-------------------------------------------------------- IACM-Bulletin of 6 January 2002 -------------------------------------------------------- * IACM: Become a member of the IACM 1. IACM: Become a member of the IACM The International Association for Cannabis as Medicine was founded in March 2000 by members of the German Association for Cannabis as Medicine. An increasing number of people outside the German speech area is joining the IACM to help to make cannabis and the cannabinoids available for medical use, worldwide, and to increase our knowledge on their pharmacology, toxicology and therapeutic potential. Become a member of this international network at: http://www.cannabis-med.org/english/member.htm New members, who join the IACM until the 1st of March 2002, receive a free copy of the 205 page special HIV/AIDS issue of the Journal of Cannabis Therapeutics, Volume 1(3/4) of 2001. 2. News in brief ***Switzerland - Hunger strike A Swiss cannabis activist started a hunger strike on the day of his arrest on 14 November 2001, now since more than 50 days. Bernard Rappaz cultivates cannabis. He is founder and manager of the hemp co-operative Valchanvre (English: Hemp valley). 25 police officers raided the co-operative and confiscated 10 tons of cannabis. Rappaz is accused of cultivating hemp that contains more than the allowed 0.3% THC. (More on: http://www.multimania.com/fdcc) ***Science - Emetogenic effects blocked by THC The endocannabinoid 2-arachidonoylglycerol (2-AG) caused vomiting in shrews. THC and several synthetic CB1 receptor agonists blocked this emetogenic effect. The nonpsychoactive cannabinoid cannabidiol (CBD) was inactive. (Source: Darmani NA. J Pharmacol Exp Ther 2002;300(1):34-42) ***UK - Pilot scheme extended Around 400 drug users have been warned instead of arrested for possession of cannabis under a pilot scheme in Brixton, south London, police said on 2 January. The scheme was introduced in July 2001 and is intended to free up police time so officers can concentrate on hard drugs. The police has argued that confiscating drugs and issuing a warning on the street could take 10 minutes of an officer's time instead of up to 10 hours if the person is arrested. The initiative has been extended until spring. (Source: PA News of 2 January 2002) ***USA - Marijuana laws NORML (National Organization for the Reform of Marijuana Laws) has completed and updated its information on marijuana laws in all states of the USA at http://www.norml.org/states/index.shtml 3. ONE YEAR AGO: - Switzerland: Study with cannabis in MS patients will be completed in spring - USA: Unimed Pharmaceuticals to be sole marketer of Marinol TWO YEARS AGO: - Spain: Acquittal due to medical use of hashish - Australia: Judge accepted cannabis as painkiller ----------------------------------------------------------------- IACM-Bulletin of 20 January 2002 ----------------------------------------------------------------- ======================================= Join the IACM http://www.cannabis-med.org/english/member.htm and receive a free copy of the HIV/AIDS issue of the Journal of Cannabis Therapeutics ======================================= * UK: GW expands trials to effects in cancer pain * USA: Californian cannabis club seeks new court ruling 1. UK: GW expands trials to effects in cancer pain GW Pharmaceuticals said on 16 January it was expanding clinical trials to ease the pain of cancer patients. Trials involving patients with multiple sclerosis and spinal cord injury had already proved successful, the company said. GW said more than 100 patients who have terminal cancer and who are suffering pain that is not responding to current therapy, will take part in trials at more than 20 centres throughout the UK. Patients will receive a cannabis extract as an under-the-tongue spray. Executive Chairman Dr. Geoffrey Guy said: "We remain confident of being able to present data to the UK regulatory authorities in 2003, and - subject to approval - bring the first cannabis-based prescription medicine to market in early 2004." (Source: Reuters of 16 January 2002) 2. USA: Californian cannabis club seeks new court ruling Lawyers of the Oakland Cannabis Buyers' Cooperative (OCBC) asked a U.S. district court to modify its 1998 injunction ordering the club to stop distributing marijuana to seriously ill patients. The move comes eight months after the highest federal court said the cooperative could not distribute cannabis to patients. The OCBC argues that the 1998 injunction of the district court is unconstitutional because the OCBC's distribution of marijuana involves commerce intrastate (within the state), not interstate commerce. Furthermore, the OCBC asks the court to decide whether the federal government may properly interfere with state sovereignty or has a compelling interest to restrict the exercise of fundamental rights, such as the amelioration of pain or the prolongation of life. Lawyers expect the new case to reach the Supreme Court again. In May 2001, the Supreme Court determined that medical marijuana dispensaries may not raise the defence of medical necessity against federal charges of manufacturing and distributing marijuana. Other issues regarding the constitutionality of the federal marijuana laws were not decided by the court in that case. (Sources: Associated Press of 8 January 2002, NORML of 10 January 2002) 3. News in brief ***France - Debate on legalisation Minister of Justice Marylise Lebranchu wants to initiate a debate on the legalisation of cannabis. According to the recent national drug report the image of cannabis has changed, approaching the image of accepted drugs such as alcohol and tobacco. In the year 2000, for the first time more than 50 percent of the French adults had used cannabis at least once in their life. (Source: dpa of 17 January 2002). ***Science - Heart attack Six cases of possible death due to heart attack following cannabis use in young adults were observed in a Norwegian study. They presented with 2 to 22 ng/ml THC in their whole blood. In 35 cases of a total of 10,000 autopsies THC was the "major toxicological finding", most of them dying due to an accident or suicide. Six of the 35 died of an unknown cause, most of them presenting with signs of heart disease in the autopsy. (Source: Bachs L, Morland H. Forensic Sci Int 2001 Dec 27;124(2-3):200-3) ***Canada - Distribution of marijuana It will probably be two or three months before people with medical exemptions will have access to cannabis because Health Canada has yet to decide how the marijuana will be packaged and distributed, said Brent Zettl, president of Prairie Plant Systems that grows the drug. (Source: Edmonton Sun of 10 January 2002) ***Science - Birth weight According to a study published in the British Journal of Obstetrics and Gynaecology, cannabis use during pregnancy may result in decreased birth weight. About 5 percent of the 12,000 women included in the study admitted using cannabis before pregnancy, and a slightly smaller proportion said they used it while they were pregnant. Cannabis use accounted for a small average redution of birth weight by 90 grams in the study. (Source: BBC News of 7 January 2002) ***Germany - Cannabis Campaign A Cannabis Campaign was started by "akzept" (Federal Association for Accepting Drug Work and Human Drug Policy) in 2001. It aims at bringing together groups and people in support of decriminalisation of cannabis use and possession. (Source: www.DieCannabisKampagne.de) ***Science - Immune function THC was shown to induce the production of the immunosuppressive cytokine TGF-beta by human peripheral blood lymphocytes. This ability of THC was blocked by a CB2 receptor antagonist but not by a CB1 specific antagonist. (Source: Gardner B, et al. Biochem Biophys Res Commun 2002 Jan 11;290(1):91-6) ***Science - Pain In an animal model for neuropathic pain the effect of nerve injury on cannabinoid receptor activation was investigated. Injury of a spinal nerve in rats resulted in functional changes, reducing the effects of a potent cannabinoid (HU-210). (Source: Chapman V. Neuropharmacology 2001 Dec;41(7):870-7) 4. ONE YEAR AGO: - 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 TWO YEARS AGO: - USA: Development of a cannabinoid patch funded by cancer society - Malta: Cancer patient avoids jail for growing cannabis ----------------------------------------------------------------- IACM-Bulletin of 3 February 2002 ----------------------------------------------------------------- ======================================= Join the IACM http://www.cannabis-med.org/english/member.htm ======================================= * USA: Second National Clinical Conference on Cannabis Therapeutics * Science: THC not superior to megestrol acetate 1. USA: Second National Clinical Conference on Cannabis Therapeutics The Second National Clinical Conference on Cannabis Therapeutics will be held on 3 & 4 May 2002 in Portland, Oregon. The main focus will be on pain therapy. The conference is co-sponsored by Patients Out of Time, the Portland Community College Institute of Health Professionals, the Oregon Health Division, Mothers Against Misuse and Abuse, and the Oregon Nurses Association. The agenda includes researchers from Israel, the United Kingdom, Holland, Canada and the United States. Patient presentations will include pain patients who receive their Cannabis medicine from the United States federal government, those receiving support from the Oregon Medical Marijuana Act and others from various states. Registration information and conference details will soon be available at www.medicalcannabis.com/. 2. Science: THC not superior to megestrol acetate THC (dronabinol) was not superior to megestrol acetate in improving appetite in cancer patients, according to a study published in January in the Journal of Clinical Oncology. US and Canadian researchers found that 49 percent of those taking THC reported improved appetite, compared with 75 percent on megestrol acetate. Only 3 percent of the dronabinol group gained weight of more than 10 percent over baseline weight, compared with 11 percent following standard treatment with megestrol. A combination of both drugs did not improve the results received by megestrol acetate alone. Patients received either 800 mg megestrol acetate, 2 x 2.5 mg dronabinol, or both drugs. Overall, 469 cancer patients with wheight loss had been enroled in the study between December 1996 and December 1999. The study was conducted as a collaborative trial of the North Central Cancer Treatment Group and the Mayo Clinic. (Sources: Jatoi A, et al. J Clin Oncol 2002;20(2):567-573; WENN via COMTEX of 28 January 2002) 3. New in brief ***USA - Poll in Maryland In a telephone poll of 833 registered voters of Maryland 37 percent of respondents said they would be more likely to support a politician who backs allowing patients to use marijuana if they have a physician's approval. 40 percent said a candidate's position on medical marijuana would not affect their vote, 18 percent said they'd be less likely to support such a candidate and 5 percent were undecided. (Source: Washington Times of 19 January 2002) ***Science - Interaction with nicotine In animal studies the interaction of THC and nicotine were investigated. Nicotine strongly facilitated reduction of body temperature, pain reduction and reduced motion induced by THC. Furthermore, the co-administration of low doses of THC and nicotine produced an anxiolytic-like response in two tests. Animals co-treated with nicotine and THC displayed an attenuation in THC tolerance and an enhancement in cannabinoid antagonist-precipitated THC withdrawal. (Source: Valjent E, et al. Br J Pharmacol 2002 Jan 2;135(2):564-578) ***Canada - Discussion on delay An article in the newspaper Edmonton Sun initiated a discussion in Canada wether the real cause for the recently announced delay in the distribution of cannabis for medical purposes by the governemnt might be problems with a convention of the United Nations. The UN Single Convention on Narcotic Drugs of 1961 allows countries to use banned drugs only for scientific or medical purposes. It might be unclear if the medical benefits of cannabis had been proven already. (Source: Edmonton Sun of 19 January 2002) ***UK - Cannabis to relax Female members of Britain's biggest trade union call for the legalisation of cannabis. They have an unusual argument - the drug offers women a calorie-free way to relax, in contrast to alcohol. A motion will be debated at the union's women's conference in Cardiff, Wales, this month. Delegates will represent 900,000 women. The motion is unlikely to be passed. (Source: Reuters of 22 January 2002) ***Canada - Teahouse shut A marijuana teahouse located in Vancouver and designed to take advantage of new federal regulations for medicinal marijuana use has been closed down, two months after its opening. Police padlocked the doors last weekend and arrested two people involved in running the teahouse. (Source: Globe and Mail of 25 January 2002) 4. ONE YEAR AGO: - 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 TWO YEARS AGO: - Canada: Judge orders discharge on marijuana trafficking case - UK: Government on odds over cannabis - Germany: Bioressource Hemp & Other Fibre Plants, September 2000 ----------------------------------------------------------------- IACM-Bulletin of 17 February 2002 ----------------------------------------------------------------- ======================================= A free sample copy of the Journal of Cannabis Therapeutics http://www.cannabis-med.org/science/jcant.htm ======================================= * USA: DEA raids medical marijuana dispensary in San Francisco 1. USA: DEA raids medical marijuana dispensary in San Francisco On 12 February officials of the Drug Enforcement Administration (DEA) raided a medical cannabis dispensary centre in San Francisco, the Harm Reduction Clinic, and seized more than 600 cannabis plants. Several homes in San Francisco and surrounding communities were raided and four people were arrested, among them Richard Watts, director of the Harm Reduction Clinic, and marijuana author Edward (Ed) Rosenthal from Oakland. Later that day, DEA head Asa Hutchinson spoke to the Commonwealth Club of California, among others on the legalization of marijuana for medicinal uses. "We have to enforce the law," he said. "Enforcement of drug laws started here in San Francisco, they should not end here." Several officials of the City of San Francisco joined the demonstrators outside the Commonwealth Club, among them District Attorney Terence Hallinan. "This is a decision to be made by the voters of California and the people of the city and county of San Francisco," Hallinan said. The raid coincided with President Bush's announcement of a stepped-up war on drugs, with a goal of cutting drug use by 25 percent in five years. (Sources: Associated Press of 12 February 2002, Reuters of 12 February 2002) 2. News in brief ***Canada - Poll on medical use About four per cent of the population over the age of 15 is using cannabis for medical purposes without permission from the government, according to a national survey conducted by Pricewaterhouse-Coopers for the health ministry (Health Canada). The poll report says the percentage represents about one million Canadians. 70 per cent believe there is already valid evidence to support the use of medicinal marijuana. 85 per cent feel marijuana should be made available for medicinal use under specific conditions. (Source: Ottawa Citizen of 3 February 2002) ***Holland - Symposium at the University of Leiden On 15 February a symposium on the medical use of cannabis was held at the University of Leiden. Notable speakers gave an overview on basic research and clinical applications, among them Raphael Mechoulam (Israel), Elizabeth Williamson (UK), William Notcutt (UK), and Kirsten Müller-Vahl (Germany). Governmental representatives from Canada and the Netherlands described ways, according to which a legal access to cannabis is created in their countries. ***Science - THC in pain Researchers at the Clinic for Anaesthesiology of the University of Cologne (Germany) reported their first experience with THC in pain management. In six individuals suffering from chronic pain THC was used in daily doses of 5-20 mg. Sufficient pain relief was achieved in three patients. (Elsner F, et al. Schmerz 2001 Jun;15(3):200-204) ***Science - Ecstasy and cannabis In a study with rats by Australian researchers at the University of Sydney cannabis reduced harmful effects caused by ecstasy. When rats were given ecstasy and cannabis together they had less depletion of brain cells and were less anxious. (Source: The Australian of 2 February 2002) ***Science - Heavy cannabis use In a study with 2,600 adolescents, aged 15-16 years, UK researchers found three groups of heavy cannabis users among the 201 heavy users of the drug. The smallest was largely distinguished by antisocial behaviour. Another cluster presented with high levels of depressed mood and low levels of self-esteem. The largest group were 'ordinary' and had little to distinguish them from non-users. Teenage heavy cannabis users should not be seen as a homogeneous group. (Source: Miller P, Plant M. Drug Alcohol Depend 2002 Feb 1;65(3):235-242.) ***Science - Dystonia A small double-blind, placebo-controlled, crossover study using the synthetic cannabinoid nabilone in patients with generalised and segmental primary dystonia found no significant reduction in dystonia following treatment with the cannabinoid. (Source: Fox SH, et al. Mov Disord 2002 Jan;17(1):145-149) ***Science - Inflammation The synthetic cannabinoid nabilone was effective in reducing inflammation in a rat model of inflammation. The effects were supposed to be mediated by an uncharacterised CB2-like cannabinoid receptor. (Source: Conti S, et al. Br J Pharmacol 2002 Jan;135(1):181-187) ***USA - California People who use marijuana on their doctor's advice will get identification cards meant to protect them from arrest under a program approved by the city council of San Diego on 13 February. (Source: Union-Tribune of 14 February 2002) ***Jamaica - Debate on legalization The Jamaican parliament will debate whether cannabis should be legal for private, medicinal or religious use by adults. A joint select committee of the Jamaican parliament will decide whether the law should be changed, government officials said, with no time limit to act. (Source: Reuters of 12 February 2002) ***Germany - ECBS Symposium The European College for the Study of Consciousness (ECBS) will held its 9th symposium in Frankenthal (Germany) on 12-14 April 2002. The main focus will be on cannabis, with talks by Peter Hess, Jochen Sattler, Daniel Lamparter, Adi Dittrich, Franjo Grotenhermen, Jörg Fachner, Markus Leweke, Henrik Jungaberle, Rolf Verres, Dietrich Ebert and others. (More: www.magnet.ch/ecbs/) ***Switzerland - CannaTrade During the trade fair on hemp CannaTrade on 1-3 March 2002 in Bern there will be lectures on the medical use of cannabis on Sunday with talks by Ethan Russo (USA), Claude Vaney (Switzerland), Mario Price (UK) and Manfred Fankhauser (Switzerland). (More: www.cannatrade.ch/) 3. ONE YEAR AGO: - Science: Endocannabinoids play an important role in circuits responsible for vomiting TWO YEARS 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 ----------------------------------------------------------------- IACM-Bulletin of 3 March 2002 ----------------------------------------------------------------- ======================================= NEW: Search engine for IACM-Bulletins The organisation as a database and the installation of a search engine was made possible through a generous donation by Bionorica, Germany. ======================================= * Europe: Conference on cannabis research in Brussels * Science/Economy: Pharmos develops CB2 receptor agonists 1. Europe: Conference on cannabis research in Brussels About 100 invited scientists and governmental representatives met for a scientific conference on cannabis in Brussels on 25 February initiated by the health ministers of Belgium, the Netherlands, France, Switzerland, and Germany, among them four health ministers of the inviting countries and one drugs commissioner (Germany). The conference gave an overview on the actual state of cannabis research, including epidemiological, psychological, sociological, and neurobiological topics on recreational use. The medical use of cannabis was only a minor topic with a talk by a representative of the Dutch Office for Medicinal Cannabis. Most of the participants agreed in the medical potential of the drug with little opposition, among them from a representative of the Swedish Health ministry. 