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IACM-Bulletin of 22 May 2022

Science/Human: Cannabis may be helpful against cancer pain according to an open study

In an open study with 24 cancer patients, who received capsules with traditional cannabis leaves powder, investigators observed improvements in pain and quality of life. It was conducted by the Department of Dravyaguna of GJ Patel Institute of Ayurvedic Studies and Research in New Vallabhvidyanagar of the state of Gujarat, India. Participants received the powder in a dose of 250 mg thrice daily and 50 mL of cow’s milk and 4 g of crystal sugar for 4 weeks.

There was a significant reduction in pain on the 3 tested pain scales and an improvement on a scale measuring anxiety and depression as well as an improvement in quality of life. Authors concluded that “Jalaprakshalana Shodhita Bhanga powder in a dose of 250 mg thrice per day relieves cancer induced pain, anxiety and depression significantly and does not cause any major adverse effect and withdrawal symptoms during trial period.”

Tavhare SD, Acharya R, Reddy RG, Dhiman KS. Management of chronic pain with Jalaprakshalana (water-wash) Shodhita (processed) Bhanga (Cannabis sativa L.) in cancer patients with deprived quality of life: An open-label single arm clinical trial. Ayu. 2019;40(1):34-43.

Science/Human: Cannabis may improve anxiety and depression according to retrospective study

According to a retrospective study with 7362 patients the use of cannabis improved anxiety and depression over time. The study was conducted by investigators of Harvest Medicine in Calgary, Canada. Patients included in the study were at least 18 years of age with completed validated questionnaires for anxiety and depression at their initial evaluation and at least one follow-up visit.

There were statistically significant improvements between baseline and follow-up scores for both questionnaires with larger improvements seen for patients who were actively seeking medical cannabis to treat anxiety or depression. From 12 months on, those reporting anxiety had an average decrease in anxiety scores that was greater than the minimum clinically important difference of 4, and the same was seen for patients reporting depression from 18 months on, with the average decrease in depression scores more than the minimum clinically important difference of 5. Authors concluded that this “study provides some evidence to support the effectiveness of medical cannabis as a treatment for anxiety and depression.”

Sachedin F, Chan C, Damji RS, de Sanctis OJ. Medical cannabis use in Canada and its impact on anxiety and depression: A retrospective study. Psychiatry Res 2022;313:114573.

Science/Human: CBD cream may be helpful in psoriasis

According to a placebo-controlled study with 51 patients suffering from mild plaques-type psoriasis the use of an ointment with 2.5% CBD reduced symptoms. The study was conducted by investigators of the Division of Dermatology of the Faculty of Medicine of Chulalongkorn University in Bangkok, Thailand, and other Thai universities. The CBD cream and the placebo were applied twice a day.

Skin regions treated with CBD showed significant improvements compared to areas treated with the placebo. Authors concluded that these “results indicated a trend of favorable response in the treatment with CBD, which has emerged as a therapeutic option for psoriasis.”

Puaratanaarunkon T, Sittisaksomjai S, Sivapornpan N, Pongcharoen P, Chakkavittumrong P, Ingkaninan K, Temkitthawon P, Promgool T, Waranuch N, Asawanonda P. Topical cannabidiol-based treatment for psoriasis: A dual-centre randomized placebo-controlled study. J EUR Acad Dermatol Venereol. 2022 May 10. [in press]

Science/Human: Cannabis preparations may be helpful in Parkinson’s disease

According to an anonymous survey with 1881 people with Parkinson’s disease different cannabis preparations improved symptoms. The study was conducted by investigators of the Department of Neurology of the University of Colorado Anschutz Medical Campus Aurora, USA.

73.0% of respondents reported medicinal use, though 30.8% did not inform their doctor. 54.6% took higher CBD, 30.2% higher THC, and 15.2% took products with similar amounts of THC and CBD. Most common use was oral administration, once daily, for less than six months. Frequent improvements were reported for pain, anxiety, agitation, and sleep. Higher THC users reported more frequent improvements in depression, anxiety, and tremor, and more frequent worsening in dry mouth than with other products.

