caflanone. It shows activity against human viruses and certain cancers.

Biotech R & D Institute, University of the West Indies, Mona, Jamaica.

Lowe H, et al. Plants (Basel) 2021;10(2):400.

Science/Human — High willingness of women to use cannabis for gynaecological conditions

In a survey with 995 women those who ever used cannabis 92% were willing to try it for gynaecological condition. Among never users 65% were willing to do so.

Department of Obstetrics and Gynecology, Oregon Health & Science University, USA.

Han L, et al. J Womens Health (Larchmt) 2021;30(3):438-444.