2. Science/Economy: Pharmos develops CB2 receptor agonists Pharmos Corporation described progress by the company in developing a new class of synthetic compounds that specifically bind to cannabinoid-2 receptors found on immune cells. These bicyclic dextrocannabinoid compounds do not cause effects on psyche and circulation. Pharmos is investigating them as anti-inflammatory modulators of the immune system, potentially effective in autoimmune and neurological diseases. The development of these compounds closely follows successful development of the tricyclic THC derivative dexanabinol. Phase III clinical studies with dexanabinol started last year in several Europian countries to test its effect on severe brain injury. Dr. George Fink, Vice President of Research, commented, "The use of natural cannabinoids for medicinal purposes have significant medical and regulatory limitations because they bind to the CB1 receptors that are located mainly in the nervous system, and thereby cause unwanted psychotropic and other side effects." (Source: PR Newswire of 25 February 2002) 3. News in brief ***Science - Chronic use study A study by Ethan Russo and colleagues published in the upcoming issue of the Journal of Cannabis Therapeutics investigated benefits and adverse effects of cannabis in four patients who legally receive marijuana for medicinal purposes in the USA. They have been smoking government-grown cannabis for 11 to 27 years. This did not produce significant physical or cognitive impairment. A PDF file of the study is available on the IACM web site at http://www.cannabis-med.org/science/jcant.htm/. ***USA/Economy: Inhaler for THC On 26 February Unimed Pharmaceuticals announced that they have entered into a collaboration with the company Inhale to develop a metered dose inhaler (MDI) of dronabinol (THC). Unimed is already marketing the synthetic dronabinol preparation Marinol capsules. (Source: Business Wire of 26 February 2002) ***The Netherlands - Research with smoked cannabis The Office for Medicinal Cannabis of the Dutch Ministry of Health wants to conduct a clinical study on smoked cannabis in 16 multiple sclerosis patients. Results are expected to be available in approximately one year. This will be the first clinical study with smoked cannabis in Europe since the 1989 study with an MS sufferer at the university of Goettingen (Germany). (Sources: Drug Policy Alliance of 21 February 2002; Meinck HM, et al. J Neurol 1989;236(2):120-122) ***UK - Cannabis in the year 2004 Cannabis will be available on prescription as early as 2004 if clinical trials are successful, the Department of Health said on 18 February. "Results are expected at the end of 2002," Health Minister Lord Hunt said. The results will have to be evaluated then by the responsible authorities. (Source: Reuters of 18 February 2002) ***Ireland - Calls for medical access On 18 February Ireland's main opposition party called for cannabis to be made available on prescription in the Republic. Fine Gael health spokesman Gay Mitchell promised to raise the matter with health minister Michael Martin in the Irish Parliament. (Source: PA News of 18 February 2002) 4. ONE YEAR AGO: - Science: Four studies to be conducted by a university research centre in California - Science: Big pharmaceutical companies get interested in cannabinoid-based medicines TWO YEARS AGO: - Science: THC destroys brain cancer in animal research - Science: Cannabinoids reduce tremor in animal model of multiple sclerosis - Science: Smoking marijuana my increase risk of heart attack ----------------------------------------------------------------- IACM-Bulletin of 17 March 2002 ----------------------------------------------------------------- * Italy: Health system has to pay for cannabis therapy, judge says * Science: Discussion on regular cannabis use and brain function 1. Italy: Health system has to pay for cannabis therapy, judge says Venice's judge Barbara Bortot ruled on 13 March that the local medical authorities of San Dona di Piave, near Venice, not only have to tolerate the medical use of cannabis by a woman with terminal lung cancer but also must obtain the drug abroad and then provide it free of charge to the patient. The woman asked the permission of the magistrate, since cannabis is illegal in Italy even for medical use. Judge Bortot ruled that the right to health, decreed in article 32 of the Constitution, allows the use of the drug. "When there is an insuppressible need for which the national healthcare doesn't offer alternative remedies, the individual's right to health imposes without limits or conditioning of any sort," wrote the judge. According to the ruling, the local medical authorities will have 30 days to provide the patient with the drug. Italy will probably request it from the Bureau for Medicinal Cannabis of the Dutch Health Ministry, according to the daily newspaper Corriere della Sera. The ruling could pave the way for many other requests from patients with illnesses such as multiple sclerosis and epilepsy, said the Italian Association for Therapeutic Cannabis (ACT). "We hope this will become a precious precedent for all those who claim the right of using cannabis as a therapeutic drug," the association said in an official statement. (Source: Reuters of 13 March 2002) 2. Science: Discussion on regular cannabis use and brain function Australian and US scientists found impairments in memory and attention in regular cannabis users that lasted beyond the period of intoxication according to a report in The Journal of the American Medical Association. In an editorial of the same journal a researcher of the Harvard Medical School in Boston (USA) cautioned conclusions from this study that cannabis use might irreversibly impair cognitive functions. In the study by Dr. Nadia Solowij of the National Drug and Alcohol Research Centre in Sydney, conducted in the USA, 102 regular cannabis users (51 short-term and 51 long-term users) completed 9 standard neuropsychological tests after 17 hours of abstinence from cannabis. Cannabis users performed significantly less well than controls on several tests, and performance measures often correlated with the duration of drug use. In his editorial Dr. Harrison Pope of the Biological Psychiatry Laboratory of the Harvard Medical School noted that a period of abstinence of 17 hours might be too short to measure possible long-term impairments. He stated that a recent meta-analysis of neuropsychological studies of long-term marijuana users found no significant evidence for deficits in 7 of 8 neuropsychological ability areas and only a small effect size for the remaining area of learning. "Even if lifetime duration of cannabis use is associated with greater impairment after 17 hours of abstinence, the data are insufficient to know whether greater impairment would be present a week or a month later. Despite the important contributions of this new study, we must still live with uncertainty," Pope concluded. (Sources: Solowij N, et al. JAMA 2002 Mar 6;287(9):1123-31; Pope HG. JAMA 2002 Mar 6;287(9):1123-31) 3. News in brief ***UN - Cannabis use In its annual report the U.N. International Narcotics Control Board (INCB) rejected arguments that marijuana should be legalized, but it urged further research "into the possible therapeutic properties and medicinal uses of cannabis or cannabis extracts." (Source: Washington Times of 27 February 2002) ***USA - 80 percent support in Wisconsin Seriously ill patients who wish to alleviate their suffering with marijuana have the support of 80.3 percent of residents of the state of Wisconsin, according to a survey released on 13 March and conducted by the Chamberlain Research Consultants. (Source: Daily Cardinal of 13 March 2002) ***UK - Support for re-classification Medical experts supported the government's intention of reclassifying cannabis as low-risk. In a report to Home Secretary David Blunkett, medical experts from the Advisory Council on the Misuse of Drugs said all cannabis preparations should be downgraded to Class C - the lowest risk grouping of controlled drugs. (Source: Reuters of 14 March 2002) ***USA - Ad in New York Times In a full-page advertisement in the New York Times of 6 March, a national coalition of doctors, nurses, medical organizations, celebrities, and more than 300 state legislators asked President Bush to allow patients with serious illnesses to apply for a permission to use marijuana to relieve their symptoms. (More at http://compassionateaccess.org) ***Germany - Union of the police In an interview with the weekly Focus the vice-president of the union of the policemen, Bernhard Witthaut, advocated the legalisation of cannabis and its sale in pharmacies. But the president of the union, Konrad Freiberg, made it clear that the union was against legalization of the drug. (Sources: dpa of 9 March 2002, ddp of 10 March 2002) ***UK - Liberal Democrats Britain's opposition Liberal Democrats said on 9 March members had voted in favour of adopting the legalisation of cannabis as party policy. Delegates at the spring conference of the UK's third-largest party also voted to end imprisonment for possession of any illegal drug, including heroin and cocaine. (Source: Reuters of 9 March 2002) ***USA - Hemp foods On 7 March a federal appeals court has temporarily blocked a Drug Enforcement Administration rule that bans food made with hemp. The agency declared in October 2001 that food products containing even trace amounts of THC were banned under the Controlled Substances Act. The appeals court will decide on the issue within the coming months. The court will hear arguments on the case on 8 April. A 90-page expert opinion on the health impact of trace amounts of THC used in the debate is online at http://www.nova-institut.de/pdf/hemp-food-risk.pdf (Source: AP of 8 March 2002) ***Science - Driving A study investigated the effects of chronic exposure to cannabis on the effects of alcohol on driving-related psychomotor skills. Chronic cannabis use (in the absence of acute administration) did not potentiate the effects of alcohol. In fact, the regular users showed lower scores for dizziness and a superior tracking accuracy compared to infrequent users after alcohol. (Source: Wright A, Terry P. Psychopharmacology 2002 Mar;160(2):213-9) ***Science - Interaction There is only a minor influence of cannabis smoking and oral THC on pharmacokinetic parameters of antiretroviral medication used in HIV infection (indinavir, nelfinavir), and the use of cannabinoids is unlikely to impact antiretroviral efficacy. (Source: Kosel BW, et al. AIDS 2002 Mar 8;16(4):543-50) 4. ONE YEAR AGO: - Switzerland: Government wants to legalize the use of cannabis TWO YEARS AGO: - IACM: Foundation of the International Association for Cannabis as Medicine - Germany: Experts discussion on cannabis as medicine ----------------------------------------------------------------- IACM-Bulletin of 31 March 2002 ----------------------------------------------------------------- * Science: THC effective in Tourette-Syndrome * Science/Spain: First clinical study of THC for the treatment of cancer * USA: News on medical marijuana initiatives and bills 1. Science: THC effective in Tourette-Syndrome A clinical study conducted at the Medical School of Hannover (Germany) and published in the current issue of Pharmacopsychiatry demonstrated that a single dose of THC reduces symptoms of Tourette-Syndrome. Under the guidance of Dr. Kirsten Mueller-Vahl 12 adult TS patients received THC (5, 7.5 or 10 mg) in a double-blind placebo-controlled crossover design. Patients received either a single dose of oral THC first or placebo first on two days separated by 4 weeks before they were crossed over to receive the other treatment. THC resulted in a significant improvement of symptoms. At the end of the study nine patients assessed the THC treatment day overall more positive than the placebo day. Three patients experienced the placebo day more positive. No serious adverse reactions occurred. Blood pressure and pulse did not change significantly. Five patients experienced mild adverse reactions, lasting 1 to 6 hours. There was a significant correlation between tic improvement and maximum blood plasma concentration of 11-OH-THC. Gilles de la Tourette-Syndrome (Tourette-Syndrome, TS) is a complex neurological disorder characterized by multiple motor tics (sudden movements) and one or more vocal tics. Another six-week-study with 24 patients that has been completed in the meantime confirmed the results of this earlier study. (Sources: Mueller-Vahl K, et al. Treatment of Tourette-Syndrome with delta-9-tetrahydrocannabinol (THC): a randomized crossover trial. Pharmacopsychiatry, April 2002. Personal communication of Kirsten Mueller-Vahl) 2. Science/Spain: First clinical study of THC for the treatment of cancer A group of Spanish researcher started the first clinical study of cannabinoids in the treatment of cancer at the Hospital of La Laguna (Tenerife). The objective of the phase I-II trial is to evaluate the effects of the main active compound of cannabis, THC, on glioblastoma multiforme, a malignant brain tumour, for which there is currently no effective treatment. The study will be also the first study to investigate intracranial application of THC, an application directly into the brain. Two years ago the team of Dr. Manuel Guzmán, of the Complutense University of Madrid had demonstrated that THC and a synthetic cannabinoid induced a remarkable regression of malignant gliomas in rats, completely destroying the tumours in a third of the treated animals. Dr. Luis González Feria, neurosurgeon of the La Laguna's Hospital, will lead the clinical study. It will start with five patients. If the treatment is tolerated well additional nine patients will be added, divided into three groups that receive three different doses. Since the glioblastoma is a very aggressive tumour, researchers do not expect to cure the patients but hope to increase survival. Patients usually die within six to eight months after diagnosis. THC will be administered for two to eight weeks and doses will depend on tolerance. Those patients will be selected whose tumours are accessible by means of surgery. The study will last three years. (Source: Reuters of 25 March 2002) 3. USA: News on medical cannabis initiatives and bills Washington DC: A federal judge's decision could pave the way for supporters of legalizing marijuana in Washington DC for medical purposes to place the matter before city voters this November. U.S. District Judge Emmet Sullivan on 28 March overturned a federal law that had blocked District of Columbia residents from putting the issue on the ballot. The law was enacted by Congress 1998, after district residents voted to legalize marijuana for medical use. (Sources: New York Times of 29 March 2002, Associated Press of 30 March 2002) Vermont: By a vote of 82 to 59 the House of Representatives approved a bill that would allow victims of debilitating diseases like cancer or AIDS to treat symptoms with cannabis, if they have a recommendation by a doctor. Governor Howard Dean, Democrat who strongly opposes the bill, announced that he would try to block the bill in the Senate. (Sources: Associated Press of 15 March 2002, New York Times of 16 March 2002). Maryland: The House of Representatives voted 80 to 56 for a bill that would create a court defence for people who use cannabis for medicinal purposes. Under the measure, if defendants can prove to a judge or jury that they used marijuana exclusively for medical reasons, they would be subject to a $100 fine, instead of the current penalty -- a $1,000 fine and up to a year in jail. The proposal would still be subject to scrutiny in the Senate. (Source: Washington Post of 26 March 2002) Until now, eight states -- Alaska, California, Colorado, Hawaii, Maine, Nevada, Oregon and the state of Washington -- allow severely ill residents to use cannabis with prior approval from a physician. 