------------------------------------------------------------------------------- ACM-Bulletin of 26 January 1998 ------------------------------------------------------------------------------- * Science: The influence of marijuana on the Tourette syndrome: * Germany: Dronabinol without restriction upon indication: * Great Britain: Government against medical use of cannabis: * USA: Civil lawsuits against Cannabis Buyers Clubs in California: * Germany: Chairman of the Kassenärztliche Bundesvereinigung approves of a medical use of cannabis: * USA: DEA initiates review of legal status of marijuana: 1. Science: The influence of marijuana on the Tourette syndrome: A structured interview was published in "Nervenarzt", which questioned 47 patients of the Medical faculty of Hanover/Germany about their use of alcohol, nicotine and marijuana and the effects of these substances on their symptoms. It was shown that marijuana has a positive influence on the symptomatology and effects an improvement. The Gilles de la Tourette syndrome, briefly: Tourette syndrome, is a common and complex neuropsychiatric spectrum disorder, that is characterised by sudden spasms especially in the face, the neck and the shoulders (oral contortions of the mouth; jerky turns of the head), so called "tics". This illness often breaks out during childhood or adolescence. In the summary the report says: "Using a structured interview, we questioned a larger group of patients with Tourette syndrome (n=47) about the use of nicotine, alcohol, and marijuana and their subjective experiences. Of 28 smoking patients only 2 (7%) reported a tic reduction when smoking. Of 35 patients drinking alcohol 24 (69%) noted an improvement. Thirteen patients reported the use of marijuana, of whom 11 (85%) noted a marked improvement. Our results provided strong evidence that alcohol and, even more than that, marijuana cause much more improvement in TS than nicotine smoking." In its final sentence the study says that "With respect to the considerable side effects of those therapy forms presently in use that apply neuroleptics, and considering the limited alternatives, cannabinoids could be used for therapy in the future, when further clinical research by way of controlled studies will have been conducted." (Source: Mueller-Vahl KR, Kolbe H, Dengler R.: Gilles de la Tourette-Syndrom. Einfluß von Nikotin, Alkohol und Marihuana auf die klinische Symptomatik. Nervenarzt 68:985-989, 1997. (published in German)) 2. Germany: Dronabinol without restriction upon indication: Dronabinol, the (-)-trans isomer of the delta-9-THC, was rescheduled in Germany and will be available on prescription from 1. February 1998 onward. As there is no preparation on the German market yet, each single packet will have to be imported. The rescheduling explicitly refers to Dronabinol, without the criterion "synthetic" being attached. For the future this brings about the opportunity to issue a Dronabinol-preparation on the market, which could be extracted from the hemp plant. A Dutch company is already developing a corresponding product. In contrast to some other countries there are no restrictions in Germany on what concerns the indication of an application of Dronabinol (Delta-9-THC). Any illness can be treated with Dronabinol, if the doctor conducting the treatment expects an improvement. This treatment falls within the scope of the general freedom of therapy and is seen as an individual attempt to cure. (Source: Publication of the Bundestag 881/97 (Parliament); Report of the 396. meeting of the health committee of the Bundesrat (Upper House of Parliament); Note from the Federal Ministry of Health of 6. January 1998) 3. Great Britain: Government against medical use of cannabis: Britain's Labour government declared on 14. February 1998, that it opposed plans to make Cannabis available on prescription for treatment. Home Affairs junior minister Paul Boateng said in parliament that the therapeutic effectiveness and safety was not adequately proven. Therefore it was "highly irresponsible" to make Cannabis available on prescription. Labour legislator Austin Mitchell, who pleads for a medical application of cannabis, told the parliament: "This muddies the war on drugs because it makes it a war on the vulnerable." He later added, that because of the present legislation, thousands of Multiple scleroses sufferers were driven into illegality. On 27. October 1997 junior Home Office minister George Howarth, in his response to a question of the Labour's Paul Flynn, had still told the Commons that the Government would consider the legalisation of cannabis for medical treatment, if studies provided evidence that it actually possessed therapeutic qualities. Until 1971 British doctors were free to prescribe cannabis, before it was taken from the list of prescribable drugs as a consequence of the Tory government tightening up regulations. (Sources: PA news of 25. October and 27. October 1997, COMTEX newswire of 14. January 1998, Reuters of 14. January 1998) 4. USA: Civil lawsuits against Cannabis Buyers Clubs in California: The US Department of Justice has filed six civil lawsuits against Cannabis Buyers Clubs in California. Northern California U.S. Attorney Michael Yamaguchi told a news conference on 9. January that the action was directed against six clubs and 10 persons. Those were accused of the distribution of marijuana which constitutes a violation of the federal drug laws (Controlled Substances Act 1970). Dennis Peron and other representatives of the Cannabis Buyers Clubs have to appear before the federal court on 29. January because of illegal distribution of drugs. Supporters of the Clubs accuse the federal government of ignoring the vote of the Californian electorate, that in November 1996 had voted with great majority in favour of the medical use of marijuana. Chuck Thomas a spokesman for the Marijuana Policy Project pointed out that "CBCs would not even be needed if the federal government would allow licensed pharmacies to distribute medicinal marijuana." On 12. January California State Senator John Vasconcellos announced a six-point programme to defend the spirit of Proposition 215. He called on state and federal officials to attend an upcoming Public Safety Committee summit on the "safe, responsible distribution of medical marijuana". (Sources: Reuters of 10. January 1998, Associated Press of 10. January 1998, UPI of 12. January 1998, Marihuana Policy Project of January 1998, DRCNet of 15. January 1998, NORML News of 15. January 1998) 5. Germany: Chairman of the Kassenärztliche Bundesvereinigung approves of a medical use of cannabis: In a TV report on the WDR channel of 15. February, the Chairman of the Kassenärztliche Bundesvereinigung (Federal Organisation of Panel Doctors) Dr. Winfried Schnorre advocated the medical use of cannabis. Most of the general practitioners of Germany are organised members of that organisation. Dr. Schnorre treats a patient suffering from Multiple Sclerosis, that uses a cannabis tincture of a Dutch producer, which is illegal in Germany. Dr. Schnorre: "With this patient I became witness to the positive effects this substance had on him - he could walk almost on his own, what he had not been able to, before. For this reason my opinion is that we urgently need to check whether in future we could incorporate this substance in our treatment." (Source: Script of the WDR "Aktuelle Stunde" of 15.January 1998)) 6. USA: DEA initiates review of legal status of marijuana: The Drug Enforcement Administration (DEA) recently determined that sufficient grounds existed to justify proceedings re-evaluating the present status of marijuana on the schedule of the Controlled Substances Act. Thus, on 19. December the DEA formally asked the Department of Health and Human Services to conduct "a scientific and medical evaluation of the available data and provide a scheduling recommendation" for marijuana and other cannabinoid drugs. The DEA´s request was issued in response to an administrative petition from 10. July 1995. The petition, that was filed by Jon Gettman and Trans High Corporation, the publisher of the High Times Magazine, presented references and arguments according to which marijuana and cannabinoids lack the "high potential for abuse" required for Schedule I or II in the Controlled Substances Act. (Sources: Legalise Ganja Campaign of 13. January 1998, NORML of 15. January 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 8 February 1998 ------------------------------------------------------------------------------- * Germany: Duration of import of Dronabinol: 6 month - shorter periods in the sequel * ACM: Proceedings of the Symposium "Cannabis and Cannabinoids as Medicine" * USA: Support For Cannabis Buyers' Clubs 1. Germany: Duration of import of Dronabinol: 6 month - shorter periods in the sequel A chemist from Berlin that had applied to the Bundesinstitut für Arzneimittel und Medizinprodukte (BAM) (a subordinate board of the Ministry of Health) for a licence for the import of Dronabinol, was told by the competent official (in charge), that the import would take 6 months. It would take 3 month before he would come to deal with the application and it would take further 3 month before the compound finally reached her pharmacy. Any next application would take less time for consideration and import. Since 1 February 1998 Dronabinol has been available on prescription in Germany. As there is no compound on the German market, yet, the only compound available so far - the synthesized Marinol - has to be imported. Dr. Schinkel, a high-ranking representative of the BAM, denied in a dialogue with a journalist that the import would actually take 6 months. He though appeared rather nervous when it was indicated to him, that he may repeat what he had said in an interview on television. Sum-up: Today we do not know how long it will take until the first patient in Germany will receive Dronabinol (Marinol). Our impression is that the intervention of the media could well speed up the process. However, even with a marked reduction of the time it takes for the necessary licences to be issued and with the import of THC, treatment will be difficult or even impracticable. 2. ACM: Proceedings of the Symposium "Cannabis and Cannabinoids as Medicine" The report of the Symposium "Cannabis und Cannabinoide als Medizin" (Cannabis and Cannabinoids as Medicine) of 22 November 1998 in Cologne, organised by the ACM, was issued some days ago. On 80 pages it includes all lectures and addresses as well as an appendix containing a survey of therapy studies, a glossary and further references. With lectures by: Dr. pharm. Manfred Frankhauser (History) PD Dr. med. Robert Gorter (Anorexia and Kachexia) Dr. med. Ulrike Hagenbach (Spasticity) Dr. med. Andreas Ernst (Pain) Prof. Dr. pharm. Rudolf Brenneisen (Receptors) Dave Pate (Glaucoma) Dr. med. Franjo Grotenhermen (Chemotherapy in Cancer) Prof. Dr. jur. Lorenz Böllinger (Legal Aspects) ACM (ed.): Cannabis und Cannabinoide als Medizin. Tagungsbericht. 1. Auflage, nova-Institut, Hürth/Köln 1998. ISBN: 3-9805840-4-6. 16 German Marks. Published in German. Available at: nova-Institute, Thielstraße 35, D-50354 Hürth, Germany, Fax: +49-2233-978369. 