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IACM-Bulletin of 29 August 2021

Science/Human: CBD may be helpful in the treatment of burnout and exhaustion according to an open study

According to an open study with 120 healthcare professionals suffering from burnout and exhaustion 300 mg of CBD in addition to standard medication improved treatment results. In this investigation by the Department of Neuroscience and Behavior of Ribeirão Preto Medical School at the University of São Paulo, Brazil, participants, who were exhausted due to the high workload during the Covid-19 pandemic either received 150 mg of CBD twice daily plus standard care (61 participants) or standard care (59 participants) alone for 28 days.

In the treatment arm, scores on the emotional exhaustion subscale of the Maslach Burnout Inventory significantly decreased at day 14 (mean difference, 4.14 points) and day 28 (mean difference, 4.01 points). However, 5 participants, all of whom were in the treatment group, experienced serious adverse events: 4 cases of elevated liver enzymes (1 critical and 3 mild)
and 1 case of severe pharmacodermia.

Crippa JAS, Zuardi AW, Guimarães FS, Campos AC, de Lima Osório F, Loureiro SR, Dos Santos RG, Souza JDS, Ushirohira JM, Pacheco JC, Ferreira RR, Mancini Costa KC, Scomparin DS, Scarante FF, Pires-Dos-Santos I, Mechoulam R, Kapczinski F, Fonseca BAL, Esposito DLA, Pereira-Lima K, Sen S, Andraus MH, Hallak JEC; Burnout and Distress Prevention With Cannabidiol in Front-line Health Care Workers Dealing With COVID-19 (BONSAI) Trial Investigators. Efficacy and Safety of Cannabidiol Plus Standard Care vs Standard Care Alone for the Treatment of Emotional Exhaustion and Burnout Among Frontline Health Care Workers During the COVID-19 Pandemic: A Randomized Clinical Trial. JAMA Netw Open. 2021;4(8):e2120603.

Science/Human: Oral cannabis preparations may be helpful in migraine according to a retrospective analysis

In a retrospective analysis of data from patients with chronic migraine, which received oral preparations from 3 strains of cannabis flowers, pain intensity decreased, while the number of migraine days did not change significantly. Patients received oral preparations from the cannabis strains FM2, Bedrocan or Bediol® daily up to 6 months. The analysis was conducted by investigators from the University of Modena and Reggio Emilia, Italy.

The number of migraine days didn’t change significantly after the 3rd and the 6th month when compared to baseline. The pain intensity, the acute medication consumption and the number of days per month in which patients took, at least, one acute medication, significantly decreased when compared to the baseline. No significant differences were found between patients who were still taking a preventive treatment for chronic migraine and those who weren’t. Different oral cannabinoid preparations displayed similar effectiveness.

Baraldi C, Lo Castro F, Negro A, Ferrari A, Cainazzo MM, Pani L, Guerzoni S. Oral cannabinoid preparations for the treatment of chronic migraine: a retrospective study. Pain Medicine. 2021 August 2021 [in press]

Science/Human: Cannabis may improve quality of life in pain patients

According to an analysis of all patients aged 18 years or older enrolled in the Pennsylvania medical marijuana program cannabis may improve quality of life in pain patients . The analysis included 353 people, of whom 51% responded to a total of 4 surveys, and was conducted by investigators of the Department of Pharmacy Practice and Pharmacy Administration at the University of the Sciences in Philadelphia, USA.

Quality of life increased significantly from survey 2 to survey 4 as did the self-reported pain and health scores. detailed analysis revealed no change in mobility or usual activities, significant improvement in anxiety and pain, and a significant worsening in self-care.