4. News in brief ***Science/UK: Driving A single glass of wine impairs driving ability more than smoking a cannabis cigarette. These are the findings of a major new study by the Transport Research Laboratory in Crowthorne (UK). They confirm the results of a preliminary study more than a year ago. The study also found that drivers on cannabis tended to be aware of their intoxicated state, and drove more cautiously to compensate their impairment. (Source: New Scientist of 19 March 2002) ***France: Prime Minister Jospin Prime Minister Lionel Jospin said that a cannabis joint smoked at home would be less bad than alcohol behind the wheel. Health Minister Bernard Kouchner recently said that alcohol and tobacco would cause much more harm than cannabis. (Source: AFP of 25 March 2002) ***Germany: Green Party The German Green Party supports the legalisation of cannabis, according to their new program passed by the party congress in March in Berlin. "The current drug policy of general criminal persecution of users has failed," the new program says. (Source: sda of 16 March 2002) ***UK: Police survey Half of police officers questioned anonymously admitted that they had taken cannabis at some time in their lives. Over half also believed that cannabis legislation harmed relations between police and young people. (Source: The Times of 16 March 2002) ***Science: Neuroprotection Results of cell studies strongly suggest that the cannabinoid-1 receptor (CB1) is not involved in the cellular antioxidant neuroprotective effects of cannabinoids. (Source: Marsicano G, et al. J Neurochem 2002 Feb;80(3):448-56) ***Science: Cerebral blood flow Memory-related regional cerebral blood flow was compared in frequent marijuana users and non-using control subjects after more than 26 hours of abstention. Memory-related blood flow in marijuana users showed decreases in prefrontal cortex and increases in memory-relevant regions of cerebellum. (Source: Block RI, et al. Pharmacol Biochem Behav 2002 May;72(1-2):237-50) 5. ONE YEAR AGO: - 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 TWO YEARS AGO: - UK: Police Foundation proposes depenalisation of cannabis ----------------------------------------------------------------- IACM-Bulletin of 14 April 2002 ----------------------------------------------------------------- * Science: Cannabis extract effective in multiple sclerosis * Science: Heavy cannabis use without long-term effect on global intelligence * The Netherlands: Cannabis on prescription within one year 1. Science: Cannabis extract effective in multiple sclerosis In a study at the Clinic Montana (Switzerland) under the guidance of Dr. Claude Vaney the effects of capsulated cannabis extract in 57 patients with multiple sclerosis were investigated. In a crossover design one half of the patients received a placebo first and then the extract, while the other half received cannabis first. The dose was adjusted according to individual tolerance. The maximal daily doses ranged from 7.5 to 30 mg THC. Muscle tone assessed with the Ashworth Scale was not significantly influenced by cannabis compared to placebo. However, subjectively the number of muscle spasms and the intensity of spasticity were reduced. Mobility as measured with the Rivermead-Mobility-Index (RMI) was improved with cannabis. Sleep was not significantly influenced. In general, the medication was tolerated well. Cognitive and motor performance were not significantly influenced by the cannabis medication. A detailed publication is under preparation. (Source: Fortissimo 1, March 2002, Journal of the Swiss Multiple Sclerosis Society) 2. Science: Heavy cannabis use without long-term effect on global intelligence Canadian researcher compared the intelligence quotient (IQ) of 15 current heavy users of cannabis, 9 current light users, 9 former regular users and 37 non-users in a group of 70 young people. Participants had been followed since birth and now were 17-20 years old. Current marijuana use was significantly correlated in a dose-related fashion with a decline in IQ when compared to the IQ measured at age 9-12. In current heavy users the IQ showed a decrease of 4.1 points, compared to gains in IQ points for light current users (5.8), former users (3.5) and non-users (2.6). The authors concluded that current cannabis use "had a negative effect on global IQ score only in subjects who smoked 5 or more joints per week" and that "marijuana does not have a long-term negative impact on global intelligence." Former users had smoked marijuana regularly in the past but not for at least 3 months. Current heavy use was defined as smoking at least 5 joints per week. Light users smoked less than 5 joints per week. (Source: Fried P, et al. Current and former marijuana use: preliminary findings of a longitudinal study of effects on IQ in young adults. CMAJ 2002;166(7):887-91) 3. The Netherlands: Cannabis on prescription within one year A large majority of legislators in the parliament's lower chamber said on 8 April that they will support a government-backed bill to let doctors prescribe cannabis. The bill also needs approval by the Senate, expected later this year. If it is passed, two growers selected and controlled by the government will produce the cannabis. Members of parliament from the three government coalition partners and the two largest opposition parties said that they would approve the bill. Health Ministry spokesman Bas Kuik said cannabis for medicinal purposes will probably be available in drugstores within a year or so. (Source: Associated Press of 8 April 2002) 4. News in brief **USA: Clinical conference on cannabis The Second National Clinical Conference on Cannabis will be held in Portland, Oregon on 3 & 4 May 2002. Detailed information, conference agenda and conference brochure are available at the home page of Patients Out of Time: http://www.medicalcannabis.com/conference/ ***UK: GW Pharmaceuticals GW Pharmaceuticals doubled the number of its clinical trials to investigate the medical benefits of cannabis. Four new trials will be carried out on patients with spinal cord injuries, multiple sclerosis and nerve damage, bringing the number of patients involved in seven GW clinical trials to about 600. (Source: The Guardian of 12 April 2002) ***USA/Canada: Census of medical cannabis groups California NORML is compiling a census of patients' groups which use cannabis medicinally, their approximate membership of users, physicians, and caregivers in the USA and Canada. For more information visit: http://www.canorml.org/prop/cblist.html (Source: Dale Gieringer, personal communication) ***USA: Ad with New York mayor New York's mayor Michael Bloomberg found himself on an advertisement of marijuana activists in the New York Times of 9 April. The advertisement is part of a campaign of NORML for the decriminalization of marijuana. Bloomberg was quoted in a 2001 magazine article as saying he had smoked marijuana and liked it. (Source: Reuters of 9 April 2002) ***USA: Maryland A bill that would have clearly reduced penalties for patients who use cannabis medicinally ($100 fine, instead of a $1,000 fine and up to a year in jail) was defeated by one vote on 6 April in a Senate Committee. The bill had passed the House of Representatives on 24 March. (Source: Carroll County Times of 6 April) ***Science: Obesity The CB1 receptor antagonist SR141716 of the French firm Sanofi-Synthelabo is in final phase III studies for the use in obesity. It has shown significant weight reduction in early studies. SR141716 blocks the effects of endocannabinoids at the cannabinoid-1 receptor. (Source: Reuters of 10 April 2002) ***Science: Gastric secretion Cannabinoids (WIN 55,212-2, HU-210) decreased the acid secretion induced by pentagastrin. This effect was blocked by a CB1 receptor antagonist but not by a CB2 receptor antagonist. Thus, the inhibition of acid secretion of the stomach by cannabinoids is mediated by CB1 receptors. (Source: Adami M, et al. Br J Pharmacol 2002 Apr 7;135(7):1598-1606) 5. ONE YEAR AGO: - Canada: Health Minister wants to facilitate the medical use of cannabis - Science: Endocannabinoids are involved in the regulation of appetite TWO YEARS 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 ----------------------------------------------------------------- IACM-Bulletin of 28 April 2002 ----------------------------------------------------------------- * Canada: No medical cannabis from the government * USA: Study with smoked cannabis in neuropathy of AIDS patients started * Canada: U.S. citizens and medical marijuana users who fled to Canada arrested 1. Canada: No medical cannabis from the government Health Minister Anne McLellan said she will not release any of the marijuana being grown for the government to distribute to sick patients until it has been tested in clinical trials, her spokeswoman said on 22 April. This statement suggests that the cannabis, being grown in an old mine in Manitoba, will not be made available to patients for several years, if ever. The clinical studies have not started, yet, and will need years. When former Health Minister Allan Rock announced the cannabis-growing contract in July 2001, he said some would be used for research and some could be given to patients who qualified because they were severely ill or dying. Rock had invited doctors to sign certificates that their patients needed marijuana, which brought protests from some medical groups. But several doctors have signed the documents and as of 2 April Health Canada had issued 205 authorizations for possession of cannabis. Those authorized patients now have no choice but to grow their own cannabis, or get someone to grow it for them, with no legal source of seeds. On 23 April a Quebec judge said that laws banning the sale of marijuana to sick people who have been granted permission to use the drug are unconstitutional. Judge Gilles Cadieux said that the Charter of Rights and Freedoms protects the right to liberty and security of the person, including the use of cannabis by patients who have been granted a medical exemption. (Sources: Canadian Press of 22 and 23 April 2002, Edmonton Sun of 23 April 2002) 2. USA: Study with smoked cannabis in neuropathy of AIDS patients started A study with smoked cannabis in neuropathy (nerve pain) associated with AIDS started at the University of California in San Francisco, let by Dr. Donald Abrams. The three year $956,000 state-funded study is under the aegis of the university's Center for Medicinal Cannabis Research. This center was established by a 1999 state law. Study participants are experienced marijuana smokers, who did not smoke 30 days before study entry. "We want to know people know how to inhale - and know ... what it's like to be stoned, so they don't freak out and sue us," Abrams said. The study is starting as a pilot study with 16 volunteers. The first of them started on 27 March. Each participant will stay in the hospital for nine days, smoking marijuana three times a day on seven of those days. If all goes well with the pilot study, a bigger study involving up to 100 subjects will follow. The study is double-blinded and uses THC free cannabis cigarettes as placebos. (Source: The Augusta Chronicle of 13 April 2002) 3. Canada: U.S. citizens and medical marijuana users who fled to Canada arrested Canadian immigration authorities arrested Kenneth E. Hayes on 18 April, and Steve Tuck and Steve Kubby on 16 April. All three face deportation hearings. All have said they would seek political refugee status in Canada if the United States asked for their extradition, or if Canada attempted to deport them. The charges are "specifically having to do with having criminal convictions in the United States," said Angela Battiston, a Canadian immigration spokeswoman. None of them deny growing or smoking cannabis but they say it's for medical reasons, which is allowed under Proposition 215, a state law approved by California voters in 1996. U.S. officials applauded the action. "It's unfortunate that many people are viewing Canada as a haven to avoid U.S. justice," said Richard Meyer, a U.S. Drug Enforcement Administration spokesman. (Source: The Press Democrat of 21 April 2002) 4. News in brief ***Science: CBD against nausea In a rat model of nausea cannabidiol (CBD) and its synthetic dimethylheptyl homolog were effective against nausea. Thus, cannabinoids without psychoactive side-effects may have therapeutic value in the treatment of chemotherapy-induced nausea. (Source: Parker LA, et al. Neuroreport 2002 Apr 16;13(5):567-70) ***USA: California The city council of Berkeley passed a resolution on 23 April affirming the city's support for medical marijuana. The council directed the Berkeley Police Department not to cooperate with the Drug Enforcement Administration in investigations of medical marijuana clubs. (Source: Daily Californian of 25 April 2002) ***Science: Psychosis In a Spanish study patients with cannabis-induced psychosis and acute schizophrenia shared several features but differed in others. The authors concluded that the continuous heavy use of cannabis can induce a psychotic disorder distinct from acute schizophrenia. (Source: Nunez LA, Gurpegui M. Acta Psychiatr Scand 2002 Mar;105(3):173-178) ***USA: NORML Conference About 550 people participated in the annual national conference of the National Organization for the Reform of Marijuana Laws in San Francisco, the largest in the organization's 32-year history. Among the speaker were San Francisco District Attorney Terence Hallinan, California State Senator John Vasconcellos, Jack Herer, Dr. Tom Ungerleider, Dr. John P. Morgan, and Barbara Ehrenreich. (Source: NORML of 26 April 2002) 5. ONE YEAR AGO: - Spain: Catalonian parliament unanimously in support of medical use of cannabis - Science: Physicians' attitude towards medical use of cannabis depends on specialty TWO YEARS AGO: - USA: Hawaii approves medical use through legislation - Germany: Discontinuance of a trial until a decision of the Federal Institute for Pharmaceuticals and Medical Products - The Netherlands: Installation of a Cannabis Agency for medical cannabis at the Health Ministry ----------------------------------------------------------------- IACM-Bulletin of 12 May 2002 ----------------------------------------------------------------- * Canada/USA: U.S. authorities refused to provide Canada access to cannabis seeds * USA: Medical cannabis club has no right to distribute the drug, federal judge says * Science: Dexanabinol effective in brain trauma * Canada: Negative health effects of cannabis are weak, a Senate committee says 1. Canada/USA: U.S. authorities refused to provide Canada access to cannabis seeds Last year U.S. drug-enforcement authorities refused to provide the Canadian government access to their research-quality supply of marijuana seeds, it emerged on 7 May for the first time. A Canadian cannabis program was intended both for research reasons and to allow patients access to legal cannabis. Former health minister Allan Rock announced details of the program in April 2001, saying the marijuana was supposed to be available by January 2002. But now it emerged at a committee meeting that U.S. authorities refused last year to supply Canada with seeds from the U.S. National Institute of Drug Abuse. The U.S. decision wasn't announced at that time, nor was it mentioned by Rock. That left Health Canada to use seeds police had confiscated, which have produced cannabis containing at least 185 different varieties. It will take some time now to establish a standardized supply of cannabis that is eligible for research. "We remain committed to ensuring that eligible Canadians have access to a standardized supply of research-grade marijuana for medical purposes," Anne McLellan, the new health minister, told the Commons health committee. "While our policy has not changed, our time lines have." (Sources: The Canadian Press of 7 May 2002, Ottawa Citizen of 8 May 2002) 2. USA: Medical cannabis club has no right to distribute the drug, federal judge says A federal judge ruled on 3 May that the Oakland Cannabis Buyers' Cooperative (California) has no constitutional right to distribute cannabis to the sick. The U.S. Supreme Court ruled last year that the group had no right to sell marijuana to patients under California's 1996 voter-approved medical marijuana law. The cooperative had sought to reopen the 5-year-old case under new legal arguments, but U.S. District Judge Charles R. Breyer rejected them at the government's urging. "With or without medical authorization, the distribution of marijuana is illegal under federal law," Breyer wrote. Robert Raich, the club's attorney, said he would appeal the decision to the San Francisco-based 9th U.S. Circuit Court of Appeals. (Source: Associated Press of 3 May 2002) 3. Science: Dexanabinol effective in brain trauma All six Israeli neurosurgical intensive care units were involved in a double-blind, placebo-controlled study to evaluate the safety of intravenous dexanabinol in severe head injury. 67 patients aged 16-65 years received a single administration of dexanabinol (48 or 150 mg) or only the vehicle. A highly significant reduction in the percentage of time with pressure within the head of above 25 mmHg, perfusion pressure within the brain of below 50 mmHg, and systolic blood pressure of below 90 mm Hg was observed in the drug-treated group. A trend toward faster and better neurological outcome on the Glasgow outcome scale at 3 and 6 months was also observed. The nature and incidence of adverse medical events were similar in the two groups. Dexanabinol is a non-psychotropic THC-derivative with neuroprotective properties. (Source: Knoller N, et al. Dexanabinol (HU-211) in the treatment of severe closed head injury: A randomized, placebo-controlled, phase II clinical trial. Crit Care Med 2002;30(3):548-554) 4. Canada: Negative health effects of cannabis are weak, a Senate committee says The Senate Special Committee on Illegal Drugs is planning to hold a series of public hearings across the country in May and June to ask Canadians if they think the government should decriminalize marijuana, says a report released on 2 May. After studying the effects of cannabis use for 14 months, the committee said scientific evidence suggests that marijuana "may have some negative effects on the health of individuals," but that these effects would be "relatively benign" and that it is no gateway drug to the use of hard drugs. Only approximately 10 percent of the users would become chronic users and 5 to 10 percent would become addicted. A final report will be released in August. The preliminary report is available at the web site of the parliament: http://www.parl.gc.ca/illegal-drugs.asp. (Source: Xinhua News Agency of 2 May 2002) 5. News in brief ***Germany: Bionorica manufactures dronabinol On 3 May the phytopharmaceutical company Bionorica announced that it manufactures dronabinol (THC) that is available from now on for pharmacists to produce dronabinol based medicines. Bionorica is the second manufacturer of dronabinol in Germany. The Frankfurt firm THC Pharm manufactures dronabinol since 1998. (Source: Press conference of 3 May 2002) ***Italy: Northern region back medical cannabis The council of Italy's northern region of Lombardy approved on 30 April a motion in favour of cannabis-based medicines, asking the Italian government and the parliament "to regulate the medical use of cannabis and its derivatives." (Source: Reuters of 1 May 2002) ***World: Million Marijuana March About 160 cities in more than 30 countries participated in this year's Million Marijuana March on 4 May. (Source: PA News of 4 May 2002) ***Science: Teenage use of drugs A caring mother is the single most important factor in preventing teenagers from abusing illegal drugs and alcohol. This is the result of a survey among 4000 pupils aged 14-15 years from cities in England, Ireland, Italy, Germany and the Netherlands. (Source: McArdle P, et al. Addiction 2002 Mar;97(3):329-36) ***USA: Hunger strike in Montana A 45-year-old woman from Missoula is on a hunger strike since 20 April protesting her inability to have legal access to cannabis in Montana to treat her immunological disorder. Her illness does not have a name. Robin Prosser cannot go out in the sun anymore and suffers from symptoms similar to multiple sclerosis. (Source: Missoula Independent of 9 May 2002) ***Science: Huntington's disease In an animal model of Huntington's disease the administration of an endocannabinoid uptake inhibitor (AM404) reduced motor hyperactivity. Huntington's disease results from genetically determined degeneration of nerve cells in the brain, which causes uncontrolled movements and emotional disturbance. (Source: Lastres-Becker I, et al. Synapse 2002 Apr;44(1):23-35) ***Science: Effects on cytochrome P450 enzymes Blood plasma levels of the antipsychotic medications clozapine and olanzapine are lower in smokers of tobacco and cannabis than in non-smokers, which is mainly