Holden SK, Domen CH, Sillau S, Liu Y, Leehey MA. Higher Risk, Higher Reward? Self-Reported Effects of Real-World Cannabis Use in Parkinson's Disease. Mov Disord Clin Pract. 2022;9(3):340-350.

Science/Human: Cannabis may be helpful in sleeping disorders according to small study

In a retrospective analysis of 38 patients, who used cannabis for sleeping disorders, about 70% reported an improvement. The study was conducted by investigators of the Department of Pharmacy, Children's Hospital of Eastern Ontario in Ottawa, Canada.

At time of data collection, 15 patients (39%) were able to reduce or completely discontinue a prescription medication indicated for sleep. On follow-up, 27 patients (71%) reported a subjective improvement in their sleep or related condition. Only 8 patients (21%) reported any adverse effects from medical cannabis use.

Vaillancourt R, Gallagher S, Cameron JD, Dhalla R. Cannabis use in patients with insomnia and sleep disorders: Retrospective chart review. Can Pharm J (Ott). 2022;155(3):175-180.

Science/Human: Cannabis users with traumatic brain injury were at lesser risk for stroke than non-users

The American College of Surgeons Trauma Quality Improvement Program was used to identify adult patients with severe traumatic brain injury in the year 2017. A total of 13,266 patients met inclusion criteria, of which 1669 were positive on THC. A total of 1377 THC positive patients were matched to 1377 THC negative patients. Data were analysed by investigators of the Department of Surgery of Tulane University School of Medicine New Orleans, USA.

No significant differences were found in in-hospital outcomes, including mortality, length of stay, cardiac arrest, pulmonary embolism, deep vein thrombosis, or acute respiratory distress syndrome.
THC positive patients had significantly decreased rates of haemorrhagic stroke.

Ali A, Tatum D, Olubowale OO, McGrew PR, Duchesne J, Taghavi S. Thromboembolic Outcomes in Tetrahydrocannabinol-Positive Trauma Patients With Traumatic Brain Injury. J Surg Res. 2022;275:194-202.

Science/Human: Cannabis may be helpful for the treatment of nausea during pregnancy

According to a survey with 550 women suffering from hyperemesis gravidarum (severe nausea during pregnancy) cannabis may reduce symptoms. 84% experienced weight loss during pregnancy; 96% reported using prescription antiemetics and 14% reported cannabis use against nausea. The survey was conducted by investigators of the Hyperemesis Education and Research Foundation, Clackamas, USA.

Most respondents reported using cannabis (71%) because their prescribed antiemetics were self-reported to be ineffective. More than half of cannabis users reported using products daily or multiple times per day (53%), primarily via smoke inhalation (59%), and mainly either THC only or THC dominant preparations were preferred. 82% of cannabis users reported symptom relief, compared to 60% of prescription antiemetic users.

First OK, MacGibbon KW, Cahill CM, Cooper ZD, Gelberg L, Cortessis VK, Mullin PM, Fejzo MS. Patterns of Use and Self-reported Effectiveness of Cannabis for Hyperemesis Gravidarum. Geburtshilfe Frauenheilkd. 2022;82(5):517-527.

Science/Human: The legalisation of cannabis in the state of Washington was associated with reduced use of alcohol and tobacco in youth

According to an analysis of 6 annual waves of cross-sectional survey data from a state-wide sample from 2014 through 2019 with 12,694 young people there was a decline in alcohol and tobacco use after legalisation. The investigation was conducted by researchers of the Department of Psychiatry and Behavioral Sciences, University of Washington in Seattle USA.

Prevalence of past-month alcohol use, heavy episodic drinking, and cigarette use and prevalence of past-year pain reliever misuse decreased, while the prevalence of past-month e-cigarette use increased since 2016. Authors wrote that “contrary to concerns about spillover effects, implementation of legalized nonmedical cannabis coincided with decreases in alcohol and cigarette use and pain reliever misuse.

Fleming CB, Ramirez JJ, Rhew IC, Hultgren BA, Hanson KG, Larimer ME, Dilley JA, Kilmer JR, Guttmannova K. Trends in Alcohol, Cigarette, E-Cigarette, and Nonprescribed Pain Reliever Use Among Young Adults in Washington State After Legalization of Nonmedical Cannabis. J Adolesc Health. 2022 May 9:S1054-139X(22)00374-3.

