-------------------------------------------------------- IACM-Bulletin of 7 January 2001 -------------------------------------------------------- * Switzerland: Study with cannabis in MS patients will be completed in spring * USA: Unimed Pharmaceuticals to be sole marketer of Marinol 1. Switzerland: Study with cannabis in MS patients will be completed in spring At the "Berner Klinik" in Montana a clinical study with anticipated 50 MS patients is conducted under the guidance of Dr. Claude Vaney, head physician of the hospital. The majority of patients have already been included in the study that is intended to be completed in spring 2001. According to a double-blind design participants get both a capsulated cannabis extract standardized on THC and placebo capsules within the four weeks of the study. Participants suffer from confirmed multiple sclerosis with relevant spasticity, that cannot sufficiently be influenced by conventional medication such as baclofen or tizanidin. Besides testing the efficacy of the cannabis extract on spasticity and pain it is intended to find out the most efficient doses. Several tests measuring motor abilities are performed and psychotropic effects, concentration ability and eyesight are recorded. (Sources: Interview with C. Vaney at www.ms-forum.ch; personal communication M. Schnelle) 2. USA: Unimed Pharmaceuticals to be sole marketer of Marinol On 2 January Unimed Pharmaceuticals, Inc. announced that effective January 1, 2001, it has become solely responsible for the marketing of Marinol capsules. Marinol(R) is the only approved synthetic form of delta-9-tetrahydrocannabinol (THC). Marinol was first brought onto the market in 1987 for the treatment of cancer chemotherapy induced nausea and vomiting. In 1992, Marinol was approved for the treatment of appetite loss and weight loss in AIDS patients. Roxane Laboratories launched Marinol in 1987. In 1992, Unimed and Roxane Laboratories started co-promoting Marinol in the United States. The co-marketing arrangement ended on 31 December 2000. Unimed Pharmaceuticals, Inc., based in the Chicago, Illinois area is a wholly owned, independently operated subsidiary of Solvay Pharmaceuticals. Solvay Pharmaceuticals, Inc. of Marietta, Georgia, is a member of the worldwide Solvay Group of chemical and pharmaceutical companies, headquartered in Brussels, Belgium. (Source: PR Newswire of 2 January 2001) 3. News in brief ***USA: The New Mexico's Drug Policy Advisory Group on 4 January released a report outlining reforms to current state and federal drug policy. It recommends allowing the use of marijuana to treat pain and suffering associated with serious illnesses and removing criminal penalties for those caught with small amounts of marijuana for personal use. The report will be reviewed by New Mexico Governor Gary Johnson. State Health Secretary Alex Valdez, a member of the panel, said medical marijuana "is a compassionate tool which can help people alleviate pain and suffering." (Source: Associated Press of 5 January 2001) ***USA: A team of Nevada doctors and pharmacists has recommended that the state conduct research to determine if marijuana is effective in treating ailments such as cancer, AIDS or glaucoma. The group said the research program would allow the state to avoid a confrontation with the federal government. The recommendations are contained in the final report released on 26 December by the Nevada Medical Marijuana Initiative Work Group, formed last year after Nevada voters in 1998 passed a ballot initiative to allow medical use of marijuana. (Source: Las Vegas Review-Journal of 27 December 2000) 4. ONE YEAR AGO: - Spain: Acquittal due to medical use of hashish - Australia: Judge accepted cannabis as painkiller TWO YEARS AGO: - UK: First legal harvest of marijuana for medical use - Science: Research on the properties of endocannabinoids to reduce blood pressure - -------------------------------------------------------- IACM-Bulletin of 21 January 2001 -------------------------------------------------------- * Belgium: Legalization of cannabis for personal use * Science: Study shows vaporizers reduce toxins in cannabis smoke * Science: Clinical trial with MS patients started in the UK 1. Belgium: Legalization of cannabis for personal use Belgium's government effectively decriminalized the possession of cannabis for personal use on 19 January. The legislation is expected to be approved by parliament early this year. Prime Minister Guy Verhofstadt said a royal decree would be issued instructing prosecutors not to pursue people for possession. The production, supply, sale and ownership of larger quantities will remain actively prosecuted, as will the use of cannabis which leads to unsociable behaviour. "We are not penalizing individual users of cannabis, but we are concentrating on production, distribution or problematic use," he told reporters. "The criminal judge won't interfere any more in lives of people who use cannabis on a personal basis and who do not create harm or do not become dependent," Health Minister Magda Alvoet said. The new regulations would bring Belgium in line with Italy, Spain and Portugal, which are all easing their regulations on the personal use of cannabis. The new regulations treat cannabis on a par with alcohol and nicotine in terms of the health risks it poses. The royal decree which will formalize the announcement will not contain any indication of what quantities of cannabis are considered for personal use. (Sources: AP of 19 January 2001, Reuters of 19 January 2001) 2. Science: Study shows vaporizers reduce toxins in cannabis smoke Medical marijuana patients may be able to protect themselves from harmful toxins in marijuana smoke by inhaling their medicine using an electric vaporizer, according to initial results of a study by California NORML (National Organization for the Reform of Marijuana Laws) and MAPS (Multidisciplinary Association for Psychedelic Studies). The study showed that it is possible to vaporize medically active THC by heating marijuana to a temperature short of the point of combustion, thereby eliminating or substantially reducing harmful toxins that are normally present in marijuana smoke. The tested vaporizer produced THC at a temperature of 185° Celsius (365° Fahrenheit) while completely eliminating three measured toxins (benzene, toluene and naphthalene). Carbon monoxide and smoke tars were both qualitatively reduced by the vaporizer, but additional testing is needed to quantify the extent of the decrease. Significant amounts of benzene began to appear at temperatures of 200° C (392° F), while combustion occurred around 230° C (446° F) or above. Traces of THC were in evidence as low as 140° C (284° F). (Source: California NORML of 7 January 2001) 3. Science: Clinical trial with MS patients started in the UK Participants in a clinical trial in Great Britain looking at the effects of cannabis on multiple sclerosis sufferers have been given their first dose of the drug. Twenty patients have begun the tests at Derriford Hospital in Plymouth. The 20 patients are part of the initial stage of the three-year study. A third gets capsules containing cannabis oil, another third gets THC, and the rest gets a placebo. The 20 MS sufferers will be closely monitored over the next three months before the study is rolled across the country to include 660 participants in 40 different centres. The cannabis oil is being produced in Switzerland especially for the trials. Participants will be started off on low doses, which will be gradually increased week by week. (Source: PA News of 18 January 2001) 4. News in brief ***Cameroon: Cameroon, a major cannabis grower, is to allow people suffering from HIV/AIDS and cancer to use the drug. But the drug is to be imported from Canada. This decision of the government is being criticized by people who claim the drug should to be cultivated in Cameroon. The Health Ministry should supervise the cultivation and so control the amount grown and provided to the hospitals. But law enforcement officers believe the cultivation of cannabis that promotes uncontrolled consumption. (Source: BBC News of 8 January 2001) ***USA: Bills allowing for the medical use of marijuana have been introduced in the House of Representatives in the states of Texas and Connecticut. Bill 513 in Texas would protect against prosecution for the use of marijuana for patients who have a recommendation from a licensed physician. Bill 5666 of Connecticut would establish a state registry of patients with a doctor's recommendation. (Source: NORML of 18. January 2001) ***Science: On 10 January Pharmos Corporation announced that its clinical phase III trial of dexanabinol for severe traumatic brain injury has commenced in Europe. Approximately 40 centres in Europe and 30 in the U.S. are expected to participate in the study. European countries participating in the study include Finland, France, Germany, the Netherlands, Italy, Spain, Belgium and the U.K., along with Israel. The Company expects total study enrolment of about 860 patients. Dexanabinol is a non-psychotropic derivative of THC. (Source: PR Newswire of 10 January 2001) ***USA: Nevada state officials try to limit a voter-endorsed initiative in November 2000 allowing use of marijuana by cancer, AIDS and glaucoma victims. According to the voters decision the legislature has to set up a distribution method so people with such medical conditions can use marijuana therapeutically. But a task force of medical experts instead recommended a research program to permit limited marijuana distribution and avoid a confrontation with the federal government's anti-marijuana laws. (Source: Associated Press of 11 January 2001) ***USA: The DEA (Drug Enforcement Administration) has now officially announced that it intends to ban most hemp products in the United States, including food made from sterile (non-psychoactive) hemp seeds and hemp-based personal-care products such as shampoo. More at: www.SaveHemp.org. (Source: Coalition to Save Hemp) 5. ONE YEAR AGO: - USA: Development of a cannabinoid patch funded by cancer society - Malta: Cancer patient avoids jail for growing cannabis TWO YEARS AGO: - Germany: New dronabinol/THC preparation of THC Pharm -------------------------------------------------------- IACM-Bulletin of 4 February 2001 -------------------------------------------------------- * Science: First issue of the Journal of Cannabis Therapeutics * Spain: Cancer patients demand medical use of marijuana * USA: Bills for medical use of cannabis in several states 1. Science: First issue of the Journal of Cannabis Therapeutics The first issue of the Journal of Cannabis Therapeutics has been released. Excerpts from the abstracts: (1) Hollister L: Marijuana (cannabis) as medicine. JCT 2001;1(1):5-27. "The modern published literature on the therapeutic potential of cannabis has been reviewed. (...) Marinol or dronabinol, is available for treating nausea and vomiting associated with cancer chemotherapy and as an adjunct to weight loss in patients with wasting syndrome associated with AIDS. Although such approval currently applies only to orally administered THC, for practical purposes smoked marijuana should also be expected to be equally effective. Promising leads, also often fragile, suggest possible uses for treating chronic pain syndromes, neurological disease with spasticity and other causes of weight loss. These indications require more study." (2) Musty RE, Rossi R: Effects of smoked cannabis and oral delta-9-tetrahydrocannabinol on nausea and emesis after cancer chemotherapy: An review of state clinical trials. JCT 2001;1(1):29-42. "(...) Method: Technical reports were obtained from 6 states which had conducted clinical trials. Each protocol was examined for the procedure used, the experimental design of the clinical trial and the results obtained. Data were available on 748 patients who smoked marijuana to and/or after cancer chemotherapy and 345 patients who used the oral THC capsule. Results: Patients who smoked marijuana experienced 70-100% relief from nausea and vomiting, while those who used the THC capsule experienced 76-88% relief. (...)" (3) Lozano I: The therapeutic use of Cannabis sativa (L.) in Arabic medicine. JCT 2001;1(1):63-70. "Arabic scientists were several centuries ahead of our current knowledge of the curative power of hemp (Cannabis sativa L., Cannabaceae). (...) We review in this paper the therapeutic uses of the plant in Arabic medicine from the 8th to the 18th century. Arab physicians knew and used its diuretic, anti-emetic, anti-epileptic, anti-inflammatory, painkilling and antipyretic properties, among others." More articles by Vincenzo Di Marzo, John McPartland, Ethan Russo, Jacques-Joseph Moreau de Tours (translation from French by Ethan Russo), and Jon Gettman. This first issue of the Journal of Cannabis Therapeutics is available at no charge to anyone requesting a copy. Requests should be sent to: Print Journal Division - Sample Copies The Haworth Press, Inc. 10 Alice Street Binghamton, NY 13904-1580 USA 2. Spain: Cancer patients demand medical use of marijuana Agata, an organization in Catalonia that supports breast cancer patients, demands legal access to marijuana for patients suffering from side effects of chemotherapy. The group obtained support by all political parties of Catalonia and the Catalan Health Council for a request to the government. The final decision has to be made by the Spanish Health Minister. Agata also met with the Catalan Cancer Institute and various public hospitals of Catalonia. A speaker of Agata said: "Most of the physicians are aware of the cannabis effects and do not oppose its consumption, if patients get the drug for themselves." In Spain, the sale of marijuana is illegal but the law does not punish personal use. According to Agata the medical use of cannabis should be legalized as well. "We do not want therapeutic use to be a privilege of informed women, but we want a medical improvement available for everybody," the group said. (Sources: La Vanguardia Digital of 27 January 2001, El Periódico de Barcelona of 27 January 2001) 3. USA: Bills for medical use of cannabis in several states NEW MEXICO: Governor Gary Johnson now has some support among Republicans and Democrats to change the state's drug laws. A bill was introduced in the Senate and in the House of Representatives, that would allow seriously ill patients to use marijuana as a medicine. The bill calls on the state Health Department to register patients who could qualify for help and to control how they get marijuana. Patients could grow their own marijuana plants at home. (Source: Albuquerque Tribune of 31 January 2001) SOUTH DAKOTA: Legislators said no to a bill that would allow the medical use of marijuana. Senators said marijuana as a medicine is worth investigating. However, federal laws and problems for state law enforcement make passage of such a bill difficult. (Source: Pierre Capital Journal of 24 January 2001) WYOMING: The Senate Judiciary Committee has voted against a bill that would have allowed the medical use of marijuana. The committee voted 3-1 on 24 January against the measure sponsored by Senator Keith Goodenough. Goodenough said this is probably the fifth time he has proposed allowing medical use of marijuana, failing each time. (Source: Casper Star-Tribune of 25 January 2001) TEXAS: Terry Keel, member of the house of Representatives and a former Travis County prosecutor and sheriff, has filed a bill allowing a defendant charged with marijuana possession to claim as a defence that the drug was recommended by a physician for treatment of a medical condition. The burden of proof would be on the defendant. It does not decriminalize the drug and avoids conflicting with federal laws banning use of the drug. Although doctors still cannot prescribe marijuana, they sometimes recommend it. (Source: Austin American-Statesman of 2 February 2001) 4. News in brief: ***Germany: Marion Caspers-Merk (Social Democratic Party) will follow Christa Nickels (Green Party) as Drugs Commissioner of the Government. This change followed the resignation of Health Minister Andrea Fischer (Green Party) and the inauguration of Ulla Schmidt (Social Democrats) as the new Health Minister. Nickels was a strong supporter of the medical use of cannabis. (Source: Press release of the Federal Health Ministry of 31 January 2001) ***World: The World Drug Report 2000 released by the Vienna-based Office for Drug Control and Crime Prevention of the United Nations estimates that roughly 180 million people, or 4.2 percent of the world's population aged 15 and over, consumed illegal drugs in the late 1990s. There were about 144 million users of cannabis, followed by amphetamine-type stimulants (29 million), cocaine (14 million) and opiates (13.5 million). (Source: Reuters of 22 January 2001) 5. ONE YEAR AGO: - Canada: Judge orders discharge on marijuana trafficking case - UK: Government on odds over cannabis TWO YEARS AGO: - USA/California: Still confusion about how to implement Proposition 215 http://www.cannabis-med.org (The old addresses will continue to work.) -------------------------------------------------------- IACM-Bulletin of 18 February 2001 -------------------------------------------------------- * Science: Endocannabinoids play an important role in circuits responsible for vomiting 1. Science: Endocannabinoids play an important role in circuits responsible for vomiting Endogenous cannabinoids produced by the human body play an important role in emetic circuits of the brain. This is the conclusion of a study by researchers of the Department of Pharmacology, Kirksville College of Osteopathic (Missouri/USA), published in the February issue of Neuropsychopharmacology. In an animal model of vomiting with shrews they investigated the mechanism of antiemetic action of cannabinoids. Since cannabinoids that bind to cannabinoid receptors prevent vomiting, it was hypothesized that blockade of either the cannabinoid CB1 receptor or the cannabinoid CB2 receptor would induce vomiting. Indeed the CB1 receptor antagonist SR 141716A caused emesis and both the frequency of emesis and the percentage of animals vomiting increased with increasing doses. A CB2 receptor antagonist was without effect. These results suggest that the antiemetic activity of THC reside in its ability to stimulate the CB1 receptor. Furthermore endogenous cannabinoids seem to play an important role in circuits that are responsible for vomiting. (Source: Darmani NA. Delta-9-tetrahydrocannabinol and synthetic cannabinoids prevent emesis produced by the cannabinoid CB(1) receptor antagonist/inverse agonist SR 141716A. Neuropsychopharmacology 2001;24(2):198-203.) 