due to induction of CYP1A2, an enzyme of the cytochrome P450 complex, by some smoke constituents. Cessation of smoking may result in an unexpected increase of plasma levels and stronger effects. The clinical implication of these observations is that smoking patients treated with medication, that use CYP1A2 for metabolism, should be monitored with regard to their smoking consumption in order to adjust doses. (Source: Zullino DF, et al. Int Clin Psychopharmacol 2002;17(3):141-143) 6. ONE YEAR AGO: - Science/UK: Four phase II trials with cannabis successful - France: Medical use of cannabis before the court - Canada: Concerns by the Canadian Medical Association TWO YEARS AGO: - Science/Germany: Clinical study on THC in Tourette's syndrome - Canada: Health Ministry looking for source of supply for marijuana - Science: First issue of Journal of Cannabis Therapeutics ----------------------------------------------------------------- IACM-Bulletin of 26 May 2002 ----------------------------------------------------------------- ======================================== The new issue of the Journal of Cannabis Therapeutics is out ======================================== * Germany: - Outing of patients who use cannabis medicinally - New complaint before the Federal Constitutional Court - Proposal for a new paragraph 31b in the narcotics act * Science: Low cannabis doses ineffective in multiple sclerosis * UK: Parliament committee recommends reconsideration of international drug treaties 1. Germany: - Outing of patients who use cannabis medicinally - New complaint before the Federal Constitutional Court - Proposal for a new paragraph 31b in the narcotics act On 23 May eleven seriously ill patients confessed their illegal medical use of cannabis with photo and residence in the weekly Stern. They suffer from multiple sclerosis, Crohn's disease (a bowl disease), cancer, asthma, migraine, HIV and hepatitis C. They call for the end of criminalisation of medical cannabis users. One of the persons involved, suffering from multiple sclerosis, recently handed in a new complaint before the Federal Constitutional Court, with support of the German Association for Cannas as Medicine. He is out for getting back his cannabis confiscated by the police some weeks ago. The District Court of Mannheim had declared the confiscation as lawful. The Association for Cannabis as Medicine also made a proposal to add a new paragraph to the narcotics for discussion that would allow prosecutors and judges to refrain from criminal procedures in case of medical use of cannabis products. This new paragraph 31b would make the possession of a doctor's recommendation a condition for exemption from punishment. This proposal is supported by Dr. Hans-Harald Koerner, head of the Centre for the Combat against Narcotics Criminality at the Chief State Council in Frankfurt (Hessian), and other lawyers. (Source: Stern of 23 May 2002) 2. Science: Low cannabis doses ineffective in multiple sclerosis An new clinical study of the University of Amsterdam found that THC is not effective in multiple sclerosis if given in maximum doses of 5 mg oral twice daily. Dr. Joep Killestein and colleagues conducted a double-blind, placebo-controlled study in 16 patients with MS who presented with severe spasticity to investigate safety, tolerability, and efficacy of oral THC and oral cannabis. Both drugs were safe, but adverse events were more common with plant-extract treatment. Compared with placebo, neither THC nor cannabis reduced spasticity at the doses applied (2.5 or 5 mg administered orally twice daily). Dr. Thomas Ungerleider and colleagues of the University of California in Los Angeles already noted in their 1987 study that "the 7.5 mg dose is required to achieve significant spasticity reduction" and in 1999 Dr. Roger Pertwee of the University of Aberdeen recommended "a degree of flexibility with respect to dose level" in studies on THC in multiple sclerosis and to start with 2.5 or 5 mg twice daily. (Sources: Killestein J, et al. Safety, tolerability, and efficacy of orally administered cannabinoids in MS. Neurology 2002;58(9):1404-1407; Pertwee RG. Prescribing cannabinoids for multiple sclerosis. CNS Drugs 1999;11(5):327-334; Ungerleider JT, et al. Delta-9-THC in the treatment of spasticity associated with multiple sclerosis. Adv Alcohol Subst Abuse 1987;7(1):39-50.) 3. UK: Parliament committee recommends reconsideration of international drug treaties In his long-awaited report on drug policy published on 22 May the Select Committee on Home Affairs recommends "that the Government initiates a discussion within the Commission on Narcotic Drugs of alternative ways - including the possibility of legalisation and regulation - to tackle the global drugs dilemma." With regard to cannabis the committee supports the intention of the government to reclassify the drug from class B to class C, putting cannabis in the same category as anti-depressants and steroids. The report said: "Whether or not cannabis is a gateway drug, we do not believe there is anything to be gained by exaggerating its harmfulness." The Liberal Democrats who back the legalisation of cannabis say the report does not go far enough. This opinion is supported by Lord Bingham, the most senior law lord in England's highest court. In an interview he criticised the government's "stupid" approach to cannabis, calling for the drug to be legalised. The whole report is available at: http://www.publications.parliament.uk/pa/cm200102/cmselect/cmhaff/318/31802.htm (Sources: Associated Press of 22 May 2002, Reuters of 23 May 2002) 4. News in brief ***Canada: High quality cannabis The company that is growing Canada's official marijuana supply says the weed has turned out to be too potent. The marijuana is not bad - the problem is it's too good, Prairie Plant Systems said on 15 May in a letter to Health Minister Anne McLellan. Company president Brent Zettl is angry about the company's "damaged reputation" arising from Ms. McLellan's recent revelations that the project to give marijuana to sick Canadians has been delayed because the material is impure. That sparked reports of bad quality. (Sources: Ottawa Citizen of 16 May 2002, Toronto Star of 16 May 2002) ***Science: Pregnancy Cognitive performance in new-borns of 354 mothers were assessed at 6.5, 12, and 13 months. Alcohol use during pregnancy was associated with poorer cognitive performance. The use of cocaine and tobacco was associated with smaller size at birth. No effects were detected in relation to cannabis use. (Source: Jacobson SW, et al. Pediatrics 2002 May;109(5):815-25) ***USA: Vermont The controversial question of whether Vermont should legalize cannabis use for people with serious illnesses appears to be dead for this session. On 24 May a joint committee of the House of Representatives and the Senate reached a tentative agreement to drop the measure and instead appoint a task force to study the issue and report its findings to the next Legislature. (Source: Rutland Herald of 25 May 2002) ***USA: Nevada There are now 154 registered users in Nevada's medical marijuana program along with 18 caregivers, said Cecile Crofoot, who runs the program within the Department of Agriculture. To her knowledge, none of those registered have gotten into legal trouble for drug violations. The program was approved by the Legislature in 2001. Nevada's is modelled after Oregon's program, which has also been ignored by federal prosecutors. (Source: Nevada Appeal of 14 May 2002) ***World: Doping The World Anti-Doping Agency (WADA) has drafted a new definition of doping, specifying that a doping substance or method "has the potential to enhance sport performance." Previous definitions did not single out performance-enhancing drugs. Rune Andersen, WADA's director of standards and harmonization, said marijuana and other non-performance enhancers would no longer be included on the list of banned doping substances. Instead, they would be listed in a new "code of conduct" category. It is expected that the new code will be implemented in January 2004, six months before the Olympic Games in Athens. (Source: Associated Press of 24 May 2002) 3. ONE YEAR AGO: - 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 TWO YEARS AGO: - USA: AIDS patients may get cannabis for Californian study ----------------------------------------------------------------- IACM-Bulletin of 9 June 2002 ----------------------------------------------------------------- ======================================== More than 2,600 subscribers to the IACM-Bulletin Doubling within one year ======================================== * USA: Protests against raids of medical cannabis clubs * Canada: Civil suit against federal government regulations 1. USA: Protests against raids of medical marijuana clubs Activists criticize the federal government's plans to crack down on medical marijuana clubs (cooperatives that grow cannabis and distribute it to patients) in California. They launched nationwide protests at Drug Enforcement Agency (DEA) offices. Protests happened on 6 June outside of about 60 DEA headquarters around the country. On 29 May federal agents raided the Aiko Compassion Center in Santa Rosa, California, and arrested two of the owners. The raid is the fourth since October 2001, following raids of medical cannabis clubs in Los Angeles, Sacramento and San Francisco. Five supporters of the sale of marijuana for medical purposes at the Los Angeles Cannabis Resources Center launched an "open-ended hunger strike" on 5 June. The centre was shut down in October 2001 when federal agents seized files, plants and other assets. (Sources: Los Angeles Times of 6 June 2002, Reuters of 6 June 2002, Associated Press of 31 May 2002) 2. Canada: Civil suit against federal government regulations Seven Canadians who use or distribute medical marijuana are asking the Ontario Superior Court to strike down federal access regulations and to order the federal government to provide them with cannabis. They argue that the federal regulations are fundamentally unconstitutional, depriving the applicants of "life and liberty," guaranteed under Section 7 of the Charter of Rights and Freedoms. The regulations, set up to provide sick people with legal access to marijuana, have made obtaining the drug difficult because the government is demanding medical declarations that few doctors will sign, the group of seven told a Queen's Park news conference on 23 May. The Canadian Medical Association and the insurer for Canadian doctors have warned physicians against signing the declarations. However, Andrew Swift, a health department spokesperson, said some doctors have signed. Since the regulations were introduced last summer, 255 people have been granted permission to use medical marijuana. (Sources: Toronto Star of 24 May 2002, Globe and Mail of 24 May 2002) 3. News in brief ***Switzerland: Lectures on cannabis as medicine On 15 and 16 June Hemp Info (Chanvre Info) is organizing lectures on Hemp in Medicine. The meeting will take place in the premises of Hemp Info in the Château au Prehl 53 near Murten. Among the speakers are Dr. Claude Vaney, Dr. Jens Wagner, Dr. Joerg Fachner, Dr. Oleg Grigoriev, Dr. Sergej Grigoryev, and Dr. Ester Fride. ***Science: Pain in spinal cord injury 471 persons with spinal cord injuries were asked about their experience with different pain treatments. The treatments rated as most helpful were opioid medications, physical therapy, and diazepam therapy. Those rated as least helpful were spinal cord stimulation, counselling or psychotherapy, administration of acetaminophen, and administration of amitriptyline. Alternative treatments reported as most helpful were massage therapy and use of cannabis. (Source: Warms CA, et al. Clin J Pain 2002 May-Jun;18(3):154-63) ***Science: Prenatal cannabis exposure This report from a longitudinal study of the effects of prenatal alcohol and marijuana exposure investigated whether these drugs affect neuropsychological development at 10 years of age. 593 children completed a neuropsychological battery. Prenatal alcohol use was found to have a significant negative impact on learning and memory skills. Prenatal marijuana exposure also had an effect on learning and memory. (Source: Richardson GA, et al. Neurotoxicol Teratol 2002 May-Jun;24(3):309-20) 4. ONE YEAR AGO: - USA: Robert Randall died - USA: Registration for medical use of cannabis TWO YEARS AGO: - UK: Cross-party support for medical use of Cannabis - Canada: Extend of deadline for bidders for marijuana contract ------------------------------------------------------- IACM-Bulletin of 23 June 2002 ------------------------------------------------------- * Science: THC reduces sleep apnoea in animal research * USA: Californian medical marijuana clubs bared from distributing the drug 1. Science: THC reduces sleep apnoea in animal research Researchers at the Center for Sleep and Ventilatory Disorders at the University of Illinois in Chicago investigated the effects of THC and the endocannabinoid oleamide on sleep, respiratory pattern and sleep apnoea in rats. Professor David W. Carley and colleagues found that THC and oleamide each stabilized respiration during all sleep stages and decreased apnoea. Authors conclude from their results that the study suggests an important role for endocannabinoids in maintaining autonomic stability during sleep, that it further demonstrates potent suppression of sleep apnoea by both THC and endocannabinoids, and that this observation may be relevant to the medicinal treatment of sleep-related breathing disorders. Sleep apnoea (American English: apnea) is a breathing disorder characterized by brief interruptions of breathing during sleep. These breathing pauses are almost always accompanied by snoring between apnoea episodes, although not everyone who snores suffers from apnoea. The frequent interruptions of deep, restorative sleep often leads to excessive daytime sleepiness and may be associated with irregular heartbeat, high blood pressure, heart attack, and stroke. The reduction of sleep apnoea by cannabinoids may be related to their interaction with the neurotransmitter serotonin. Serotonin can increase sleep-related apnoea. Cannabinoids are known to inhibit the stimulating effects of serotonin on nodose ganglion cells. The nodose ganglion is a set of nerve cells outside the spinal cord, which transport information about blood pressure, carbon dioxide concentration, and other information on the state of the body via the spinal cord to the brain. (Source: Carley DW, et al. Functional role for cannabinoids in respiratory stability during sleep. Sleep 2002;25(4):391-398) 2. USA: Californian medical marijuana clubs bared from distributing the drug A federal judge in California has ruled in favour of a request of the Federal Justice Department to block three northern California medical marijuana clubs from distributing the drug to patients with a permanent injunction. U.S. District Judge Charles Breyer of San Francisco ruled against the Oakland Cannabis Buyers Cooperative, the Marin Alliance for Medical Marijuana and a dispensary located in Ukiah. Attorneys for the Oakland Cannabis Buyers Cooperative said they would appeal Breyer's ruling to a higher court, the Ninth Circuit Court of Appeals. In his ruling on 13 June, Breyer said, "In the absence of an injunction, the defendants (the clubs) are likely to resume distributing marijuana in violation of the Controlled Substances Act." California is one of eight states that allow individuals to grow or use small amounts of cannabis for medical purposes as long as the use is ordered and supervised by a physician. (Source: NORML of 13 June 2002, CNSNews.com of 14 June 2002) 3. News in brief ***Science: Appetite of rats THC and the endocannabinoid anandamide reduced the time until rats started to eat. Apart from its rapid onset, cannabinoid-induced eating retained the normal, species-typical characteristics. Data suggest that cannabinoids promote eating by increasing the incentive value of food. (Source: Williams CM, Kirkham TC. Physiol Behav 2002 Jun;76(2):241-50) ***Science: Comparison of THC and marijuana effects Two studies were conducted to compare the subjective effects of pure THC to whole-plant cannabis containing an equivalent amount of THC in normal healthy volunteers. In one study with 12 participants the substances were administered orally in cookies and in the other with 13 participants they were administered by smoking. In both studies all participants received all five substances one after the other, a low and a high dose of THC, a low and a high dose of marijuana, and placebo. In both studies, THC and marijuana produced similar subjective effects, with only minor differences. (Source: Wachtel SR, et al. Psychopharmacology (Berl) 2002 Jun;161(4):331-339) ***Germany: World Conference Ethnotherapies The World Conference Ethnotherapies will take place on 11-13 October 2002 at the University of Munich. On the 14th of October there will be a workshop for therapists. More information at http://www.institut-ethnomed.de/. ***UK: GW Pharmaceuticals GW Pharmaceuticals has reported increased interim losses. But the company said it will have cannabis-based medicines ready for launch by 2004. Pre-tax losses hit 5.7 million British pounds. GW has increased its staff numbers from 85 to 102. (Source: PA News of 13 June 2002) ***Europe: Report on medical cannabis The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published a report on the legal situation of medical cannabis in the European Union. It can be found together with other comparative studies, at http://eldd.emcdda.org/databases/eldd_comparative_analyses.cfm 4. ONE YEAR AGO: - 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 TWO YEARS AGO: - Science: Tumour promoting effect of THC in animal study ------------------------------------------------------- IACM-Bulletin of 7 July 2002 ------------------------------------------------------- * Germany: Second firm to manufacture dronabinol (THC) 1. Germany: Second firm to manufacture dronabinol (THC) Since June 2002 Delta 9 Pharma, a company of Bionorica (Neumarkt, Bavaria), provides pharmacies with dronabinol, who can make medicines (capsules, tinctures) from it, according to official formulas of the German Pharmacists Association. The increased resonance in the media has increased the demand for dronabinol by patients and doctors which allowed to reduce the price. Delta 9 Pharma is the second German firm to produce dronabinol and provide pharmacies with it, following THC Pharm (Frankfurt) which provides pharmacies with dronabinol since about three years. Bionorica is a well-known manufacturer of herbal medicines. Both firms manufacture THC (dronabinol) from cannabidiol (CBD) of fibre hemp by isomerization. Prices for dronabinol of Delta 9 Pharma (selling prices in pharmacies): 250 mg - about 300 Euro (about $ 310) 500 mg - about 520 Euro (about $ 535) Prices for dronabinol of THC Pharm (selling prices in pharmacies): 250 mg - about 270 Euro (about $ 280) 500 mg - about 465 Euro (about $ 480) 1000 mg - about 860 Euro (about $ 885)   According to that 1 milligram dronabinol costs about 1 Euro with a selling volume of 500 mg. With a medium daily need of 10 to 20 mg this results in monthly treatment costs of about 300 to 600 Euros. (Sources: Personal communications by THC Pharm and Delta 9 Pharma) 2. News in brief ***UK/Scotland: Cannabis trial in Scotland Clinical trials of the British firm GW Pharmaceuticals with a cannabis extract sprayed under the tongue have been extended to Scotland. Pain patients at Gartnavel Hospital, Glasgow, may participate in the study. Nine hospitals around Britain are now participating. GW Pharmaceuticals hopes to test the drug on up to 1,000 patients. (Source: The Scotsman of 1 July 2002) ***Science: Increase of sleep duration The synthetic cannabinoids HU-210, HU-310, and arachidonyl-2-chloroethylamide increased the sleep duration after anaesthesia with isoflurane in mice, even with low doses. (Source: Schuster J, et al. Neurosci Lett 2002 Jul 5;326(3):196-200) ***Science: Cancer of immune cells Cannabinoids that bind to the CB2 receptor (including THC, HU-210, and anandamide) induced apoptosis (programmed cell death) in a number of human leukaemia and lymphoma cell lines. This anti-cancer effect was in part mediated by the CB2 receptor. (Source: McKallip RJ, et al. Blood 2002 Jul 15;100(2):627-34) ***Science: Neuropathy in diabetes Neuropathic pain may occur in diabetes due to damage of sensory nerves. A key measure of sensory nerve function is neuropeptide release evoked by a stimulus. The synthetic CB1 receptor agonist CP55940 inhibited this neuropeptide release in both non-diabetic and diabetic mice. (Source: Ellington HC, et al. Neuropharmacology 2002 Jun;42(7):966-975) ***Germany: Social Democratic Party According to an internal submittal of the Social Democratic Party (SPD) in the Bundestag (German Parliament) the possession of cannabis should no longer be a criminal offence, but punished with a fine. This was reported by the weekly Focus. A speaker of the SPD told the German Press Agency (dpa) that she did not know anything about such a submittal. The Social Democratic Party together with the Greens, who support the legalisation of cannabis, form the Federal Government. (Source: dpa of 29 June 2002) ***Science: Two new books Two comprehensive new English handbooks have recently been published. - Grotenhermen F, Russo E, eds. Cannabis and Cannabinoids. Pharmacology, Toxicology, and Therapeutic Potential. Binghamton NY: Haworth Press, 2002, about 450 pages. With contributions by about 50 authors. This volume is also available in German and will be published in Spanish soon. - Onaivi ES, ed. Biology of Marijuana. From Gene to Behaviour. London/New York: Taylor & Francis, 2002, about 630 pages. With contributions by about 50 authors. 