Peterson A, Dautrich T. Measuring the Change in Health-Related Quality of Life in Patients Using Marijuana for Pain Relief. Med Cannabis Cannabinoids. 2021 August 12. [in press]

News in brief

Europe/Germany: Cantourage and Drapalin import cannabis for medical use from South Africa and Jamaica
Cantourage brings the first medical cannabis flowers from Jamaica to the EURopean market. As of 19 August , Jamaican Lumir cannabis flowers are available in German pharmacies for the first time - providing a new, indica-dominant product to patients in Germany. Drapalin is the first EURopean wholesaler to import medicinal cannabis from Africa. The wholesaler from Munich now has the first EU-GMP compliant medical cannabis strain from Africa in its portfolio. The medicinal cannabis is produced in the landlocked South African state of Lesotho.
PR Newswire of 19 August 2021
Apotheke ADHOC of 6 August 2021

Science/Human: In US states with medical cannabis laws cigarette smoking decreased compared to
Data from 939,725 adolescents living in 46 states who participated in the Youth Risk Behavior Surveillance System between 1991-2015 showed, that cigarette initiation decreased in states with medical marijuana laws compared to states without such laws.
Cannabis Policy Research Center of Excellence, Research Department, Cannabis Control Commission, Commonwealth of Massachusetts
Johnson J, et al. Cannabis. 2021;4:1

Science/Human: Regular cannabis use is associated with minimal decrease of driving abilities
In a study with 24 occasional cannabis users (1 to 2 times per week), 31 daily users and 30 non-users who underwent tests in a driving simulator investigators “observed a decrement in driving performance assessed by SDLP [standard deviation of lateral placement] after acute cannabis smoking that was statistically significant only in the occasional users in comparison to the nonusers.”
Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, United States.
Brooks-Russell A, et al. Accid Anal Prev. 2021;160:106326.

Science/Human: Cannabis use may be associated with a higher risk of bleeding after percutaneous coronary interventions
According to a study with 113477 patients, who underwent percutaneous coronary interventions Cannabis use was associated with higher risk for cerebral vascular accidents and bleeding and lower risk for acute kidney injury.
Department of Internal Medicine, University of Michigan, USA.
Yoo SGK, et al. JACC Cardiovasc Interv. 2021;14(16):1757-1767.

Science/Human: Cannabis use is associated with a lower alcohol intake in heavy drinkers
In a study with 96 heavy alcohol drinkers Cannabis use was associated with lower days of heavy drinking.
Institute for Cognitive Science, University of Colorado Boulder, USA.
Karoly HC, et al. Addiction. 2021;116(9):2529-2537.

Science/Cells: THC may reduce toxicity to isolated mitochondria from the heart
In isolated mitochondria from heart cells THC was “not directly toxic in isolated cardiac mitochondria, and even may be helpful in reducing mitochondrial toxicity.”
Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Iran.
Salimi A, et al. Toxicol Mech Methods. 2021:1-21.

Science/Human: The number of cannabis users among war veterans is higher than in the general population
An estimated 11.9% of military veterans report using cannabis, 2.7% screened positive for cannabis use disorder and 1.5% possessed a medical cannabis card. Authors wrote that “veteran cannabis use may be increasing and is particularly prevalent among veterans with psychiatric conditions.”
Department of Psychiatry, University of California, San Diego, USA
Hill ML, et al. Addict Behav. 2021;120:106963.

Science/Animal: The bowel of horses contains a high number of cannabinoid receptors
Researchers showed, that the ileum of horses contains a high number of cannabinoid receptors, which may be of therapeutic importance in inflammation of the bowel of horses.
Department of Veterinary Medical Sciences (UNI EN ISO 9001:2008), University of Bologna, Italy.
Galiazzo G, et al. J Equine Vet Sci. 2021;104:103688.

Science/Human: An analysis of case reports on cannabis in cancer
A review of published case reports “provide insufficient data to support the claim for cannabis as an anticancer agent, and should not be used in place of evidence-based, traditional treatments outside of a clinical trial.”
The Cancer Research Center, HealthPartners/Park Nicollet, Minneapolis, Minnesota, USA.
Guggisberg J, et al. Cannabis Cannabinoid Res. 2021 Aug 7. [in press]

Science/Human: Danish patients, who received cannabis, are more satisfied with their treatment than controls
In a survey of Danish patients receiving medicinal cannabis those who received it were more satisfied with their treatment than were controls and scored lower on depression. Cases reported higher levels of pain than controls.
Copenhagen Research Center for Mental Health - CORE, Denmark.
Kudahl B, et al. Complement Ther Clin Pract. 2021;45:101476.