2. News in brief ***Science: In eight glaucoma patients resistant to conventional therapies the synthetic cannabinoid WIN55212-2 decreased the intraocular pressure between about 20 and 30%. These data confirm that CB1 receptors have direct involvement in the regulation of human intraocular pressure. (Source: Porcella A, et al. Eur J Neurosci 2001;13(2):409-412. ***USA: The legislature of the state of Maryland will debate whether to legalize marijuana for therapeutic uses. Patients would be allowed to possess up to seven plants and one ounce of usable marijuana. Twenty-nine delegates, including nine Republicans, have signed on to the bill, which has a hearing scheduled for 1 March. Marijuana Policy Project Executive Director Robert Kampia says that of 25 states considering legalizing marijuana for medicinal use this year, Maryland is among the three most likely to approve it. (Sources: Washington Times of 9 February 2001, NORML of 15 February 2001) ***Science: THC increases sexual desire in female rats. The effect of THC was inhibited by antagonists to both progesterone and dopamine D1 receptors. The studies indicate that THC acts on the CB1 cannabinoid receptor, therewith initiating a signal transduction response that requires both membrane dopamine and intracellular progesterone receptors for effective induction of sexual behaviour. (Source: Mani SK, et al. Proc Natl Acad Sci U S A. 2001;98(3):1249-1254.) ***Switzerland: 53 percent of the Swiss favour legalization of use and possession of cannabis. This figure was released on 15 February by the private Swiss Institute for Alcohol and other Drug Problems. In the survey of 1,600 people between the ages of 15 and 74, 27 percent said they had used cannabis at least once in their life. About 1.2 percent said they used it daily. Five percent of people between 20 and 25 years of age reported daily use. (Source: Associated Press of 15 February 2001) ***Science: A new study contradicts the idea that marijuana is a "gateway" to harder drug use, saying that appears to have been true only for the baby boom generation peaking around 1960. Writing in February's issue of the American Journal of Public Health, Andrew Golub and Bruce Johnson of the National Development and Research Institutes in New York said young people who smoked marijuana in the generations before and after the baby boomers do not appear necessarily likely to go on to use harder drugs. The researchers said these findings suggest that the gateway phenomenon reflects norms prevailing among youths at a specific place and time. (Source: Xinhua News Agency of 5 February 2001) 3. ONE YEAR AGO: - Germany: Constitutional Court does not accept complaints of eight patients - Canada: Medical marijuana club raided - Canada/USA: Canadian court orders Renee Boje surrendered for extradition TWO YEARS AGO: - USA: AIDS groups urge U.S. to approve the medical use of marijuana ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 4 March 2001 -------------------------------------------------------- * Science: Four studies to be conducted by a university research centre in California * Science: Big pharmaceutical companies get interested in cannabinoid-based medicines 1. Science: Four studies to be conducted by a university research centre in California The Center for Medicinal Cannabis Research in La Jolla - a collaboration between the campuses of the University of California in San Diego and San Francisco - announced on 22 February that it will spend about 841,000 U.S. dollars this year on four studies with cannabis. In two independent studies, researchers in both San Francisco and San Diego will investigate whether smoking marijuana can alleviate neuropathy, a condition which afflicts AIDS, diabetes and other patients with severe tingling and pain in their hands and feet. One of the two studies will focus on hospitalised patients, the other on outpatients. In San Diego, another researcher will examine how repeated treatment with cannabis affects driving ability of patients with HIV-related neuropathy or multiple sclerosis. The patients will be tested using a driving simulator. Another San Diego scientist will study how smoking marijuana might ease the uncontrollable muscle spasms and pain in multiple sclerosis. The research proposals must still get a permission by the Food and Drug Administration (FDA), the National Institute on Drug Abuse (NIDA) and the Drug Enforcement Agency (DEA). The marijuana used in the research will be provided by the University of Mississippi. The Center for Medicinal Cannabis Research opened in August 2000 with money from the state of California. The first studies are intended to start in May. $3 million of state money are available for the research. (Sources: San Jose Mercury News of 23 February 2001, Sacramento Bee of 23 February 2001) 2. Science: Big pharmaceutical companies get interested in cannabinoid-based medicines Big companies such as Pfizer, GlaxoSmithKline and Novartis are starting to get interested in the therapeutic use of cannabinoids and their derivatives, according to a report of the Wall Street Journal. Today, the only prescribable cannabinoids are THC (dronabinol, Marinol) and the dronabinol derivative nabilone. Marinol was approved in the U.S. as a nausea drug in 1985, and as an appetite-stimulant for AIDS patients in 1992. Sales today reach an estimated $20 million annually. Individual scientists, academic labs and small drug firms are pushing the research hardest, largely because big drug companies have traditionally been reserved with regard to the cost and the political problems associated with marketing marijuana as medicine. Also, because cannabis is a natural product in the public domain, it can't be patented. However, some patented non-psychotropic derivatives such as CT-3 and dexanabinol are under clinical investigation as well. Today big companies are starting to get interested in the field. "We see them -- Pfizer, GlaxoSmithKline, Novartis -- all the time at the meetings of the society now," says Dr. Roger Pertwee, professor at the University of Aberdeen in the U.K. and secretary of the International Cannabinoid Research Society (ICRS). "They never came in the past." (Source: Wall Street Journal of 28 February 2001) 3. News in brief ***USA: Vermont and Massachusetts add to the list of states where legislators will discuss bills for a legal access to the medical use of cannabis. The Vermont bill allows people suffering from cancer, glaucoma, AIDS or other chronic illnesses to use marijuana legally with a physician's note. It is sponsored by 21 members of the House of Representatives. In Massachusetts about a dozen state legislators support four medicinal marijuana bills. (Sources: Burlington Free Press of 27 February 2001, Boston Herald of 25 February 2001) ***Science: A clinical study randomly comparing THC and placebo in patients with Tourette's syndrome at the Medical School of Hanover under the guidance of Dr. Kirsten Mueller-Vahl has recently been completed. 17 patients passed through the whole six week study. In some participants THC caused a considerable decrease of symptoms, thus confirming results of an earlier study. Side effects usually were mild even with a dosage of 10 mg. One patient developed a state of anxiety lasting about 24 hours folowing the administration of 5 mg. (Sources: Personal communication of Kirsten Mueller-Vahl, Die Welt of 1 March 2001) ***Germany: On 2 May 2001 a congress on the medical use of cannabis will be held at the city-hall of Saarbruecken. Speakers will be Dr. Guenter Amendt (publicist and sociologist), Dr. Martin Schnelle (European Institute for Oncological and Immunological Research, Berlin), Werner Sack (lawyer and pedagogue, Frankfurt), Robin Sircar (lawyer, Saarbruecken), Dr. Frans Gosselinckx, Belgium), Willem Scholten (Health Ministry, Netherlands), Christian Steup (pharmacist, THC Pharm, Frankfurt), and others. More at: www.hanfmedizin.de ***Spain: Celltech Pharma, a company specialized in biotechnology, intends to bring nabilone on the market in Spain. Nabilone is a synthetic derivative of THC with a slightly modified molecule structure. The process of national registration is expected to need one or two years. Today nabilone can only be used in hospitals and a package with 20 capsules costs about 30,000 pesetas (about $170). Celltech says that with a national registration the prize may be down to 20% of the actual prize. (Source: Cinco Días of 27 February 2001) ***Germany: The President of the Medical Association of the state of Berlin, Dr. Guenther Jonitz, speaks out for the legalization of cannabis and a state controlled sale of the drug. In an interview with the Aerztezeitung (Medical Journal) Jonitz said, one should not shut the eyes to reality. Cannabis was less dangerous to health than alcohol. "For many people the use of cannabis is just as usual as the use of wine." The only difference would be the legal status, one drug being legal and the other not. (Source: Aerztezeitung of 20 February 2001) 4. ONE YEAR AGO: - Science: THC destroys brain cancer in animal research - Science: Cannabinoids reduce tremor in animal model of multiple sclerosis TWO YEARS AGO: - World: U.N. report encourages research into the medical use of cannabis - Canada: Health Minister orders clinical trials ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 18 March 2001 -------------------------------------------------------- * Switzerland: Government wants to legalize the use of cannabis 1. Switzerland: Government wants to legalize the use of cannabis The Swiss government on 9 March endorsed a draft law that would legalize the consumption of cannabis and allow a limited number of shops where the drug could be sold, similar to the Dutch coffee shop model. Production and sale would be heavily regulated. Only Swiss-grown marijuana would be legal, exporting marijuana would remain a crime, purchases of marijuana would be limited to Swiss residents only, and sales to minors would be still prohibited. "Decriminalizing the consumption of cannabis and the acts leading up to this takes account of social reality and unburdens police and the courts," the government said in a statement. The cabinet agreed in principle in October 2000 to legalize cannabis use. It has now recommended that police be allowed to turn a blind eye to people growing and trading small amounts of soft drugs. The Swiss parliament still needs to approve reform later this year, but authorities believe the legislation will be approved in some form. (Sources: Press release of the Swiss government of 9 March 2001, Reuters of 9 March 2001, Time Magazine of 16 March 2001) 2. News in brief ***Science: Researchers at the Bayer AG, a German pharmaceutical company, found that cannabinoid CB(1) receptors were upregulated in a rat model of chronic neuropathic pain. They write in the March issue of the European Journal of Pharmacology that this increase of cannabinoid receptors following nerve damage may be the reason for the increased pain-relieving effect of cannabinoids in chronic pain conditions compared to their low efficacy in acute pain. (Source: Siegling A, et al. Eur J Pharmacol 2001;415(1):R5-R7) ***USA: 78 percent of the citizens of New Mexico support Governor Gary Johnson's proposal to legalize the medical use of marijuana, according to a poll released on 3 March. The poll also found generally broad support across the political spectrum for Johnson's proposal to decriminalize the possession of small amounts of cannabis. On 6 March the medical use of cannabis was approved by the Senate of New Mexico with a 29-12 vote. The bill now heads to the House of Representatives. (Sources: Associated Press of 3 March 2001, Albuquerque Tribune of 7 March 2001) ***Science: Young people with high self-esteem are more likely to take illicit drugs than those whose self-confidence is low, a survey of 15,000 British children aged 14 and 15 revealed. The results contradict the concept that drug use is most prevalent among anxious or insecure youth looking for an escape from poor conditions or a way to feel better about themselves. Heather Ashton, a professor of pharmacology at Newcastle University, said last week that the results of the survey did not surprise her: "Students all report they take drugs for pleasure and that it has nothing to do with anxiety or stress. Years ago young people who take drugs were seen as psychotic or low or risk-takers. Now that is not the case." (Source: Observer of 11 February 2001) ***Science: The Endocannabinoid system may be involved in the cardioprotection triggered by lipopolysaccharide (LPS). The cardioprotective effects of LPS treatment, in terms of infarction and functional recovery after ischemia in rat hearts, were abolished by a CB(2) receptor antagonist. A CB(1) receptor antagonist had no effect. "Our results suggest an involvement of endocannabinoids, acting through the CB(2) receptors, in the cardioprotection triggered by LPS against myocardial ischemia," researchers of the University of Montreal (Canada) write in the European Journal of Pharmacology. (Source: Lagneux C, et al. Eur J Pharmacol. 2001 Mar 9;415(1):R5-R7.) 3. ONE YEAR AGO: - Foundation of the International Association for Cannabis as Medicine - Germany: Experts discussion on cannabis as medicine TWO YEARS AGO: - USA: Government-funded report proposes access to medical marijuana within clinical trials as interim solution - Science: Treatment of Tourette's syndrome with marijuana and THC ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 1 April 2001 -------------------------------------------------------- * IACM: 2001 Meeting in Berlin * UK: House of Lords again calls for legal access to medical use of cannabis * USA: Medical use of cannabis before the Supreme Court 1. IACM: 2001 Meeting in Berlin The International Association for Cannabis as Medicine in cooperation with the Medical Association of Berlin and the Charité, Medical Faculty of the Humboldt University of Berlin, would like to invite you to attend the next meeting of the IACM and to visit Berlin on 25-27 October 2001. Meeting Program: • 25 October (evening): Meeting of the IACM Board Members, General Meeting of IACM • 26 October: International lectures, Workshops • 27 October: Congress on the medical use of cannabis and the cannabinoids open for the public On 26 October, there will be international lectures, workshops and exchange of experience for members of the IACM and others interested in the medicinal use of cannabis and the cannabinoids. Language will be English. On 27 October, there will be a congress open for the public, mainly physicians, pharmacists and patients from Berlin and surrounding towns who are interested in getting an overview on the current state of knowledge. Language will be German, but there will also be some lectures in English that are translated into German. Scientists interested in giving a presentation on 26 and/or 27 October should contact the IACM (info@cannabis-med.org) by May 15, 2001. 2. UK: House of Lords again calls for legal access to medical use of cannabis A select committee of Britain's House of Lords accused the Medicines Control Agency of not dealing with cannabis based medicines in the same impartial manner as with other medicines. In a report released on 22 March the select committee on science and technology also called for an end to the prosecution of therapeutic cannabis users who possess or grow cannabis for their own use. It claimed that the medical authorities were making it more difficult than necessary for drug companies to produce cannabis based medicines. The committee was particularly critical of the Medicines Control Agency for "not approaching the question of licensing cannabis based medicines in a properly balanced way, especially given the long-established history of cannabis use and the needs of patients for whom there is no medicinal alternative." The committee, which is chaired by Lord Winston, said that it stood by its original recommendation that cannabis should be rescheduled from a schedule 1 to a schedule 2 drug under the Misuse of Drugs Regulations Act 1985, in order to facilitate research. The Royal Pharmaceutical Society of Great Britain welcomed the report. Professor Tony Moffat, the Society's Chief Scientist, said that the committee's report was another constructive step towards the development of cannabis based medicines. The report is available at http://www.publications.parliament.uk/pa/ld200001/ldselect/ldsctech/50/5001.htm (Sources: House of Lords Select Committee on Science and Technology. Therapeutic Uses of Cannabis. 2nd Report, Session 2000-2001, London 2001; Ferriman A. Regulators accused of bias against cannabis based medicines. BMJ 2001;322:691; PR Newswire of 22 March 2001) 3. USA: Medical use of cannabis before the Supreme Court On 28 March the Supreme Court heard oral arguments in the case United States versus Oakland Cannabis Buyers' Cooperative, a case to decide whether distributors of marijuana to patients can raise a "medical necessity" defence in federal court. The Court's decision will not affect existing state laws on the medical use of cannabis. The ruling is expected by June. A ruling for the Oakland Cannabis Buyers Cooperative would allow special marijuana clubs to resume distributing the drug to patients in California. A ruling against the club would mean the government could prosecute distributors aggressively in federal court, regardless of whether states have approved the medical use of marijuana. California Attorney General Bill Lockyer is backing the Oakland club, arguing that the Californian state has the right to enforce its law allowing seriously ill patients to use marijuana. (Sources: Associated Press of 28 March 2001, Reuters of 28 March 2001) 4. News in brief ***USA: Following the passage of the medical marijuana law in Colorado in November 2000 the Colorado Department of Public Health and Environment has adopted rules for issuing cards to patients allowing them to use cannabis. The state would allow authorized users to grow a limited number of marijuana plants and issue identification cards at a cost of $150 a year. A registry and distribution system would be in place by June 1. (Source: Denver Post of 28 March 2001) ***UK: Multiple sclerosis sufferer Paul Roddy has won another victory after a charge of illegally possessing cannabis was dropped. On 23 March Mr Roddy was cleared by a jury at Manchester Crown Court of illegally possessing the drug, but was re-arrested for an identical offence soon later. Now it was decided that it is not in the public interest to proceed with the case. (Source: Manchester Evening News of 27 March 2001) 5. ONE YEAR AGO: - UK: Police Foundation proposes depenalisation of cannabis TWO YEARS AGO: - Germany: Handing over of signatures in support of the Frankfurt Resolution - Science: New patent for dexanabinol as TNF-alpha inhibitor ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 15 April 2001 -------------------------------------------------------- * Canada: Health Minister wants to facilitate the medical use of cannabis * Science: Endocannabinoids are involved in the regulation of appetite 1. Canada: Health Minister wants to facilitate the medical use of cannabis Canada plans to make it easier to possess and cultivate marijuana for medical purposes, Canadian Health Minister Allan Rock said on 6 April. The government intends the new rules to apply by 31 July. Rock first allowed Canadians to apply for the medical use of cannabis in May 1999, and 220 people have received such exemptions from the law. But Ontario's highest court ruled in July 2000 that the federal government should make the process more transparent, particularly in defining who can apply. Under the proposed new rules, people would still have to apply for exemptions from the general ban, but the regulations would eliminate the current fixed limits on how much cannabis someone can possess. This would be replaced with individual recommendations by a physician -- in effect, a prescription for marijuana. Patients would also be able to choose a friend to grow marijuana for them. Renewals of exemptions would be granted on an annual basis instead of the current six months. (Source: Reuters of 6 April 2001) 2. Science: Endocannabinoids are involved in the regulation of appetite New research suggests that endocannabinoids are part of the brain's complex system for