3. ONE YEAR AGO: - Canada: New regulations will take effect at the end of July - Science: News at the 2001 meeting of the ICRS TWO YEARS 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 ------------------------------------------------------- IACM-Bulletin of 21 July 2002 ------------------------------------------------------- * UK: Government announces to relax cannabis laws * USA: California's Supreme Court rules in favour of medical cannabis 1. UK: Government announces to relax cannabis laws On 10 July Home Secretary David Blunkett told parliament cannabis would be downgraded from a Class B to a Class C drug, putting it in the same category as anabolic steroids and growth hormones, and making its use and possession less serious crimes. "The message to young people and families must be open, honest and believable," Blunkett said. "Cannabis is a potentially harmful drug and should remain illegal. However, it is not comparable with crack, heroin and Ecstasy." Prime Minister Tony Blair said the proposal did not amount to decriminalisation and had wide support among the police because it would allow them to spend more time fighting more serious drugs. In Britain, possession of a Class B drug currently carries a maximum penalty of five years in jail. Possession of a Class C drug carries a maximum sentence of two years, but that penalty is rarely invoked for first-time offenders. Blunkett said that in most marijuana possession cases police would simply confiscate the drug and issue a warning to the offender. (Sources: Reuters of 10 July 2002, AP of 11 July 2002) 2. USA: California's Supreme Court rules in favour of medical cannabis Medical marijuana users are immune from criminal prosecution in California state courts under a ruling by the state's Supreme Court. Under California law, possessing or growing marijuana "is no more criminal - so long as its conditions are satisfied - than the possession and acquisition of any prescription drug with a doctor's prescription," the California Supreme Court ruled on 18 July. The ruling stems from the arrest and conviction of Myron Mower, who uses cannabis to alleviate complications from diabetes. Mower was arrested in 1997 and convicted of possessing and cultivating marijuana. The appeals court affirmed Mower's conviction. The ruling of the Californian Supreme Court sent the case back to the appeals court for a new trial. Medical users of cannabis in California, however, are still subject to prosecution under federal law which prohibits cannabis even for medical use. (Source: AP of 19 July 2002) 3. News in brief ***Canada: Acquittal for cannabis club president On 5 July Philippe Lucas, 32-year-old man from Victoria and president of the Vancouver Island Compassion Society, received an absolute discharge from illegally possessing cannabis by the Victoria provincial court. His society has operated in Oak Bay for 14 months and with tacit police approval distributed cannabis to patients. When Lucas reported a break-in and that one kilogram of marijuana had been stolen, he was charged with illegal possession when he claimed ownership of the stolen drug. (Source: Victoria Times-Colonist of 6 July 2002) ***USA: Washington DC Voters of the District of Columbia (Washington DC) could get another chance to vote on legalizing cannabis for medicinal uses following an earlier vote in 1998. On 8 July the Marijuana Policy Project presented to the Board of Elections and Ethics 39,000 signatures from residents who want to bring the issue to referendum. If at least 17,500 signatures are verified, the issue will be on November's ballot. (Source: Washington Post of 8 July 2002) ***Science: Colon movement Endocannabinoids are a physiological regulators of colon propulsion in mice. Researchers found that anandamide and the synthetic CB1 receptor agonist WIN 55,212-2 inhibited colonic propulsion, an effect that was blocked by the selective CB1 receptor antagonist SR141716A. Administered alone, SR141716A increased motility. Additionally high amounts of endocannabinoids (2-AG, anandamide) were found in the colon. (Source: Pinto L, et al. Gastroenterology 2002 Jul;123(1):227-234) ***Science: Schizophrenia Researchers found that a small proportion of schizophrenias might have been precipitated by cannabis use. They interviewed a sample of 232 individuals with first episodes of schizophrenia. 62% of the patients with drug abuse (mainly cannabis) and 51% of those with alcohol abuse began the habit before illness onset (=first sign of the disorder). Abuse onset and illness onset occurred highly significantly within the same month. (Source: Buhler B, et al. Schizophr Res 2002 Apr 1;54(3):243-51) ***Europe: Cannabis report of health ministers The Belgium Health Minister has published a report on a meeting of 25 February in Brussels. About 100 invited scientists and governmental representatives participated in a scientific conference on cannabis, initiated by the health ministers of Belgium, the Netherlands, France, Switzerland, and Germany. The 167 page report (in English) "Cannabis 2002 Report" is available at: Ministry of Public Health, Brussels, Belgium, Phone: 0032-2-2104807. (Source: Cannabis 2002 Report) ***Germany: Cannabis and Driving The Federal Constitutional Court announced on 12 July that sole cannabis possession is not a sufficient reason to call in question driving ability. The court ruled in favour of a car driver who lost his driving license after he refused to let his urine screened for drugs. The highest German court argued that there was no connection between drug use and driving in this case. (Source: Press release of the Federal Constitutional Court of 12 July 2002) 4. ONE YEAR AGO: - Science: Discussion on the medical value of cannabinoids in British Medical Journal - Science: News at the 2001 meeting of the ICRS (II) TWO YEARS 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 ------------------------------------------------------- IACM-Bulletin of 4 August 2002 ------------------------------------------------------- * Science: Endocannabinoids extinguish bad memories in the brain * Science: News at the 2002 meeting of the ICRS (I) 1. Science: Endocannabinoids extinguish bad memories in the brain Researchers at the Max Planck Institute of Psychiatry in Munich (Germany) have shown that the endogenous cannabinoid system plays a central role in the extinction of aversive memories. Transgenic mice without the brain cannabinoid receptor (CB1) and mice treated with a CB1 receptor antagonist showed strongly impaired extinction of fear in experiments. The animals that were conditioned to associate a musical tone with an electric shock, produced a fear reaction, and continued to react even when the tone was not followed by a shock. Normal mice quickly stopped reacting to the tone once it was not associated with a shock, but the treated mice needed much more time to forget their fear. Dr. Beat Lutz and his team found out that the amygdala, an area of the brain central to storing memory and fear, was flooded with endocannabinoids, when the mice were gradually forgetting the learned response to the shock. The use of cannabis would not produce the same effect in humans, Lutz said, because it overflows the whole brain and is not specific enough. Dr. Pankaj Sah, a neuroscientist at the Australian National University in Canberra said in a comment the latest findings may explain why some people with psychiatric problems try to find relief with marijuana. He suggested that people with certain psychiatric problems perhaps are self-medicating in an attempt to help their brains extinguish some painful or traumatic memory or thought. (Sources: Marsicano G, et al. The endogenous cannabinoid system controls extinction of aversive memories. Nature 2002 Aug 1;418(6897):530-4; Sah P. Neurobiology: Never fear, cannabinoids are here. Nature 2002 Aug 1;418(6897):488-9; Reuters of 31 July 2002; Seattle Times of 1 August 2002; Abstract of Giovanni Marsicano et al. at the 2002 ICRS Meeting) 2. Science: News at the 2002 meeting of the ICRS (I) Below are some research results presented at the 12th Annual Symposium on the Cannabinoids of the International Cannabinoid Research Society (ICRS) from 10 to 14 July in the USA (California). (See also the next IACM-Bulletin.) (1) Effects of cannabinoids on autoimmune diseases of the central nervous system were investigated in animal models. Autoimmune diseases of the brain and spinal chord (EAE) and of the eye (EAU) were induced in normal mice and in transgenic mice devoid of CB1 receptors. Disease progression was much faster in transgenic mice than in normal mice. Exogenous cannabinoids (THC and WIN 55,212-2) produced a significant degree of preservation of the retina in EAU. This suggests that cannabinoids may have some neuroprotective effects during multiple sclerosis. (Abstract by Gareth Pryce et al.) (2) The possible role of endocannabinoids in the inhibition of colon cancer growth was examined in healthy and cancer tissue obtained by means of biopsy from humans. Both healthy and cancer colon tissue expressed CB1 and CB2 receptors. Anandamide and 2-AG levels in colon cancer tissues were about twice as high as in healthy colon tissue. Moreover, anandamide dose-dependently inhibited the growth of colon cancer cells, which was blocked by a CB1 receptor antagonist. (Abstract by Vinzenzo di Marzo et al.) (3) The non-psychotropic phytocannabinoid cannabidiol (CBD) reduced inflammation and hyperalgesia in a rat model of acute inflammation. Furthermore, animals that had received CBD showed lower biochemical parameters of inflammation, a lower level in prostaglandins E2 (PGE2) in plasma, a lower activity of cyclooxygenase (COX) in the inflamed paw, and a lower content of nitric oxide and free radicals in the paw. (Abstract by Barbara Costa et al.) (4) The daily simultaneous application of low doses of THC and morphine prevented the development of tolerance to morphine as observed with daily high doses of morphine, but yielded similar analgesic effects in mice. (Abstract by Diana C. Cichewicz and Sandra P. Welch) (5) In glaucoma cell death in the retina may occur due to toxicity of the increasingly produced neurotransmitter NMDA. The effect of cannabinoids (CB1 agonists) on NMDA induced retinal nerve cell death in mice were investigated. Eyes treated with both the cannabinoid and NMDA retained two times the retinal nerve cells as the eyes exposed only to NMDA, demonstrating a protective effect of the cannabinoid. (Abstract by G. Ayoub et al.) (Source: Reader of the 2002 ICRS meeting. The 182 page reader with all abstracts is available for download at www.cannabinoidsociety.org.) 3. News in brief ***Science: THC aerosol An aerosol of THC was administered to mice with a metered dose inhaler (MDI) to test its physiochemical and pharmacological properties. Results showed that further development of a THC metered dose inhaler could provide an appropriate delivery device for the therapeutic use of cannabinoids. (Source: Wilson DM, et al. Drug Alcohol Depend 2002 Aug 1;67(3):259-67) ***Journals: Free sample copy offer A free sample copy of the Journal of Cannabis Therapeutics and the new Journal of Industrial Hemp is available from: Sample Copy Dept The Haworth Press, Inc. 10 Alice Street Binghamton, NY 13904 USA ***USA: Press conference at Capitol On 24 July members of the House of Representatives Barney Frank (Democrat), Ron Paul (Republican), Dana Rohrabacher (Republican) and Janice Schakowsky (Democrats) joined former Ronald Reagan presidential aide Lyn Nofziger and several patients in a press conference at the Capitol Hill in Washington to call on Congress to allow states to allow the medical use of cannabis. Their bill has little chance of passing Congress this year. (Source: AP of 24 July 2002) ***USA: San Francisco Frustrated by the federal government's determination to shut down medical marijuana clubs, the city of San Francisco is thinking about growing its own cannabis. A measure will be put on the November ballot that would have city officials explore the possibility of growing marijuana on publicly owned lots and distributing it to ill patients. (Sources: Associated Press of 23 July 2002, New York Times of 24 July 2002) ***Science: Lung function The effects of cannabis and tobacco use on the lung function of 900 young adults from New Zealand who were examined at the age of 18, 21 and 26 years were investigated. The effect of cumulative cannabis use on the ratio of the forced expiratory volume in one second (FEV1) and the vital capacity was marginally significant (p<0.09), while cigarette smoking (p<0.05), age (p<0.001) and weight (p<0.001) were significant predictors of lung function. (Source: Taylor DR, et al. Addiction 2002 Aug;97(8):1055-61) ***Science: Apoptosis I Ceramide was used to induce apoptosis (programmed cell death) in astrocytes (certain cells in the brain that are not nerve cells). Cannabinoids were shown to rescue astrocytes from ceramide-induced apoptosis in a dose- and time-dependent manner. (Source: Taylor DR, et al. et al. J Biol Chem 2002 Jul 19) ***Science: Apoptosis II Experiments with cell cultures and mice showed that the immunosuppressive effects of THC might in part be caused by the induction of apoptosis in immune cells. (Source: McKallip RJ, et al. J Pharmacol Exp Ther 2002 Aug;302(2):451-65) ***Canada: Asylum seekers from the US Cannabis-smoking political asylum seekers from the United States are unlikely to receive refugee status in Canada, immigration experts said on 23 July. At least three Americans (Steve Kubby, Ken Hayes and Renee Boje) living in Canada are arguing that they have been persecuted in their homeland because of their attempts to grow, cultivate, or use marijuana for medical purposes. (Source: Globe and Mail of 24 July 2002) ***Science: Dexanabinol On 24 July Pharmos Corporation received approval from the Israelian Health Ministry to clinically test dexanabinol as a preventive agent against the mild cognitive impairment that can follow heart surgery. Dexanabinol is a non-psychotropic THC derivative. Cognitive loss following heart surgery was not considered a major problem until two years ago, when a study showed that the impairment caused by a blockage of blood flow to the brain that followed the surgery was long term. (Source: Jerusalem Post of 25 July 2002) 4. ONE YEAR AGO: - Canada: New rules on medical use of marijuana take effect - Science: Study with smoked cannabis in pain funded by Canadian government TWO YEARS 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 ------------------------------------------------------- IACM-Bulletin of 18 August 2002 ------------------------------------------------------- * Canada: Medical cannabis club of Toronto raided * Science: News at the 2002 meeting of the ICRS (II) * Science: Cannabinoid receptor antagonist in obesity 1. Canada: Medical cannabis club of Toronto raided Four people were arrested on 13 August after police raided the Toronto Compassion Centre which sold medical marijuana to more than 1,200 people. The four were charged with trafficking in a controlled substance and possession for the purpose of trafficking. The club has been operating openly for more than four years. Clients required a letter of diagnosis from their doctor. Police did not say what motivated them to raid the centre. A constable said they were under orders from their superior officer not to discuss the case. "We were under the impression that they weren't happy with what we were doing, but they were going to look the other way because they realized I wasn't selling it to kids," Warren Hitzig, the founder and former director of the centre and one of the arrested said after he was released on 14 August. Hitzig is now banned from entering his former office. The centre's future remains unclear. One other Toronto medical cannabis club, CALM (Cannabis as Living Medicine), still exists. (Sources: Toronto Star of 14 and 16 August 2002) 2. Science: News at the 2002 meeting of the ICRS (II) Below are some more research results presented at the 12th Annual Symposium on the Cannabinoids of the International Cannabinoid Research Society (ICRS) from 10 to 14 July in the USA (California). (See also the last IACM-Bulletin.) (1) Cognition: A meta-analysis of 39 studies was conducted to investigate whether regular cannabis use might have long-term consequences on the nervous system. Researchers concluded: "The studies that met our criteria yielded no basis for concluding that long-term cannabis consumption is associated with generalized neurocognitive