Science/Human: Many patients with upper extremity conditions use cannabis in Canada

In 2018, investigators of the Department of Orthopedic Surgery of the University of Saskatchewan, Canada, conducted a survey of 1561 patients with upper extremity conditions at 7 surgical centres. Participants were asked whether they currently use cannabis. If yes, they were asked questions regarding usage patterns.

In the 6 months after legalization, 790 (51%) participants felt that cannabis was safer than prescription narcotics, with 450 (29%) currently using cannabis. Reasons for cannabis use included pain (56%), stress (51%) and recreation (42%). Of the 1105 patients not using cannabis, 267 (24%) were more likely to consider it after legalization.

Sims L, Goetz T, White N, Badre A, Grammon B, Trenholm A, Strelzow J, Grewal R, Wrist Evaluation Canada. Cannabis use patterns among patients with upper extremity conditions at the time of legalization in Canada. Can J Surg. 2022;65(3):E335-E341.

News in brief

Thailand: The government will give away 1 million cannabis plants to its citizens for free
Starting 9 June, growing cannabis as a “household crop” will become legal in Thailand as long as it is used for “medicinal purposes,” according to CNN. Citizens can also grow the plant as a “small-scale commercial enterprise.” The Thai government will distribute cannabis plants to mark this lifting of restrictions on owning and growing cannabis, Public Health Minister Anutin Charnvirakul announced.
Desert News of 17 May 2022.

Spain: The legalisation of medical cannabis is advancing in the country
The Subcommission in the Health and Consumer Commission had its fifth and last session, meaning that it is in "sentencing status." Now, after listening to the presentations of 23 experts (for and against legalization in Spain) and analysing the experience of other EURopean Union countries with cannabis, the deputies will have to debate the information received and make a proposal to regulate medical cannabis before the end of June. Carola Pérez, president of the Spanish Observatory of Medical Cannabis (OECM), as Speaker of the IACM Patient Council declared: "Patients have to be in the hands of the State and doctors, not narcos".
El Planteo of 10 May 2022

Science/Cells: CBD extracts show antibacterial activity against salmonella
A new study found antibacterial activity of CBD against Salmonella newington and S. typhimurium exposure through biological assays, bacterial kinetics, and fluorescence microscopy.
The Microbiology Program, College of Science, Technology, Engineering, and Mathematics (C-STEM), Alabama State University, Montgomery, USA.
Gildea L, et al. Molecules. 2022;27(9):2669.

Science/Cells: THC and CBD alleviate cytokine storm inflammation
New research revealed that CBD and, for the first time, THC significantly inhibited inflammation by the reduction in the levels of IL-1 beta in macrophages (a form of white blood cells) and human bronchial epithelial cells. CBD and THC significantly diminished the levels of the pro-inflammatory cytokines IL-6, IL-8, and tumour necrosis factor-α (TNF-α) after LPS treatment in these cells.
Department of Biological Sciences, University of Lethbridge, Canada.
Suryavanshi SV, et al. Cells. 2022;11(9):1391.

Science/Human: Cannabis use during pregnancy had no negative effects on mothers and new-borns
In a study with 11,825 deliveries their cannabis use was not associated with adverse outcomes in mothers and their new-borns.
Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, USA.
Greiner KS, et al. J Matern Fetal Neonatal Med. 2022;35(12):2286-2293.

Science/Human: About 9% of Canadians cultivate cannabis at home
According to a survey of more than 10,000 Canadian cannabis users almost one in ten Canadian cannabis consumers reported home cultivation of cannabis in 2020, with modest increases following legalization and most growing within the non-medical limit of four plants. Home cultivation was less common in provinces where home cultivation was prohibited.
School of Public Health Sciences, University of Waterloo, Canada.
Wadsworth E, et al. Addict Behav Rep. 2022;15:100423.