controlling when and how much to eat. It is known for some time that leptin is the key hormone for the regulation of the circuit in the hypothalamus responsible for appetite control. Leptin reduces food intake by upregulating appetite-reducing factors and downregulating appetite-stimulating factors. The finding that endocannabinoids (anandamide and 2-arachidonyl glycerol) are involved in this process helps explain why people get hungry after using cannabis or THC and why it helps patients with loss of appetite and weight. In the study published in the journal Nature, researchers found that mice without CB1 cannabinoid receptors ate less than normal mice did. And when ordinary mice were given the cannabinoid receptor antagonist SR141716A that blocked endocannabinoids from acting at these receptors, they ate less than normal as well. Furthermore, reduced levels of leptin were associated with elevated levels of endocannabinoids in the hypothalamus, and application of leptin reduced endocannabinoid levels. These findings indicate that endocannabinoids in the hypothalamus may activate CB1 receptors to maintain food intake, and that they can act independently of the level of certain other appetite-triggering substances. (Sources: Di Marzo V, et al. Leptin-regulated endocannabinoids are involved in maintaining food intake. Nature 2001;410:822-825; AP of 11 April 2001) 3. News in brief ***IACM - Frequently asked questions: A new service on the IACM web site offers the possibility to ask questions and have a look at answers to frequently asked questions. The first question is: "Pregnancy: Does cannabis/THC do harm to the fetus if it is used during pregnancy?" The next questions to be answered are: "Interactions: Does cannabis/THC interact with other drugs used for the treatment of diseases?" and "Asthma: How should cannabis or THC be taken to treat asthma?" More at: www.cannabis-med.org ***Science - HIV/AIDS study: On 3 April the first study on the medical use of marijuana approved by the U.S. government started in California. The San Mateo County Health Center will provide cannabis cigarettes to 60 HIV and AIDS patients who suffer from neurological disorders. Dr. Dennis Israelski, chief of infectious diseases at the county's hospitals and clinics, will oversee the 12-week study. The U.S. Drug Enforcement Administration (DEA) approved the study on 22 November 2000. (Sources: AP of 4 April 2001, IACM-Bulletin of 26 November 2000) ***Science - Nausea and vomiting: Canadian researchers of Wilfrid Lauier University, Waterloo, Ontario, demonstrated in an animal model of anticipatory nausea and vomiting that THC is able to prevent this form of nausea. Their study based on the emetic reactions of the musk shrew is published in Neuroreport. Retching caused by an injection of lithium chloride was completely suppressed by pre-treatment with a moderate dose of THC. This provides the first experimental evidence in support of reports that THC suppresses anticipatory vomiting. (Source: Parker LA, Kemp SW. Tetrahydrocannabinol (THC) interferes with conditioned retching in Suncus murinus: an animal model of anticipatory nausea and vomiting (ANV). Neuroreport 2001;12(4):749-751.) ***Science - Pain: Researchers of the Virginia Commonwealth University in Richmond, USA, examined the effect of short-term exposure to THC, morphine, or both drugs in combination on receptor density in a mouse model. They demonstrated that all three types of opioid receptors were significantly decreased in morphine-tolerant mouse, while this reduction was not seen in combination-treated animals. The scientists concluded that a combination of THC and morphine retains high pain mitigating properties without causing changes in receptors that may contribute to tolerance. (Source: Cichewicz DL, et al. Changes in opioid and cannabinoid receptor protein following short-term combination treatment with delta(9)-tetrahydrocannabinol and morphine. J Pharmacol Exp Ther 2001;297(1):121-127.) ***Science - Blockade of THC effects: SR141716, a CB1 cannabinoid receptor antagonist developed in 1994, was given to humans now for the first time. 63 healthy men received different doses of SR141716 or a placebo and smoked a marijuana cigarette 2 hours later. SR141716 produced a dose-dependent blockade of marijuana effects. Lead researcher Dr. Marilyn Huestis of NIDA (National Institute on Drug Abuse), said the findings help point the way toward possible treatment for people addicted to marijuana, for treating obesity and schizophrenia and improving memory. (Source: Huestis M, et al. Blockade of effects of smoked marijuana by the CB1-selective cannabinoid receptor antagonist SR141716. Arch Gen Psychiatry 2001;58:322-328.) 4. ONE YEAR AGO: - Science/UK: Clinical trial with Cannabis approved by the MCA - Economy/USA: Investigational new drug (IND) application for CT3 - USA: Clinical conference on Cannabis therapeutics TWO YEARS AGO: - Australia: Survey on the medical use of cannabis - Science: Interaction of anandamide with dopamine, a basis for the treatment of movement disorders and schizophrenia - USA: Implementation of medical marijuana law in a Californian town ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 29 April 2001 -------------------------------------------------------- * Spain: Catalonian parliament unanimously in support of medical use of cannabis * Science: Physicians' attitude towards medical use of cannabis depends on specialty 1. Spain: Catalonian parliament unanimously in support of medical use of cannabis On 25 April the parliament of the Spanish autonomous region Catalonia unanimously decided to ask the government in Madrid to legalise the medical use of cannabis. The initiator of this decision was Agata, a Catalonian organization of women with breast cancer. Since five years Agata is calling for legal access to cannabis for patients suffering from side effects of chemotherapy. The resolution of the parliament says, that the government should "take all necessary administrative measures to allow the therapeutic use of cannabis." It says that the therapeutic properties of cannabis "have been known for thousands of years" and that scientific studies have shown its benefit in several diseases, among them cancer, multiple sclerosis and epilepsy. All parties of the Catalonian Parliament urged the Congress in Madrid to adopt the political consensus obtained in the Catalonian parliament. Caterina Mieras of the PSC (Socialistic Party of Catalonia) said that scientific studies have shown that cannabis is a safe medicine and that the "margin of safety is high". Dolors Montserrat of the PP (Partido Popular, conservative party) said that "we have the obligation to work to improve the quality of life." In Andalusia, the IU-CA, a political organisation of Andalusia, presented a proposal to the Andalusian Parliament and to the Central Congress to legalize the medical use of cannabis. The proposal comprises the demand for research into the medical benefits of the plant. (Sources: El Mundo of 26 April 2001, El Correo of 26 April 2001, ABC de Sevilla 25 of April 2001) 2. Science: Physicians' attitude towards medical use of cannabis depends on specialty The results of an U.S. survey presented at the annual meeting of the American Society of Addiction Medicine indicate that physicians are divided on the medical use of cannabis. Researchers at Rhode Island Hospital in Providence asked 960 doctors to tell their attitude towards the statement, "Doctors should be able to legally prescribe marijuana as medical therapy." 36% of the responders agreed, 38% disagreed and 26% were neutral. Specialty, residence in a state that had ever approved research into the medical use of cannabis and physicians' "permissiveness" were associated with supporting the medical use of cannabis. The researchers surveyed physicians in five specialties: addiction medicine, general psychiatry, gynaecology, family practice and internal medicine. They found gynaecologists and internists more likely to support the medical use of the drug than other surveyed specialists. Because doctors in those two specialties are more likely to see cancer patients, they may be more sensitive to marijuana's potential for managing chemotherapy side effects and pain, the Rhode Island team proposed. They noted that the other specialists surveyed are more likely to see active substance abusers and may be more concerned about the drug's negative effects. (Source: Reuters of 23 April 2001) 3. News in brief ***USA - Bill in Colorado Bill HB 1371 for the medical use of marijuana was approved on a 21-12 vote in the Colorado Senate. It now has been approved by both houses of the parliament, but must return to the House of Representatives for consideration of a Senate amendment before it goes to Governor Bill Owens. 54 percent of the voters in Colorado supported a ballot initiative for the medical use of cannabis in the general election of November 2000. (Source: Denver Rocky Mountain News of 24 April 2001) ***USA - Forgotten law of New York In 1980 a medical marijuana law was enacted in New York, the first of its kind. But the mechanism needed to make the law effective was never put in place, and it is largely forgotten. The law said that a doctor could petition a hospital board for permission for a patient to use marijuana. The New York Times reminded of this forgotten law. (Source: New York Times of 20 April 2001) ***USA - New head for drug policy office President Bush plans to name a conservative known for his tough approach on drugs to head the Office of National Drug Control Policy, a government official said on 20 April. Walters has stressed the importance of harsh penalties for drug users and opposed the use of marijuana for medical purposes. (Source: Associated Press of 20 April 2001) ***USA - Acquittal in California Two men arrested for growing 899 cannabis plants were acquitted on 18 April on charges of cultivating and possessing marijuana by a Sonoma County jury. They had claimed they were growing the plants for the 1,200-members of a San Francisco medical marijuana club called CHAMP (Cannabis Helping Alleviate Medical Problems). (Source: Associated Press of 18 April 2001) ***USA - Meeting of NORML NORML (The National Organization for the Reform of Marijuana Laws) held its annual conference from 19-21 April in Washington. Among the speakers were New Mexico's Republican Governor Gary Johnson, U.S. Representative Barney Frank, Dr. Lester Grinspoon, Harvard Medical School Emeritus, and Dr. John Morgan, professor of Pharmacology at City University of New York Medical School. (Source: Wired News of 23 April 2001) 4. ONE YEAR AGO: - USA: Hawaii approves medical use through legislation - The Netherlands: Installation of a Cannabis Agency for medical cannabis at the Health Ministry TWO YEARS AGO: - Canada: Debate in the House of Commons on medical use of marijuana - Switzerland: Drug commission recommends legalization of Cannabis ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 13 May 2001 -------------------------------------------------------- * Science/UK: Four phase II trials with cannabis successful * France: Medical use of cannabis before the court * Canada: Concerns by the Canadian Medical Association 1. Science/UK: Four phase II trials with cannabis successful GW Pharmaceuticals said it had obtained encouraging results from phase II clinical trials with cannabis and was now extending its program into Phase III trials. The company has invested 12 million pounds (17 million US dollars) in its research and hopes to market its first prescription cannabis-based medicine in 2003. GW's trials have involved patients taking cannabis-based medicine by spraying it under their tongues. Dr. Geoffrey Guy, chairman of GW Pharmaceuticals, said: "Data from our four Phase II studies in approximately 70 subjects is positive and encouraging. Patients are clearly gaining benefit." Results appeared to show significant reduction in pain, muscle spasm and bladder dysfunction as well as improved neurological function. Guy said the company had received approval from Canadian health authorities allowing it to start trials in Canada. (Source: Reuters of 2 May 2001) 2. France: Medical use of cannabis before the court On 3 May the administrative court of Paris examined the question of medical use of cannabis by two patients, members of the Mouvement de légalisation contrôlée (MLC, movement for controlled legalisation). In the name of 10 persons with incurable diseases the MLC had applied for the importation of 10 kilograms of cannabis to the Health Ministry in 1998. Health Minister Bernard Kouchner did not answer and the MLC appealed to the administrative court. The representative of the government spoke out against the claims of the MLC. According to the government international treaties are opposed to the demand of the two patients to import cannabis for therapeutic purposes. The ruling by the six judges is expected by 29 May. (Source: AFP of 2 May 2001, AP of 3 May 2001) 3. Canada: Concerns by the Canadian Medical Association The Canadian Medical Association (CMA) expressed concerns in its response to Health Canada's draft regulations on the medicinal use of cannabis. The draft regulations expand the scope of illnesses for which cannabis can be used and changes the role of the physician. The CMA urges the government to increase its efforts to assess the clinical efficacy of marijuana's active ingredients in order to develop evidence-based guidelines for its use. "We understand the pressures on Health Canada and are willing to work with the department on an urgent basis to establish parameters for the judicious medicinal use of marijuana," said Dr. Barrett, President of the CMA. According to the CMA physicians were not in a position to counsel patients regarding the use of cannabis, specifically with regard to proper dosage, interactions with other drugs, or its impact on other pre-existing medical conditions. Meanwhile the Canadian Association of Chiefs of Police said that the police has no problem with the medical use of marijuana. (Sources: CMA news release of 8 May 2001, CCN Newswire of 8 May 2001, Toronto Sun of 8 May 2001) 4. News in brief ***Austria - Medical use A 43 year old AIDS patient was allowed by a judge to cultivate and use cannabis for therapeutic reasons. Several medical expert opinions supported the use of cannabis by the man living in Wels, who has already been convicted several times due to the possession of cannabis. (Source: ORF of 1 May 2001) ***Science - Neuropathic pain Researchers of Novartis in London (UK) examined the effects of cannabinoid agonists on hyperalgesia in a model of neuropathic pain in the rat. The results show that cannabinoids are highly potent and efficacious antihyperalgesic agents. This activity is likely to be mediated via an action in both the central nervous system and in the periphery. (Source: Fox A, et al. Pain 2001 May;92(1-2):91-100.) ***UK - Scotland Scots favour cannabis on prescription. A survey by Herald newspaper showed that 64 percent of those interviewed said the drug should be legalised on prescription, while a further 15 percent said it should be made available for general use. In December 2000 eight out of 10 doctors called for the right to prescribe cannabis for their patients. (Source: Comtex Newswire of 8 May 2001) ***USA - Oregon About 1,600 Oregonians hold cards that allow them to legally use cannabis to treat specific maladies. The 1998 law allows patients who qualify for the cards to possess up to 3 ounces. (Source: Register-Guard of 8 May 2001) ***USA - Nevada Lawmakers said on 7 May that the state does not have the money to start a medical marijuana program overwhelmingly approved by the voters in 1998 and 2000. They said that no money exists this year to pay the 30,000 U.S. dollars start-up costs. (Source: Las Vegas Review-Journal of 8 May 2001) ***The Netherlands - Drive-through shops Dutch authorities plan to open two drive-through shops next year where "drug tourists" can buy marijuana and hashish. The officials in Venlo say they want to make it easier for Germans who come to the southern Dutch border town for drugs. They also want to keep the "drug tourists" from lingering in the Netherlands. Cannabis is technically illegal in the Netherlands, but authorities tolerate their use and it is openly sold in small amounts. (Source: Associated Press of 2 May 2001) ***USA - U.N. drug policy The U.S.A. lost its seat on the International Narcotics Control Board. They had campaigned for a third term for American representative Herbert Okun, who has served as vice president of the board, but he was voted off. The 13-member INCB monitors compliance with U.N. drug conventions on substance abuse. (Source: AP of 7 May 2001) 5. ONE YEAR AGO: - Science/Germany: Clinical study on THC in Tourette's syndrome - Canada: Health Ministry looking for source of supply for marijuana TWO YEARS AGO: - Science: Cannabis use appears not to affect cognitive functioning - Australia: Calls for treating drugs as a health and social issue - Canada: Ontario Superior Court permits AIDS patient to use marijuana ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) IACM - Translations: If your native tongue is French, Spanish, Italian or Dutch and you understand well German or English, and if you want to support the IACM, then, please contact Dr. Franjo Grotenhermen at info@cannabis-med.org. Your help is cordially welcome. -------------------------------------------------------- IACM-Bulletin of 27 May 2001 -------------------------------------------------------- * IACM: Second Call for Papers, Berlin Meeting 2001 * Science: Second issue of the Journal of Cannabis Therapeutics * USA: Supreme Court ruled against medicinal cannabis clubs 1. IACM: Second Call for Papers, Berlin Meeting 2001 At the upcoming conference on October 25-27, 2001, it is intended to bring together scientists, clinicians, and physicians to share their experience on the therapeutic potential of cannabis and the cannabinoids, and to allow others interested in this topic to get first-hand information. Among the participants will be: Andreas Heinz, Claude Vaney, Ricardo Navarrete Varo, Ester Fride, Ethan Russo, Franjo Grotenhermen, Gernot Ernst, John Zajicek, Kirsten Mueller-Vahl, Manfred Fankhauser, Markus Leweke, Martin Schnelle, Raphael Mechoulam, Rudolf Brenneisen, Ulrike Hagenbach, William Notcutt, Winfried Meissner, Tod Mikuriya, Bela Szabo, and others. (More information: www.Berlin2001.net) 2. Science: Second issue of the Journal of Cannabis Therapeutics The 1(2) issue of the Journal of Cannabis Therapeutics has been released. From the content: (1) Alakbarov FU. Medicinal properties of cannabis according to medieval manuscripts of Azerbaijan. J Cannabis Ther 2001;1(2):3-14. "Azerbaijani people have rich and ancient traditions in the medicinal use of cannabis. The traditional methods of its application are described in the medieval Azerbaijani manuscripts in the field of medicine and pharmacognosy written in Old Azerbaijani, Persian, Arabic and date back to the 9-18th centuries AD. (...) various parts (the roots, resign, leaves and seeds) of Cannabis sativa L. were widely used (...)