Science/Animal: Cannabis roots contain pain relieving compounds
In a study with mice and extract of cannabis roots showed pain relieving effects and antiasthmatic activity.
Universidade Federal Rural de Pernambuco- UFRPE, Brazil.
Menezes PMN, et al. J Ethnopharmacol. 2021;278:114259.

Science/Cells: Activation of the CB1 receptor may reduce inflammation of the muscles
Investigations with muscle cells showed that “cannabinoid CB1 receptors may be useful pharmaceutical targets in the treatment of inflammation and related disorders in skeletal muscle tissues.
Faculty of Pharmacy, Philadelphia University, Amman, Jordan.
Haddad M, et al. J Inflamm Res. 2021;14:3959-3967

Science/Animal: Hemp seed oil may reduce atherosclerosis by reducing vascular inflammation
In a study with genetically modified mice, which fastly develop atherosclerosis hemp seed oil showed anti-atherosclerotic effects by reducing inflammation and improving endothelial cell integrity.
College of Food Science and Engineering, Wuhan Polytechnic University, People's Republic of China.
Huang W, et al. J Agric Food Chem. 2021;69(32):9102-9110.

Science/Human: CBD may not reduce cocaine craving according to a placebo-controlled study
In a placebo-controlled study with 78 patients suffering from cocaine use disorder 800 mg of CBD did not really reduce cocaine craving or relapse.
Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada.
Mongeau-Pérusse V, et al. Addiction. 2021;116(9):2431-2442.

Science/Animal: Cannabigerolic acid may have antiepileptic properties
In a study with mice several cannabinoids, including CBGA (cannabigerolic acid) and CBDVA (cannabidivarinic acid) showed antiepileptic properties.
Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, New South Wales, Australia.
Anderson LL, et al. Br J Pharmacol. 2021 Aug 12. [in press]

Science/Human: CBD may have long-term beneficial effects on patients with Dravet syndrome
A long-term observation of 330 patients with treatment resistant Dravet syndrome, with a median treatment duration of 444 days “CBD treatment had an acceptable safety profile and led to sustained, clinically meaningful reductions in seizure frequency.”
University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.
Scheffer IE, et al. Epilepsia. 2021 Aug 18. [in press]

Science/Animal: The CB2 receptor may play a central role in ageing of the kidneys
In a study with mice researchers showed that the CB2 receptor plays an important role in dysfunction of the mitochondria and kidney ageing.
State Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Zhou S, et al. J Cell Mol Med. 2021 Aug 19. [in press]

Science/Human: Inhalation of dry CBD powder may considerably increase the bioavailability
In a study with healthy participants administration of CBD with a dry powder inhaler resulted in a 71-fold higher in blood compared to CBD after oral intake authors wrote that CBD administered by a dry-powder “provided more rapid onset and increased bioavailability than oral CBD.”
Department of Neurology, Comprehensive Epilepsy Center, New York University School of Medicine, New York.
Devinsky O, et al. J Pharm Sci. 2021:S0022-3549(21)00413-5.

Science/Human: Cannabis use by adults may not result in brain white matter changes
Results of a study with 39 regular cannabis users and 28 controls “suggest that long-term near-daily cannabis use does not necessarily affect white matter microstructure, but vulnerability may be higher during adolescence.”
Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Netherlands.
Cousijn J, et al. Addict Biol. 2021:e13081

Science/Animal: CBD may reduce side effects of the antipsychotic medication haloperidol
Results of a study with mice suggest “that CBD could attenuate haloperidol-induced orofacial dyskinesia and improve non-motor symptoms.” The effects may be mediated by the activation of PPAR-Gamma receptors.
Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Sonego AB, et al. Prog Neuropsychopharmacol Biol Psychiatry. 2021;111:110367.

Science/Animal: CBD may reduce consequences of traumatic brain injury
Results of a study with animals suggest that “dual therapy by targeting the site of injury internally with a CBD-infused medical carrier followed by systemic supplementation may offer a more effective countermeasure than systemic or implant treatment alone for the deleterious effects of penetrating head wounds.”
Department of Cell Biology & Anatomy, New York Medical College, Valhalla, USA.
Friedman LK, et al. Exp Neurol. 2021:113844

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