Science: Many CBD effects involve the transient receptor potential channels (vanilloid receptors)
A review shows that transient receptor potential channels, also called vanilloid receptors, mediate, at least in part, the effects of CBD on seizure, inflammation, cancer, pain, acne, and relaxation of blood vessels.
Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
Etemad L, et al. Life Sci. 2022 Jul 1;300:120582. [in press]

Science/Human: The endocannabinoid system plays a role in taste dysfunctions of patients with Alzheimer’s disease
New research results with patients showed that volumetric changes occur in the brain regions associated with smell and taste in Alzheimer's and Parkinson's patients. It was observed that endocannabinoids played a role in these volumetric changes and the olfactory and taste dysfunctions of the patients.
Department of Anatomy, Faculty of Medicine, Kastamonu University, Kastamonu, Turkey.
Petekkaya E, et al. J Clin Neurosci. 2022;100:52-58.

Science/Animal: CBD and THCV protect against peripheral neuropathy caused by paclitaxel
The plant cannabinoids CBD (cannabidiol) and THCV (tetrahydrocannabivarin) protect against peripheral neuropathy and pain caused by the chemotherapeutic agent paclitaxel in a study with rats.
College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, USA.
Kumar Kalvala A, et al. Int Immunopharmacol. 2022 Jun;107:108693. [in press]

Science: Interactions between methylphenidate and cannabinoids
THC and CBD may have a small effect on the degradation of methylphenidate and thus increase its effects
University of Florida, USA.
Qian Y, et al. Drug Metab Dispos. 2022:DMD-AR-2021-000823.

Science/Human: CBD had no effect on functional dyspepsia in a placebo-controlled study
In a placebo-controlled study CBD in a dose of 20 mg per kilogram bodyweight had no effect on functional dyspepsia.
Clinical Enteric Neuroscience and Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, USA.
Atieh J, et al. Am J Gastroenterol. 2022 May 9. [in press].

Science: CBD had no effect on arthritis in a placebo-controlled trial
In a placebo-controlled trial CBD in a dose of 20 to 30 mg per day had no effect on hand osteoarthritis and psoriatic arthritis.
Department of Rheumatology, Aalborg University Hospital, Denmark.
Vela J, et al. Pain. 2022;163(6):1206-1214.

Science/Animal: Activation of the cannabinoid receptor GPR55 may reduce inflammation of the brain and depression
The onset of depression is usually accompanied by neuroinflammation and impaired adult neurogenesis. Activation of the GPR55 receptor is associated with neuroprotective anti-inflammatory effects and “could be a potential treatment for depression.”
Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, China.
Shen SY, et al. Neurobiol Dis. 2022 Jul;169:105743. [in press]

Science/Human: Heavy and chronic cannabis use does not impair motor function
According to a study with 23 cannabis users with low, moderate and heavy use, cannabis use was not associated with brain motor function.
Department of Biophysics and Clinical MRI Methods, Faculty of Medicine of Fez, Morocco.
Boujraf S, et al. CNS Neurol Disord Drug Targets. 2022 May 16. [in press]

Science/Human: Learned threats are associated with increased blood levels of endocannabinoids
In a study with healthy volunteers investigators demonstrated that during acquisition of threat responses the level of the endocannabinoid anandamide is increased in blood.
Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Weisser S, et al. Neuropsychopharmacology. 2022 May 13. [in press]

Science/Human: Activation of the cannabinoid 1-receptor may prevent from adverse effects of methamphetamine
In a study with rats activation of the CB1-receptor prevented from adverse effects of high doses of methamphetamine on cognition and social behaviour.
Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Iran.
Khodamoradi M, et al. Neurosci Lett. 2022;779:136634.

Science/Cells: CBD may increase the activity of the immune system against the new coronavirus
Research with human cells shows, that “CBD may prime components of the innate immune system, increasing readiness to respond to RNA-type viral infection without activating apoptosis, and could be studied for potential in prophylaxis.”
University of Waterloo, Department of Kinesiology and Health Sciences, Faculty of Health, Waterloo, Canada.
Fernandes MF, et al. Life Sci. 2022;301:120624.

Science/Human: CBD did not improve treatment results in patients with anxiety disorders
In a placebo-controlled trial with 80 patients a daily dose of 300 mg oral CBD did not improve treatment outcomes in patients with anxiety disorders.
Department of Experimental Psychology and Helmholtz Institute, Faculty of Social and Behavioural Sciences, Utrecht University, Netherlands.
Kwee CM, et al. EUR Neuropsychopharmacol. 2022;59:58-67.

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