3. USA: Support For Cannabis Buyers' Clubs Officials in Oakland, Mendocino County, and Santa Cruz unanimously passed resolutions condemning the federal government's effort to close down local cannabis buyers' clubs. Oakland city officials called the local buyers' club "a well-organized, safe, and responsible" facility, and urged the federal government "to desist from any and all actions that pose obstacles to access to cannabis for Oakland residents." Similarly, the Mendocino Board of Supervisors resolved its support for the Ukiah Cannabis Buyers' Club, and further called on Congress to conduct hearings on the legalization of marijuana. The Santa Cruz City Council resolved to support the Santa Cruz Cannabis Buyers' Club as well as a local dispensary not named in the suit, The Wo/Men's Alliance for Medical Marijuana. Last week, an U.S. district court judge combined the six cases against the clubs into one. Public hearings in the federal lawsuit are scheduled to begin on 24 March. (Source: NORML of 5 February 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 21 February 1998 ------------------------------------------------------------------------------- * Science: Leading research magazine claims WHO suppressed publication of scientific evidence about health risks of marijuana * Great Britain: A committee of the Upper House is looking into scientific cases for and against criminalisation of medical and recreational uses of cannabis * Canada: Opening of Medical Marijuana Clubs * Canada: Discussion about Rebagliati fuels the discussion about medical use of cannabis 1. Science: Leading research magazine claims WHO suppressed publication of scientific evidence about health risks of marijuana According to the current issue of the New Scientist, officials of the WHO in Geneva have suppressed the publication of a study of the university of Amsterdam about the lower health risks of marijuana in comparison to alcohol and tobacco. The chapter dealing with this comparison was dropped from a WHO report published in December 1997. "It is understood that advisers from the US National Institute on Drug Abuse and the UN International Drug Control Programme warned the WHO that it would play into hands of groups campaigning to legalize marijuana," the magazine says in the article "What the WHO doesn't want you to know about cannabis". Dr Billy Martin of the Medical College of Virginia in Richmond, a member of the expert panel which drafted the report, said that some WHO officials "went nuts" when they saw the draft report. In the paper leaked to the New Scientist it is said, that cannabis has fewer effects on health than either tobacco or alcohol in five out of seven categories, and carries only a marginally higher risk in the other two. For example while heavy drinking leads to cirrhosis, severe brain injury and an increase risk of accidents and suicide, the report concludes that there is only "suggestive evidence that chronic cannabis use may produce subtle defects in cognitive functioning". Dr Maristela Monteiro, a scientist with the WHO program on substance abuse, confirmed that the analysis was dropped from the report but denied the organization had been pressured into doing it. "It was not a fair comparison from our point of view and from public health perspective it was not very useful," she said in an interview. "We thought it was biased toward showing less harm from cannabis." According to Ms. Monteiro this was not a matter of drug legalisation but one of public health. The aim should be to further restrict legal drugs instead of the release of those prohibited. In June this year the WHO is going to publish a 400-pages book on marijuana which shall also deal with the contested topic of the report on its risks. (Sources: New Scientist of 21 February 1998 (internet-version), dpa of 18 and 19 February 1998, Reuters of 18 February 1998, PA News of 19 February 1998) 2. Great Britain: A committee of the Upper House is looking into scientific cases for and against criminalisation of medical and recreational uses of cannabis The House of Lords' Committee of Science and Technology is setting up a sub-committee to look into scientific cases for and against continuing to ban the medical and recreational uses of cannabis. The committee is chaired by Lord Perry of Walton, a former professor of pharmacology and a fellow of the Open University. The official spokesman of the Prime Minister Tony Blair said it was a legitimate issue and the government had no problem with it. But the position of the government was clear: "We don't believe decriminalisation is the right thing to do." Peers will take evidence from March until July, and publish their findings in October. They will have their first meeting on 3 March. Dr Roger Pertwee, a reader in biomedical sciences at the university of Aberdeen, and President of the International Cannabinoid Research Society (ICRS) wrote in an article for The Scotsman, that there "is no doubt that further research into the medicinal properties of cannabis and cannabinoids is needed... As all this will take considerable time, a strong case can be made for allowing doctors to prescribe cannabis, nabilone or dronabinol for disorders such as MS and spinal injury. This would seem preferable to the present state of affairs where many patients who in all other ways appear to be law-abiding citizens feel so strongly that they need the medical benefits of cannabis that they are prepared to risk punishment." (Sources: PA News of 11 February 1998, The Scotsman of 19 February 1998) 3. Canada: Opening of Medical Marijuana Clubs In several cities of southern Ontario, Medical Marijuana Buyers Clubs will be opened and will distribute marijuana at cost-price for sick people. There will be clubs in Toronto, Vancouver, London, Kitchener, Peterborough und Guelph. More dispensaries are planned in Mississauga, Oakville and Etobicoke. In a news release on 13 February the organizers stated that access will be restricted to those with doctors' letters confirming they suffer from cancer, AIDS/HIV, muscular dystrophy, multiple sclerosis, paraplegia/quadriplegia, epilepsy, glaucoma and intractable pain, including arthritis. Every outlet will keep less than 30 grams of marijuana on hand. Supporters of the clubs complain the lacking will of state authorities to negotiate with the clubs. The police suspects the organizers to advocate the legalization of marijuana. (Sources: London Free Press of 14 February 1998, Ottawa Citizen of 14 February 1998, Kitchener-Waterloo Record of 17 February 1998, Ottawa Sun of 19 February 1998) 4. Canada: Discussion about Rebagliati fuels the discussion about medical use of cannabis The discussion about the temporary disqualification of the Canadian snowboarder Ross Rebagliati at the Olympic Games in Nagano is fuelling the discussion about the legalization of marijuana in Canada. The 26-years old gold-medal winner was cheered enthusiastically by his fans at his arrival at Vancouver airport and in his hometown Whistler. Traces of THC-metabolites (17.8 ng/ml) in his urine led the IOC (International Olympic Committee) to deny him his gold medal. Only a few hours later this decision was renounced for lack of legal grounds. The Canadian Minister of Justice, Anne McLellan, promised to deliberate together with Health Minister Allan Rock on the possibility to legalize at least the medical use of marijuana. McLellan had announced a national debate on the issue in November 1997. On 10 December 1997 an Ontario judge had ruled that a Toronto man could grow and use Marijuana to control his severe epilepsy. In his reasoning he pointed out that the law banning the medicinal use of the drug was in violation of constitutional law. Meanwhile a Toronto man living with AIDS is taking the federal government to court demanding the legal right to use marijuana as medicine. The case is set to open in Ontario Court on 4 May. (Sources: Reuters of 10 December 1997, Ottawa Citizen of 21 November 1997, Toronto Star of 6 February 1998, dpa of 18 February 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 8 March 1998 ------------------------------------------------------------------------------- * The Netherlands: Marinol available * Germany: Cannabinoids for pain therapy - A workshop on the "Deutscher Schmerztag" in Frankfurt - * Great Britain: Suspended jail sentence for pain patient * Science: Voices to the WHO-report on cannabis * USA: Judiciary Committee of the House of Representatives against medical use of cannabis 1. The Netherlands: Marinol available Since the beginning of march, Marinol can be prescribed from Dutch physicians. Marinol is a registered trade mark of Unimed Pharmaceuticals, Inc., and is marketed by Roxane Laboratories, Inc. It contains synthetic dronabinol in sesame oil. Dronabinol is the generic name for the pharmacological active (-)-trans-isomer of delta-9-tetrahydrocannabinol - in short: delta-9-THC or THC -, the most important psychoactive ingredient of the hemp plant (Cannabis sativa L.). The Marinol imports come from a distributor in the UK. It is not known, why the import comes from the UK and not directly from the USA, where it is made. Nabilone, a synthetic THC-derivative, may soon be prescribed in the Netherlands, too. In the beginning of August the Dutch Ministry of Health had prohibited the prescription of marijuana by physicians and its sale by pharmacies. Nevertheless marijuana-cigarettes or cannabis tincture are still available in some pharmacies. (Sources: dpa of 14 August 1997, Taz of 19 February 1998, El Pais of 19 February 1998, personal communication Dave Pate) 2. Germany: "Cannabinoids for pain therapy" - A workshop on the "Deutscher Schmerztag" in Frankfurt - At the annual meeting "Deutscher Schmerztag" (German Pain Day) on 2-8 March the use of cannabis and cannabinoids in pain therapy was discussed in a workshop on 5 March. There were talks from Dr. Robert Gorter of the Institute for Oncological and Immunological Research in Berlin, Dr. Rudolf Brenneisen, Professor at the Pharmaceutical Institute of the University of Bern and Prof. Wolfram Keup, head of the German early warning system for the abuse of chemical substances. Dr. Andreas Ernst, pain therapist from Berlin, presented the event. Prof. Brenneisen, Dr. Gorter and Dr. Ernst are members of the advisory board of the Arbeitsgemeinschaft Cannabis als Medizin. Prof. Keup is a proponent of the gateway theory and opposes the medical use of cannabis. Concepts for the use of cannabis in several pain conditions were presented from a medicinal and pharmacological view, as well as the problem of possible abuse. In the final discussion there was general agreement about the wish to increase research on the therapeutic potential of cannabis in order to reach an approval for its medical use. 3. Great Britain: Suspended jail sentence for pain patient A 31-year-old man who uses cannabis to relieve pain from injuries suffered in an accident in 1989 was spared a jail sentence on 6 March. Judge David Griffiths had expressed sympathy for Ricky Dawson after hearing that he suffered fits and headaches as a result of a car crash. He had three previous convictions for possessing cannabis when police raided his home in New Road, Minster, Sheppey, Kent, in October 1996 and seized 491 grams of cannabis. The judge suspended a four-month prison term but warned that if he committed a drugs offence in the next two years it could be implemented. "To mark the gravity of the offence it is necessary to impose a custodial sentence," he said. But there were exceptional circumstances which allowed him to suspend the sentence. "It is very important that you find some other way of trying to deal with the problem you have," he told Dawson. On 5 March a House of Lords committee formally set out its plans for an inquiry into the effects of cannabis. Its chairman, Lord Perry of Walton, a former Professor of Pharmacology, does not expect the committee to come out with a recommendation on legalisation. "All drugs have risks attached to them. If the risk is not enough to ban it for medicinal use it could still be enough to ban it for recreational use." The committee will hear evidence from a range of witnesses including the British Medical Association, the Alliance for Cannabis Therapeutics and the Multiple Sclerosis Society. (Sources: PA News of 5 and 6 march, Reuters of 6 march) 4. Science: Voices to the WHO-report on cannabis In an article for a Canadian newspaper sociologist Robin Room wrote that he and two colleagues from Canada and Australia were asked by an Expert Working Group of the World Health Organization (WHO) to prepare a report comparing the health and psychological consequences of marijuana, alcohol, tobacco and opiates. Room is Chief Scientist at the Addiction Research Foundation division of the Addiction and Mental Health Services Corporation of Toronto/Canada. He rejected the reproach of the WHO that their comparison was unreliable or unscientific. The comparison was legitimate and the public deserved from scientists "our best efforts and advice on important issues of public health," he wrote. The WHO had dropped the comparison from the report with the argument the comparison was not reliable and unscientific, which led to a lot of resonance in the media. According to Robin two big things were left unsaid in the flap. "One is that marijuana does cause harm to health. (...) The second is that marijuana appears relatively less harmful only because of the severe and wide-ranging health and social harms from alcohol and from tobacco. (...) Our worries about illicit drugs sometimes seems like a convenient distraction. But it is alcohol and tobacco that are the main sources of drug harm in Canada today." That cannabis is less dangerous than for example alcohol, that causes 60.000 deaths in Germany every year, was confirmed by Dr. Werner Platz, addiction expert at the Karl Bonhoeffer Clinic for Mental Health in Berlin/Germany: "There is no reason to criminalize cannabis. The health risks of a joint are comparable to a glass of wine," he said in the Berliner Zeitung. In an interview with the Süddeutsche Zeitung Dr. Franjo Grotenhermen, Chairman of the Arbeitsgemeinschaft Cannabis als Medizin (ACM) pointed out, that cannabis had already been compared to legal drugs in former reports: "Cannabis is not more harmful than social accepted drugs like coffee, tea and alcohol. Especially in comparison to alcohol marijuana is coming off well: It does not cause liver damage or damage of nerve cells in the brain." Both, the WHO document, entitled "Cannabis: a health perspective and research agenda", and the background paper are available upon request from the Division of Mental Health and Substance Abuse, WHO, Geneva, Phone: +41-22-791 4791, Fax: +41-22-791 48 51. (Sources: Press release of the WHO of 19 February 1998, Berliner Zeitung of 24 February 1998, Globe and Mail of 5 March 1998, Süddeutsche Zeitung of 5 March 1998) 5. USA: Judiciary Committee of the House of Representatives against medical use of cannabis At the end of February the Subcommittee on Crime of the House Judiciary Committee approved a resolution stating that "marijuana is a dangerous and addictive drug and should not be legalized for medical use." All seven Republicans voted for the resolution, the two Democrats against it. A week later on 4 March the resolution was approved by the House Judiciary Committee against the votes of the Democrats. An amendment offered by Representative John Conyers was rejected. It claimed that "States have the primary responsibility for protecting the health and safety of their citizens" and that the Federal Government should not interfere with any state's policy which could also include the medical use of marijuana. Republicans also rejected an amendment proposed by Representative Martin Meehan according to which this issue deserves further study. Any lifting of the legal ban prohibiting marijuana, even for medical purposes, would be a wrong and potentially dangerous message in the fight against the misuse of drugs, the Republicans argued. (NORML of 26 February and 5 March 1998) 6. *** Events *** International Conference on Marihuana and Medicine - 20-21 May 1998 - New York University Post-Graduate Medical School 550 1st Avenue, New York NY 10016 - organised by the International Cannabinoid Research Society (ICRS) - The goal of this conference is to evaluate past and current scientific studies about marihuana and its therapeutic potential. - US: Phone: 212-263-5295 Fax: 212-263-5293 Email: Luis.Rodriguez@MCDAD.med.nyu.edu Email: NahasG01@popmail.med.nyu.edu Europe: Fax: + 46 8 583 55946 Email: agurell@swipnet.se *** Exhibition "Cannabis as Medicine" - 28 March 1998 until 10 May 1998 - Hanf-Museum (Hemp Museum), Mühlendamm 5, Berlin Phone: +49-30-24 24 827 *** Discussion "Cannabis as Medicine" - 28 March 1998 - Wolfgang-Neuss-Salon in the UFA-Fabrik, Viktoriastr. 