decline, with the possible exception of slight decrements in the area of learning new information." (Abstract by Igor Grant et al.) (2) Depression: In a mouse model of human depression the natural cannabinoid CBD but not THC showed similar antidepressant effects as a known antidepressant drug (imipramine). (Abstract by Richard Musty et al.) (3) Inflammation: The cytokines interleukin-1-beta and tumour necrosis factor alpha contribute to the inflammation and the progression of joint destruction in arthritis. The cannabinoid ajulemic acid (CT3) reduced the level and secretion of interleukin-1-beta in human blood cells. without affecting the level of tumour necrosis factor alpha. (Abstract by Bonnie Bidinger et al.) (4) Pregnancy: Children of 13 to 16 years whose mothers had used cannabis or tobacco during pregnancy were tested. Results showed that prenatal exposure to cannabis had no effect on global intelligence but was associated with reduced performance in tasks that required visual memory, analysis and integration of information. Prenatal tobacco exposure was associated with lower global intelligence and auditory memory. (Abstract by Peter Fried et al.) (Source: Reader of the 2002 ICRS meeting. The 182 page reader with all abstracts is available for download at www.cannabinoidsociety.org.) 3. Science: Cannabinoid receptor antagonist in obesity A small phase II study by the French pharmaceutical company Sanofi-Synthelabo in obese people with the cannabinoid receptor antagonist SR141716 (Rimonabant) has just been completed. In the 16-week trial the highest dose group lost 4 kg of weight on average. SR141716 blocks the CB1 receptor. This receptor is activated by THC resulting in increased appetite. Rimonabant caused some gastrointestinal side effects at the highest dose, but was generally well-tolerated, a Sanofi spokesman said. In August 2001, the company initiated phase III trials of Rimonabant, studying 6,180 patients. The first study is a two-year North American trial of 2,800 patients comparing 5 milligram and 20 milligram doses of Rimonabant to placebo for weight reduction and prevention of weight regain. A similar study with 1,400-patients is conducted in Europe. Alongside these trials, Sanofi is running two other 990-person studies looking at the effects of the drug in patients with diabetes and lipid problems. (Source: Associated Press of 14 August 2002) 4. News in brief ***Canada: 800 Canadians allowed to use cannabis Since 30 July 2001, when Health Canada introduced new access regulations allowing ill Canadians to use cannabis, 315 new patients have been granted authorization. That is about one every day. 472 people had already been granted exemption from criminal procedure under the precedent law. Thus, the total number of permitted marijuana users today is 786. Of those, 208 are growing their own plants with personal production licences. (Source: Calgary Sun of 3 August) ***Science: Psychosis A three-year longitudinal study of a general population of 4,045 psychosis-free persons and of 59 subjects with a diagnosis of psychotic disorder was conducted in the Netherlands. Cannabis use increased the risk of becoming psychotic within the studs period in psychosis-free persons and was associated with a poorer prognosis in persons with a psychotic disorder. (Source: Van Os J, et al. Am J Epidemiol 2002 Aug 15;156(4):319-27) 5. ONE YEAR AGO: - Canada: GW Pharmaceuticals starts clinical trials in Canada TWO YEARS AGO: - USA: Legal fight for opening of the Oakland Cannabis Buyers Cooperative - Belgium: Seminar on marijuana in Parliament ------------------------------------------------------- IACM-Bulletin of 1 September 2002 ------------------------------------------------------- * Canada: Confusion about plans of Health Minister * Science: British survey on cannabis in multiple sclerosis 1. Canada: Confusion about plans of Health Minister Health Minister Anne McLellan told the Canadian Medical Association on 19 August that she had "a certain degree of discomfort" with distributing the cannabis grown for the government program in an abandoned copper mine in Flin Flon, Manitoba, to patients. She said she wants to wait until scientific trials prove cannabis is safe before giving it to patients. This led to assumptions that the government might significantly change their politics regarding the medical cannabis project. Trials have not begun and will take several years. Originally the cannabis grown in the mine was intended for clinical research and at the same time for the distribution to patients. However, McLellan made it clear that the laws that allow people with certain medical conditions to apply for special exemptions that allow them to use cannabis to relieve their symptoms will stay in effect. "We have 855 of those people. More people continue to apply," McLellan said. These people may also apply for the right to cultivate cannabis for personal use. (Sources: National Post of 29 August 2002, Toronto Star of 26 August 2002, Edmonton Sun of 21 August 2002) 2. Science: British survey on cannabis in multiple sclerosis A survey of multiple sclerosis patients living in England found that 45 percent use cannabis either for relief of disabling leg spasms or to ease MS pain. The findings were presented at the 10th World Congress on Pain. Neurologist Dr. M. Sam Chong of King's College Hospital, London, said the "use rate is actually higher than we expected." He said that about half of the patients started using cannabis only after MS was diagnosed. 74 percent either eliminated or controlled leg spasms while 54 percent said they used marijuana mainly for pain relief. The 15-page surveys were mailed to 300 MS patients who are included in an MS patient database used by the neurology department and outpatient clinics. 258 questionaires were returned. He said that patients who reported more severe symptoms were more likely to use marijuana, than patients who had mild or moderate symptoms. (Source: United Press International of 18 August 2002) 3. News in brief ***Science: Pruritus/itching Pruritus due to liver disease can be particularly difficult to treat and frequently is intractable to a variety of medical therapies. Three patients with intractable pruritus and significant decreases in their quality of life, including lack of sleep, depression, inability to work, and suicidal ideations, were administered THC (dronabinol). All patients were started on 5 mg of THC at bedtime. All 3 patients reported a decrease in pruritus and a marked improvement in sleep. The duration of antipruritic effect was approximately 4 to 6 hours. (Source: Neff GW, et al. Am J Gastroenterol 2002;97(8):2117-9) ***USA: Mikuriya accused Dr. Tod Mikuriya, a psychiatrist from Berkeley (California) and well-known supporter of the medical use of cannabis, who has sanctioned marijuana use by six thousand Californians in the past five years is being accused by the state Medical Board of "unprofessional conduct" in his handling of 18 cases. Not one of the 18 complaints was initiated by a patient, Mikuriya sais; all were sent to the Board by the police, sheriffs and drug agencies. (Source: Anderson Valley Advertiser of 14 August 2002) ***Science: Pain 15 patients with chronic pain who indicated that they used cannabis therapeutically completed a questionnaire in Canada. The median frequency of use was four times per day (range: 1 to 16 times per day). Twelve patients reported improvement in pain and mood, while 11 reported improvement in sleep. Tolerance to cannabis was not reported. (Source: Ware MA, et al. Pain Res Manag 2002;7(2):95-9) ***Germany: Majority against criminal sanctions The majority of Germans object criminal prosecution of people who posses cannabis. According to a poll by Emnid 36.4 percent of the 1007 participants favoured the idea to handle cannabis possession similar to a traffic offence with a fine. 26.0 percent favoured legalisation of cannabis possession. 35.7 percent spoke out for the current mode of criminal sanctions. (Source: dpa) ***Science: Addiction The younger someone is when first trying marijuana, the more likely he or she is to become dependent on illegal drugs later in life, U.S. government researchers said on 28 August. The report, based on representative data (National Household Survey), found that 18 percent of adults who said they first tried pot before the age of 15 met the criteria for either dependence or abuse of alcohol or illicit drugs, compared to 2.1 percent of adults who said they had never used marijuana. (Source: Reuters of 28 August 2002) 4. ONE YEAR AGO: - Science: Cannabis less effective against vomiting than serotonin antagonists TWO YEARS 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 ------------------------------------------------------- IACM-Bulletin of 15 September 2002 ------------------------------------------------------- * Canada: Senate Committee on Drugs recommends legalization of cannabis * USA: City plans to protest with distribution of cannabis * Canada: Clinical trials could take five years 1. Canada: Senate Committee on Drugs recommends legalization of cannabis The Special Committee on Illegal Drugs set up by Canada's Senate unananimously recommended on 4 September that the government should legalize the use of cannabis, saying it should be sold on a regulated basis like alcohol. "Essentially the committee recommends from now on that marijuana be legalized and available for restricted use, so Canadians can choose whether to consume it or not," said committee chairman Senator Pierre Claude Nolin. "In a free society such as ours it is up to each person to decide whether they want to use cannabis or not. We do not want to encourage this consumption any more than we encourage the consumption of alcohol," he added. The committee concluded in a 600-page report that cannabis was not a so-called gateway drug and was in fact much less dangerous than alcohol. It says that the "prohibition of cannabis jeopardizes the health and well-being of Canadians much more than does the substance itself." With regard to the medical benefits the Committee noted that there are "clear, though non-definitive indications of the therapeutic benefits of marijuana in the following conditions: analgesic in chronic pain, antispam for multiple sclerosis, anticonvulsive for epilepsy, antiemetic for chemotherapy and appetite stimulant for cachexi." The reports of the Special Committee on Illegal Drugs are available at: http://www.parl.gc.ca/illegal-drugs.asp (Sources: Senate Special Committee on Illegal Drugs. Cannabis: Our Position for a Canadian Public Policy. Senate of Canada. September 2002; Reuters of 4 September 2002; Associated Press of 4 September 2002) 2. USA: City plans to protest with distribution of cannabis City leaders of Santa Cruz (California) plan to join medical marijuana users at a marijuana giveaway at City Hall next week, hoping to send a message to federal authorities that, in this town, medical marijuana is welcome. The invitation comes one week after agents from the Drug Enforcement Agency (DEA) arrested the owners of a cannabis farm, Valerie and Michael Corral, and confiscated 130 plants that had been grown to be used as medicine. "It's just absolutely loathsome to me that federal money, energy and staff time would be used to harass people like this,'' said vice mayor Emily Reilly, who with several City Council colleagues plans to pass out medical marijuana to sick people from the garden-like courtyard at City Hall on 17 September. DEA spokesman Richard Meyer was not amused. "I'm shocked that city leaders would promote the use of marijuana that way," he said. "What is that saying to our youth?" (Sources: Associated Press of 6 and 11 September 2002) 3. Canada: Clinical trials could take five years Clinical trials with inhaled cannabis required by federal Health Minister Anne McLellan could take more than five years to complete, according to Dr. Mark Ware of McGill University in Montreal. In July 2001, the university announced that Dr. Ware had received federal approval for Canada's first clinical study on marijuana and pain. The year-long study was to have begun at Montreal General Hospital in January. "We haven't actually started yet," Ware said on 11 September. A "series of requirements," including an import license to bring cannabis from the United States, have to be acquired, he said. The study would involve 32 patients suffering from chronic pain. More studies would follow. (Source: Montreal Gazette of 12 September 2002) 4. News in brief ***Science: Pain Researchers at the McGill University Health Center in Montreal (Canada) presented a case report, a "dramatic response to inahaled cannabis in a woman with central thalamic pain and dystonia." The woman suffered from severe pain and hemiplegic dystonia for more then ten years. Several brain operations have been conducted. Numerous additional treatments including opiates have also been unsuccessful. Smoking cannabis resulted in complete pain relief. Despite aprupt cessation of chronic high-dose of morphine therapy the woman also reported of no opioid withdrawal with cannabis use. (Source: Chatterjee A, et al. J Pain Symptom Manage 2002;24(1):4-6) ***USA: Symposium A symposium on Cannabinoids in Pain Management will be held on 28 September in Reno (Nevada) as part of the 13th Annual Clincial Meeting of the American Academy of Pain Management. Speakers will be Philip Robson, John McPartland, Ethan Russo, Mark Ware, William Notcutt, Petra Makela, and Igor Grant. (Source: www.aapainmanage.org) ***Science: Effects on bladder and uterus Researchers noted contrasting effects of a synthetic cannabinoid on motility of the rat bladder and uterus. The cannabinoid reduced the motility of the bladder while it increased the motility of the uterus, both probably through activation of CB1 receptors. (Dmitrieva N, Berkley KJ. J Neurosci 2002;22(16):7147-53) 5. ONE YEAR AGO: - Science/UK: 77 percent show relief in pain studies of GW - Science/UK: 200 patients enrolled in multiple sclerosis study of MRC TWO YEARS AGO: - USA: California doctors can recommend marijuana, a federal judge ruled - Canada: Minister announces new approach for the use of marijuana for medical purposes ------------------------------------------------------- IACM-Bulletin of 29 September 2002 ------------------------------------------------------- * Science: Cannabinoids inhibit the development of Alzheimer's disease * USA: Protests supported by city officials of Santa Cruz 1. Science: Cannabinoids inhibit mechanisms that result in Alzheimer's disease Dr Nathaniel Milton of London's Royal Free and University College medical school found that cannabinoids were able to protect nerve cells from the toxicity of amyloid-beta. This could help to prevent the development of Alzheimer's disease. The brain of an Alzheimer's sufferer contains abnormal deposits called "plaques" and "tangles". Associated with these deposits are proteins called amyloid-beta protein and tau protein. Increased brain levels of amyloid-beta are supposed to result in aggregation of this protein to form plaques which cause nerve damage. In his research to be published in the journal Neuroscience Letters, and which Milton will also present at a conference on neurobiology of aging in Florida this October he reports that cannabinoids can stop amyloid-beta killing nerve cells. "My basic hypothesis," he says, "is that amyloid-beta is taken up into neurons, where it is phophorylated and kills them. It's this toxic action that cannabinoids prevent." Milton discovered this by incubating human nerve cells in culture, and then poisoning them with amyloid-beta. When he added cannabinoids, amyloid-beta was apparently no longer toxic. Will we see in the future that cannabis users are immune to Alzheimer's disease? Milton says not, because his research shows not only the ability of cannabinoids to protect against brain cell death in Alzheimer's disease, but also that too much of them is toxic. (Source: The Guardian Unlimited of 26 September 2002) 2. USA: Protests supported by city officials of Santa Cruz Medical marijuana advocates - joined by city leaders of Santa Cruz (California) - passed out cannabis to about a dozen sick people at City Hall on 17 September. "Santa Cruz is a special place, and today we're letting the world know how compassionate we can be," Mayor Christopher Krohn said. More than 1,000 community members jammed into the garden-like courtyard for a supportive demonstration during the giveaway to protest a recent U.S. government raid on a local cannabis growing cooperative. Californian cooperatives have been providing cannabis to patients since 1996, when Californian voters approved a medical marijuana initiative. But federal drug enforcement agents raided several such cooperatives. The California law allowing the medical use of marijuana has always been in conflict with federal law. Drug Enforcement Administration spokesman Richard Meyer said he was appalled by the event, and feared the community is sending a dangerous message to its children. (Sources: Reuters of 17 September 2002, AP of 17 September 2002, New York Times of 18 September 2002) 3. News in brief ***Germany: Further liberalisation of cannabis laws? The Social Democratic Party (SPD) and the Greens will continue to form the federal government after the won election on 22 September. There may be a change in the resistance of the SPD against more liberal drugs laws as demanded by the Greens. In an internal paper the SPD dismisses complete legalisation of soft drugs but want to push ahead further decriminalisation of possession of small amounts. (Source: Dpa of 27 September 2002) ***Science: Interaction of anti-inflammatory drugs and THC Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and indomethacin have been shown to decrease the analgesic effects of cannabinoids. Conversely chronic use of THC also decreases the efficacy of nonsteroidal anti-inflammatory drugs possibly by altering the cyclooxygenase system. (Source: Anikwue R, et al. J Pharmacol Exp Ther 2002 Oct;303(1):340-6) ***USA: Washington D.C. Efforts to legalize marijuana for medical purposes in the District of Columbia were blocked on 19 September when a federal appeals court overturned, without explanation, an earlier court ruling. The decision ends a 14-month campaign by the Marijuana Policy Project to put the marijuana initiative before the voters of Washington D.C. in November 2002 again. This is the second time that the measure has been blocked in the District. (Source: Washington Post of 20 September 2002) ***UK: Mowlan says legalise drugs Mo Mowlam is urging the British and US governments to fight the war on terrorism by legalising the international drugs trade rather than "bombing civilians in Muslim countries". Legalising drugs would cut off funding for terrorists and stop their practices, according to the former Cabinet minister who used to have responsibility for drugs policy. (Source: PA News of 18 September 2002) 4. ONE YEAR AGO: - Science: Cannabis and THC improve bladder function in MS and spinal cord injury TWO YEARS AGO: - IACM: Principles and structure of the IACM - Canada: Marijuana available from the Health Ministry within one year - USA: Patent