." (2) Deakle D. Simeon Seth on Cannabis (Cognoscenti of Cannabis II). J Cannabis Ther 2001;1(2):15-20. "Simeon Seth's Lexicon on the Properties of Foods (Syntagma de alimentorum facultatibus) is perhaps the most important document providing understanding of how dietetics were applied in Byzantine and Arabic culture in the 11th century. (...) A section from his treatise is herein translated (...). (3) Russo E. Hemp for headache: An in-depth historical and scientific review of cannabis in migraine treatment. J Cannabis Ther 2001;1(2):21-92. "Cannabis, or 'marijuana,' has been employed in various forms throughout the millennia for both symptomatic and prophylactic treatment of migraine. This document examines its history of medicinal use by smoking and other methods in ancient cultures (...). In modern times ethnobotanical and anecdotal references continue to support the efficacy of cannabis for headache treatment, while biochemical studies of THC and anandamide have provided scientific justification for its use (...). (4) Webster P. Marijuana and music: A speculative exploration. J Cannabis Ther 2001;1(2):93-105. "(...) As an example of such unofficial, unpublished, and underground research, the author presents a speculative exploration on the cannabis-produced altered state of consciousness and its relation to the appreciation and production of music. (...)" (Source: Abstracts of the Journal of Cannabis Therapeutics, 1(2), 2001) 3. USA: Supreme Court ruled against medicinal cannabis clubs On 14 May the Supreme Court unanimously ruled (by a vote of 8-0) that third parties who grow or distribute marijuana for medical purposes may not raise the defence of medical necessity under federal law. This could mean the end for the cannabis distribution clubs in California. Writing for the court, Justice Clarence Thomas cited a thirty year old federal law on the medical potential of cannabis and said the Controlled Substances Act of 1970 "reflects a determination that marijuana has no medical benefits worthy of an exception." Much research, however, has been done since 1970 suggesting another conclusion. The courts decision does not touch the right of individual patients in some states to use cannabis, but it will be more difficult to obtain the drug because the Supreme Court says distribution violates federal law. (Sources: AP of 15 May 2001, U-WIRE via COMTEX of 15 May 2001) 4. News in brief ***Science - Appetite in cancer patients THC was only a bit more effective than placebo to regain appetite of cancer patients, the Mayo Clinic said on 12 May. In a double blind study involving 150 patients appetite improved in 73 percent of patients taking a standard medicine for cancer-related appetite loss, megestrol acetate, against 47 percent taking dronabinol (THC). (Source: Reuters of 13 May 2001) ***Spain - Another parliament for medical use Following the Catalonian parliament the regional parliament of the Balears demanded on 22 May to legalize the use of cannabis for medical purposes. Socialists as well as conservatives supported the motion. (Sources: Diario Médico of 21 May 2001, Personal communication by Ricardo Navarrete Varo of 23 May 2001) ***USA - Nevada The state House of Representatives on 23 May approved a measure that would authorize medical use of marijuana and would lessen the criminal penalty faced by anyone who possesses the drug. The bill was approved 30-12 and goes to the Senate. (Source: AP of 23 May 2001) ***Canada - Medical Association Journal The Canadian Medical Association Journal (CMAJ) is calling on the government to decriminalize the possession of marijuana for personal use. Editor Dr. John Hoey argues the social and legal consequences of being arrested for marijuana possession far outweighs the minimal health affects of moderate use of the drug. (Source: CMAJ of 15 May 2001;164(10):1397) ***France - Clinical research intended The possible therapeutic use of cannabis shall be examined in several hospitals in Paris Marseille, Toulouse and Lyon, according to a statement by Health Minister Bernard Kouchner of 14 May. The properties to be investigated are its antiemetic and analgesic potential. (Source: AFP of 14 May 2001) ***UK - GW Pharmaceuticals GW Pharmaceuticals is to announce plans for a listing on the London Stock Exchange. 16 million pounds (about 23 million US dollars) of proceeds, and 5.5 million pounds in the bank, would be used to increase the production of cannabis and funding of clinical trials. (Source: Reuters of 15 May 2001) ***Science - Pain and hyperalgesia Research in rat showed that hyperalgesia associated with inflammation of the urinary bladder was attenuated by the endocannabinoids anandamide (via CB1 receptors) and palmitylethanolamide (putatively via CB2 receptors) in a dose-dependent fashion. (Source: Farquhar-Smith WP, Rice AS. Anesthesiology 2001 Mar;94(3):507-513) 5. ONE YEAR AGO: - USA: AIDS patients may get cannabis for Californian study TWO YEARS AGO: - Canada: House of Commons supports legalization of pot for medical reasons - USA: Government makes marijuana easier to get for research ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) IACM - Translations: If your native tongue is French, Italian or Dutch and you understand well German or English, and if you want to support the IACM, then, please contact Dr. Franjo Grotenhermen at info@cannabis-med.org. Your help is cordially welcome. -------------------------------------------------------- IACM-Bulletin of 10 June 2001 -------------------------------------------------------- * USA: Robert Randall died * USA: Registration for medical use of cannabis 1. USA: Robert Randall died Robert Randall, who made history in 1976 when he persuaded a federal court in Washington to give him access to government supplies of marijuana has died at 53. He died on 2 June at his home in Sarasota, Florida, of AIDS-related complications. Randall developed glaucoma in his teens. An ophthalmologist told him in the early 1970s that he would go blind within a few years. But he never lost his sight. He grew his own cannabis until he was arrested and prosecuted. He then underwent exhaustive tests that indicated no other glaucoma drug available lowered his intraocular pressure and halted deterioration of his eyesight. He used that argument in demanding legal access to marijuana. In November, 1976, Randall became the first person in modern US history to obtain legal, medical access to marijuana. In 1978 the federal government established a special program ("Compassionate IND"), under which he and some other patients were able to gain access to a non-approved drug. In 1981, Randall and his wife Alice O'Leary founded the Alliance for Cannabis Therapeutics (ACT), an organization to reform laws prohibiting medicinal use of marijuana. By the early 1990s, Randall was concentrating on the therapeutic effects of marijuana on AIDS sufferers and helped AIDS patients to gain access to cannabis under the Compassionate IND program. Hundreds of AIDS patients applied under the program, but the federal government abruptly shut it down. Only Randall and seven other early patients continued to be able to receive legal medical marijuana from the government. (Sources: Associated Press of 5 June 2001, http://www.drcnet.org/wol/189.html#robertrandall) 2. USA: Registration for medical use of cannabis Nevada: State lawmakers voted on 4 June to legalize marijuana for medical purposes and relax penalties for possession of the drug. The bill would allow seriously ill Nevadans to have up to seven cannabis plants for personal use, and it would allow the creation of a state registry for patients whose doctors recommend they use marijuana for medical reasons. Nevadans voted overwhelmingly in 1998 and 2000 to allow the medical use of marijuana. Colorado: On 1 June the first two Coloradans got their medical-marijuana cards. It was the first day of a program for the medical use of cannabis. At least 600 applications are expected in the first year based on what happened with Oregon's medical-marijuana program. The law went into effect not without a warning from Governor Bill Owens and Attorney General Ken Salazar to the state's doctors that they may face federal prosecution if they recommend the treatment. California: Conservative and liberal senators joined on 6 June to pass a state-wide medical marijuana registry. The measure is intended to defend California's medical marijuana law against last month's U.S. Supreme Court decision that the state law (Proposition 215) cannot supersede federal laws against marijuana distribution. The measure passed the Senate 23-8. (Sources: UPI of 1 June 2001, Denver Rocky Mountain News of 2 June 2001, Associated Press of 4 June 2001, Sacramento Bee of 6 June 2001) 3. News in brief ***Science - Opioid-induced emesis Opiates often cause nausea and vomiting. Cannabinoids were able to reduce opioid-induced vomiting in an animal study with ferrets. A CB1 receptor antagonist but not a CB2 receptor antagonist blocked this antiemetic action, suggesting that antiemetic effects of cannabinoids appear to be mediated by the central nervous system. (Source: Simoneau II, et al. Anesthesiology 2001 May;94(5):882-887) ***Spain - Aragon Following the parliaments of Catalonia and the Balears the regional parliament of Aragon on 30 May unanimously voted to urge the central government in Madrid to legalizes the therapeutic use of cannabis. (Source: Diario Médico of 31 May 2001) ***Belgium - Clinical trials allowed The government approved a royal decision allowing the medical use of cannabis within clinical trials. The king is expected to sign the decision in June. Cannabis has to be prescribed by a doctor of a university hospital, a centre for pain therapy, or a hospital with an approval to treat side effects of chemotherapy, glaucoma, multiple sclerosis, AIDS or chronic pain. (Sources: Press release of the Belgium government of 1 June 2001, Gazet van Antwerpen of 2 June 2001) ***Science - CT-3 The synergistic effects of opioids and cannabinoids, specifically CT-3, a synthetic derivative of THC, in pain therapy will be investigated at the University of Sydney under the guidance of Dr. Christopher W. Vaughan. If successful, this research will provide a rational basis for analgesic synergies between CT-3, opioids and Nonsteroidal Antinflammatory Drugs. (Source: Business Wire of 29 May 2001) ***Israel - Dexanabinol Pharmos Corporation has been awarded a grant of up to 1.7 million US dollars by the Israelian government to support the development of dexanabinol for traumatic brain injury. Dexanabinol is a synthetic non-psychotropic THC-derivative with neuroprotective properties (Source: PR Newswire of 29 May 2001) ***Canada - Support from conservatives Moves to decriminalize the use of cannabis get support from several conservatives. Joe Clark, leader of the Progressive Conservative Party, says softer penalties for marijuana possession are warranted. Keith Martin of the Canadian Alliance says: "Serious criminals, rapists, pedophiles and murderers aren't getting prosecuted because our courts are tied up with kids who have been caught with a joint in their pocket. It's a losing battle and a waste of taxpayers' money." (Source: Wall Street Journal of 5 June 2001) 4. ONE YEAR AGO: - UK: Cross-party support for medical use of Cannabis - Canada: Extend of deadline for bidders for marijuana contract TWO YEARS AGO: - Canada: The first two patients got governmental approval to use marijuana -- Research plan for clinical studies and cultivation of cannabis - Science: Elevated endocannabinoids a compensation for a hyperactive dopamine system in schizophrenia? ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 24 June 2001 -------------------------------------------------------- Register now at: www.Berlin2001.net * USA: American Medical Association opposes criminalization of patients and physicians * Canada: Cannabis growers may get a license * Science: Cannabis use may rarely trigger heart attack in people with coronary disease 1. USA: American Medical Association opposes criminalization of patients and physicians A proposal to endorse the limited use of marijuana for seriously ill patients was rejected on 18 June at the American Medical Association's (AMA) annual meeting. The AMA preferred to allow individual doctors to make up their own minds about the issue. While the 547 delegates declared that scientific evidence was lacking to prove marijuana's medical usefulness, it reasserted its opposition to criminalizing patients or doctors who use it in a resolution on 19 June. "Our plea again is that no criminal sanctions be applied to marijuana use, and to encourage our patients to discuss this freely with their doctors," Dr. Herman Abromowitz said of the resolution. (Sources: Reuters of 19 June 2001, Associated Press of 19 June 2001) 2. Canada: Cannabis growers may get a license Officials of the Canadian health ministry (Health Canada) say that by the end of July, marijuana growers will be able to apply for special licenses to produce small amounts of cannabis legally for people with chronic diseases. Since 1999, more than 250 Canadians have received government permission to smoke marijuana for medical purposes, and many more will qualify when the new regulations take effect. The government is under pressure to have the new regulations ready to take effect by the end of July. An Ontario court of appeals last year gave the government until 31 July to improve the possibilities for the medical use of marijuana. (Source: Seattle Times of 17 June 2001) 3. Science: Cannabis use may rarely trigger heart attack in people with coronary disease Smoking cannabis moderately increases the risk of a heart attack for middle-aged and elderly users during the first hour after using the drug, a study published in the recent issue of the journal Circulation says. A small portion of patients with heart attack (0.2%) had smoked cannabis shortly before the symptoms started. Of the 3882 patients with heart attack, 124 reported smoking marijuana in the prior year, among them 9 within 1 hour of heart attack symptoms. The average age of the cannabis users was about 44, with 23% of them aged 50 to 69. The risk of heart attack onset was significantly elevated 4.8 times over baseline (95% confidence interval: 2.4-9.5) in the first hour after cannabis use. In the second hour it was 1.7 times greater, and returned to baseline afterwards. Cannabis use increases heart rate by about 40 beats per minute. It may also cause the blood pressure to increase when the person is lying down, and to decrease when the person stands up. With regular use tolerance develops to these effects. Dr. Murray Mittleman, a professor at Harvard Medical School and director of cardiovascular epidemiology at Beth Israel-Deaconess Medical Centre, and his colleagues wrote in their publication that smoking marijuana is "a rare trigger of acute myocardial infarction". He noted that cannabis was about as risky as taking a walk for an active person with heart disease, or as sex for a patient with sedentary life style. (Source: Mittleman MA, et al. Circulation 2001;103:2805, United Press International of 11 June 2001, Reuters of 11 June 2001, Boston Globe of 12 June 2001) 4. News in brief ***Netherlands - Health insurance Amicon The health insurance Amicon thinks about paying for the medical use of cannabis. The drug would be delivered by the Association of Cannabis Users of Enschede (VEC, Vereniging van Enschedese Cannabisconsumenten), VEC distributes marijuana that is grown without chemicals to about 4.000 persons, among them about 250 patients. (Source: De Twentsche Courant Tubantia of 14 June 2001) ***UK - GW at the stock market GW Pharmaceuticals said on 19 June it had increased the size of an initial public offering size (IPO) following strong demand from investors. It raised 25 million pounds ($34.8 million), or nine million pounds more than originally expected. GW expects to seek approval from UK regulators for its first cannabis based medicines in 2003. (Source: Reuters of 21 June 2001) ***Canada - Grant Krieger Grant Krieger, activist for the medical use of marijuana, was justified in breaking the law and selling cannabis to chronically ill people, a court ruled on 20 June. Krieger, 46, who has multiple sclerosis and has been fighting for more than five years to have the drug legalized for medical purposes, had been charged with possession for the purpose of trafficking. (Source: Canadian Press of 21 June 2001) ***USA - Nevada Governor Kenny Guinn signed a law on the use of cannabis for medicinal purposes. It allows patients or their caregivers to have up to seven plants for their personal use. It is similar to laws in Oregon and Maine in that respect. (Source: American Medical News of 25 June 2001) ***USA - Consequences of Supreme Court ruling In the first month since the Supreme Court said that it is illegal for third parties to sell marijuana for medical use, the decision appears to be having little effect in the eight states with medical marijuana laws. The Bush administration has taken no public action to enforce the ruling and has been silent about its next move. (Source: Associated Press of 14 June 2001) ***France - Medical use before the court On 29 May the administrative court of Paris rejected the possibility to import cannabis for medical use. In the name of 10 persons with incurable diseases the movement for controlled legalisation (MLC, Mouvement de légalisation contrôlée) had applied for the importation of 10 kilograms of cannabis. (Source: AFP of 29 May 2001) 5. ONE YEAR AGO: - Science: Tumour promoting effect of THC in animal study TWO YEARS AGO: - UK: Doctors urge legalising of cannabis for medicinal and recreational use ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 8 July 2001 -------------------------------------------------------- * Canada: New regulations will take effect at the end of July * Science: News at the 2001 meeting of the ICRS 1. Canada: New regulations will take effect at the end of July New regulations expanding the legal medical use of marijuana will take effect on 30 July. "Today's announcement is a landmark in our ongoing effort to give Canadians suffering from grave and debilitating illnesses access to marijuana for medical purposes," Health Minister Allan Rock said on 4 July. Special ID cards will be issued to people who are legally permitted to smoke, possess or grow cannabis for medical purposes. They would not require approval from a doctor, but need apply directly to the department, Rock said. The new regulations would make Canada the first country in the world to permit its citizens to legally use marijuana for medical purposes. Those applying for the licenses will have to show clear symptoms associated with certain illnesses and with a prognosis of death within 12 months, symptoms associated with officially listed medical conditions, or with "symptoms associated with other medical conditions." The regulations were drawn up after a court ruling last year that gave the government until July 31 to change criminal laws so that people requiring marijuana for medicinal purposes could legally obtain and possess it. 290 people have been authorized to possess and/or cultivate cannabis for medical purposes until now. (Sources: Associated Press of 4 July 2001, United Press International of 5 July 2001) 2. Science: News at the 2001 meeting of the ICRS At the annual meeting of the International Cannabinoid Research Society (ICRS) from 28 to 30 June in Spain a number of interesting new research results were presented. Some are presented below and in the next issue of the IACM-Bulletin. (1) The effects of oral and rectal THC on bladder function were investigated in 15 patients with spinal cord injury at the REHAB in Basel (Swiss Paraplegic Centre). THC positively influenced a number of parameters of bladder function, indicating a decrease of overactivity of the bladder sphincter. (Source: Abstract by Ulrike Hagenbach et al.) (2) A Spanish group demonstrated that cannabinoid receptors exist in the skin and that their activation inhibits the growth of skin cancer cells. CB1 and CB2 type receptors were found in several layers of the skin. In cell experiments a synthetic cannabinoid receptor agonist induced programmed cell death in skin cancers cells of mice. (Source: Abstract by M. Llanos Casanova, et al.) (3) The case of a women with severe chronic abdominal pain following operations of the bladder and the colon 18 years ago was presented. Within a twelve week period she received four different preparations in a double blind manner: THC, CBD, 50-50 mixture of CBD and THC, and placebo. She received almost total pain control. During the period were she received the CBD/THC mixture psychoactive side effects were much lower than with THC alone despite the same amount of THC. (Source: Abstract by William Notcutt, et al.) (4) Following traumatic brain injury in mice the level of the endocannabinoid 2-AG (2-arachidonoyl glycerol) was significantly elevated. High levels of 2-AG had a positive effect on recovery from brain injury. 