10-18, Berlin with - Dr. Jörg Caus: Medical Use of Cannabis - Martin Schnelle: Current Research Issues - Patients of the Self Help Group 'Cannabis as Medicine', Berlin ------------------------------------------------------------------------------- ACM-Bulletin of 22 March 1998 ------------------------------------------------------------------------------- * Canada: Severe threshold limit value for THC in food: 10 micrograms per gram * Spain: Defence of medical marihuana at an International Symposium on Cannabis * Internet News * Science: "Therapeutic use of cannabis" in the Lancet 1. Canada: Severe threshold limit value for THC in food: 10 micrograms per gram In 1998 Canadian farmers will be allowed to cultivate industrial hemp for the first time in 60 years. This was announced by Health Minister Allan Rock on 13 March: "This new crop has a tremendous potential for creating new jobs in agriculture, industry, research and retail." Canada is the second industrial nation to release a threshold value for THC in food. The Canadian one is more severe than the Swiss one. In 1996 the responsible state authorities of Switzerland laid down a threshold limit for THC in food of 50 milligrams per kilo (= micrograms per gram). Canada now introduced a limiting value of 10 micrograms THC per gram for trade, import and export. The amount of THC in most hemp food products on the European market falls short of the threshold value of 10 micrograms. However there may be problems with oil from hemp seed. Hemp seed does not contain THC, but during the production process some of the THC of the seed tunics or leafs may get into the oil. 15 oils produced at the Pharmaceutical Institute of the University of Bern (Prof. Dr. Rudolf Brenneisen) contained 3 to 30 micrograms THC per grams. Most of the commercially available hemp seed oils contained more than 10 micrograms per gram. The German Federal Institute for the Protection of the Consumers' Health and Veterinary Medicine (BgVV, Bundesinstitut für gesundheitlichen Verbraucherschutz und Veterinärmedizin) intervened in the discussion about limiting values of THC in food by a press release on 22 October 1997. With regard to a possible impairment of the immune system, effects on hormones and damage to the foetus, the BgVV demanded a maximum daily intake of 1-2 micrograms THC per kilo body weight. This would lead to a limiting value of 1 microgram THC per gram food or even less. Scientists on the topic reacted with astonishment in a press release of 27 October. There would be no scientific medical basis for this proposed maximum value, but it would jeopardize an upcoming young industry. In the European Union there is an ongoing discussion about a limiting value for THC in food with the aim to obtain a uniform regulation in the EU-countries. (Sources: Press release of Health Canada of 13 March 1998; AP of 13 March 1998; Lehmann T et al: J Anal Toxicol 21:373-375, 1997; Press release of the BgVV of 22 October 1997; Press release of Grotenhermen/Karus/Theimer/Mölleken/Schillo of 27 October 1997) 2. Spain: Defence of medical marihuana at an International Symposium on Cannabis From 4 to 5 March an international workshop on the cannabinoids was held in Madrid. Pharmacological and molecular aspects of the cannabinoid receptor systems, endogenous ligands, effects of the cannabinoids on reproduction, the role of the endogenous cannabinoid system in brain development as well as therapeutic applications of the cannabinoids and analogues were discussed. Among those invited to participate were Roger R. G. Pertwee of the University of Aberdeen/UK, Billy Martin of the Virginia Commonwealth University/USA, Raphael Mechoulam of the Hebrew University/Israel, José A. Ramos and José A. Fuentes of the University of Complutense/Spain, Vinzenzo Di Marzo of the CNR Naples/Italy, Allyn Howlett of the Saint Louis University/USA and others. According to the participants cannabis and single cannabinoids are effective in the treatment of different kind of severe illnesses, among them pain conditions and multiple sclerosis. (Source: ICRS Interactive News Forum, CORA) 3. Internet News a) Paul E. Mallet of the Department of Psychology at the University of Sydney/Australia announced the launch of a new internet mailing list dedicated to the discussion of cannabinoid research: "The primary goal of the 'Cannabinoid Science' mailing list is to provide a forum for cannabinoid scientists to discuss topics relating to their research." To subscribe to the Cannabinoid Science internet mailing list, send a message to server-request@usa.net The body of the message should contain: SUBSCRIBE cbscience YourFirstName YourLastName More information at: http://www.smoe.org/nbh/cbscience. Paul E. Mallet, Ph.D. e-mail: mallet@psych.usyd.edu.au home page: http://www.psych.usyd.edu.au/staff/mallet b) A new German speaking newsgroup 'de.sci.medizin.bis' as a forum for all who are interested in the medical aspects of the hemp plant was founded. The aims are the exchange of information and knowledge, questions and news about the therapeutic use of cannabis as well as the coordination of initiatives. More information on the newsgroup, open for physicians, patients and other interested: http://www.hanfnet.de/de.sci.medizin.bis/ For requests you may contact Susanne Krause: krause1@student.uni-siegen.de 4. Science: "Therapeutic use of cannabis" in the Lancet Excerpt of the letter to the editor "Therapeutic use of cannabis" by Dr. Franjo Grotenhermen, Chairman of the Board of Directors of the ACM: (...) Single cannabinoids are expensive medicaments and are seldom used. Although we might ignore it as scientists, as physicians we should realize that the use of illegal natural cannabis products of uncertain quality will continue as long as there is no easy legal access to cheap medical cannabis preparations. There have to be strong scientific arguments against the medical use of the whole plant to justify this unsatisfactory situation. (...) Many patients with varying illnesses profit therapeutically on a daily basis by reproducing the known medicinal effects of cannabis with illegal preparations of different origin; this could be carried out more safely with standardised, carefully produced preparations. (...) The arguments for cannabinoids versus cannabis, is based on the wish to restrict those who want cannabis use to be legalised. Maybe it is based on fear of not being taken seriously by the scientific community but in fact this fear may undermine the credibility of the scientific argument." (Source: Lancet of 7 March 1998) 5. *** News in brief *** Germany: The husband of a pain patient suffering from poliomyelitis, living near the city of Göttingen, was fined with about 2000 German Marks (about 1300 Dollars) for the possession of marijuana. An expert opinion of a physician who testified that his wife profited by cannabis could not change his judge's decision. (Source: Personal communication) *** Great Britain A march for the legalization of cannabis organized by the English newspaper 'Independent on Sunday' will take place on 28 March in London. (Source: Independent on Sunday) *** Great Britain A 40 year old woman of Danvers Road/Devon who grew and used cannabis to ease the pain of her multiple sclerosis was warned today by a judge that she would be sent to prison if she continued. (Source: PA News of 13 March 1998) *** USA The mayors of San Francisco, Oakland, Santa Cruz and West Hollywood appealed to President Clinton on 18 March to drop federal lawsuits aimed at closing Cannabis Buyers' Clubs in California. (Source: AP of 19 March, Washington Post of 19 March 1998) *** USA About 60% of Americans support the prescription of marijuana for seriously ill patients according to a review published by the Journal of The American Medical Association (JAMA). (Source: JAMA of 18 March 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 5 April 1998 ------------------------------------------------------------------------------- * Germany: State authorities surprised about the high demand for Marinol * New Zealand: Legalisation of cannabis will protect public health * Germany: Petition for medical use of cannabis in Berlin * Science: Troubled teenagers at high risk for dependence 1. Germany: State authorities surprised about the high demand for Marinol In the middle of March the Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM, a subordinate board of the Ministry of Health) gave licences for the import of Marinol to three drug import firms. Pharmacies can order the drug at one of these firms. In the beginning of February the BfArM declared that it would take three months to deal with an application for import. After some response from the media and a lot of inquiries the BfArM now sped up the process. Apparently the BfArM has been surprised about the high demand for Marinol. The BfArM also addressed to the German pharmaceutical company Boehringer Ingelheim whose subsidiary company Unimed Pharmaceuticals is producing Marinol in the US. Since 1 February 1998 Dronabinol (delta-9-THC) has been available on prescription in Germany. The only compound available so far is the synthesized Marinol. In contrast to some other countries there are no restrictions in Germany concerning the indication for the medical use of Dronabinol. (Source: Letter from Dr. Schinkel, BfArM, of 20 March 1998) 2. New Zealand: Legalisation of cannabis will protect public health According to a report of the Drug Policy Forum Trust legalisation of cannabis and control of the market would protect public health and minimise cannabis abuse. But the Government has ruled out any move to legalise cannabis. Associate Health Minister Roger Sowry has dismissed the report: "I believe that it would not be in the public interest to decriminalise cannabis while there are real question marks about the safety of its use." His views were echoed by a number of MPs from the Wellington region according to the Wellington Post. Many said that more research was needed. Only ACT list MP Ken Shirley said the report backed what he already believed. "I still think the current laws are a nonsense and to a large extent counterproductive. The qualifications of the people on the trust are beyond dispute." Ohariu-Belmont MP Peter Dunne, who tried cannabis as a student, said his party did not support decriminalisation, but believed it was time the issue was properly debated. Drug Policy Forum Trust said there was already plenty of research, which showed the health effects of cannabis were no worse than alcohol or tobacco. Legalising cannabis would make it easier to educate and deal with health problems. In their report "Cannabis Policy Options, Alternative Systems of Cannabis Control in New Zealand", released on 30 March, the authors noticed that "New Zealand politicians and public should accept that cannabis has become part of our culture. Whatever harms are associated with cannabis are magnified by driving its use underground." Forum trustees are Dr. Robin Briant, Auckland Hospital senior physician; Dr. Peter Crampton, Health Services Research Centre research fellow; Professor Fred Fastier, University of Otago emeritus pharmacology; Amster Reedy, Maori scholar; Professor Norman Sharpe, Auckland Medical School medicine department head; Helen Shaw, educationalist; and Professor Warren Young, Victoria University professor of law. (Sources: Cannabis Policy Options, Alternative Systems of Cannabis Control