for a cannabinoid patch ------------------------------------------------------- IACM-Bulletin of 13 October 2002 ------------------------------------------------------- ======================================== S w e d i s h version now available. Subscription at: www.cannabis-med.org/swedish/subscribe.htm ======================================== * Science/Canada: Clinical study with smoked cannabis in HIV/AIDS started * Science/Germany/Switzerland: Clinical study with oral cannabis extract in weight loss of cancer patients stopped recruitment 1. Science/Canada: Clinical study with smoked cannabis in HIV/AIDS started The Community Research Initiative of Toronto and St. Michael's Hospital in Toronto announced on 9 October the start of the first Canadian government-sponsored trial evaluating the appetite enhancing effects of smoked cannabis in HIV/AIDS. The pilot study under the guidance of Dr. Kevin Gough of St. Michael's Hospital will also test the safety of short-term exposure to different strengths of cannabis, and how cannabis interacts with HIV medications. Secondary questions will include the effects of smoked marijuana on nausea, pain, mood and neuro-cognitive function. Unlike previous cannabis studies, the Toronto team is conducting the research on an outpatient basis. The study is conducted with a crossover design, meaning that all participants will receive cannabis containing different concentrations of THC at different times including a placebo cannabis with no THC. The results of the pilot study will help determine the design of a larger, multi-centre, clinical trial across Canada. (Sources: Canada NewsWire of 9 October 2002, Toronto Star of 9 October 2002) 2. Science/Germany/Switzerland: Clinical study with oral cannabis extract in weight loss of cancer patients stopped recruitment In a large clinical study investigating the efficacy of an oral cannabis extract in cancer patients with appetite and weight loss compared to THC and placebo, that has been conducted in Germany, Switzerland and the Netherlands since November 1999, the principal investigators have now stopped patient recruitment. In an interim analysis completed in September 2002 there were no relevant differences between patients who had received 5 mg THC daily in a cannabis extract, 5 mg isolated THC or a placebo with regard to appetite and quality of life after six weeks of therapy. A total of 156 patients from 25 study centres, among them university clinics in Aachen, Berlin, Bonn, Jena, Leipzig, and Tubingen had been included into this interim analysis. The results of the final analysis with then 236 patients are awaited for Spring 2003. In a statement the Co-Chairmenship, consisting of Professor Thomas Cerny, Dr. Florian Strasser (Canton's Hospital St. Gallen/Switzerland), and Dr. Martin Schnelle (Institute for Oncological and Immunological Research, Berlin/Germany), pointed out, that there were also no relevant differences in side effects between the three patients groups, so that "the dose of 5 mg THC daily used in the study was apparently too low." It is intended to develop a new study protocol which besides a higher dose shall consider further possibilities of improvement. It should be avoided to "draw hasty conclusions since the questions posed in this study are still unanswered and need further studies," the statement says. (Source: Statement of the Co-Chairmenship of 7 October 2002) 3. News in brief ***Canada: Legal marijuana factory A group announced on 30 September the official opening of what they call Canada's first marijuana factory. The facility in Vancouver is set up to process 110 cannabis plants into moist dark pellets that dissolve easily in olive oil or butter, to ingest the drug in foods. Michael Maniotis, spokesman for the group, said the factory is run under licences issued by Health Canada that exempt from marijuana laws those who are terminally ill. The THC pills produced at the factory will be given to three licence holders at no cost. (Source: Globe and Mail of 30 September 2002) ***UK: Last patient recruited The Medical Research Council announced that it has recruited the last of 660 patients to a 1.9 million Euro trial, which investigates the efficacy of oral cannabis in multiple sclerosis. Dr John Zajicek of Derriford Hospital in Plymouth is leading the study, which is using the same capsulated cannabis extract as the German/Swiss study in cancer patients (see above). Results will be released in May or June 2003. (Sources: Reuters of 3 October 2002, Independent of 7 October 2002) ***USA: New Mexico According to a recent poll in New Mexico, 72 percent of respondents said they would favour "legalizing marijuana use by those who have serious medical conditions, to alleviate pain and other symptoms." (Source: Santa Fe New Mexican of 5 October 2002) ***USA: Coalition for Rescheduling Cannabis A coalition of organizations advocating medical access to cannabis filed a comprehensive rescheduling petition with the Drug Enforcement Administration (DEA) on October 9, 2002. Among the twelve members of the coalition are American Alliance for Medical Cannabis, National Organization for the Reform of Marijuana Laws, Jon Gettman and Patients Out of Time. More at: http:// www.drugscience.org (Source: Press release of Coalition for Rescheduling Cannabis of 9 October 2002 ***USA: California Four plaintiffs in California filed suit in federal court on 9 October against U.S. Attorney General John Ashcroft and Asa Hutchinson, administrator of the Drug Enforcement Administration (DEA) requesting an injunction to stop the federal government from arresting people for medically using marijuana, as permitted under state law. Two of the plaintiffs, Angel McClary Raich and Diane Monson, are patients with serious medical conditions. (Source: CNN of 10 October 2002) ***UK: Acquittal A 45 year old man accused of possessing 55 grams of cannabis escaped punishment on 9. October after he told magistrates he needed the drug for health reasons. He claimed smoking cannabis eased the pain of his crippling spinal condition. The case is believed to be one of the few in which magistrates have accepted medical reasons as a defence to possession of a large quantity of cannabis. (Source: Independent of 10. October 2002) ***Science: Convulsions/epilepsy Endocannabinoids seem to play a natural role in the suppression of convulsions. The endocannabinoid anandamide was found to be an efficacious anticonvulsant in a mouse model of epilepsy. Conversely, a CB1 receptor blocker reduced the maximal seizure threshold, facilitating convulsions, and indicating the presence of an endogenous cannabinoid tone that modulates seizure activity. (Source: Wallace M, et al. Eur J Pharmacol 2002 Oct 11;452(3):295) ***Science: Sperm function Research shows that anandamide is involved in normal sperm function. Sperm require several hours exposure to secretions in female reproductive tracts, before acquiring the capacity to fertilize eggs. Anandamide is present in several of these reproductive fluids. Researchers found that THC in nanomolar concentrations in a culture medium reduced sperm fertilizing capacity. They assume that THC may impact fertility in women who use cannabis. However, researchers do not explain why this does not seem to happen in reality and how nanomolar concentrations of THC can be reached in reproductive fluids under natural conditions. (Source: Schuel H. et al. Mol Reprod Dev 2002 Nov;63(3):376-87) 4. ONE YEAR AGO: - 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 TWO YEARS AGO: - Europe: Governments soften line on cannabis - Spain/Science: Anti-tumour effect of THC cannot be investigated in humans ------------------------------------------------------- IACM-Bulletin of 27 October 2002 ------------------------------------------------------- * USA: Cannabis-law reform initiatives at the November elections 1. USA: Cannabis-law reform initiatives at the November elections Voters in Arizona and Nevada will decide on state wide cannabis-law reform initiatives at this year's mid-term elections on 5 November. There are also an additional local initiative in San Francisco and a measure on the cultivation of industrial hemp in South Dakota. Arizona (Proposition 203): Voters will decide whether existing marijuana penalties on the possession of up to two ounces of marijuana should be reduced from a criminal offence to a civil violation punishable by a fine (1 ounce = 28.5 grams). The measure would also amend Arizona's existing medicinal marijuana law. It would allow state-registered patients or their caregivers to legally possess up to two ounces of cannabis, and requires state officials to implement a medicinal cannabis distribution system. Nevada (Question 9): Question 9 would eliminate criminal and civil penalties for the use or possession of up to three ounces of marijuana by persons 21 years of age or older, and mandate the state to implement a system whereby adults could obtain marijuana through a legally regulated market. Citizens of the town of San Francisco will decide whether they want the city to grow marijuana for patients. About 3,600 people in San Francisco have permission to use cannabis as medicine. (Sources: Las Vegas Review-Journal of 20 October 2002, NORML of 24 October 2002) 2. News in brief ***USA/Canada: Implications on trade across the border Officials of the U.S. government said they may drastically decrease trade across the northern U.S. border if the Canadian government relaxes its marijuana laws. They say that decriminalizing of cannabis being considered by the Canadian government would increase trafficking by organized crime elements. The U.S.A. would respond with tighter border checks that could hinder trade crucial to the Canadian economy. (Source: Associated Press of 15 October 2002) ***USA: New York governor candidates Several candidates for governor in New York expressed their support for the medical use of cannabis, including Independence Party candidate B. Thomas Golisano, and Democratic Party candidate H. Carl McCall. New York Governor George Pataki (Republican) opposes this idea. The candidates of the Marijuana Reform Party, the Greens and the Libertarian Party support general legalisation of cannabis. (Source: Associated Press of 16 October 2002) ***Science: Vomiting Several cannabinoids (among them THC) inhibited activation of 5-HT(3A) receptors independently of cannabinoid receptors. 5-HT3 (serotonin) antagonists are very effective drugs against vomiting. Researchers assume that cannabinoids act at a modulatory site of the 5-HT(3A) receptor and conclude: "This site is a potential target for new analgesic and antiemetic drugs." (Source: Barann M, et al. Br J Pharmacol 2002 Nov;137(5):589-96) ***Science: Alzheimer's disease Basic research shows that the endocannabinoids anandamide and noladin ether prevent the neurotoxicity of the amyloid-beta peptide which plays an important role in Alzheimer's disease. (Source: Milton N. Neurosci Lett 2002 Oct 31;332(2):127) ***Science: Glaucoma The effect of the novel putative endogenous cannabinoid noladin ether on intraocular pressure was investigated. Noladin ether decreased intraocular pressure immediately after local administration at the rabbit eye, while the known endocannabinoids anandamide and 2-arachidonylglycerol (2-AG) cause a transient increase first. The effects on intraocular pressure of noladin ether differed from those of the known endocannabinoids probably because of its more stable chemical structure. They were probably mediated by the CB1 receptor. (Source: Laine K, et al. Invest Ophthalmol Vis Sci 2002 Oct;43(10):3216-22) 3. ONE YEAR AGO: - The Netherlands: Dutch government wants to allow the medical use of cannabis - Science: News at the 2001 congress of the IACM TWO YEARS AGO: - Science: THC reduces nausea and vomiting associated with HIV therapy - USA: Medical marijuana registry in Oregon successful ------------------------------------------------------- IACM-Bulletin of 10 November 2002 ------------------------------------------------------- * USA: Doctors are allowed to recommend the use of cannabis to their patients * UK: Cannabis based medicine may be available already in 2003 1. USA: Doctors are allowed to recommend the use of cannabis to their patients A federal appeals court in California ruled that the government cannot revoke the licenses of doctors who recommend marijuana to their patients. The federal government should now abandon its misguided policy of targeting doctors and sick people to fight cannabis use. In the decision of 29 October the 9th Circuit Court of Appeals upheld a lower court ruling which protects the constitutional right of doctors to recommend medical marijuana. "An integral component of the practice of medicine is the communication between a doctor and a patient," the appeals court's three-judge panel said in its unanimous ruling. Doctors who "recommend" medical cannabis were simply exercising their free speech rights guaranteed by the First Amendment of the Constitution. The court further rejected the government's assertion that, by recommending the medical use of marijuana, doctors were inviting their patients to break the law, noting that there are legal ways patients might seek marijuana, such as through a government-approved research project or attempting to persuade the federal government to change the cannabis laws. The First Amendment of the U.S. Constitution says: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances." (Sources: Reuters of 29 October 2002, Associated Press of 30 October 2002, New York Times of 31 October 2002, The Constitution of the United States of America) 2. UK: Cannabis based medicine may be available already in 2003 GW Pharmaceuticals said on 5 November that four Phase III trials investigating the efficacy of their cannabis preparation in multiple sclerosis showed its product was significantly better than placebo in relieving disease symptoms. Phase III is the last stage of drug testing before approval. The medicine, which is sprayed into the mouth, effectively reduced nerve damage pain, spasticity and sleep disturbance in the tests involving around 350 patients. In other trials the spray is also being studied for treating pain in cancer and spinal cord injury. "The performance of GW's medicine has exceeded our own expectations," said Executive Chairman Geoffrey Guy. "Subject to regulatory approval, we are now on track to deliver our first prescription medicine to the UK market next year." In two more European countries cannabis may be available in pharmacies in 2003, in the Netherlands and Germany. In the Netherlands a move to bring marijuana of licensed growers into the pharmacies is prepared by the governmental Office of Medicinal Cannabis. In Germany the Federal Association of Pharmacists on request by the Federal Health Ministry is developing a formula for a cannabis extract, so that pharmacists can prepare the medicine. (Sources: Reuters Health of 5 November 2002, and others) 3. News in brief ***Science: Appetite The results of a study with rats revealed an unexpected role for peripheral CB1 receptors in the regulation of feeding. Food deprivation produced a sevenfold increase in the content of the endocannabinoid anandamide in the small intestine but not in the brain or stomach. Refeeding normalized intestinal anandamide levels. Peripheral but not central administration of cannabinoids (anandamide and WIN55,212-2) promoted reinforced eating in partially satiated rats. Similarly, peripheral but not central administration of a CB1 antagonist reduced food intake. (Source: Gomez R, et al. Neurosci 2002 Nov 1;22(21):9612-7) ***USA: Mid-term elections A measure approved by 63 percent of San Francisco voters on 5 November makes it official city policy to explore the establishment of a cannabis growing and distribution program for patients. It does not mean that San Francisco immediately will start growing marijuana, but rather that city officials will have the right to explore various possibilities. In contrast to this, other cannabis measures failed at this year's mid-term elections. Voters in Arizona and Nevada refused decriminalisation or legalisation of marijuana use. (Sources: Associated Press of 6 November 2002, Agence France-Press of 6 November 2002) ***USA: Oregon and Colorado 3.5 years after the program started in 1998 the number of Oregonians with state approval to use marijuana medicinally climbed to 4,162. The number in Colorado with a similar state law is 181 within two years. (Source: Associated Press of 1 November 2002) ***Science: Cannabis, alcohol, tobacco and depression 736 subjects from New York were interviewed at ages of about 14, 16, 22, and 27 years, and psychiatric disorders were assessed. Adolescent tobacco use was significantly associated with an increased risk of alcohol dependence and drug use disorders but not with depression at the age of 27 years. Early alcohol use and early marijuana use was associated with later major depressive disorder and drug use disorders. (Source: Brook DW, et al. Gen Psychiatry 2002 Nov;59(11):1039-44) 4. ONE YEAR AGO: - 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 TWO YEARS 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 ------------------------------------------------------- IACM-Bulletin of 24 November 2002 ------------------------------------------------------- * Science: Cannabis may be helpful in Parkinson's disease * UK: British Lung Foundation warns against cannabis smoking * Science: Cannabis use and mental disorders 1. Science: Cannabis may be helpful in Parkinson's disease Nearly half of Parkinson's disease patients who have tried cannabis say the drug helped relieve their symptoms, according to a patients' survey. Dr. Evzin Ruzicka, neurologist at Charles University in Prague (Czech Republic), reported the findings at the Movement Disorders Society's Seventh International Congress of Parkinson's Disease and Movement Disorders held on 10-14 November in Miami (USA). The investigators asked all patients who were treated for Parkinson's disease at a centre in Prague to complete a questionnaire that asked about cannabis use and about several Parkinson's disease symptoms. Of 630 questionnaires sent out 339 (54%) were returned. Among the responders, 25% reported that they had used cannabis. Most had used it orally, either as fresh or dried leaves. Within this group, 39 patients (46%) reported that their Parkinson's disease symptoms in general were relieved after they started using cannabis. 