2-AG and the cannabinoid system may play a neuroprotective role. (Source: Abstract by Raphael Mechoulam, et al.) (5) Pre-treatment with two different synthetic cannabinoids was able to protect against two causes of nerve damage in cell cultures. The two neurotoxic chemicals were given after the cannabinoids had already been removed. The neuroprotection by cannabinoids was dose-dependent and CB1-receptor mediated. (Source: Abstract by Shou Yuan Zhaung, et al.) (Source: Program and abstracts of the 2001 ICRS Symposium on the Cannabinoids) 3. New in brief ***USA - Oregon About 2.300 cards that allow the medical use of cannabis have been issued until now in Oregon. Since the overall population of Oregon is 3.4 millions this is about 700 in one million citizens or 0.7 in 1,000. (Source: American Medical News of 25 June 2001) ***Science - New cannabinoid receptor Experiments with mouse brain give evidence to the existence of a new cannabinoid receptor in the brain distinct from the CB1 receptor. (Source: Breivogel CS, et al. Mol Pharmacol 2001 Jul;60(1):155-163). ***Portugal - Decriminalization of drugs Cannabis-related offences, such as use are decriminalised from July 2001. Minor offences will no longer be treated as criminal but as administrative offences. The same applies to other drugs. (Source: European Monitoring Center for Drugs and Drug Addiction - www.emcdda.org) ***UK - Warning instead of fine A pilot program started on 2 July in a borough of London in which anyone caught with a small amount of marijuana is let off with a verbal warning. Authorities say the program, which will last for six months, is not about leniency, but about freeing officers from paperwork. (Sources: PA News of 2 July 2001, Associated Press of 5 July 2001) ***Germany - Hamburg Minister of Justice Minister of Justice of the state of Hamburg, Lore Maria Peschel-Gutzeit (Social Democratic Party), calls for a radical rethinking in the treatment of dying persons. Among others the use of cannabis use should be allowed for these patients. (Source: Berliner Kurier of 18 June 2001) 4. ONE YEAR AGO: - Germany: Petition committee of the Bundestag supports medical use of cannabis - Science: News at the meeting of the ICRS - Science: Cannabinoids in pain areas of the spinal cord TWO YEARS AGO: - USA: Government eases restrictions on THC capsule Marinol - Germany: Plans to classify cannabis as an unlicensed medicine ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 22 July 2001 -------------------------------------------------------- * Science: Discussion on the medical value of cannabinoids in British Medical Journal * Science: News at the 2001 meeting of the ICRS (II) 1. Science: Discussion on the medical value of cannabinoids in British Medical Journal Two review articles of historical data on the efficacy of cannabinoids in pain and chemotherapy-induced nausea published in the British Medical Journal of 7 July received much media interest. The review by Dr. Fiona A Campbell and colleagues concluded that "cannabinoids are no more effective than codeine in controlling pain (...)." The review by Dr. Martin R Tramèr et al. said that "in selected patients, the cannabinoids tested in these trials may be useful as mood enhancing adjuvants for controlling chemotherapy related sickness. Potentially serious adverse effects (...) are likely to limit their widespread use." In a commentary Dr. Elsa Kalso of the University of Helsinki expressed doubts whether there is need in cannabinoid-based drugs. Dr. Roger Pertwee of the University of Aberdeen said in an interview: "The data reviewed in the BMJ paper are the same as those we reviewed in the report of the British Medical Association on cannabis published in 1997. This report recommended that the prescription of cannabinoid medicines should be permitted for patients with intractable pain." In a letter to the editor Dr. Franjo Grotenhermen of the Cologne Nova-Institute noted that pooled data "will miss much of the interesting information, particularly differences in efficacy for different conditions (...) The question of interest is not whether cannabinoids are potent analgesics compared to codeine but in which painful conditions cannabinoids are effective." Dr. Philip Robson of GW Pharmaceuticals said: "GW agrees with the authors of the paper that post-operative pain is not the area in which cannabinoids are likely to provide superior therapeutic benefit over existing treatments. (...) However, the paper also recognises that cannabis could be useful in other areas of pain, in particular neuropathic pain and spasticity, and it is these areas in which GW is focusing its current research." (Sources: Campbell FA, et al. BMJ 2001;323:13; Tramèr MR, et al. BMJ 2001;323:16; Kalso E. BMJ 2001;323:2-3; www.gwpharm.com; Grotenhermen F. Letter to the editor of 19 July 2001) 2. Science: News at the 2001 meeting of the ICRS (II) Below are some more research results presented at the annual meeting of the International Cannabinoid Research Society (ICRS) from 28 to 30 June in Spain. (See also the last IACM-Bulletin.) (1) THC and other cannabinoids prevented programmed cell death (apoptosis) induced by ceramide in nerve cells (astrozytes). This effect was CB1 receptor mediated. (Abstract by Teresa Gómez del Pulgar, et al.) (2) Pilot studies with a cannabis extract in the UK with two female patients suffering from chronic back pain and sciatica and with two female multiple sclerosis patients demonstrate the variable responsiveness to a treatment with cannabis. One of the patients with back pain achieved substantial reduction of pain while there was only some improvement in sleep in the other. The two MS patients also showed marked differences with regard to benefit and side effects. (Two abstracts by William Notcutt, et al.) (3) The cannabinoid receptor antagonist SR141716 had antidepressant effects in an animal model of depression. Mice were suspended by applying adhesive tape near the end of the tail and their behaviour was studied. (Abstract by Richard E. Musty, et al.) (4) Endocannabinoids are important for normal food intake in newborn mice, which can be disturbed by the antagonist SR141716. The inhibition of neonatal food intake and growth by the antagonist is mostly a result of specific CB1-receptor blockade. (Abstract by Ester Fride, et al.) (5) The analgesic properties of THC (20 mg) and morphine (30 mg) alone and in combination in healthy subjects were tested. THC did not significantly reduce pain in the tests. Some analgesic effects were only observed in combination with morphine. (Abstract by Rudolf Brenneisen, et al.) (6) The activation of peripheral CB2 receptors produced antinoception to thermal stimuli. CB2 receptor agonists may have promise for the treatment of pain without causing central CB1 mediated effects. (Abstract by T. Philip Malan, et al.) CORRECTION: In the last IACM-Bulletin a study by Hagenbach et al. was presented. Erroneously it was stated that THC decreased the overactivity of the bladder sphincter. Actually THC decreased the overactivity of the bladder muscle (detrusor). (Source: Program and abstracts of the 2001 ICRS Symposium on the Cannabinoids) 3. News in brief ***Canada - Pharmacists are prepared Alberta pharmacists say they are prepared to distribute cannabis for medicinal purposes, if there is a supplier. "We would approach it the same as any other drug," said Greg Eberhart of the Alberta College of Pharmacists. The college is urging the profession to learn about proper doses, side effects and potential interactions. (Source: Calgary Herald of 19 July 2001) ***USA - Colorado/Kaiser Permanente Attorneys for Kaiser Permanente in Colorado have given its doctors a tentative green light to endorse medical use of cannabis for qualified patients. Doctors sought legal advice from the lawyers of the organisation in recent weeks after they became concerned about facing prosecution. Under state law, doctors must sign official documents stating that their patients could benefit from using marijuana. Kaiser Permanente is America's largest not-for-profit health maintenance organization, serving 8.1 million members in several states. (Sources: Denver Rocky Mountain News of 7 July 2001, www.kaiserpermanente.org) ***UK - Poll on cannabis A poll published on 8 July said a growing number of Britons were in favour of cannabis being legalised. A poll for the Independent on Sunday newspaper reported that 37 percent of Britons wanted the drug legalised with 51 percent opposed. In 1996 66 percent were against legalising cannabis, and just 26 percent in favour. The poll comes two days after Peter Lilley, a right-winger of the conservative party, who was minister in the cabinets of former Prime Ministers Margaret Thatcher and John Major, said cannabis should be legalised. (Source: Reuters of 7 July 2001). 4. ONE YEAR AGO: - Science/USA: Use of marijuana and THC safe in AIDS patients taking protease inhibitors - Science: News at the meeting of the ICRS (II) - Germany: Rejection of applications for the medical use of cannabis by the Federal Institute for Pharmaceuticals and Medical Products TWO YEARS AGO: - UK: Acquittal for a man who supplied cannabis to the ill - Canada: Addiction expert backs medical use of marijuana ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 5 August 2001 -------------------------------------------------------- * Canada: New rules on medical use of marijuana take effect * Science: Study with smoked cannabis in pain funded by Canadian government 1. Canada: New rules on medical use of marijuana take effect Canadians suffering from terminal illnesses and chronic conditions can legally grow and smoke cannabis, or designate someone else to grow it for them, under regulations that took effect on 30 July. About 300 patients are currently exempted from cannabis prohibition. More than 500 new applications are pending, and more are expected. The new rules permit drug possession for (1) the terminally ill with a prognosis of death within one year; (2) those with symptoms associated with specific serious medical conditions, among them severe arthritis, cancer, HIV/AIDS, epilepsy and multiple sclerosis; and (3) those with other medical conditions who have statements from two doctors saying conventional treatments have not worked. The regulations includes a government-approved supply of marijuana, now being grown in a former copper mine in northern Manitoba. The first marijuana harvest is expected this fall. It will be supplied by the government to eligible patients and used for research on therapeutic effects. The new health regulations were drawn up after a court ruling last year that gave the government until 31 July to create a way for people requiring marijuana for medicinal purposes to legally obtain it. (Source: Associated Press of 30 July 2001) 2. Science: Study with smoked cannabis in pain funded by Canadian government Health Minister Allan Rock, and Dr. Alan Bernstein, President of the Canadian Institutes of Health Research, announced on 26 July a Government of Canada contribution of $235,000 to fund a clinical study that will examine the therapeutic uses of cannabis. This is the first clinical trial related to the medical use of marijuana to be funded by Health Canada. Researchers at the Pain Centre of McGill University will conduct a one-year pilot study of smoked cannabis for chronic neuropathic pain at the General Hospital of Montreal. The study will also be the world's first peer-reviewed clinical trial examining the effects of smoked cannabis in a non-HIV or multiple sclerosis population. While other studies have tested the effects of cannabis constituents on pain, this will be the first trial in which participants will smoke the substance as outpatients. "The McGill Pain Centre has designed this study to mirror, as much as possible, the real-life conditions under which patients can currently use cannabis," said lead researcher Dr. Mark Ware, an assistant professor of anaesthesia at McGill University. (Source: CNN Newswire via COMTEX of 26 July 2001) 3. News in brief ***Science - Study in long-term users Four recipients of federally provided medical marijuana in the USA were examined for the health effects of their long-term cannabis use. Minor changes in pulmonary function were found in two of the four. No other negative functions were discovered. The study was headed by Montana neurologist Dr. Ethan Russo and Virginia nurse Mary Lynn Mathre. Results will be published in the Journal of Cannabis Therapeutics in January 2002. ***Science - Modulation of FAAH The enzyme fatty acid amide hydrolase (FAAH) plays a major role for the degradation of the endocannabinoid anandamide. Decrease of FAAH level leads to an increase of anandamide levels, resulting in possible therapeutic effects, e.g. analgesia. Thus, modulation of FAAH levels may be interesting for therapeutic purposes. (Cravatt BF, et al. Proc Natl Acad Sci U S A 2001;98(16):9371-9376) ***USA - San Mateo County study So far only one AIDS patient has met the strict criteria required for enrolment into a San Mateo County study. The county has been recruiting for its pioneering medicinal marijuana study for three weeks, since the arrival of the cannabis from a federal farm in Mississippi. (Source: Contra Costa Times of 25 July 2001) ***Science - Opiate withdrawal Findings of a study in mice suggest that in morphine dependence, upregulation of cannabinoid CB1 receptors occurs. Thus, CB1 receptor agonists may have potential as therapeutic drugs for opiate withdrawal symptoms. (Source: Yamaguchi T, et al. Brain Res 2001;909(1-2):121-126) ***Science - Brain tumours Local administration of a selective CB2 receptor agonist induced a considerable regression of malignant gliomas in mice. The results support a therapeutic approach for the treatment of this brain tumour without psychotropic side effects. (Source: Sanchez C, et al. Cancer Res 2001;61(15):5784-5789) ***Science - Amyotrophic lateral sclerosis Cannabis has many properties that may be applicable to the management of amyotrophic lateral sclerosis (ALS). These include analgesia, muscle relaxation, bronchodilation, saliva reduction, appetite stimulation, sleep induction, and neuroprotection. (Source: Carter GT, Rosen BS. Am J Hosp Palliat Care 2001;18(4):264-270) ***Science - Effects on circulation Cannabinoids elicit dilation of coronary and brain arteries in rats by direct activation of cannabinoid CB1 receptors of blood vessels. (Source: Wagner JA, et al. Eur J Pharmacol 2001;423(2-3):203-210) ***UK - Decriminalisation A BBC survey showed that at least 81 Labour members of parliament would be prepared to vote for decriminalisation of cannabis if it was recommended by a Royal Commission, against 31 who said they would oppose it. (Source: PA News of 19 July 2001) 4. ONE YEAR AGO: - IACM: First meeting at the Bioresource Hemp in September - Canada: Highest Court of Ontario calls marijuana law unconstitutional - Germany: Four days Bioresource Hemp with one day on cannabinoids - Science: Enhanced levels of endocannabinoids in the globus pallidus associated with reduction in movement in an animal model of Parkinson's disease TWO YEARS AGO: - Science: Kind of penalty has low effect on cannabis use ( More at the IACM-Bulletin archives: http://www.cannabis-med.org ) -------------------------------------------------------- IACM-Bulletin of 19 August 2001 -------------------------------------------------------- >> The IACM congress program at www.Berlin2001.org << * Canada: GW Pharmaceuticals starts clinical trials in Canada 1. Canada: GW Pharmaceuticals starts clinical trials in Canada GW Pharmaceuticals, a British company developing cannabis-based medicines for pain relief, said on 14 August it was starting clinical trials in Canada. The Phase II trial will take place under the supervision of Dr. Daniel DeForge of the Rehabilitation Centre, Ottawa Hospital. It will include sufferers of multiple sclerosis, spinal cord injury and other forms of chronic pain. World-wide two institutions are devoloping cannabis based medicines with the aim of pharmaceutical approval. The Institute for Oncological and Immunological Research, a Berlin-based research institute for medicinal plants, started phase II/III trials in 1999 with capsules containing a standardized cannabis extract. Clinical trials are under way or have recently been completed in Germany, the Netherlands, Switzerland, and the UK. The institute intends to advance drug development with cannabis to a certain point and than to enter into license negotiations with a pharmaceutical company. GW Pharmaceutical, a Salisbury-based firm, started phase II trials in 2000 with under-the-tongue sprays of a standardized cannabis extract in the UK and also intends to expand their trials to other countries. (Sources: Reuters of 14 August 2001, PA News of 14 August 2001, personal communications) 2. News in brief ***Jamaica - Government commission for legalization A government commission report released on 16 August recommends legalizing the private use and possession of small amounts of the cannabis by adults. The report by the National Commission for Ganja argues that moderate use of the drug causes no short or long-term health effects among most users. "Marijuana's reputation among the people as a panacea and a spiritually enhancing substance is so strong that it must be regarded as culturally entrenched," the report says. (Sources: AP of 16 and 17 August 2001) ***Science - Pain Animal research demonstrated that cannabinoids that bind to the CB1 cannabinoid receptor act on a part in the brain (called: nucleus reticularis gigantocellularis pars alpha, GiA) that is important for mitigation of neuropathic pain. (Source: Monhemius R, et al. Brain Res 2001 Jul 10;908(1):67-74) ***Germany - Health insurance German health insurances may refuse to pay for a treatment with dronabinol (THC) prescribed by physicians, a judge of a social welfare tribunal ruled on 9 August in disfavour of a patient with multiple sclerosis from Mannheim. The patient who already tried to obtain legal access to cannabis with a complaint before the Federal Constitutional Court, was denied reimbursement of the treatment costs with dronabinol. A treatment with dronabinol is about 10 times more expensive than treatment with illegal cannabis in Germany. (Source: Personal communication) ***USA - Oregon tightens rules On 10 August