in New Zealand, of 30 March 1998, internet version; Evening Post (Wellington) of 1 April 1998) 3. Germany: Petition for medical use of cannabis in Berlin On 25 March the Self Help Group Cannabis as Medicine of Berlin and members of the Green Party handed over a petition for the medical use of cannabis products to the Chairman of the Petition Committee of the House of Representatives of the State of Berlin, Reinhard Roß. The petition says: "In addition to the burden of a chronic or incurable disease, we all have to endure the consequences of the general prohibition of the marijuana plant." It demands the support of clinical research, the possibility to obtain natural cannabis products and single cannabinoids on prescription in every pharmacy, and the possibility to grow marijuana with an approval of a physician. The Self Help Group of Berlin was founded in November 1995 and includes patients with cancer, AIDS, multiple sclerosis, asthma, glaucoma, migraine, hepatitis, spinal cord injury, pain conditions, epilepsy and depression. A member of the Self Help Group belongs to the Board of Directors of the ACM. 4. Science: Troubled teenagers at high risk for dependence According to a recent American study marijuana use by teenagers who have prior serious antisocial problems can quickly lead to dependence on the drug, a NIDA (National Institute on Drug Abuse) press release of 31 March says. Dr. Thomas Crowley, psychiatrist at the Addiction Research and Treatment Service, University of Colorado School of Medicine, head of the research team conducting the study, said their study indicates that teenagers get in trouble first, then become dependent. More than two-thirds of teens complained of withdrawal symptoms when they stopped using marijuana. More than 80 percent of the boys and 60 percent of the girls in the survey met the adult clinical criteria for dependence on marijuana. The study's conclusions are based on interviews, medical examinations, social history, and psychological evaluations of 165 boys and 64 girls between the ages of 13 and 19 who had been referred by social service or criminal justice agencies to a university-based treatment program for delinquent, substance-involved adolescents. "I want to emphasize that this is a group of kids in treatment for substance problems. This is not your average kid in a sophomore class," Crowley said in an interview. To be included in the study, youths had to have at least one diagnosis of drug dependence and three conduct disorder symptoms, including such things as frequent stealing, lying, running away, and, often, arrest. In a German study from researcher of the University of Berlin, published in summer 1997 and based on interviews of 1,458 cannabis users, an average of 8 % were dependent according to DSM-IV criteria. If only persons who only used cannabis were included the dependence rate was 2 %. (Sources: Press release from NIDA of 31 March 1998, Reuters of 31 March 1998, Kleiber D, et al.: Cannabiskonsum in der Bundesrepublik Deutschland: Entwicklungstendenzen, Konsummuster und Einflußfaktoren. Ministry of Health, Bonn 1997) 5. *** News in brief *** Great Britain: About 10,000 protesters, some openly smoking 'spliffs' - the British version of the American term 'joint' - marched in London on 28 March demanding legalization of the drug. There were no arrests or confrontations. Hinting at the debate in the USA the Washington Post wrote: "... thousands of demonstrators marched through the heart of London today on behalf of a fashionable political idea that has been a complete non-starter in the United States ..." (Sources: AP of 28 March 1998, dpa of 28 March 1998, Washington Post of 28 March 1998) *** Great Britain: A local Court has acquitted a man that got a liver operation and therefore was using marihuana to alleviate the pain. The smoking was considered a mitigation. (Source: The Times of 24 March, quoted from CORA) *** Great Britain: Another man was fined 100 pounds for growing and giving cannabis to his wife, a Multiple Sclerosis sufferer. He has already been prosecuted twice for growing and supplying cannabis to his wife in 1993 and 1995. He will always be willing to go to prison rather than see his wife suffer which has made her suicidal. "It's not possible for me to stop because between a prison term or death for my wife there is just no contest," he said. (PA News of 2 and 3 April 1998) *** USA: The U.S. Department of Justice launched the strongest challenge yet to California's medical marijuana clubs on 24 March, asking a judge to shut them down for violation of federal drug laws. Superior Court Judge David Garcia has denied these motions on 3 April, and has instead scheduled a jury trial for 27 April. (Sources: Reuters of 24 March 1998, UPI of 3 April 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 19 April 1998 ------------------------------------------------------------------------------- * USA: Judge orders the Cannabis Cultivators' Club in San Francisco to shut down * Canada: The opening of medical marijuana clubs * Great Britain: Hearing of the House of Lords committee 1. USA: Judge orders the Cannabis Cultivators' Club in San Francisco to shut down The Cannabis Cultivators' Club of San Francisco, which serves some 9,000 people, was ordered to close on 15 April after a judge ruled that it was "illegally selling" the drug. Superior Court Judge David Garcia said the Club and its founder Dennis Peron had overstepped the provisions of Proposition 215 which made it legal for sick people to use marijuana. Garcia granted state Attorney General Dan Lungren's request for a nuisance abatement order allowing the club to be seized and closed. "The Court finds uncontradicted evidence in this record that defendant Peron is currently engaging in the illegal sales of marijuana," Garcia wrote in his decision. He cited Peron's admission that he had sold marijuana through the club to people who were acting as primary caregivers for bedridden or hospital-bound patients. Those sales are not authorized under any interpretation of the law, the judge said. Proposition 215, passed by 56 percent of the state's voters in November 1996, allows "patients or defined caregivers, who possess or cultivate marijuana for medical treatment recommended by a physician, are exempt from general provisions of law which otherwise prohibit possession or cultivation of marijuana." "Let's say what this is really about - they didn't want us to vote for Proposition 215," Peron said. "They don't like the law. They're seizing on technicalities." He said the club was ready to disband - but would resume operations immediately as "a new community entity" called the San Francisco Cannabis Healing Center: "You cannot just throw people out on the street." Between 8 and 13 of April three Californian newspapers published an article of Willie L. Brown Jr., Mayor of San Francisco, dealing with the debate over the Cannabis Buyers' Clubs. Refering to the will of the Californian voters he strongly supports the clubs. "... The debate over medical marijuana is, above all else, about compassion for people in pain... In San Francisco and in cities across the state, local health and police officials have worked with medical marijuana dispensaries to ensure that they operate in the spirit of the law. ... The current system isn't perfect. But until marijuana is approved by the Federal Drug Administration as a prescription drug, California's medical marijuana dispensaries are a viable medical alternative. ... Rather than censure this public health crisis with a lawsuit, the Justice Department should urge the Clinton administration to work with local and state governments to implement a plan for distributing medical marijuana that complies with both federal and state law and that puts the needs of patients first." (Sources: AP of 16 and 17 April 1998, Reuters of 16 and 17 April 1998, Los Angeles Times of 8 April 1998, Oakland Tribune of 12 April 1998, San Jose Mercury News of 13 April 1998) 2. Canada: The opening of medical marijuana clubs A Canadian newspaper reported about the installation of a local medical marijuana club in Waterloo as a local chapter of the Medical Marijuana Centers of Ontario. Organizer Jeannette Tossounian started last week. About 40 people have asked for membership forms. Two physicians have declined and 10 doctors have co-operated. Doctors are asked to verify that a patient suffers from a particular medical condition and to sign the form which says: "I have discussed with my patient what I am aware of in terms of the health benefits and risks of marijuana. I would consider prescribing it if I were legally able to do so." Tossounian phones the doctor's office to confirm the signature is legitimate and then meets the members. In a club brochure, Tossounian advertises her phone number. But the club's marijuana is not kept at or distributed from her apartment. She arranges to pick it up and deliver it at locations that are "pretty much confidential." In a news release of 13 February 1998 activists announced their intention to open medical marijuana buyers clubs in several cities of southern Ontario. (Source: The Record (Kitchener-Waterloo) of 13 April 1998) 3. Great Britain: Hearing of the House of Lords committee Extreme caution should be exercised before cannabis is introduced for medical purposes because there is a great potential for misuse, experts argued on 7 April before a House of Lords committee examining the scientific arguments over the medical and recreational use of cannabis. Any use of a medical drug involved essential questions of potency and purity and in the case of cannabis there were "fairly daunting" technical problems, they said. Professor David Grahame-Smith, chairman of the Advisory Council on Misuse of Drugs, explained that the benefits of cannabis were difficult to measure because the potency of the drug partly depended on how it was taken. He said that so far there was little evidence of any actual benefit from the drug. Professor Malcolm Lader, from the Institute of Psychiatry, and chairman of the technical sub-committee of the Advisory Committee on Misuse of Drugs, added that the varying strength of cannabis made it difficult to have a controlled experiment on the drug. The ability of cannabis to generate appetite could be particularly useful for Aids patients but at the same time one did not know about the drug's effects on the immune system, he said. Professor Griffith Edwards, from the National Addiction Centre, said: "Perhaps we should also learn from history... People in the last century were aware of how unpredictable cannabis is and realised that drugs such as aspirin were better medicine." It was the first time that the sub-committee of the Lords' Science and Technology committee, which expects to present its report to the Government by the end of the year, took evidence. Dr. Franjo Grotenhermen, chairman of the Board of Directors of the ACM said: "There are different pharmacokinetics with different routes of administration not only for cannabis but also for other drugs. Standardization on the most important ingredients is possible for cannabis as it is possible for other herbs. We can learn from history that Cannabis can be helpful for a multitude of severe ill conditions, which often can be treated only insufficiently with the available therapeutic means. Today the unpredictability of the pharmacological effects of cannabis can be overcome by standardization. Besides, inhalation, an uncommon route of administration in former times, allows a good titration of the desired effects." (Source: AP of 7 April 1998) 4. *** News in brief *** The Netherlands: According to a study of the Centre for Drug Research at the University of Amsterdam there were less smokers of marijuana in the Netherlands than in the USA, although the drug can be bought legally in coffee shops. The study says that about 2-3 percent of the Dutch population above the age of 12 are using marijuana at least once per month versus about 5 percent in the US where its use is illegal. (Source: Taz of 18 April 1998) ***USA: Hawaii's House Committee on Health approved a resolution on 4 April urging the federal government to expedite research into the medical efficacy of marijuana. Earlier this year, the bill's sponsor, Rep. David Tarnas introduced legislation exempting patients and their primary caregivers who possessed or cultivated marijuana for medical use from criminal penalties. The Health Committee rejected that bill, but its Chairman encouraged Tarnas to draft a separate resolution endorsing research. (Source: NORML of 9 April 1998) ***USA: The Senate approved a "sense of the Senate" resolution on 3 April denying funding for any future medical marijuana research projects. The amendment is included in a measure outlining Congressional budgets for the next five years. Although the amendment is not legally binding, the resolution may influence decisions of the Congress. (Source: NORML of 9 April 1998) *** Belgium: Belgium's state prosecutors will be told next week to go easy on people possessing cannabis for private use, Belgian media reported on 18 April. A new Justice Ministry circular to prosecutors' offices