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IACM-Bulletin of 15 August 2021

Science/Human: A combination of THC and palmitoylethanolamide improved symptoms in Tourette’s syndrome according to a pilot study

In a 12-week uncontrolled trial with 16 adults with Tourette syndrome a combination of THC and PEA (palmitoylethanolamide) reduced symptoms. They received a maximum daily dose of 10 mg THC and a constant 800 mg dose of PEA. The study was conducted at Yale University in New Haven, USA.

The treatment led to an average improvement in tic symptoms of more than 20% within one week after starting treatment compared to baseline. Twelve of the 16 participants elected to continue to an extension phase following the 12 weeks, and only two participants dropped out early. Side effects were common but were generally managed by decreasing THC dosing, slowing the dosing titration, and shifting dosing to night-time.

Bloch MH, Landeros-Weisenberger A, Johnson JA, Leckman JF. A Phase-2 Pilot Study of a Therapeutic Combination of Δ(9)-Tetrahydrocannabinol and Palmitoylethanolamide for Adults With Tourette's Syndrome. J Neuropsychiatry Clin Neurosci. 2021:appineuropsych19080178.

Science/Human: About one third of MS patients use cannabis in Oregon and Southwest Washington according to survey

According to a survey with 1000 patients with MS living in Oregon and Southwest Washington 30% were current cannabis users for their disease and most of them reported therapeutic benefits. The study was carried out by investigators from the Oregon Health and Science University and other institutions in Portland, USA.

Cannabis was mostly used by multiple routes of administration, and most of these people report this being helpful for their multiple sclerosis. People who were younger, had lower household income, had progressive disease, and had more than minimal disability were more likely to use cannabis and report it was beneficial for their MS. People who were not using disease modifying therapies were also more likely to report benefit from cannabis use.

Rice J, Hildebrand A, Spain R, Senders A, Silbermann E, Wooliscroft L, Yadav V, Bourdette D, Cameron M. A cross-sectional survey of cannabis use by people with MS in Oregon and Southwest Washington. Mult Scler Relat Disord. 2021;55:103172.

Science/Human: Many patients with back pain use CBD according to a survey

According to a survey with 214 patients suffering from back pain, who used CBD, about half of the participants experienced pain relief. Investigators from the Hospital for Special Surgery in New York, USA, wrote that most participants would recommend CBD to a friend for pain relief.

CBD was initially used for potential relief of back pain (66.7%), neck pain (37.0%), leg pain (35.2%), and/or arm pain (9.3%). Users also sought improvements in insomnia (25.9%) and mood (18.5%). Oil was the most popular formulation (64.8%). Reported benefits were pain relief (46.3%), improved sleep (33.3%), and reduced anxiety (20.4%). 24.1% of patients reported no benefit from CBD use.

Lovecchio F, Langhans MT, Bennett T, Steinhaus M, Premkumar A, Cunningham M, Farmer J, Albert T, Huang R, Katsuura Y, Qureshi S, Schwab F, Sandhu H, Kim HJ, Lafage V, Iyer S. Prevalence of Cannabidiol Use in Patients With Spine Complaints: Results of an Anonymous Survey. Int J Spine Surg. 2021 Jul 20:8087.

Science/Human: Cannabis use may reduce opioid doses in chronic pain

According to interviews of 100 chronic pain patients, who had a licence for cannabis use, cannabis use was associated with reduced opioid usage. The study was conducted by investigators of Sackler Faculty of Medicine, Tel Aviv University, Israel. Of the participants aged 18-70 years 76 ever used opioids.

Of them, 93% decreased or stopped opioids following cannabis initiation. Ten patients met the criteria for cannabis use disorder. The prevalence of cannabis use disorder was higher among the younger participants compared to other users.

Zloczower O, Brill S, Zeitak Y, Peles E. Risk and benefit of cannabis prescription for chronic non-cancer pain. J Addict Dis. 2021:1-11.

News in brief

Argentina: Studies begin on the use of cannabis in pain associated with cancer
The use of cannabis for medicinal purposes continues to bring good news in the field of research. A group of scientists from the Austral University and CONICET signed an agreement with the state-owned company Cannava in Jujuy, with the idea of starting preclinical studies on the use of cannabis for cancer-related pain.
TN con Bienestar of 26 July 2021

UK: The cannabis spray Sativex will be tested in clinical study against aggressive brain tumour
The cannabis spray Sativex will be tested in patients with glioblastoma in a large controlled study. The Brain Tumour Charity, which is funding the trial, will recruit 232 patients early next year from at least 15 hospitals, including specialist cancer centres, across the UK. Two-thirds will receive Sativex and the standard medication temozolomide while the other third will be given the chemotherapy drug and a placebo.
The Guardian of 3 August 2021

Netherlands: The Dutch government wants to fund clinical research on CBD rich cannabis products in epilepsy
The Dutch Health Ministry has announced that a grant of 1.4 million EURos will be made available for research into the efficacy of medical cannabis products in the treatment of intractable epilepsy in children. The grant will be open to researchers who plan to conduct relevant research into whether CBD rich medical cannabis products are able to reduce seizures in children with treatment-resistant epilepsy. Applications will be open until 28 September, 2021.
Canex of 5 August 2021

USA: The state of Michigan will invest 20 million dollars into the research of medical cannabis
A pair of research projects funded by 20 million dollars in tax revenue from Michigan’s adult-use cannabis program will analyse the effects of medical cannabis in military veterans, state officials announced on 10 August. The bulk of the money, nearly 13 million dollars, will examine “the efficacy of marijuana in treating the medical conditions of United States armed service veterans and preventing veteran suicide,” according to recipients at the Multidisciplinary Association for Psychedelic Studies (MAPS).
Marijuana Moment of 10 August 2021