Oregon tightened rules doctors must follow under the state's medical-marijuana law, responding to the discovery that a single doctor has signed 40 percent of the state's marijuana applications. Under the new rules, a physician who signs a written statement on behalf of an applicant must maintain an up-to-date medical file for the patient, create and perform a treatment plan. The stricter regulations will apply only to pending and future applications. (Source: Seattle Times of 11 August 2001) ***IACM - Frequently asked questions Every two weeks you will find a new answer to a frequently asked question on the web site of the IACM at "Ask the IACM". Topics already online comprise pregnancy, interactions with other medicines, asthma, chromosomal damage, heart attack, male fertility, migraine, cannabis tincture and Alzheimer's disease. Next to come: urine tests, risks of cannabis smoking. ***Science - Intraocular pressure THC lowers intraocular pressure. This effect was substantially attenuated by local pre-treatment with indomethacin, suggesting that THC may influence intraocular pressure at least in part by a prostaglandin-mediated process. Indomethacin is a non steroidal anti-inflammatory drug and is already known to reduce psychic effects and tachycardia caused by THC. (Source: Green K, et al. Ophthalmic Res 2001 Jul-Aug;33(4):217-20) ***Science - Cannabinoid receptors Cannabinoid receptors have been reported to exist in mammals, birds, amphibians, fish, sea urchins, leeches, mussels, and Hydra polyps but they seem to be absent in insects. (Source: McPartland J, et al. J Comp Neurol 2001 Aug 6;436(4):423-9) 3. ONE YEAR AGO: - USA: Legal fight for opening of the Oakland Cannabis Buyers Cooperative - Belgium: Seminar on marijuana in Parliament TWO YEARS AGO: - USA: Nevada Pharmacy Board wants study on marijuana ballot question - UK: Party leader and two leading Scottish church officials call for a debate on drug laws -------------------------------------------------------- IACM-Bulletin of 2 September 2001 -------------------------------------------------------- * Science: Cannabis less effective against vomiting than serotonin antagonists 1. Science: Cannabis less effective against vomiting than serotonin antagonists In an experimental study with 13 healthy volunteers smoked cannabis was effective in reducing nausea and vomiting, but the 5-HT3 (serotonin) antagonist ondansetron was significantly more effective. The study at the Department of Psychiatry of the University of Chicago examined the antiemetic effect of smoked marijuana cigarettes containing 8.4 and 16.9 mg THC compared to 8 mg ondansetron. Nausea and emesis were induced by syrup of ipecac. Marijuana significantly reduced ratings of nausea and slightly reduced the incidence of vomiting compared to placebo. Ondansetron completely eliminated the emetic effects of ipecac. These findings support and extend previous results, indicating that smoked marijuana reduces feelings of nausea and also reduces emesis. However, its effects were evaluated to be modest relative to the highly potent antiemetic drug ondansetron. Ipecac (or: ipecacuanha) is a plant extract which when swallowed causes vomiting usually in 15-20 minutes. It is used in medicine after poisoning to eliminate the poison from the stomach. (Source: Soderpalm AH, et al. Antiemetic efficacy of smoked marijuana. Subjective and behavioral effects on nausea induced by syrup of ipecac. Pharmacol Biochem Behav 2001 Jul;69(3-4):343-350) 2. News in brief ***Science - Two surveys The German ACM in co-operation with the Institute for Oncological and Immunological Research in Berlin is conducting a survey on the medical use of cannabis and dronabinol. The questionnaire is available in German only. Dr. Ethan Russo is conducting a survey on the medical use of cannabis in migraine/headache. The questionnaire is available in English only. The questionnaires are available at: www.cannabis-med.org/german/fragebogen.htm www.cannabis-med.org/english/questionnaire.htm ***Science - Hyperalgesia Cannabinoids attenuated hyperalgesia evoked by intraplantar injection of capsaicin in rats through spinal and peripheral mechanisms. The study shows that cannabinoids possess antihyperalgesic properties at doses that alone do not produce analgesia. (Source: Johanek LM, et al. Pain 2001 Sep;93(3):303-315) ***USA - New DEA chief The new chief of the US drug control agency DEA (Drug Enforcement Administration), Asa Hutchinson, said on 20 August he would strive to enforce the prohibition of the medical use of cannabis. Speaking to reporters on his first official day on the job, he said that the scientific and medical organisations have thus far determined there is no legitimate medical use for marijuana. (Sources: Associated Press of 20 and 21 August 2001) ***USA - Increased support for legalization According to a poll by USA Today, CNN and Gallup support for legalizing marijuana is at its highest level since polls included this question in 1969. The poll found that 34% favoured legalizing marijuana use while 62% were opposed. Support for legalization was highest among 18- to 49-year-olds and people in the West. Opposition was greatest among the elderly. Parents with children under 18 had similar views as others. (Source: USA Today of 23 August 2001) ***USA - Nevada A state-run medical marijuana program allowing patients to grow and use the drug will begin on 1 October after unanimous approval of regulations by the responsible authorities on 30 August. Under the state law, patients with a corresponding approval can grow small amounts of the drug in their homes for personal use. (Source: Las Vegas Review-Journal of 31 August 2001) ***Argentina - Cortese on medical use Lorenzo Cortese, chief of the drug control agency, is open for the medical use of cannabis. "If there is a scientific consensus on the beneficial effects of the use of marijuana in terminal patients, there is no doubt that this would impel legalization," he said. He added that this issue should be treated similar to the medical use of opiates, but said that so far the results of studies into the therapeutic effectiveness of cannabis were not definite. (Source: La Nación of 27 August 2001) ***USA - Hawaii So far, more than 200 patients are allowed to use marijuana for medical purposes. Over a year ago, the medical use of cannabis was legalized in Hawaii. But the Hawaii Medical Association is opposed to prescribing cannabis, because physicians who recommend medical marijuana could be subject to criminal prosecution by federal authorities. (Source: U-WIRE via COMTEX of 28 August 2001) 3. ONE YEAR AGO: - USA: Center for Medicinal Cannabis Research at the University of California - Science: THC derivative CT-3 safe in Phase I clinical trial - USA: Supreme Court stops marijuana distribution in California TWO YEARS AGO: - The Netherlands: Installation of a cannabis agency for research purposes - Switzerland: Five variants for a new law on drugs under discussion -------------------------------------------------------- IACM-Bulletin of 16 September 2001 -------------------------------------------------------- * Science/UK: 77 percent show relief in pain studies of GW * Science/UK: 200 patients enrolled in multiple sclerosis study of MRC 1. Science/UK: 77 percent show relief in pain studies of GW GW Pharmaceuticals said on 10 September its cannabis spray had delivered significant benefit for 77 percent of chronic pain sufferers in clinical trials. 41 out of the first 53 patients enrolled in the Phase I and II studies derived statistically significant benefit, including reduced pain, improved sleep and overall symptom relief. Side effects, including headaches and nausea, were "predictable and generally well tolerated," the study added. Some patients did become intoxicated but generally the ability to control dosage with the spray mechanism allowed users to strike a balance between pain reduction and psychic effects. Results of trials at three centres in Great Britain (Oxford, Great Yarmouth and London) were presented at the meeting of the American Academy of Pain Management in Arlington. Dr William Notcutt of James Paget Hospital in Great Yarmouth in eastern England outlined promising results from one of the studies at the British Association for the Advancement of Science Conference in Glasgow (Scotland) on 3 September. He studied 23 people with intractable pain for more than a year. Only one of the 23 patients failed to benefit from the cannabis spray that is applied under the tongue and two others dropped out because of side effects. (Sources: Reuters of 3 and 10 September 2001, Financial Times of 4 September 2001) 2. Science/UK: 200 patients enrolled in multiple sclerosis study of MRC Two hundred people have signed up for the first large scale British study into the effects of cannabis on multiple sclerosis, it was announced on 6 September. The research is funded with 1.2 million pounds (about 1.77 million US dollars) by the Medical Research Council (MRC). The study protocol was developed by the Royal Pharmaceutical Society of Great Britain. Dr John Zajicek of Derriford Hospital, Plymouth, is leading the project. In January 2001 the first recruits were signed up in Plymouth and from June the trial was extended nationwide. In total 660 people are needed for the three-year programme, which will involve 38 hospitals across Britain. Patients are randomly given one of three treatments, capsules with cannabis extract, THC capsules (Marinol), or placebo capsules. Results are expected by summer 2003. (Source: PA News of 6 September 2001) 3. News in brief ***Science - Neuroprotection THC was neuroprotective in rats given the toxic agent ouabain. THC treated animals showed reduced volume of oedema by 22% in the acute phase and 36% less nerve damage after 7 days. The effect was not CB1 receptor mediated. (Source: van der Stelt, et al. J Neurosci 2001 Sep 1;21(17):6475-6479) ***Science . Antitumour effects A synthetic non-psychotropic derivative of the THC metabolite THC-CCOH showed antitumour effects in mice. Ajulemic acid (CT3) inhibited the growth of subcutaneously implanted human glioma cells by acting primarily via CB2 receptors. In vitro, ajulemic acid proved to be approximately one-half as potent as THC in inhibiting tumour growth against a variety of cancer cell lines. However, its effects lasted longer. (Source: Recht LD, et al. Biochem Pharmacol 2001 Sep 15;62(6):755-763) ***Science - Discrimination of use 11-COOH-THCV (11-nor-delta-9-tetrahydrocannabivarin-9-carboxylic acid), a major metabolite of delta-9-tetrahydrocannabivarin (THCV), was identified in the urine of cannabis users but not in the urine of users of Marinol (THC). Thus, the identification of 11-COOH-THCV indicates the use or ingestion of natural cannabis products. THCV is one of the 9 known cannabinoids of the THC type. (Source: ElSohly et al. J Anal Toxicol 2001 Sep;25(6):476-480) ***Science - Schizotypal features Research examined the relationship between cannabis use and schizotypal features in 20 healthy cannabis users and 20 controls, all of them students of the university of Hamburg. Cannabis users exceeded controls in schizotypal scores. Schizotypal subjects seem to be more likely to use cannabis than the general population. (Source: Mass R, et al. Psychopathology 2001 Jul;34(4):209-214) 4. ONE YEAR AGO: - USA: California doctors can recommend marijuana, a federal judge ruled - Canada: Minister announces new approach for the use of marijuana for medical purposes TWO YEARS AGO: - USA: Federal Appeals Court opens door to legal medical use of cannabis - Switzerland: MS Society for legal medical use of cannabis -------------------------------------------------------- IACM-Bulletin of 30 September 2001 -------------------------------------------------------- * Science: Cannabis and THC improve bladder function in MS and spinal cord injury 1. Science: Cannabis and THC improve bladder function in MS and spinal cord injury Preliminary results of clinical research conducted in the UK and in Switzerland show that cannabis and THC are able to reduce hyperactivity of the bladder in patients with multiple sclerosis and spinal cord injury. The Swiss study conducted at the REHAB in Basel under the guidance of Dr. Ulrike Hagenbach includes 15 patients with spastic spinal cord injury who received oral or rectal THC. Compared to placebo there was an improvement of some parameters of bladder activity, e.g. maximum capacity of the bladder (MCC, maximum cystometric capacity). The British study conducted at the National Hospital for Neurology and Neurosurgery in London under the guidance of Dr. Ciaran Brady and professor Clare Fowler includes patients with advanced multiple sclerosis and problems with bladder function who received a cannabis spray under the tongue. Early results of 10 evaluable patients have been presented to the Association of British Neurologists. Maximum capacity of the bladder increased and frequency of need to empty the bladder during day and night decreased. Details of the research results will be presented at the upcoming conference of the International Association for Cannabis as Medicine on 26-27 October in Berlin (). (Sources: Press release of the British Medicinal Cannabis Research Foundation of 26 September 2001, abstracts of Ciaran Brady and Ulrike Hagenbach for the IACM Berlin conference) 2. News in brief ***USA - Nevada A program on the medical use of cannabis starts on 1 October. Qualified patients may grow up to seven cannabis plants and are registered in a confidential patient registry. Nevada is the ninth state of the USA to establish a medical marijuana program. Nevadans voted in 1998 and 2000 in favour of the medical use of marijuana. (Source: Las Vegas Review-Journal of 31 August 2001) ***Science - Multiple sclerosis Researchers found changes in cannabinoid receptor binding in certain brain regions (striatum, cortex) of rats with experimental allergic encephalomyelitis (EAE). The EAE is an animal model of multiple sclerosis. These changes might be related to the alleviation of some motor signs observed after the treatment with cannabinoids in multiple sclerosis. (Source: Berrendero F, et al. Synapse 2001 Sep 1;41(3):195-202) ***Science - Cancer Palmitylethanolamide (PEA) enhances the anti-cancer effect of the endocannabinoid anandamide in human breast cancer cells, in part by inhibiting the expression of fatty acid amide hydrolase (FAAH). The FAAH is responsible for the degradation of anandamide. PEA also enhanced the anti-cancer effect of the cannabinoid receptor agonist HU-210. (Source: Di Marzo V, et al. Biochem J 2001 Aug 15;358(Pt 1):249-55) ***UK - Activist arrested A legalise cannabis activist had to appear before the court on 25 September. Colin Davies was arrested on 15 September after he attempted to open Britain's first cannabis cafe. The aim of the shop was to sell cannabis to recreational users at a higher price so people who used it for medical purposes could get it cheaper. He has to appear again before the court on 27 November. (Source: PA News of 15 and 25 September 2001). ***UK - Drug market The UK market for cannabis was about 1.58 billion pounds (about 2.33 billion US dollars) in 1998 according to research conducted for the government. The total street value of all illegal drugs in 1998 was estimated to be 6.61 billion pounds (about 9.75 billion US dollars) (Source: PA News of 21 September 2001). ***Science - Withdrawal There seems to be a reciprocal relationship between the cannabinoid and opioid system in dependence. THC was able to block some of the withdrawal symptoms in morphine dependent mice, and morphine was able to reduce some of the withdrawal symptoms in THC dependent mice. The mu-opioid receptor seems to be involved in THC dependence. (Source: Lichtman AH, et al. J Pharmacol Exp Ther 2001 Sep;298(3):1007-14) ***USA - California The city of San Diego is considering a plan to issue identity cards for approved users of medical marijuana. Until now San Francisco is the only large California city that issues medical such identity cards. (Source: Associated Press of 25 September 2001) 3. ONE YEAR AGO: - IACM: Principles and structure of the IACM - Canada: Marijuana available from the Health Ministry within one year - USA: Patent for a cannabinoid patch TWO YEARS AGO: - USA: Study with smoked marijuana in migraine approved - Australia: Calls for legal access to medical use of cannabis - USA: FDA regarding designation of marijuana as an Orphan Drug - USA: Washington D.C. voted in favour of medical use of marijuana - USA: Sale of Marinol increased -------------------------------------------------------- IACM-Bulletin of 14 October 2001 -------------------------------------------------------- * Germany: THC Pharm gets permission for the production of a cannabis extract * USA: DEA defines all products that contain THC to be schedule I controlled substances * Spain: Elected president of the ICRS against medical use of marijuana 1. Germany: THC Pharm gets permission for the production of a cannabis extract The Frankfurt firm THC Pharm got the approval from the authorities to produce a cannabis extract. The firm told the press that it wants to use plants from Central Asia, which are cultivated outdoors and not cloned. Since a cannabis extract cannot be prescribed there is a need for a change in the narcotics act which is possible soonest at the end of 2002. Until then it is intended to develop a preparation. Today THC Pharm derives dronabinol from fibre hemp that can be used by pharmacies for the preparation of medicines. In November 2001 the Federal Association of German Pharmacists Societies will publish a monograph on dronabinol and instructions for the manufacturing of dronabinol capsules and oily dronabinol drops. Further German pharmaceutical firms, that are engaged in the development of cannabis preparations since this year are Merck and Bionorica. (Sources: Press release of THC Pharm of 2 October 2001, personal communications) 2. USA: DEA defines all products that contain THC to be schedule I controlled substances In a document published on 9 October in the Federal Register, the Drug Enforcement Administration (DEA) issued an interpretive rule stating that under the Controlled Substances Act (CSA) and DEA regulations, any product that contains any amount of tetrahydrocannabinols (THC) is a schedule I controlled substance, even if such product is made from portions of the cannabis plant that are excluded from the CSA definition of "marihuana." These regulations are intended to ban products from hemp seed and hemp seed oil that contain minor amounts of THC. In another document issued on 9 October, DEA is issuing interim rules. The document says: "Any person who, as of October 9, 2001, possesses a THC-containing hemp product not exempted from control under this interim rule has until February 6, 2002 to dispose of such product in the manner described in this document." (Sources: FedNet via COMTEX of 9 October 2001, http://www.nara.gov/fedreg/) 3. Spain: Elected president of the ICRS against medical use of marijuana On the web site of the Spanish journal Muy Interessante Dr. José Javier Fernández, professor at the universities of Barcelona and Madrid and elected president of the International Cannabinoid Research Society (ICRS), speaks out against the medical use of cannabis and in favour of synthetic cannabinoids. Marijuana would often be smoked and mixed with tobacco. There were many substances in cannabis, about 60 different cannabinoids, other molecules and substances that are used for adulteration of the illegal drug. "This mixture does not seem recommendable for medical use." Single cannabinoids, such as the THC derivative nabilone would "optimise the forms of treatment by control of dose and duration that is not possible with marijuana." Therapeutic modulation of the endogenous cannabinoid system would be possible with synthetic cannabinoids, such as JWH133. "The future of cannabinoids consists in this type of individual substances ..." Dr. Franjo Grotenhermen of nova Institute in Cologne, chairman of the International Association for Cannabis as Medicine, argued: "From clinical studies with single cannabinoids and whole plant preparations we have no scientific arguments that would exclude one or the other (single cannabinoids or cannabis) from therapeutic use. Most arguments that are used against the medical use of illegal cannabis are arguments against cannabis prohibition, since it is no problem to standardize cannabis, refrain from adulteration and use healthy ways of application. JWH133 is a CB2 receptor agonist and it is recommended to prefer a CB2 agonist over a CB1 agonist if the first is effective. However, it will be difficult to achieve therapeutic effects mediated by CB1 receptors of the brain without causing psychic effects. The attempt to separate desired and unwanted effects failed with opiates and other drugs acting on the central nervous system." (Source: http://www.muyinteresante.es/canales/muy_act/set_pyc.htm) 4. News in brief ***USA - DEA seizes patient files The Drug Enforcement Administration agents on 28 September seized files that contain legal and medical records of more than 5,000 patients who use marijuana. Agents raided the home and office of Dr. Mollie Fry, a physician, and her husband, Dale Schafer, a lawyer. Fry and Schafer run the California Medical Research Center in Cool, California, a clinic specializing in medicinal marijuana. DEA spokesman Richard Meyer said the search warrant for the records was signed by a federal magistrate, but he would not discuss what narcotics agents were looking for. (Source: Tahoe Daily Tribune of 3 October 2001) ***Germany - Certification for IACM-congress The congress on cannabis and the cannabinoids of the IACM on 26-27 October in Berlin will be officially certified as a medical training seminar by the competent authority. ***Science - Patients' attitudes A self-completion questionnaire was used to investigate patients' beliefs about cannabinoids and the associations between those beliefs and their willingness to try cannabinoids as analgesics. 