will make clear that trafficking and marketing of cannabis is still illegal. But prosecutors will be told to give the "lowest of judicial priorities" to bringing charges for the possession of small amounts of cannabis for private use. Le Soir daily newspaper said Belgium had chosen its own policy on drugs, rejecting both "the laxness of the Dutch coffee shops" and "French intransigence." (Source: Reuters of 18 April 1998) 5. Correction of ACM-Bulletin of 5 April 1998 Writing about the medical marijuana dispensaries in California we mistakenly confused two cases in the ACM-Bulletin of 5 April 1998. We wrote: "The U.S. Department of Justice launched the strongest challenge yet to California's medical marijuana clubs on 24 March, asking a judge to shut them down for violation of federal drug laws. Superior Court Judge David Garcia has denied these motions on 3 April, and has instead scheduled a jury trial for 27 April." However: a) The U.S. Department of Justice lawsuit to close six California medical marijuana clubs is being heard by Judge Charles Breyer. A preliminary decision of some sort is expected within a few weeks. b) The state of California lawsuit has been filed against Dennis Peron's San Francisco Cultivators' Club by state Attorney General Dan Lungren. The judge in that case is David Garcia. (See above) (Source: Dale Gieringer, personal communication) We are very sorry for causing any confusion. We invite our subscribers to inform us about issues that might be interesting for the international discussion about the medical use of cannabis and the cannabinoids. Yours ACM ------------------------------------------------------------------------------- ACM-Bulletin of 3 May 1998 ------------------------------------------------------------------------------- * Great Britain: Director of ACT before the House of Lords committee * USA: Cannabis Buyers' Club of San Francisco reopened under a new name * Germany: Professor of law calls denial of the medical use of cannabis unlawful 1. Great Britain: Director of ACT before the House of Lords committee The Director of the Alliance for Cannabis Therapeutics (ACT), Clare Hodges, described her experience with the use of cannabis before the House of Lords committee examining the scientific arguments over the medical and recreational use of cannabis. The ACT, a loose alliance of patients, doctors and politicians, is campaigning for cannabis to be available on prescription. Clare Hodges developed multiple sclerosis 15 years ago. She suffered "great discomfort" in her bladder and sometimes had to go to the toilet at least 12 times a night. No conventional medicines provided sustained relief. Six years ago a friend got some cannabis for her: "It was effective within about five minutes. The tension in my bladder and spine melted away, and I felt less sick and stiff." Peers were also told by physiology professor Patrick Wall of the need for more research into the medicinal use of cannabis. The expert, who is professor of physiology at St Thomas' Hospital in London, later spoke of the benefits patients said they got from cannabis. He said after the hearing that it was "ridiculous" that doctors had to apply for special permission to do research into cannabis above and beyond what was required for work on heroin or cocaine. (Source: PA of 28 April 1998) 2. USA: Cannabis Buyers' Club of San Francisco reopened under a new name The Cannabis Healing Center replaced the Cannabis Cultivators Club, a day after the old club was shut down under a court order. The Cannabis Cultivators Club supplied marijuana to about 9,000 patients and was run by Dennis Peron. It was closed on 21 April and reopened as San Francisco Healing Center on 22 April under the direction of 79-year-old Hazel Rodgers, who uses marijuana for glaucoma. A judge refused California Attorney General Dan Lungren's demand for a legal order to close the new club down immediately. Superior Court Judge William Cahill said there was not enough evidence to warrant a restraining order against the club. He scheduled a fresh hearing on the issue for early June. Less than 18 months after medical marijuana use was legalized in California by Proposition 215, the network of marijuana clubs, co-ops and dispensaries that arose to deliver cannabis to patients is in some trouble, according to an article of the San Francisco Chronicle. Of 18 medical marijuana providers operating openly seven months ago, six are out of business and five are facing closure due to criminal or civil lawsuits. The remaining seven groups are still open and not facing legal trouble. Medical marijuana clubs, co-ops and dispensaries in California still in operation, no charges pending - Humboldt Cannabis Center, Arcata, Humboldt County (150 members) - Compassionate Use Co-Op, Rackerby (45 members) - C.H.A.M.P., San Francisco (500 members) - Medical Cannabis Delivery Service, San Francisco (400-500 members) - Wo/Men's Alliance for Medical Marijuana, Santa Cruz (150 members) - MedEx Delivery Service, Santa Cruz (9 members) - Los Angeles Cannabis Buyers' Club, West Hollywood (460 members) Still open, but threatened by legal problems - San Francisco Cannabis Cultivators Club, S.F. (9.000 members) - Oakland Cannabis Buyers' Cooperative, Oakland (1.000 members) - Marin Alliance for Medical Marijuana, Fairfax (300 members) - Ukiah Cannabis Buyers' Club, Ukiah (250 members) - Santa Clara County Medical Cannabis Center, San Jose (270 members) Recently closed - Flower Therapy, San Francisco - Santa Cruz Cannabis Buyers' Club, Santa Cruz - Medical Marijuana Care Center, Monterey - Orange County Patient/Doctor/Nurse Support Group, Santa Ana - San Diego Cannabis Caregivers' Club, San Diego - Ventura County Medical Cannabis Center, Thousand Oaks (Sources: Reuters of 21, 22 and 30 April 1998, San Francisco Chronicle of 23 April 1998) 3. Germany: Professor of law calls denial of the medical use of cannabis unlawful In the German 'Juristenzeitung' (Lawyer's Journal) of February Jürgen Schwabe, Professor of Law from Hamburg, calls the denial of therapeutic application of cannabis in severe ill conditions unlawful. In his article he illustrates the juristic problem of the protection of man from himself: "The modern state protects his citizens from themselves by an abundance of rules. Often the legitimation for this compelled self-protection is doubtful..." One of his mentioned examples is the prohibition of cannabis. In the judgement of the Constitutional Court of Germany of 1994 this prohibition was above all legitimated by interests of public welfare. Schwabe says that in cases of interests of public welfare "of course" one has to verify whether, in the individual case, the interests of the user prevail over the interests of public welfare. The article finishes with the sentences: "Even if there are interests of public welfare that allow for state restriction, a certificate of exemption has to be awarded to those subjected to the prohibition of course, to whom these interests are irrelevant or whose own interests clearly outweigh the public welfare interests. It has to be called a scandal that according to press reports, even cancer and aids patients are denied cannabis treatment though this would clearly alleviate their suffering. It is inexplicable that, so far, no one has yet promptly and forcibly brought any legal actions against such evident unlawfulness." (Source: Schwabe, J.: Der Schutz des Menschen vor sich selbst. Juristenzeitung 2/1998, p. 66-75) 4. News in brief ****Italy: The Italian government is intending to tolerate the use of cannabis in groups as it does already for personal use according to press reports. The shared use in a group shall no longer be penalised if the drug is not sold to the consumer but given away, the Milan newspaper Corriere della Sera reported on 23 April 1998. (Source: Taz of 24 April 1998) ***Great Britain: According to a survey carried out by market research company Taylor Nelson Sofres, 62% of Britains are against the legalisation of cannabis for recreational purposes. 32% support the legalisation for medical purposes. (Source: PA of 26 April) ***USA: Alaskan voters will decide this November whether to legalize the medical use of marijuana. The Alaska initiative seeks to allow patients suffering from a "debilitating medical condition" and holding a state-issued identification card to legally possess up to one ounce of marijuana. Registered patients would also be able to cultivate marijuana for medical use. (Source: NORML of 23 April 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 17 May 1998 ------------------------------------------------------------------------------- * Australia: Demand for research of the therapeutic value of cannabis * The Netherlands: Survey among the members of the MS-Society * Germany, Switzerland, Austria: ACM meeting in December 1. Australia: Demand for research of the therapeutic value of cannabis Drug companies and health experts were urged on 5 May to investigate the use of cannabis in AIDS and cancer treatment. In their report to the Ministerial Council on Drug Strategy, South Australian researchers said cannabis could be used to stimulate appetite, improve mood and induce sleep in people with AIDS, relieve nausea in chemotherapy patients or as a painkiller. Drug and Alcohol Services Council clinical policy and research director Dr. Robert Ali called for a mature debate, saying it was time to investigate whether cannabis or synthetic cannabinoids could be used as medicine. He called on researchers to investigate smoke-free methods of using cannabis, such as skin patches and inhalers, because not all patients would want to smoke the drug. Dr. Ali was backed by the Australian Medical Association and the Australian Federation of AIDS Organisations. SA Human Services Minister Dean Brown said cannabis research could be undertaken in SA without any legislative changes. He said the call for further investigation was not support for recreational marijuana use and did not represent a step towards legalisation of the drug. Pharmaceutical company Faulding said it would consider researching the therapeutic value of cannabis if the political and social issues could be overcome. Managing director Ed Tweddell said research by other institutions into cannabis and cannabinoids had been promising, and the area of research fitted well with Faulding's focus on cancer and pain treatment. (Source: Australian Associated Press of 5 May 1998) 2. The Netherlands: Survey among the members of the MS-Society In the beginning of 1998 the Dutch Institute of Demoscopic Research TNO published results of a survey among the members of the Dutch Multiple Sclerosis Society about the use of cannabis. From the summary of the report: "It is known that cannabis is generally able to alleviate physical complaints. Until now, however, there is only little knowledge about the modes, the scope or the effects of application of cannabis in chronic patients in general and, more specifically, in MS-patients. For a better understanding of these fields a study on mode and scope of application of cannabis was conducted which was financed by the Ministry of Health, Welfare and Sport and by the foundation 'Friends of Multiple Sclerosis Research' in the Netherlands as well as by the Dutch official Institute of Demoscopic Research TNO. Approximately one third of all members of the MSVN that were addressed by letter took part in the study. 13 % of the patients had taken cannabis once in time and 5 % still are consumers. The majority of these had started their cannabis use after multiple sclerosis had been diagnosed. The following criteria distinguish the cannabis consumers from non-consumers: The consumers are predominantly male, the larger part of them received a higher education, they often are singles or share an accommodation or are divorced and they rather live in large villages or cities. Half of the consumers take cannabis one to two times a day, in most cases cannabis is smoked and 60 % percent of it is bought in coffee shops. Those patients suffering from multiple sclerosis generally state that they apply cannabis both for psychical and for physical reasons. The main reasons to object its use are unwillingness to smoke, fear of addiction, and ignorance about access and the mode of application. In the course of this commissioned study no further reasons for the application of cannabis or its effects were examined. For the lack of state-wide comparative figures the present cannabis consumption of patients with multiple sclerosis was compared to the consuming population of Amsterdam. It was found that the portion of male users among the patients equals their portion of the citizens of Amsterdam. Among the female patients with MS over forty years the part of those consuming is two to four times bigger than among the women in Amsterdam of the same age. As a conclusion it was suggested to further analyse the results of the described effects of cannabis application among the MS-patients in order to utilise them for a clinical study. This corresponds to the recommendation that the health committee directed to the Health Minister in which the committee states the necessity of a clinical study on the therapeutical effects of cannabis." (Source: Report of TNO Preventie en Gezondheid: Aard en omvang van Cannabis gebruik bij mensen met Multiple Sclerose. 