Canada: Thousands of kilograms of cannabis are thrown away due to overproduction
Cannabis producers are throwing away more product than ever before. Since 2018, nearly 450 thousand kilograms have been destroyed, according to reporting from MJBizDaily. Nearly 280 thousand kilograms of that was from 2020 alone, representing almost 20 percent of all production that year. Add to that nearly 3.8 million finished packages of dried flower, 1.5 million packages of extracts, and more than 700,000 packaged edibles.
The Walrus of 5 August 2021

Brazilia: 23,000 Brazilian patients use cannabis for therapeutic purposes
By 2020, according to a report by Prohibition Partners, 23,121 Brazilian patients were using products, pharmaceutical or otherwise, based on cannabis for therapeutic purposes. It is expected that this number will increase considerably until 2025.
Poder 360 of 10 August 2021

Science/Animal: THC may promote remyelination in nerve cells
In two models of toxin-induced demyelination THC administration enhanced regeneration of certain nerve cells, oligodendrocytes, white matter remyelination and motor function recovery in mice. Multiple Sclerosis is characterised by demyelination of nerve cells.
Aguado T, et al. British Journal of Pharmacology. 03 July 2021 [in press]

Science/Human: Cannabis may cause medication overuse headache in migraine
In a study with 368 patients with migraine both the use of cannabis and the use of opioids were associated with an increased risk of developing medication overuse headache.
Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Palo Alto, USA.
Zhang N, et al. Headache. 2021 Aug 9. [in press]

Science/Animal: Non-psychotropic cannabis showed prosocial effects in mice
In a study with mice, which received nonpsychotropic cultivars of cannabis investigators registered increased social interactions without influencing bodyweight and motility.
Division of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Italy.
Mastinu A, et al. Cannabis Cannabinoid Res. 2021 Aug 9. [in press]

Science/Human: First episodes of psychosis were associated with higher levels of tobacco, cannabis and cocaine use
In a large study patients with a first episode of psychosis “had significantly higher prevalence of tobacco, cannabis, and cocaine use than controls.”
Department of Psychiatry, University of Oviedo, Spain.
González-Blanco L, et al. Schizophr Res. 2021;236:19-28.

Science/Animal: Activation of the CB2 Receptor plays a protective role in sepsis
In a study with mice “CB2 receptors activation plays a protective role in sepsis through inhibition of pyroptosis. The effect of CB2 receptors against pyroptosis depends on the existence of endogenous CB2 receptors.”
Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China.
Zhang B, et al. Int Immunopharmacol. 2021;99:108038.

Science/Human: A new CBD preparation was safe and well tolerated in a pilot study
In a study with 12 healthy participants a spray of “a water-soluble nanoparticle CBD-dominant anti-inflammatory cannabis medicine” was safe and well tolerated. The maximum concentration of CBD for the low and high doses administered once per day occurred at 60 min for both concentrations. Investigators concluded that the “oro-buccal nanoparticle formulation achieved plasma concentrations that were largely comparable to other commercial and investigated formulations relative to the concentrations administered.”
Medlab Clinical Ltd, Alexandria, Australia.
Vitetta L, et al. Inflammopharmacology. 2021 Aug 6. [in press]

Science/Human: Cannabis use may be associated with an increased risk of intestinal obstruction in patients with diverticulitis
In a study with 48,214 patients with diverticulitis, 447 patients had a history of cannabis use. “After adjusting for age, sex, race, and the Charlson Comorbidity Index, cannabis use was an independent risk factor for intestinal obstruction in patients hospitalized with diverticulitis.”
Internal Medicine, Rutgers University, Newark, USA.
Rim D, et al. Cureus. 2021;13(7):e16768.

Science/Cells: The use of cannabidiol may be beneficial in dogs with cancer of the urinary system
In a study with cancer cells of the urinary system CBD (cannabidiol) showed “promising results as a single agent or in combination with mitoxantrone and vinblastine for treatment of canine urothelial carcinoma cells.”
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada.
Inkol JM, et al. PLoS One. 2021;16(8):e0255591.

Science/Human: In a study with people with cocaine use disorder CBD reduced inflammation
In a study with people suffering from cocaine use disorder, of whom half received a daily dose of 800 mg for 92 days and the other half a placebo blood analyses showed, that CBD has anti-inflammatory effects in this population.
Faculty of Medicine, Department of Psychiatry and Addictology, Université de Montréal, Canada.
Morissette F, et al. Neuropsychopharmacology. 2021 Jul 30. [in press]

Science/Human: Caffeine use during pregnancy may have similar negative effects as cannabis use on the exposed children
In a study with 9,978 children aged 9 to 11 years “the effect size for association of externalizing problems with prenatal caffeine exposure was comparable with that reported for prenatal alcohol (The American Journal of Psychiatry, 177, 2020 and 1060) and prenatal cannabis (JAMA Psychiatry, 78, 2020 and 64) exposures from previous ABCD publications.”
Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, USA.
Zhang R, et al. J Child Psychol Psychiatry. 2021 Jul 27. [in press]

Science: Delta-9-cis-tetrahydrocannabinol may be present in fibre hemp
While delta-9-trans-tetrahydrocannabinol, usually abbreviated as THC, is responsible for psychedelic effects in cannabis used for recreational and medicinal purposes it was long thought that the cis-isomer was not present in nature. Investigators now found delta-9-cis-tetrahydrocannabinol in samples of fibre hemp.
Laboratorium für Organische Chemie, ETH Zürich, Switzerland.Schafroth MA, et al. J Nat Prod. 2021 Jul 25. [in press]

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