52% of patients were doubtful about taking cannabinoids: unwillingness was strongly associated with specific concerns about side effects, addiction, tolerance, and losing control. (Source: Gill A, Williams AC. Clin J Pain 2001 Sep;17(3):245-8) ***Science - Alcohol and cannabis In a study with human subjects ethanol increased THC blood levels and subjective effects after marihuana smoking. Data suggest that ethanol may increase the absorption of THC. (Source: Lukas SE, Orozco S. Drug Alcohol Depend 2001 Oct 1;64(2):143-9) ***Science - Hemp seed oil Medical researchers of the University of Kuopio, Finland, investigated the effects of hemp seed oil on physical parameters in a double blind study with 14 subjects, who ingested either 30 ml hemp seed oil or linseed oil for a period of four weeks. Hemp seed oil resulted in statistically higher levels of GLA (gamma-linolenic acid) in the serum triglycerides and in the cholesteryl esters. Both oils showed statistically significant increases in blood levels of linoleic acid and alpha-linolenic acid. Increased serum levels of GLA might help explain beneficial effects in some chronic diseases such as allergies and rheumatoid arthritis, Dr Jace Callaway, one of the principal investigators said. (Source: Press release of the University of Kuopio of 17. September 2001). 5. ONE YEAR AGO: - Europe: Governments soften line on cannabis - Spain/Science: Anti-tumour effect of THC cannot be investigated in humans TWO YEARS AGO: - Science: Pain triggers release of endocannabinoids - Canada: 14 patients getting legal access to marijuana - Australia: Medicinal cannabis by mail order -------------------------------------------------------- IACM-Bulletin of 28 October 2001 -------------------------------------------------------- * The Netherlands: Dutch government wants to allow the medical use of cannabis * Science: News at the 2001 congress of the IACM 1. The Netherlands: Dutch government wants to allow the medical use of cannabis The Dutch government decided on 19 October to change the law to allow doctors to prescribe cannabis and pharmacists to supply it with "pharmaceutical quality". Parliament is expected to vote in the next few months on the proposal to put medicinal marijuana on the national health care plan. Most users would then have the cost of their joints paid by the government as long as it is prescribed by a doctor. The Bureau for Medicinal Cannabis of the Health Ministry will supervise the growing of marijuana, its quality control and distribution. No exact date has been set for the program's launch as it was not yet clear how long preparations will take. The law is needed to remove an "undesirable" contradiction between practice and law "despite lack of scientific evidence" of the effects of marijuana use, a government statement said. Many patients using the drug without professional assistance have had successful results, it added. "Experiences are positive: less pain, less nausea after chemotherapy, less stiffness with MS," the statement said. Although the sale of cannabis is technically illegal, Dutch authorities tolerate the sale of small amounts in hundreds of so-called "coffee shops". "People with painful diseases such as AIDS are going to coffee shops, but there is no doctor who is controlling the use," Health Ministry spokesman Bas Kuik said. (Sources: Reuters of 19 October 2001, AP of 19 October 2001, dpa of 19 October 2001) 2. Science: News at the 2001 congress of the IACM At the 2001 meeting of the International Association for Cannabis as Medicine (IACM) from 26 to 27 October in Berlin (Germany) a number of interesting new research results were presented. Some are presented below. (1) The effects of an extract of cannabis in animal tests of depression, spasticity and analgesia were examined. The cannabis extract did not produce an anti-depressive effect in mice. However, the extract produced a decrease in spastic behaviours and showed analgesic properties. These data suggest that THC extracts will be useful for spastic conditions and for pain. (Source: Abstract by Richard Musty and Richard Deyo) (2) Patients and rats with liver cirrhosis have low blood pressure. In rats the low pressure can be elevated by a CB1 receptor antagonist, which also reduces the elevated blood flow in the arteries of the intestine (Aa mesenteriae). Compared with non-cirrhotic controls, in cirrhotic human livers there was a three-fold increase in CB1 receptors on isolated endothelial cells of the blood vessels. The results indicate a novel approach for the treatment of the vasodilated state of advanced liver cirrhosis. (Source: Abstract by Jens Wagner) (3) Research in rats show that CB receptor agonists exerts an inhibitory influence on bladder motility but an excitatory influence on uterus motility. This inhibitory effect was greater in rats with inflamed bladders than in rats with uninflamed bladders, suggesting that inflammation increases effectiveness of cannabinoids in the bladder. The effect on the uterus was reduced in rats with inflamed bladders. This research supports the positive effects on the hyperactive bladder in patients with multiple sclerosis and spinal cord injury. (Source: Abstract by Karen Berkley and Natalia Dmitrieva) (4) In a patient with multiple sclerosis a cannabis extract with a THC/CBD ratio of 1:1 was better tolerated than THC alone. Her main pain problems were severe urethral pain and a pain deep within her pelvis. She achieved almost total pain control from the cannabis extract. Psychological side effects were predominantly seen during the periods when she used THC alone. During the periods when she used a 1:1 mixture of THC and CBD, the incidence of side-effects fell dramatically, although she was using the same overall amount of THC. (Abstract by William Notcutt) Abstracts will be published in the Journal of Cannabis Therapeutics. (Source: Program and abstracts of the IACM 2001 congress on cannabis and the cannabinoids) 3. News in brief ***Science - Nausea Cannabinoids inhibit vomiting through CB1 receptors in the brainstem of the ferret. Endocannabinoids are a novel neuroregulatory system involved in the control of emesis. (Source: Van Sickle et al. Gastroenterology 2001 Oct;121(4):767-74) ***Science - Cannabidiol The non-psyotropic plant-cannabinoid cannabidiol (CBD) might exert some effects by activation of the vanilloid receptor type 1 or by increasing the levels of anandamide. (Source: Bisogno T, et al. Br J Pharmacol 2001 Oct 4;134(4):845-852) ***Science - Cocaine relapse In cocaine dependent rats the selective CB1 receptor antagonist, SR141716A, attenuated the relapse to cocaine seeking induced by re-exposure to cocaine. Data reveal an important role of the cannabinoid system in the neuronal processes underlying relapse to cocaine seeking. (Source: De Vries TJ, et al. Nat Med 2001 Oct;7(10):1151-4) ***USA - Marijuana arrests Police arrested an estimated 734,500 persons for marijuana violations in 2000, according to a report by the FBI released on 22 October 2001, the highest ever recorded by the FBI. (Source: NORML of 22 October 2001) 4. ONE YEAR AGO: - Science: THC reduces nausea and vomiting associated with HIV therapy - USA: Medical marijuana registry in Oregon successful TWO YEARS AGO: - Science: Endocannabinoids in glaucoma - Australia: New South Wales government wants to set up a committee on the medical use of cannabis -------------------------------------------------------- IACM-Bulletin of 11 November 2001 -------------------------------------------------------- * IACM: 2001 Conference on Cannabis and the Cannabinoids * IACM: New members of the Board of Directors and the Patient Representative * USA: Drug Enforcement Administration raids Californian medical cannabis club * UK: Cannabis laws to be eased 1. IACM: 2001 Conference on Cannabis and the Cannabinoids On 26-27 October the IACM hold its first international conference on cannabis and the cannabinoids in cooperation with the Berlin Medical Association and the Charité at the Virchow Clinic of the Berlin Charité with about 80 participants from 10 countries. About 35 speakers contributed to the lecture sessions and/or the workshops on Sepsis/circulation, Politics, Appetite loss/nausea/antiemesis, Dependency/addiction, Pain, and Neurology. Participants enjoyed sharing first hand information on new research results and exchanging ideas. The 38-page volume of abstracts containing most of the talks (Rik Musty, Jens A. Wagner, Margret R. Höhe, Bela Szabo, Joerg Fachner, Ester Fride, Donald I. Abrams, Karen J Berkley, Ciaran M Brady, Ulrike Hagenbach, Andreas M. Stadelmann, Eberhard Schlicker, Myra Klee, Franjo Grotenhermen, Kirsten Mueller-Vahl, Rudolf Brenneisen, Clare Hodges, Florian Strasser, Thomas M. Tzschentke, Tod Mikuriya, and Derik Hermann) is available by sending a bank note of 10 US dollars or 20 German Marks to the IACM requesting the volume of abstracts. There is only an English version available. Abstracts will also be reprinted in the Journal of Cannabis Therapeutics. On 27 October there was a parallel event for the public at the Berlin Medical Association with 12 review lectures on the medical use of cannabis products and their possible side effects. 2. IACM: New members of the Board of Directors and the Patient Representative Dr. Ethan Russo (USA), Dr. William Notcutt (UK), and Dr. Ricardo Navarrate-Varo (Spain) have been elected as new members of the Board of Directors at the General Meeting of the IACM on 25 October in Berlin. Before, the number of the Board of Directors had been increased from a current maximum of seven to a maximum of ten members. The current board members Dr. Franjo Grotenhermen (Germany, Chairman), Dr. Kirsten Müller-Vahl (Germany), Dr. Martin Schnelle (Germany), Dr. Ulrike Hagenbach (Switzerland) and Dr. Kurt Blaas (Austria) were confirmed. Clare Hodges, Chair of the UK Alliance for Cannabis Therapeutics, was elected as the first member of the Patient Representative, that may comprise a maximum of two members. The membership fee for regular members was slightly increased, from 60 to 75 Euros/US-Dollars, so that regular membership will now include a subscription to the Journal of Cannabis Therapeutics. (Source: Minutes of the IACM General Meeting on the 25th of October 2001) 3. USA: Drug Enforcement Administration raids Californian medical cannabis club Drug Enforcement Administration agents searched the Los Angeles Cannabis Resource Center (LARC) on 25 October, seizing computers, financial documents, 400 marijuana plants and medical records of some 3,000 current and former patients. The centre, which has been open since 1996, provides marijuana to patients suffering from AIDS, epilepsy, glaucoma, cancer and other serious illnesses. At a press conference on 26 October with Scott Imler, president of the LARC, members of the West Hollywood City Council and a representative of the Los Angeles County Sheriff's Department, Councilman John Duran said: "Our city is going to stand with our residents and this club. These people will be forced once again into the streets to deal with drug dealers." In the following days others shut their club down themselves. The owners of the club 'Cannabis Healing Californians' said they think the Drug Enforcement Administration raid of the LARC is the opening shot in a large-scale attack on the medical use of marijuana by the Bush administration. "They have completely destroyed the legal medical marijuana market in Los Angeles," Dr. Dale Gieringer of the National Organization for the Reform of Marijuana Laws said. On 5 November District Attorney Terence Hallinan asked the Drug Enforcement Administration to rethink its campaign against the clubs and "to respect our city's approach to medical marijuana, which has reduced crime, saved money and contributed to public well-being." (Sources: Associated Press of 26 October and 7 November 2001, Los Angeles Independent of 3 November 2001, San Francisco Bay Guardian of 6 November 2001) 4. UK: Cannabis laws to be eased Home Secretary David Blunkett announced on 23 October he wants the laws covering cannabis to be eased so possession will no longer be an arrestable offence. The drug would remain illegal but be re-classified from a class 'B' to a class 'C' drug. The aim is to free police to concentrate on harder drugs and improve current legislation. In a parallel move, licensing of cannabis derivatives for medical use will be given government backing if current trials prove successful. Cannabis possession and supply would remain a criminal offence, attracting maximum sentences of five years for supply and two years for possession. But rather than arresting people caught with cannabis, police will be more likely to issue a warning. Present classes: Class A. Heroin, cocaine, Ecstasy, LSD. Class B. Amphetamines, cannabis. Class C. Anabolic steroids, benzodiazepines. According to a poll carried out by Mori for the News of the World following Blunkett's announcement a majority of Britains believe cannabis should be legal and sold under licence in a similar way to alcohol. Some 65% of those questioned agreed it should be legalised and 91% said it should be available on prescription from doctors. In a debate in the House of Commons on 9 November several speakers welcomed the move by the Home Secretary but urged the government to go further. (Sources: The Times of 24 October 2001, BBC News of 23 October 2001, PA News of 28 October and 9 November 2001) 5. News in brief ***Science - Journal of Cannabis Therapeutics A PDF file of a free sample copy of the Journal of Cannabis Therapeutics is now available online on the web site of the IACM at http://www.cannabis-med.org/science-international/JCANT.htm ***USA - Arkansas The majority of Arkansans surveyed in a new poll favour the legalization of cannabis for medicinal purposes, if its use is directed by a doctor. The third annual Arkansas Poll found that 63 percent of 767 state residents, questioned in a telephone survey, supported legal medicinal access to cannabis. (Source: ASCRIBE NEWS via COMTEX of 25 October 2001) ***USA - Nevada State officials of Nevada said they are unaware of any moves by the Federal Justice Department against Nevada's medical marijuana program that began on 1 October. Nevada's law is different to that in California and would less likely provoke similar action. (Source: Associated Press of 1 November 2001) ***Canada - Cannabis Bill According to member of parliament Keith Martin a majority of federal politicians support his bill calling for the decriminalisation of marijuana. Bill C-344 would impose a system of fines - up to $1,000 - rather than criminal penalties for possession of small amounts of cannabis. (Source: Globe and Mail of 8 November 2001) ***Spain - Study with dronabinol The Health Minister announced on 24 October that it had approved two clinical phase III trials with cannabinoids. One will investigate the effect of the natural cannabinoid THC (dronabinol) in patients with glioblastoma, a type of aggressive brain tumour. The other will investigate the effect of the non-psychotropic synthetic cannabinoid dexanabinol in serious head trauma. (Source: El País of 25 October 2001) ***Canada - First cannabis teahouse On 31 October the first cannabis teahouse opened in Canada. The HC Marijuana Users Teahouse of Canada, located in Vancouver, takes advantage of regulations that allow the use of cannabis for medicinal purposes. The central area of the teahouse, with tables and barstools, accommodates about 100 people. At the back, there is a separate room for those permitted to use cannabis medicinally. (Source: Globe and Mail of 1 November 2001) ***Science - Treatment of obesity The fatty acid ethanolamide oleylethanolamide (OEA) seems to be involved in appetite regulation. While anandamide, another fatty acid ethanolamide, induces increased appetite, OEA reduced appetite and body weight in rats, Dr. Daniele Piomelli, professor at the University of California in Irvine, and his colleagues wrote in the recent issue of Nature. (Source: ASCRIBE NEWS via COMTEX of 7 November 2001) ***Science - Cancer Treatment of a cancer cell line of rats with the anandamide analogue Met-F-AEA resulted in a drastic reduction of tumour volume. This reduction was accompanied by a strong reduction of K-Ras activity. Ras proteins (H-Ras, N-Ras, K-Ras) play an important role in signal transduction pathways leading to cell proliferation or death. (Source: Bifulco M, et al. FASEB, published online on 29 October 2001). ***Science - Cognitive performance I Three groups of individuals aged 30 to 55 years were compared with regard to their cognitive abilities: 63 current heavy users of cannabis, 45 former heavy users, and 72 non-users. Results showed that some cognitive deficits appear detectable at least 7 days after discontinuation of heavy cannabis use. By day 28, however, there were virtually no significant differences among the groups on any of the test results. Thus, cannabis effects on cognition