26 (31%) reported an improvement in tremor while at rest, and 38 (45%) experienced a relief of bradykinesia. Relief of muscle rigidity was reported by 32 (38%), and 12 (14%) said they had an improvement in levodopa-induced dyskinesias. The respondents reported that the improvement in symptoms occurred an average of 1.7 months after they had started using cannabis. Patients who used it for at least three months were more likely to experience symptom relief than those with shorter experience. (Source: Reuters Health of 13 November 2002) 2. UK: British Lung Foundation warns against cannabis smoking A report on the risks of cannabis smoking issued by the British Lung Foundation attracted some media resonance. The report comes to similar conclusions as previous reviews of the available studies. It says, that the concentrations of known cancer causing agents "are up to 50% higher in the smoke of a cannabis cigarette" compared to the smoke of tobacco cigarettes, that smoking a cannabis cigarette results "in fourfold greater amount of tar inhaled," due to longer breath holding and other factors, and that "3-4 cannabis cigarettes a day are associated with the same evidence of acute and chronic bronchitis and the same degree of damage to the bronchial mucosa as 20 or more tobacco cigarettes a day." The report notes that "research linking cannabis smoking to the development of respiratory cancer exists although there have also been conflicting findings" and that the evidence concerning "a possible link between cannabis smoking and Chronic Obstructive Pulmonary Disease (COPD) has not yet been conclusively established." COPD includes diseases such as chronic bronchitis and emphysema. It says, that cannabis of today might be more dangerous compared to cannabis 30 years ago since it contains higher amounts of THC. However, the report does not mention that higher THC contents allow to smoke less cannabis to get the same effect, which is advantageous with regard to possible damage to the respiratory tract. The report warns from cannabis smoking against asthma while conceding that cannabis may also be taken orally without any damage to the lungs, but stating that "oral intake of THC has also shown to cause unwanted side-effects," - which is, however, true for every asthma drug. (Sources: British Lung Foundation. A smoking gun. Available at: http://www.lunguk.org/news/a_smoking_gun.pdf, PA News of 10 November 2002, Reuters of 11 November 2002) 3. Science: Cannabis use and mental disorders It is established that persons with mental disorders such as schizophrenia, anxiety and depression have a higher rate of tobacco use, cannabis use and alcohol dependence. Additionally, causal relationships to these disorders have been proposed for alcohol dependency and cannabis use. Three studies published in the British Medical Journal support the assumption of a causal relationship between cannabis use and mental illnesses, at least in young users of the drug. An Australian study with 1,601 pupils found that teen-age girls who were daily cannabis users were five times more likely to suffer from later depression and anxiety than other adolescents, while there was no increased risk for male teenagers. In a study of 1,037 people born in New Zealand between 1972-73, those who began using cannabis by age 15 were four times more likely to suffer "schizophreniform disorders" - but not schizophrenia - at the age of 26 than adolescents who did not use the drug. After psychotic symptoms at age 11 were controlled for, the still slightly increased risk was non longer significant, suggesting that teenagers already at greater risk of later developing mental health problems are also more likely to smoke cannabis. In contrary to the Australian study the New Zealand study did not find an association between cannabis use at age 15 and later depressive disorder.  Another study of 50,087 Swedish men aged 18 to 20 showed the use of cannabis increased the risk of schizophrenia within the next 15 years by 30 percent, and that the risk increased with increased intensity of use. Of 1,648 subjects who had used cannabis 18 (1.1%) developed schizophrenia. Of 70 subjects who used the drug more than 50 times 4 (5.7%) developed schizophrenia. In an invited comment Dr. Joseph Rey and Dr. Christopher Tennant of the University of Sydney stated in the same journal that these and other findings "strengthen the argument that use of cannabis increases the risk of schizophrenia and depression", but that it is still unclear "whether the use of cannabis triggers the onset of schizophrenia or depression in otherwise vulnerable people or whether it actually causes these conditions in non-predisposed people." (Source: British Medical Journal of 23 November 2002 at: www.bmj.com) 4. News in brief ***Science: Journal of Cannabis Therapeutics The new issue of the Journal of Cannabis Therapeutics, volume 2(3/4), has been published. Please find the abstracts of all articles and the complete text of an extensive historical review on cannabis treatments in obstetrics and gynaecology by Dr. Ethan Russo at >www.cannabis-med.org/science/jcant.htm<. ***Spain: Meeting of the SEIC The Sociedad Española de Investigación sobre Cannabinoides (Spanish Society on the Investigation of Cannabinoids) held its third annual meeting on 15-16 November in Malaga. More at: >http://www.ucm.es/info/seic-web<. ***Slovenia: Conference on medical use A conference on the medical use of cannabis was held on 18 November in the General Hospital of Ljubljana organised by the Government Office for Drugs. Speakers were Willem Scholten, William Notcutt, Brendan Hughes and Henrie Korthout. ***Science: Cannabis and cognition Very heavy use of cannabis may be associated with persistent decline in cognitive performance. Participants were divided according to weekly smoked cannabis cigarettes into light users (2-14 joints, mean: 11), middle users (18-70 joints, mean: 42) and heavy users (78-117 joints, mean: 94). After 28 days of abstinence participants performed a number of neurocognitive tests. Very heavy users performed significantly worse on 5 of the 35 tests compared to light users, suggesting irreversible effects. Memory, executive functioning, psychomotor speed, and manual dexterity were affected. (Source: Bolla KI, et al. Neurology 2002 Nov 12;59(9):1337-43) ***Science: Cannabis and psychosis Cannabis use was not associated with development of psychosis in a very high-risk group. 100 young people identified by the presence of subthreshold psychotic symptoms, or a combination of first-degree relative with a psychotic disorder and recent functional decline were followed for a 12-month period. 32% developed an acute psychotic episode. The risk was not associated with the level of cannabis use prior to enrolment in the study. Authors conclude that the results suggest that cannabis use may not play a relevant role in the development of psychosis in a high-risk group for the disease. (Source: Phillips LJ, et al. Aust N Z J Psychiatry 2002 Dec;36(6):800-6.) 5. ONE YEAR AGO: - 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 TWO YEARS AGO: - Science/USA: Marijuana study with AIDS patients in California - IACM: German ACM and Austrian CAM are the first regional sections of the IACM ------------------------------------------------------- IACM-Bulletin of 8 December 2002 ------------------------------------------------------- * Science: Blocker of anandamide breakdown reduces anxiety * USA: Medical marijuana laws do not affect law enforcement activities * Science: Cannabis no gateway drug 1. Science: Blocker of anandamide breakdown reduces anxiety Substances that block the enzyme that is responsible for the breakdown of the endocannabinoid anandamide might be used to treat anxiety and depression, a new study says. Endocannabinoids act similar to THC at the cannabinoid receptor but their effect is short-lasting since they are quickly split into breakdown products by the enzyme FAAH (fatty acid amide hydrolase). Inhibitors of FAAH prolong and thus amplify endocannabinoid effects. Two FAAH-inhibitors, URB532 and URB597, were tested in animal models of anxiety and depression. When given the substances, the animals squeaked less when subjected to isolation and were less hesitant when placed in a maze. These effects were accompanied by augmented brain levels of anandamide. The effect of these experimental drugs is similar to antidepressants, which boost brain levels of another neurotransmitter, serotonin, lead researcher Daniele Piomelli, professor of pharmacology at the University of California at Irvine, said. "Some people have low levels of serotonin, and maybe there are some people who have low levels of anandamide," he said. Human studies with the new drugs could begin within a year, he added. (Source: Kathuria S, et al. Nat Med 2002 Dec 2; United Press International of 30 November 2002, Associated Press of 30 November 2002) 2. USA: Medical marijuana laws do not affect law enforcement activities According to a survey of the General Accounting Office (GAO) state laws legalizing the medical use of cannabis are operating primarily as voters intended and have not led to widespread abuses. "Officials from over half of the 37 selected federal, state, and local law enforcement organizations we interviewed in the four states said that the introduction of medical marijuana laws had not greatly affected their law enforcement activities," the report says. In some cases, law enforcement officials said that marijuana laws resulted in "a general softening" in attitudes among the public toward marijuana, but "none of the federal officials we spoke with provided information to support a statement that abuse of medical marijuana laws was routinely occurring in any of the states, including California." Both the number of patients using cannabis medicinally and the number of doctors prescribing it is relatively low in Alaska, Hawaii and Oregon. Only 1-3 percent of the physicians in Oregon and Hawaii - the two states where such records are kept - recommended cannabis to their patients. Most registered patients were over 40 years old. "Severe pain and muscle spasms were the most common medical conditions for which marijuana was recommended," the report says. According to its own words "the U.S. General Accounting Office (GAO) is an agency that works for Congress and the American people. Congress asks GAO to study the programs and expenditures of the federal government. (...) GAO advises Congress and the heads of executive agencies about ways to make government more effective and responsive." The GAO report, "Marijuana: early experiences with four states' laws that allow use for medical purposes," is available online at: http://www.gao.gov/new.items/d03189.pdf. (Sources: United Press International of 30 November 2002, Associated Press of 30 November 2002) 3. Science: Cannabis no gateway drug A study by the RAND Drug Policy Research Center contradicts the theory that marijuana acts as a so-called gateway drug to more harmful drugs such as heroin and cocaine. Using data from the National Household Survey on Drug Abuse between 1982 and 1994, the study concluded teenagers who took hard drugs were predisposed to do so whether they tried cannabis first or not. "We've shown that the marijuana gateway effect is not the best explanation for the link between marijuana use and the use of harder drugs," said Andrew Morral, lead author of the study. "An alternative, simpler and more compelling explanation accounts for the pattern of drug use you see in this country, without resort to any gateway effects." "The people who are predisposed to use drugs and have the opportunity to use drugs are more likely than others to use both marijuana and harder drugs," Morral said. "Marijuana typically comes first because it is more available. Once we incorporated these facts into our mathematical model of adolescent drug use, we could explain all of the drug use associations that have been cited as evidence of marijuana's gateway effect." "This is a very important study with broad implications for marijuana control policy," said Charles R. Schuster, a former director of the National Institute on Drug Abuse and now director of the Addiction Research Institute at Wayne State University. "I can only hope that it will be read with objectivity and evaluated on its scientific merits, not reflexively rejected because it violates most policy makers' beliefs." (Sources: RAND News Release of 2 December 2002 at www.rand.org, Reuters of 2 December 2002) 4. News in brief ***Science: Comparison of THC and cannabis Smoked cannabis with 3.1% THC was compared with 20 mg of oral THC, both taken four times daily. They produced similar subjective-effect ratings although some effects of smoked cannabis were more pronounced and less prone to the development of tolerance. Both drugs increased food intake for 3 days of drug administration, but had little effect on psychomotor performance. (Source: Hart CL, et al. Psychopharmacology (Berl) 2002 Dec;164(4):407-15.) ***USA: California Reacting to raids of California medical marijuana cooperatives by the federal Drug Enforcement Administration (DEA), several cities around the state, including the City Councils of San Francisco, Berkeley, and Sebastopol, are directing their local police to stop cooperating with federal agents. (Source: Los Angeles Times of 21 November 2002) ***USA: Vermont The Legislature's Medical Marijuana Study Committee that included a judge, the police chief, the attorney general, as well as doctors and patients concluded that marijuana has medical value. On its final meeting on 5 December the committee agreed that the federal government had mistakenly classified marijuana as a drug without medical uses. (Source: Associated Press of 6 December 2002) 5. ONE YEAR AGO: - France: Study of INSERM on health effects of cannabis - Science/USA: Approval for studies at the University of California from DEA TWO YEARS 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 ------------------------------------------------------- IACM-Bulletin of 22 December 2002 ------------------------------------------------------- >>> IACM Meeting 2003 in Cologne <<< The next scientific conference of the IACM will be held on 12-13 September 2003 in cooperation with the Department of Psychiatry and Psychotherapy and the Department of Anaesthesiology of the University of Cologne. The annual IACM General Meeting will be hold on the evening of the 11th of September. (See more at: www.cannabis-med.org) * Canada: Parliamentary committee urges to lax cannabis laws * USA: Support for founders of cannabis club by City Council of Santa Cruz 1. Canada: Parliamentary committee urges to lax cannabis laws A parliamentary committee urged the Canadian government on 12 December to relax its laws on possession of marijuana, an idea that Washington's drugs commissioner immediately branded as dangerous. The special committee on the non-medical use of drugs said in a report that marijuana should be decriminalized, but not legalized. This means people possessing and cultivating cannabis in amounts less than 30 grams would be fined if caught, rather than getting a criminal record as at present. The report supports the intention of Justice Minister Martin Cauchon, who said he planned to introduce legislation early next year to decriminalize marijuana. "We concluded that the possession of marijuana should remain illegal and trafficking in any amount of cannabis should remain a crime," committee chairwoman Paddy Torsney told a news conference. "Smoking any amount of marijuana is unhealthy but the consequences of conviction of a small amount of marijuana for personal use are disproportionate to the potential harm," she said. But in the United States, officials condemned the idea that cannabis was not particularly dangerous. John Walters, director of the White House Office of National Drug Control Policy, said the recommendations would lead to greater use of marijuana and other drugs, and if Canadian laws were relaxed the United States might have to increase security at the two nations' shared border to prevent trafficking. The report is available at: www.parl.gc.ca/InfoComDoc/37/2/SNUD/Studies/Reports/snudrp02-e.htm. (Source: Reuters of 12 December 2002) 2. USA: Support for founders of cannabis club by City Council of Santa Cruz Valerie and Michael Corral, founders of the Wo/Men's Alliance for Medical Marijuana, were unanimously deputized on 10 December by the City Council of Santa Cruz (California). They now have the authority to cultivate, distribute and possess medical marijuana under the city's ordinance. Council members hope this will increase legal protections for the couple, who are wary of future prosecution. They were arrested and 130 of their plants were confiscated in a federal Drug Enforcement Administration (DEA) raid in September. "It's essentially a show of support for their professionalism and the really conscientious controlled system they've developed," said Councilwoman Cynthia Mathews. "I don't know what kind of deputization they were given but that does not change the fact that it's illegal," said DEA spokesman Richard Meyer. "No one has a blank check to distribute marijuana." (Source: Associated Press of 11 December 2002) 3. News in brief ***Canada: Cannabis by internet A Quebec judge ended a drug trafficking trial on 19 December, dropping all charges against two activists, Marc-Boris Saint-Maurice and Alexandre Neron, who dispensed the drug for medical use at a Montreal Compassion Club. Judge Gilles Cadieux said the absence of a legal source of marijuana for people who are allowed to use medical cannabis takes away their right to life and liberty. Shortly after the ruling the Marijuana Party started a web site to sell cannabis for patients over the internet at >www.marijuanahomedelivery.ca<. (Sources: Globe and Mail of 19 December 2002, Reuters of 19 December 2002) ***Germany: Federal Drugs Commissioner In an interview the Federal Drugs Commissioner Marion Caspers-Merk called for a reorganization of criminal persecution of cannabis possession. The practice of law should be unified according to the Dutch model. "We have to see that the most liberal country in Europe, the Netherlands, delivers five grams without punishment. I think the order of magnitude is right, but the coffee shops are wrong." At the same time the drugs commissioner warned against a belittlement of cannabis use. (Source: Dpa of 7 December 2002) ***Science: Inflammation THC was shown to modulate the immune response of T lymphocytes. It suppressed the proliferation of T cells and changed the balance of T helper 1 (Th1) and T helper 2 (Th2) cytokines. It decreased the pro-inflammatory Th1 reaction (e.g. the production of interferon-gamma) and increased the Th2 reaction. This may explain why THC is effective against inflammation with a strong Th1 reaction, e.g. in multiple sclerosis, Crohn's disease and arthritis. (Source: Yuan M, et al. J Neuroimmunol 2002 Dec;133(1-2):124-131) ***Science: Vomiting It is known that 5-HT3 antagonists are potent antiemetic drugs, and there are hints from clinical studies in children and experimental research that cannabinoids exert their antiemetic properties at least in part not by cannabinoid receptors. This new research shows that cannabinoids (among them delta-9-THC and anandamide) inhibited currents induced by 5-hydroxytryptamine (serotonin) in cells through 5-HT3A receptors independently of cannabinoid receptors. Authors conclude that this observation may be interesting for the development of new analgesic and antiemetic drugs. (Source: Barann M, et al. Br J Pharmacol 2002 Nov;137(5):589-96) 4. ONE YEAR AGO: - Canada: Patients may get marijuana from the government - Science: Cannabis no gateway drug TWO YEARS AGO: - Canada: Mine in Manitoba will produce legal marijuana - Netherlands: Establishment of an Office of Medicinal Cannabis