1998, ISBN 9067435171). 3. Germany, Switzerland, Austria: ACM meeting in December The annual meeting of the ACM will be held on 4 to 5 December 1998 in Cologne. On 5 December there will be talks of: - Dr. Christian Raetsch, ethnopharmacologist, Hamburg - Dr. Robert Gorter, Institute for Oncological and Immunological Research, Berlin - Dr. Roger Pertwee, University of Aberdeen/Scotland - Prof. Raphael Mechoulam, Hebrew University of Jerusalem/Israel - Dr. Kirsten Mueller-Vahl, University of Hanover - Joerg Fachner, University of Witten/Herdecke - Dr. Franjo Grotenhermen, nova-Institute Cologne 4. News in brief ****Australia: An expert panel endorsed decriminalisation of marijuana on 10 May. National Drug and Alcohol Research Center researcher Dr. Nadia Solowij said it was wrong for marijuana use to be treated as an offence rather than a health issue: "Even though I have identified some harms associated with cannabis use they are subtle and I think the greater harm ... is the fact it's illegal and exposes people to criminal activity and other harder drugs." Professor David Penington said young people rejected conventional arguments that marijuana use should be a criminal offence when alcohol was responsible for far more deaths and ill-health. (Source: AP of 10 May 1998) ****USA: On 1 June Dr. Ethan Russo will submit his second grant application to the National Institutes of Health, seeking permission for a study of marijuana in the treatment of migraine headaches. Dr. Russo's first application to NIH was rejected in November 1997. Both of Dr. Russo's applications have been supported by MAPS (Multidisciplinary Association for Psychedelic Studies). For more information, see www.maps.org., or contact ERUSSO@wmclinic.com. (Source: Rick Doblin, personal communication) ****Great Britain: According to a report of the British Medical Journal of 2 May the Royal Pharmaceutical Society of Great Britain will develop guidelines for clinical research with cannabinoids. "The aim is that the guidelines will encourage the Home Office to approve research licenses which are currently being delayed (...) with about 14 applications pending. The new research protocols might help the Home Office to compare license applications with a set of guidelines and decide which should be licensed." (Source: Warden, J.: UK experts will speed up work on cannabis. BMJ 316:1333 (1998). ****USA: An U.S. district judge has ruled on 14 May that California pot clubs must stop selling medical marijuana in violation of federal law. In a decision Judge Charles Breyer found that whether or not medical marijuana clubs are legal under state Proposition 215 they are not legal under federal statutes that take precedence over California law. Defiant pot club operators said they were disappointed by Breyer's decision, but nonetheless detected enough legal wiggle room in it to believe that their fight to remain open can continue. (Source: San Francisco Chronicle of 15 May 1998) ****Germany: The Minister of Social Affairs of the state of Schleswig-Holstein, Heide Moser, proposed a reform of the Narcotic Act. The law should allow possibilities for experiments of controlled sale of cannabis products. Schleswig-Holstein failed with the proposal of an experiment of the sale of hashish in pharmacies last year due to resistance of federal authorities. (Source: Focus of 4 May 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 31 May 1998 ------------------------------------------------------------------------------- * USA: Californian summit about the medical use of marijuana * California Medical Association suggests to reclassify marijuana as a prescriptive drug * Germany, Switzerland, Austria: Survey about the medical use of cannabis and the cannabinoids 1. USA: Californian summit about the medical use of marijuana California Medical Association suggests to reclassify marijuana as a prescriptive drug At a summit about the medical use of marijuana on 26 May a group of California state legislators asked President Clinton to help resolve the impasse blocking the state from implementing its 1996 law (Proposition 215) permitting medical marijuana use. "Mr. President, we can't ignore this issue. It won't go away, so long as human beings believe they have the right to attend to their own illness, as their doctor recommends, rather than as government dictates," said a strongly worded letter signed by state Sen. John Vasconcellos of Santa Clara, Senate President Pro Tem John Burton of San Francisco and 21 other senators and Assembly members. Some of those who did attend the summit said that the Cannabis Buyers' Clubs were not an ideal outlet for the drug. "My [preference] would be to prescribe marijuana like I prescribe other drugs," said Mitchell Katz, the public health director in San Francisco. That, however, would require the federal government to reclassify marijuana from a Schedule I to a Schedule II drug. The California Medical Association suggested this solution: "Due to the lack of scientific justification for Schedule I classification of marijuana and the consequent virtual standstill in research on its medical benefits, ... we support efforts to reschedule marijuana," the Board of Trustee's said. But Gerald Uelman, former dean of Santa Clara University Law School, responded that it took federal officials 20 years to respond to such a request made in 1972. In the last months there has been strong pressure on the Californian Cannabis Buyers' Clubs where sick people can get marijuana, and many of them have been closed. On 25 May sheriff's deputies forcibly closed the San Francisco Cannabis Healing Center. It opened last month at the site of the Cannabis Cultivators Club, which was closed by a state court order on 21 April. Now local officials are promoting the city's Department of Public Health as the most likely new distributor for medicinal pot. "The will is there to put this in Public Health's court," Supervisor Tom Ammiano said on 27 May. "We have to make it happen as soon as possible." (Sources: UPI of 26 May 1998, Reuters of 27 May 1998, Sacramento Bee of 27 May 1998, Los Angeles Times of 27 May 1998, San Francisco Chronicle of 28 May 1998, NORML of 28 May 1998) 2. Germany, Switzerland, Austria: Survey about the medical use of cannabis and the cannabinoids The Arbeitsgemeinschaft Cannabis als Medizin (ACM, Asociation for Cannabis as Medicine) has started a systematic survey about the medical use of cannabis (marijuana, hashish, cannabis tincture) and single cannabinoids (Nabilone, dronabinol/Marinol). All patients of Germany, Switzerland and Austria who have experience with the medical use of cannabis products can participate. The questionnaire will be evaluated from the Institute for Oncological and Immunological Research in Berlin (Director: Dr. Robert Gorter). The survey will be conducted anonymously. The institute will prepare a report about the results of the survey. An interim report will be presented at the meeting of the ACM on 4 and 5 December 1998. Questionnaires are available upon request at the ACM or can be downloaded from the internet: http://www.hanfnet.de/acm/fragebogen.doc 3. News in brief ****World 90 Drug policy reform organisations have joined as the Global Coalition for Alternatives to the Drug War and will declare the 'Global Days against the Drug War', to be held on 5 June through 10 June. Events to promote alternative drug policies will take place in 40 cities worldwide, at the occasion of the United Nations Special Session of the General Assembly on Drugs, UNGASS, which starts on 8 June. According to the new guidelines of the UNGASS, only the expansion of existing policies will be open for discussion. The drug policy reform organisations are issuing a declaration that will be presented in New York at the Non-Govern-mental Organisations conference that is part of UNGASS. More informations: http://www.stopthedrugwar.org/globalcoalition/ (Source: Press release of the Global Coalition for Alternatives to the Drug War of 25 May 1998) ****Australia The Australian Drug Law Reform Foundation (ADLRF) launched its 10-point Plan for Effective Drug Laws, aimed at changing the federal government's approach to the drug problem on 24 May. It recommended regulating and taxing commercial production and sale of cannabis, removing criminal sanctions for personal use and retaining penalties for unauthorised cultivation, production, transport, sale and possession of all drugs. "Prohibition has not worked. It causes increased corruption, crime, disease and death," ADLRF president Alex Wodak said. (Sources: Australian Associated Press of 24 May 1998, Email of Alex Wodak) ------------------------------------------------------------------------------- ACM-Bulletin of 14 June 1998 ------------------------------------------------------------------------------- * Great Britain: License for the cultivation of drug hemp for medical research * The Netherlands: Clinical studies on cannabis extract in AIDS and cancer patients planned * U.N.: Special General Assembly session on the problem of drugs without new perspectives 1. Great Britain: License for the cultivation of drug hemp for medical research The pharmaceutical company GW Pharmaceuticals has been licensed under the Misuse of Drugs Act 1971 for the cultivation, storage and distribution of cannabis for medical research. The drug will be cultivated in a greenhouse at a secret site. According to Dr. Geoffrey Guy, founder of GW Pharmaceuticals, "the scale of the project will be sufficient to allow the acquisition of 500-600 patient years of safety and efficacy data". Guy said: "There is a considerable body of evidence to suggest that cannabis may have a number of medicinal uses: for the relief of pain and spasticity in multiple sclerosis; for pain relief in other neurological disorders, such as paraplegia and neuralgia; as an appetite stimulant in treating AIDS patients with wasting disease; for the prevention of nausea and vomiting associated with cancer chemotherapy; and in the eye disease glaucoma." The licences have been issued to enable a full pharmaceutical research program to be undertaken. In the event of a Product Licence being granted for a cannabis-based medicine, the Home Office would be very willing to come forward with a change in the controls of the Misuse of Drugs Act 1971 to allow the prescribing of such a medicine. Initially, the complex will develop extracts of cannabis plants grown under controlled conditions. Research will investigate whether the drug can be used safely to treat a range of illnesses and to establish the best delivery method into patients - other than smoking - of cannabis and/or its constituents. Guy said, the Home Office had also indicated that they are willing to issue export licences to him for the purpose of cooperation with international research programmes. GW Pharmaceuticals Ltd has recently negotiated a world wide cooperation with the Dutch medicinal cannabis breeding specialists HortaPharm B.V., who have extensive experience in the cultivation and standardisation of cannabis for medical purposes. (Sources: Reuters of 11 June 1998, AP of 11 June 1998, Press release of GW Pharmaceuticals of 11 June 1998, email of Geoffrey Guy of 12 June 1998) 2. The Netherlands: Clinical studies on cannabis extract in AIDS and cancer patients planned The Dutch Ministry of Public Health gave permission to the medical company Weleda in Zoetermeer in the Netherlands to import 10 kilograms of hemp from the USA. This allows clinical studies to begin still this year. The Weleda company that produces medicaments and cosmetics on an anthroposophical basis, wants to manufacture the biologically grown hemp into 180,000 capsules of medicine. Each capsule shall contain 2.5 mg THC of the oily cannabis extract. The capsules will be employed in studies on AIDS- and cancer patients under the direction of Prof. Gorter, director of the European Institute for Oncological and Immunological Research. The studies shall examine the appetite stimulating and antiemetic effects in AIDS and cancer patients as well as its effects on quality of life. The patients require two capsules per day, a dose that does not induce any psychical effects. This course of application by capsules allows for a more exact dosage and ensures a more constant quality-standard of the marijuana than application by smoking marijuana or drinking marijuana-tea. As since August 1997 Dutch chemistries are prohibited by law to supply patients with cannabis, many patients have to buy the drug in Coffee shops. For many this is very troublesome. However, the Coffee shops undertook an action to distribute marijuana at cost-price on presentation of medical prescriptions. Since March 1998 the synthetic preparation Marinol is at the patients´ disposal, which contains the single active agent THC (Dronabinol) of the hemp plant. This preparation imported from the USA costs about 12 US-Dollars per capsule in the Netherlands; hence it is considerably more expensive than the natural cannabis in capsules one of which will cost about 1.5 US-Dollars. The Dutch "Stichting Patientenbelangen Medicinale Marihuana" welcomes the decision of the Dutch Ministry of Public Health to grant the so-called "opium-licence" to the medical company Weleda. In the course of the studies that are planned the natural cannabis shall be compared to the synthetic THC-preparation and placebos. According to Prof. Gorter the studies shall commence in autumn this year in cooperation with several university-clinics. (Sources: De Volkskrant of 30 May 1998, Het Parool of 30 May 1998, personal communications) 3. U.N.: Special General Assembly session on the problem of drugs without new perspectives "Illusions of yesterday" is the title of a report of the German Magazine 'Der Spiegel' about a three-day special General Assembly session of the United Nations on the problem of drugs that ended on 11 June. The participants, among them about 30 heads of states, adopted a raft of documents designed to minimize the supply and demand for drugs in the next decade. A political statement sets the year 2003 as a target date for the establishment of "new or enhanced drug demand reduction strategies and programmes." On the supply side, countries commit themselves to "develop strategies with a view to eliminating or significantly reducing the illicit cultivation of the coca bush, the cannabis or marijuana plant and the opium poppy by the year 2008." Critics regard this concept of the 'War on Drugs' as a failure. According to a resolution of the General Assembly of the U.N. on 23 February 1990 in New York the last decade of the 20th century already should have been the "U.N.