in heavy users appear to be reversible and related to recent cannabis exposure. (Source: Pope HG Jr,, et al. Arch Gen Psychiatry 2001 Oct;58(10):909-15) ***Science - Cognitive performance II Acute marijuana smoking produced minimal effects on complex cognitive task performance in experienced marijuana users who used an average of 24 cannabis cigarettes per week. (Source: Hart CL, et al. Neuropsychopharmacology 2001 Nov;25(5):757-65) 6. ONE YEAR AGO: - Australia: New South Wales considers legal use of cannabis for medicinal purposes - Science: Endocannabinoids inhibit bronchospasm and cough - USA: Initiatives for the medical use of marijuana passed in Colorado and Nevada TWO YEARS AGO: - Science: THC in Tourette-Syndrome - USA: Maine voters endorse medical use of marijuana - Germany: Study with cannabis in cancer cachexia - ACM: Papers of the 1998 meetings published - USA/Canada: Renee Boje has claimed refugee status in Canada -------------------------------------------------------- IACM-Bulletin of 25 November 2001 -------------------------------------------------------- * Canada: Debate on law on medical use of cannabis * Science: Discussion on review papers in the British Medical Journal * UK: Police unsure about how to deal with cannabis cafe 1. Canada: Debate on law on medical use of cannabis The Canadian Medical Protective Association (CMPA) has written to Health Minister Allan Rock that the regulations that allow legal access to cannabis for patients since July 2001 place an unfair responsibility on physicians. "The CMPA believes the medical declarations required under the regulations place an unacceptable burden on physicians to inform themselves as to the effectiveness of medicinal marijuana in each patient's case, as well as the relative risks and benefits of the drug and what dosage would be appropriate," said Dr. John Gray of the association in his letter. "This information is simply not available." Other Canadians express their opinion that the regulations are too strict. Lawyer John Conroy, who has been involved with many cases involving the medical use of marijuana, calls the criteria for the medical use of cannabis "absurd" and says the regulations make it too difficult for people who are suffering health problems to legally use the drug. Many patients would have to fight to achieve what he considers is a basic right, that is access to the medicine of their choice. (Sources: Edmonton Sun of 11 November 2001, Saanich News of 21 November 2001) 2. Science: Discussion on review papers in the British Medical Journal On 24 November the British Medical Journal published four letters to the editor discussing review articles on the efficacy of cannabinoids in pain and chemotherapy-induced nausea published in July. The review papers had been rather reserved with regard to the medical potential of cannabinoids in these two indications. Dr. Leslie Iversen, professor of pharmacology at the University of Oxford, wrote: "Campbell et al gave themselves an impossible task with their systematic review. Anyone who has reviewed the scientific literature on the medical uses of cannabis rapidly finds that there is a dearth of well controlled clinical trials. A meta-analysis of the use of cannabis in treating pain is therefore likely to find little of substance to comment on. (...) Unfortunately, this did not deter the authors from coming to a series of emphatic but ill founded conclusions." Dr. Ethan Russo, clinical assistant professor at the University of Washington and editor of the Journal of Cannabis, stated: "What is surprising is that the authors chose to broaden the alleged impact of their limited investigation to relegate the use of cannabis and cannabinoids to a back seat in future analgesic applications. (...) The popular media have seized the opportunity, and in the process valuable laboratory and clinical research, and their funding, in analgesia and pain control have been severely compromised." Dr. Franjo Grotenhermen of the Cologne nova-Institut and Chairman of the International Association for Cannabis as Medicine noted: "I am unsure whether the methods applied in the systematic reviews by Campbell et al and Tramèr et al are able to answer the questions of today's interest. If you pool the data from older studies of pain you will miss most of the interesting information. (...) The question of interest is not so much whether they are potent analgesics compared with codeine but, rather, which painful conditions they are effective in." (Sources: British Medical Journal of 7 July and 24 November 2001, ) 3. UK: Police unsure about how to deal with cannabis cafe Britain's first cannabis café, in Stockford, Manchester, was raided by the police for the second time on 20 November. After raiding it on 15 September, the day it opened, the police seemed to have adopted a live-and-let-smoke policy, generously acknowledging, that there is an "ongoing debate about the medical benefits, or otherwise, of cannabis." On 20 November, as the BBC was inside filming the cafe for a program about drug policy, the police returned, threw everyone out and charged the owner, Colin Davies, and several others with various drug-related offences. An article in the New York Times stated that "it is unclear what the Stockport police really think of the Dutch Experience." In a confidential survey, conducted among the members of DrugScope, a government-backed charity, 81 percent of the 300 groups of police forces, courts, probation officers and drug care workers said, that cannabis should be sold at licensed places such as pubs, cafes and shops. (Sources: The Observer of 11 November 2001, New York Times of 22 November 2001) 4. News in brief ***IACM-Bulletin There are now more than 2,000 subscribers to one of the six IACM-Bulletins in six languages. Subscribers doubled every year since its start in 1997 as the German ACM-Bulletin. ***Switzerland - Steps to legalization The health committee of the Swiss Council of States (upper house of the Swiss Parliament) has voted 6 to 4 in favour of legalizing the use and possession of cannabis and followed the proposal of the government. The sale and cultivation of cannabis will remain a criminal offence, but will be not be prosecuted under certain circumstances. The vote was in response to a government proposal. The next step involves a debate and vote on the bill by the whole upper house. (Source: AP of 13 November 2001) ***Science - Cannabidiol Mechanisms of action of cannabidiol (CBD) were analysed. CBD was shown to interact with vanilloid receptor type 1 and to increase the level of anandamide. (Source: Bisogno et al. Br J Pharmacol 2001 Oct;134(4):845-52) ***Science - Intestinal inflammation In mice bowel inflammation increased the potency of cannabinoid agonists possibly by 'up-regulating' CB1 receptors. In addition, endocannabinoids, whose turnover is increased in intestinal inflammation, might tonically inhibit bowel motility. (Source: Izzo et al. Br J Pharmacol 2001 Oct;134(3):563-70) ***Europe - Cannabis use The Lisbon-based European Monitoring Centre for Drugs and Drug Addiction said in its annual report for 2001 that the proportion of adults who had ever used cannabis ranged from 10 percent in Finland to 20-25 percent in Denmark, France, Ireland, the Netherlands, Spain and the United Kingdom. Between one and nine percent of EU adults have used cannabis in the past 12 months. (Source: Reuters of 20 November 2001) ***Science - Cell proliferation Endocannabinoids seem to inhibit cell proliferation by a mechanism involving combined activation of both vanilloid receptors and to a lesser extent cannabinoid receptors. However, at present there is no universal mechanism known whereby phytocannabinoids affect cell proliferation. (Source: Jacobsson et al. J Pharmacol Exp Ther 2001 Dec 1;299(3):951-959) ***Science - Cross-sensitisation with morphine Repeated THC application to rats induced behavioural sensitisation not only to cannabinoids but also to opiates. This cross-sensitisation was symmetrical since rats sensitised to morphine were also sensitised to cannabinoids. These observations were regarded by the authors as a neurobiological basis for a relationship between cannabis use and opiate use. (Source: Cadoni et al. Psychopharmacology (Berl) 2001 Nov;158(3):259-266) ***Science - Receptors in fetal brain In the fetal human brain, low numbers of cannabinoid receptors could be observed as early as the 14th week of gestation. Receptor density increased slowly but did not reach adult levels by the end of the 24th week. The distribution pattern in the fetal brains was markedly different from the adult pattern. The relatively low number of cannabinoid receptors in the fetal human brain may explain the relatively mild consequences of cannabis use during pregnancy. (Source: Biegon A, Kerman IA. Neuroimage 2001 Dec;14(6):1463-1468) 5. ONE YEAR AGO: - Science/USA: Marijuana study with AIDS patients in California - IACM: German ACM and Austrian CAM are the first regional sections of the IACM TWO YEARS AGO: - Science: Survey on the medical use of cannabis products in the German speech area - Science: Phase I trial with cannabis for medical use -------------------------------------------------------- IACM-Bulletin of 9 December 2001 -------------------------------------------------------- * France: Study of INSERM on health effects of cannabis * Science/USA: Approval for studies at the University of California from DEA 1. France: Study of INSERM on health effects of cannabis On 22 November the French National Health and Medical Research Institute (Inserm, Institut national de la santé et de la recherche médicale) presented a 58-page literature review with the title "Cannabis - which effects on behaviour and health?". The report was ordered by a governmental working group on the fight against drugs and drug addiction. Main topics of the report are factors that influence use, acute and chronic effects, and groups of special interest (pregnant women, individuals with mental disorders). It did not deal with the medical use of cannabis. The report stated that - about 10 percent of those who ever used cannabis have a risk to become dependent, compared to 30 percent with tobacco, - regular use of cannabis may increase the risk for certain cancers since cannabis smoke contains more carcinogens than tobacco smoke, - cannabis effects on the nerves are functional and reversible, and do not cause long-term damage. Health Minister Bernard Kouchner, who presented the report, confirmed to launch five studies in 2002 to evaluate the medical value of cannabis, among them in multiple sclerosis and pain. (Sources: Inserm. Cannabis - quels effects sur le comportement et la santé ? Paris: Les éditions Inserm, 2001; Le Quotidien de Médecine of 23 November 2001; Libération of 23 November 2001) 2. Science/USA: Approval for studies at the University of California from DEA The University of California at San Diego has received final approval from the federal government for a study on the medical benefits of marijuana. Researchers intend to study the effects of cannabis on patients with multiple sclerosis and on AIDS patients with neuropathy (nerve pain). The studies will be the first of the university's Center for Medicinal Cannabis Research, a program created by the state Legislature in 1999. Project directors are Dr. Jody Corey-Bloom for the MS study and Dr. Ronald Ellis for the neuropathy study. The Drug Enforcement Administration (DEA) granted the final approval on 28 November. (Sources: AP of 29 November 2001, ASCRIBE NEWS via COMTEX of 30 November 2001) 3. News in brief ***Italy - Acquittal with 700 grams For the first time, a court accepted the medical use of cannabis as legal. A judge of the Court of Rome dismissed charges against a 44 year old man, accused of importing 700 grams of hashish. The act was not regarded as a crime because the accused used cannabis to control his epilepsy and to avoid the use of heavy doses of barbiturates. (Source: La Repubblica of 23 November 2001) ***USA - Hyperactivity in children An American judge has allowed the mother of a hyperactive child to carry on giving him cannabis. The judge dismissed a petition by social services to remove the child from his mother's home in California. The mother tried cannabis after a suggestion of a paediatrician. She reported her son's behaviour improved markedly, and he developed friendships with other children. (Source: WENN via COMTEX of 6 December 2001) ***Science - Dexanabinol in brain injury Israeli pharmaceutical company Pharmos said on 29 November a two-year trial to test the effect of dexanabinol on severe brain injury has recently started in six European countries. Dexanabinol is a non-psychotropic THC-derivative. (Source: Reuters of 29 November 2001) ***Science - Intraocular pressure Cannabinoid receptors (CB1) have been found in the trabecular meshwork and ciliary processes of the human eye. The endocannabinoid anandamide was detected in the trabecular meshwork. Authors assume that the intraocular pressure-lowering effects of cannabinoids result from activation of CB1 receptors in the trabecular meshwork, increasing aqueous outflow. (Source: Stamer WD, et al. Eur J Pharmacol 2001 Nov 23;431(3):277-286) ***Science - Brain temperature THC in doses of 0.1 mg/kg and 10 mg/kg significantly increased the temperature of the brain and did not significantly change body core temperature in rats. (Source: Perron RR, et al. Neuroreport 2001 Dec 4;12(17):3791-4) ***Science - Appetite Administration of anandamide into the ventromedial hypothalamus (a brain region) stimulated appetite in rats by a CB1 receptor dependent mechanism. (Source: Jamshidi N, Taylor DA. Br J Pharmacol 2001 Nov;134(6):1151-4) 4. ONE YEAR AGO: - Science: Most patients gain benefit from cannabis in a British study - USA: Supreme Court agreed to decide on medical use of marijuana - Science: Cannabinoids may be useful in some forms of diarrhoea TWO YEARS AGO: - Canada: Mine in Manitoba will produce legal marijuana - Netherlands: Establishment of an Office of Medicinal Cannabis -------------------------------------------------------- IACM-Bulletin of 23 December 2001 -------------------------------------------------------- * Canada: Patients may get marijuana from the government * Science: Cannabis no gateway drug 1. Canada: Patients may get marijuana from the government The first batch of federally approved marijuana is available for shipment, the Health Ministry said on 21 December. "Marijuana from Prairie Plant Systems will be made available to researchers and patients who have received licences to possess," a department official said. The department signed a contract last year with Prairie Plant Systems to grow cannabis in an abandoned mine in Manitoba as part of a government policy to make the drug available to Canadians for medical purposes. The contract required that the first supply be ready by 1 January 2002 with a minimum THC content of five per cent. The Health Ministry will now contact some 680 patients approved to use medical marijuana to find out if they are interested in receiving some. The department will begin distributing the product early in the new year. A final decision on a distribution mechanism will be made once the Health Department gets patient feedback. (Source: Canadian Press of 21 December 2001) 2. Science: Cannabis no gateway drug Cannabis does not lead to the use of hard drugs, according to a study to be published by the Centre for Economic Policy Research, London, the British Sunday Times said in an article. The survey is based on drug users in Amsterdam over a 10-year period. The study by Jan van Ours of Tilburg University in the Netherlands shows that cannabis users typically start using the drug between the ages of 18 and 20, while cocaine use usually starts between 20 and 25. But it concludes that cannabis is not a stepping stone to using cocaine or heroin. Four surveys, covering nearly 17,000 people, were carried out in Amsterdam in 1987, 1990, 1994 and 1997. The study found that there was little difference in the probability of an individual taking up cocaine as to whether or not he or she had used cannabis. Although significant numbers of people in the survey did use soft and hard drugs, this was linked with personal characteristics and a predilection to experimentation. (Source: Sunday Times of 16 December 2001) 3. News in brief ***Science - Parkinson's disease The therapy of Parkinson's disease with levodopa may cause dyskinesia (a movement disorder). In a pilot study with seven patients a research group at the University of Manchester showed that nabilone, a synthetic THC derivative, significantly reduced levodopa-induced dyskinesia in patients with Parkinson's disease. (Source: Sieradzan KA, et al. Neurology 2001 Dec 11;57(11):2108-2111) ***Germany - Discussion within government parties Member of the German Bundestag Volker Beck (Green Party) stated in a press release that the intention of the Swiss government to legalize the use of cannabis might be a model for Germany. Federal Drugs Commissioner Marion Caspers-Merk (Social Democratic Party) strongly refused this idea. The Social Democrats and the Greens form the government. (Source: Taz of 15 December 2001) ***USA - State initiatives There are 22 states which in this legislative session debate bills on the medical use of cannabis, among them Wisconsin, Iowa, Minnesota and South Dakota. There are currently eight states with state laws that allow the medical use: Alaska, California, Colorado, Hawaii, Maine, Nevada, Oregon and Washington. (Source: The Daily Press of 12 December 2001) ***Science - Epilepsy Authors provide a review on the effects of alcohol and cannabis on epilepsy. They conclude: "There are currently insufficient data to determine whether occasional or chronic marijuana use influences seizure frequency. Some evidence suggests that marijuana and its active cannabinoids have antiepileptic effects, but these may be specific to partial or tonic-clonic seizures." (Source: Gordon E, Devinsky O. Epilepsia 2001 Oct;42(10):1266-1272) ***Science - Vanilloid receptors The endogenous cannabinoid anandamide but not 2-arachidonyl glycerol activated vanilloid receptors in the hippocampus. (Source: Al-Hayani A, et al. Neuropharmacology 2001 Dec;41(8):1000-1005) ***Science - Hypotension/heart attack The endocannabinoids anandamide and 2-arachidonyl glycerol were detected in monocytes and platelets after acute myocardial infarction in rats. They contribute to hypotension following heart attack through relaxation of the arteries. (Source: Wagner JA, et al. J Am Coll Cardiol 2001 Dec;38(7):2048-2054) ***Europe/UK - Two politicians arrested Two members of the European Parliament have been arrested and charged with possessing cannabis. Marco Cappato, a member of the Italian Radical Party, and Chris Davies, a member of the British Liberal Democrat Party, presented themselves outside the police station of Stockport with small amounts of cannabis in support of Colin Davis, who was arrested in November for supplying cannabis from his cannabis cafe. (Sources: PA News of 20 and 21 December 2001, Reuters of 15 and 20 December 2001). 4. ONE YEAR AGO: - Canada: Mine in Manitoba will produce legal marijuana - Netherlands: Establishment of an Office of Medicinal Cannabis TWO YEARS AGO: - UK: Trials into the efficacy of cannabis in multiple sclerosis - Switzerland: Cannabis in subpsychotropic dosage may be used - Canada: Five-year plan for medical use of marijuana - USA: Vice President supports 'flexibility' on medical use