-Decade against Drug Abuse" ringing in the victory of mankind over addiction. Similar resolutions have been past in the sixties and seventies. One main cause for the U.N. to adhere to their unsuccessful strategy is an agency with 272 employees, the United Nations Drug Control Program (UNDCP), with its main residence in Vienna/Austria and its chief Pino Arlachi. The UNDCP with offices in 20 countries was founded in 1990 to convert the anti-drug program. On the other hand dozens of scientists, artists and politicians are urging secretary general Kofi Annan, "to start a real open and honest dialogue about the future of the worldwide drug policy," instead of "rhetorically propagandising a drug-free society." In Germany the letter is signed by Health Minister of Lower Saxony Heide Moser, the author Guenther Grass, the publicist Johannes Gross and others. Among the most influential signers is American billionaire and philanthropist George Soros. "Our drug policy is crazy," Soros says about the 'War on Drugs'. "This war is more harmful to society than the drug abuse itself." About 100 drug policy reform groups recently united to form the 'Global Coalition for Alternatives to the Drug War' and have declared 'Global Days against the Drug War'. Non-governmental organisations turned thumbs down on the entire U.N. exercise, which one called a "bad pep rally for a bad policy." These organisations, advocating innovative social, medical and legal programmes, say that repressive measures only fill prisons while failing to reduce the harm caused by drugs. (Sources: Numerous press agencies and articles) 4. News in brief ****USA: Democrats approved a resolution supporting passage of the Washington State Medical Marijuana Initiative (I-692) at last week's State Democratic Convention. The initiative mandates that "patients with terminal or debilitating illnesses who, in the judgment of their physicians would benefit from the medical use of marijuana, shall not be found guilty of a crime under state law for their possession and limited use of marijuana." Proponents of I-692 must gather approximately 182,000 signatures by 2 July to place the measure on the November ballot. (Source: NORML of 11 June 1998) ****USA: According to a report of the University of Connecticut Health Center in Farmington chronic users of marijuana may find it hard to give up the habit. They may experience irritability and anxiety during withdrawal. Patients enrolled in a marijuana addiction treatment options study claim "they didn't know how hooked they were until they tried to quit," said Dr. Ronald Kadden. The preliminary findings are from a 3-year project with patients using marijuana daily or many times per week for many years. (Source: Reuters of 12 June 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 28 June 1998 ------------------------------------------------------------------------------- * USA - No evidence of Marinol substance abuse - Unimed plans expansion of indications * Great Britain: Townswomen's Guild calls for legalisation of cannabis for seriously ill patients * France: Alcohol is a far worse health hazard than smoking cannabis * Canada: Possession of cannabis should no longer be a crime 1. USA - No evidence of Marinol substance abuse - Unimed plans expansion of indications The manufacturer of Marinol, Unimed Pharmaceuticals, announced on 17 June that San Francisco researchers evaluating clinicians' experiences with Marinol use have found no observed cases of abuse among patients. Marinol contains synthetic THC (dronabinol), the primary psychoactive component of the hemp plant (Cannabis sativa L.). Study findings were presented in conjunction with the College of Problems of Drug Dependency's Annual Scientific Meeting being held in Scottsdale, Arizona. The study, which was conducted nationwide over a nine-month period, included the collection of experiences among researchers, physicians, addiction medicine specialists and law enforcement personnel. Among the findings: - There is no evidence of Marinol substance abuse. - Marinol use remains within the therapeutic dosage range over time. - Cannabis users have demonstrated no interest in abuse of Marinol. - There is no street market for Marinol. - Marinol does not provide effects that are considered desirable in a drug of abuse. Unimed also seeks to extend the indications of Marinol with new clinical trials to study the medicament for the treatment of agitated behaviour among people suffering from dementia. In 1997 a study with 15 patients with Alzheimer's disease who were refusing food was published. THC not only increased body weight, the treatment as well decreased severity of disturbed behaviour. (Sources: Dow Jones of 17 June 1998; PRNewswire of 17 June 1998; Volicer L Stelly M Morris J McLaughlin J Volicer BJ: Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease. Int J Geriatr Psychiatry (1997) 12:913-919) 2. Great Britain: Townswomen's Guild calls for legalisation of cannabis for seriously ill patients Almost three-quarters of delegates at the Townswomen's Guild's National Council meeting on 18 June approved a motion backing the legalisation of cannabis for "specific medical purposes". Guild members made their decision after being urged to show "common sense and compassion" by Clare Hodges, multiple sclerosis victim and director of the Alliance for Cannabis Therapeutics. She described the positive effects cannabis has on her illness. Her five-minute plea was greeted with rapturous applause from the overwhelming majority of Townswomen. The motion was passed by 1,163 votes to 407 after delegates from across the United Kingdom heard how Queen Victoria and jazz musician Louis Armstrong used marijuana. One delegate told the 3,000-strong group of largely elderly Townswomen: "Louis Armstrong smoked it all his life and it didn't impair his performance. Queen Victoria's physician prescribed it for Her Majesty for the relief of menstrual pain." (Source: PA News of 18 June 1998) 3. France: Alcohol is a far worse health hazard than smoking cannabis According to a report of the state medical research institute INSERM and foreign experts published on 16 June, alcohol, heroin and cocaine are the most dangerous drugs to health. Tobacco, psychotropic drugs, tranquillisers and hallucinogens are in a second group, with cannabis in a list of substances categorised as posing relatively little danger. The report says both alcohol and heroin were highly addictive both physically and psychologically, threatened health and encouraged dangerous social behaviour. Alcohol and tobacco were associated with cancer, hepatitis and cardiovascular ailments. Drunkenness was also seen as a major cause of suicides, murders and traffic and workplace accidents. But cannabis was seen as having low toxicity, little addictive power and posing only a minor threat to social behaviour. The report, commissioned by Junior Health Minister Bernard Kouchner, is embarrassing for the government just a few days after President Jacques Chirac and Prime Minister Lionel Jospin rejected calls to de-criminalize soft drugs. "The prime minister does not favour decriminalising any drug," government spokesman Daniel Vaillant told reporters on 17 June. Bernard Kouchner told the National Assembly that the report is "toxicologically correct but politically wrong." A statement of the Greens party says: "The report again shows that the basis [for drugs policies] is totally wrong." (Source: Reuters of 17 June 1998) 4. Canada: Possession of cannabis should no longer be a crime According to a policy discussion document of the National Working Group on Addictions Policy of the CCSA (Canadian Centre on Substance Abuse) from May 1998 the simple possession of cannabis should no longer be a criminal offence. The paper with the title "Cannabis Control in Canada: Options Regarding Possession" suggests a "fine only" option. "The civil violation option offers the best opportunity to achieve the most appropriate balance between the need to reduce the harms associated with cannabis use and the need to restrain the cost and harms involved in attempts to control use," the report says. "It would remove cannabis possession from the criminal law, preclude imprisonment due to failure to pay fines, and eliminate the criminal record consequences of a conviction." The authors point out that the "enforcement of current law against cannabis possession has a very limited deterrent effect." There "is no clear relationship between changes in enforcement and levels of illicit drug use over the past several decades." Criminalizing marijuana seemed to have little effect on an individual's decision to use the drug. The new policy would remain consistent with Canada's international treaty obligations to discourage marijuana possession. Besides the attitude of the Canadians had changed: "The vast majority of Canadians no longer favor jail sentences for simple possession of cannabis." (Sources: NORML of 18. June 1998; "Cannabis Control in Canada: Options Regarding Possession", A Canadian Centre on Substance Abuse policy discussion document prepared by the CCSA National Working Group on Addictions Policy, Internet: http://www.ccsa.ca/canfinal2.htm) 5. Events in Germany ****18 July 1998: Hemp Party in Hamburg A large party with a manifold programme on the 'Fischmarkt'. ****29 August 1998: Hemp Parade in Berlin The second Hemp Parade under the motto "Vote for hemp. Legalization now". Last year there were about 50.000 demonstrators. This year about 100.000 are expected. ****25.-27. September 1998: Third CannaBusiness in Hennef near Cologne Fair and exhibition around hemp and cannabis, with Bioressource Hemp. 6. News in brief ****Canada: Grant Krieger, 43, from Saskatchewan has been convicted on 16 June of possessing cannabis for the purpose of trafficking. He will be sentenced on 17 August. Krieger was charged a year ago after stating publicly he intended to sell 15 grams of marijuana to a chronically ill friend. Judge Robert Davie said personal use of marijuana for medical reasons may be allowed under the Constitution, but distributing it to others isn't. Krieger vows to take his case to the Supreme Court, if necessary. (Sources: Canadian Press of 16 June 1998, Calgary Sun of 17 June 1998) ****Great Britain: The decriminalisation of illegal drugs is not a "viable option", the Government insisted on 15 June in a debate. Junior Home Office minister Gerald Howarth warned that any softening of the law would result in an increase in drug-related problems. Liberal Democrat Dr Jenny Tonge condemned the present legal situation on drugs as "slightly ridiculous". Labour's Paul Flynn cited the example of Continental countries, such as Switzerland, which had seen a reduction in drug-related crime since adopting a more lenient drugs policy. The US, which has had this policy of prohibition for many years, now "has the worst drug problem of the world". (Source: PA News of 15 June 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 12 July 1998 ------------------------------------------------------------------------------- * USA: Study of marijuana in AIDS patients has begun * Science: Cannabinoids for the prevention of brain damage 1. USA: Study of marijuana in AIDS patients has begun The long-delayed study of AIDS researchers with marijuana in AIDS patients, led by Dr. Donald Abrams of the University of California, has finally begun. The first subject was enrolled in the study in May 1998. The National Institute on Drug Abuse (NIDA) approved and funded the study "Short-term Effects of Cannabinoids in HIV Patients". On 18 September 1997 NIDA announced that Abrams will receive his full grant request of $978,000 for his study of the use of smoked marijuana, oral dronabinol, and placebo, in HIV-positive patients. Abrams waited five years and submitted three separate research protocols before finally receiving approval from the federal government. In 1992 Abrams got an approval of the Food and Drug Administration (FDA) for a pilot study to examine the effects of marijuana on appetite and weight in HIV-positive patients. But NIDA rejected Abrams' first protocol. The purpose of the ongoing study will be to determine whether or not marijuana therapy is safe for patients taking the new protease inhibitor drugs, which in combination with older AIDS drugs such as AZT and 3TC have caused dramatic improvements in many patients. Abrams said that because marijuana is metabolised by the same liver enzymes that process protease drugs, there is a chance that pot consumption could render the new drugs either dangerous or ineffective. Each of the 63 enrolled volunteers will be confined to San Francisco General Hospital for 25 days during the experiment. Only three or four patients will be studied each month with a duration of the whole study of about two years. One-third of the subjects will be asked to smoke three rolled marijuana cigarettes each day. A second group of patients will take instead the approved prescription drug Marinol, which contains synthetic THC. A third group will be given a placebo. Study protocol at: http://www.maps.org/mmj/proto.htm. "The earth has shifted," announced MAPS President Rick Doblin, whose organization donated $10,000 for the preparation of Abrams' applications. If the study demonstrates that smoked marijuana does not have serious short-term side effects on the health of HIV-positive patients, Abrams wants to research safety and efficacy of the chronic use of marijuana for HIV-associated anorexia and weight loss. (Sources: MAPS, NORML, San Francisco Chronicle of 9 October 1997, MPP-Report of spring 1998, study protocol) 2. Science: Cannabinoids for the prevention of brain damage According to researchers of the US National Institute for Mental Health in Maryland two natural compounds of the cannabis plant, delta-9-tetrahydrocannabinol (THC), the most important psychoactive cannabinoid, and Cannabidiol (CBD), a non-psychoactive cannabinoid, act to prevent damage to brain tissue placed in laboratory dishes. This property might be used to prevent brain damage in stroke victims and head trauma if the new findings, published in the proceedings of the National Academy of Sciences this week, are converted into medical practice. Stroke victims suffer a blood clot which starves brain cells of glucose and oxygen and sets off a cascade of chemical reactions which destroy cells. Antioxidants are given to protect stroke victims from exposure to toxic levels of the neurotransmitter glutamate, released in excess after head trauma and stroke. Glutamate stimulates both N-methyl-D-aspartate (NMDA) and non-NMDA receptors. While activation of NMDA receptors has been implicated in a variety of neurophysiologic processes, excessive NMDA receptor stimulation is thought to be primarily responsible for neuronal injury in a wide variety of acute neurological disorders including hypoxia-ischemia, seizures, and trauma. The US study, led by biologist Aidan Hampson, found that THC and CBD block this destructive process. Dr Hampson stumbled on the finding while trying to find out why the human brain has so many cannabinoid-receptors. Scientists asserted that above all CBD could hold advantages over other antioxidants because the compound is fast acting and non-toxic. The results suggest that Cannabidiol could also become a treatment for other neurological disorders such as Parkinson's and Alzheimer's disease. "We have something that passes the brain barrier easily, has low toxicity and appears to be working in animal trials - so I think we have a good chance," Dr Hampson said. Another cannabinoid, the synthetic cannabinoid Dexanabinol (HU-211), has already been extensively examined in animal studies during the last years. It is an effective drug in protecting brain cells against the effects of ischemia. Dexanabinol exhibits pharmacological properties of a NMDA-receptor antagonist and is a novel inhibitor of tumour necrosis factor-alpha (TNF-alpha) production. In addition, Dexanabinol is a potent scavenger of peroxy and hydroxy radicals in vitro and it protects cultured neurons from toxicity of radical generators. In a clinical phase I trial Dexanabinol was well tolerated in man. Phase III trials are planned. Cannabidiol is already known to be well tolerated in man - from clinical research with CBD in patients with psychosis, movement disorders and seizures. (Sources: Australian AP of 4 July 1998; NORML of 9 July 1998; Gallily R et al.: J Pharmacol Exp Ther (1997) 283:918-924; Brewster ME et al.: Int J Clin Pharmacol Ther (1997) 35:361-165; Shohami E et al. J Neuroimmunol (1997) 72:169-177) 3. News in brief ****USA: Petitioners hoping to place medical marijuana proposals on the November ballots in Colorado, Oregon, and Washington state turned in signatures to their respective Secretary of State offices this week. In all cases, the number of signatures far exceeded the state's requirement to place an initiative on the ballot. Proposals in all three states seek to exempt seriously ill patients from state criminal marijuana charges if they use the drug medicinally under a physician's supervision. (Source: NORML of 9 July 1998) ****USA: In Oakland, medicinal marijuana users will be able to keep a 1 1/2-pound supply of cannabis on hand - well above the 1-ounce threshold set by state Attorney General Dan Lungren. On 7 July the city council in Oakland approved one of the most liberal medical marijuana measures in the country. Oakland officials say the amounts were intended to allow patients a three month supply of marijuana and were established on the basis of U.S. Food and Drug Administration tests on the drug that ration users to ten marijuana cigarettes per day. (Source: Reuters of 8 July 1998) ****Great Britain: A middle-aged Norwich man who grew about $15,000 worth of cannabis plants to relieve his back pain, has been spared jail by a judge. 60 hemp plants were found at the home of 50-year-old scaffolder Robert Webster. It was not suggested that Webster was growing the plants on a commercial basis. He was given a seven month prison sentence suspended for 12 months and fined about $1,000. Sentencing him on 26 June Judge Paul Downes accepted that Webster had not been supplying the drugs and there were "exceptional circumstances." (Source: Sun of 28 June 1998) ****Switzerland: The Federal Court concedes great discretion to the cantons for the punishment of cannabis possession. It affirmed the fine of a consumer who was convicted by a judge of the canton of Aargau because of the possession of 11 grams of hashish. The defendant unsuccessfully referred to Article 19b according to which the preparation of ones own consumption is not punishable if the quantity is low. The Swiss law gives much room to the authorities of the different cantons in interpreting "low quantity". The Federal Court mentioned the practice of the prosecutor of the city of Basel to tolerate doses up to 30 grams of marijuana whereas the more severe judiciary of Solothurn tolerates only amounts that are sufficient for a single use. The decriminalisation of marijuana consumption will be discussed in the framework of the intended revision of the Narcotic Act. (Source: Blue Window of 29 June 1998) ****Great Britain: According to a new guide to help parents talk to their children about alcohol and other drugs, launched on 30 June by the Government, research shows that 26% of 11-16-year-olds and 57% of 16-22-year-olds have tried an illegal drug at some point. Among 16-22-year-olds, 28% have taken an illegal drug in the last three months. 36% of young people under the age of 30 are likely to have tried cannabis. (Source: AP News of 30 June 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 26 July 1998 ------------------------------------------------------------------------------- * Science: Cannabinoid/anandamide-receptor systems involved in peripheral control of pain * USA-Europe: US-Drug Czar weakens his criticism on Dutch drug policy 1. Science: Cannabinoid/anandamide-receptor systems involved in peripheral control of pain Substances like anandamide and palmithylethanolamide produced by the human body and binding to cannabinoid receptors are not only involved in pain processing in the central nervous system but also in the control of pain initiation in peripheral tissues. Scientists of the University of Naples/Italy and the Neuroscience Institute of San Diego/USA published their findings based on animal research in Nature of 16 July. According to Antonio Calignano and colleagues CB1-like cannabinoid receptors to which binds anandamide and CB2-like receptors to which binds palmithylethanolamide (PEA) are involved in local alleviation of pain. The researchers examined the question whether similar to the opioides, where central and peripheral mechanisms of pain control are known, this is true as well for the cannabinoid-receptor system. When anandamide was injected into the paw of mice together with a pain behaviour evoking substance there was no pain reaction. The central nervous system was not involved in this effect. This inhibition of nociception was attributed to the activation of CB1-like receptors, which may be located on peripheral endings of sensory nerves involved in pain transmission. PEA as well caused local pain attenuation, which was reversed by CB2-antagonists, while CB1-antagonists had no effect. In addition, PEA was more potent when administered locally than systemically. The cellular localisation of these CB2-like receptors and their possible structural relationship with the CB2-receptor on immune cells are unknown. Anandamide and palmithylethanolamide show a very strong synergistic effect. When injected simultaneously they inhibited the pain reaction with a potency that was 100-fold greater than each of the compounds separately. These results indicate that endogenous cannabinoid receptor ligands, in addition to their influence on pain processing in brain and spinal chord, participate in the control of pain initiation in peripheral tissues. This opens the possibility for the development of new peripherally acting drugs and gives additional explanation for the pain inhibiting effects of cannabis and the cannabinoids. (Source: Calignano, A., La Rana, G., Giuftrida, A., Piomelli, D.: Control of pain initiation by endogenous cannabinoids. Nature (1998) 394:277-281). 2. USA-Europe: US-Drug Czar weakens his criticism on Dutch drug policy After the visit of the United States' top drugs adviser General Barry McCaffrey in the Netherlands on 16 July Dutch officials said that the exchange of ideas on policy was useful. But they said Dutch and U.S. views on drugs remained far apart. McCaffrey had visited Sweden first. There he praised Sweden's drug policies, where no differentiation is made between soft drugs, such as marijuana, and cocaine and heroin, while he called Dutch policy a "disaster". "The murder rate in Holland is double that in the United States. The per capita crime rates are much higher than the United States," McCaffrey told a press briefing in Stockholm on 13 July. Sweden was the first part of a European tour which included the Netherlands, Austria and Switzerland. McCaffrey attacked the Swiss drug policy as well, saying the Swiss addiction rate was much higher than that of the United States or anywhere else in Europe. After a closer look at the Dutch policy, he weakened his criticism and talked about "a strong feeling of partnership" with his hosts. "I walk away from this visit with some things that I think will assist us in developing a more sensible American drug policy," McCaffrey told reporters. The Dutch pointed out that his former statements concerning crime rates in the Netherlands were based on incorrect data. But McCaffrey has not apologized for the error, arguing the figures came from Interpol. Els Borst, health minister in the outgoing government, had dinner with McCaffrey and said the drugs tsar had been more amenable to open discussion than she had expected. But McCaffrey refused to accept some of facts on the results of Dutch drugs policy, she said. The Netherlands argues there should be a strict separation between hard and soft drugs policy. It tolerates the small-scale production and sale of soft drugs but actively discourages the abuse of hard drugs. Addiction to hard drugs like heroin is less common in the Netherlands than in other countries, according to the Dutch. McCaffrey, who refused to visit a coffee shop, argued the toleration of soft drugs was dangerous. (Sources: Reuters of 13 und 17 July 1998, AP of 14 und 16 July 1998) 3. News in brief ****Science: Clinical trials have shown that high doses of cannabis can induce schizophrenic-like symptoms like paranoia and delusions in otherwise healthy individuals, a psychiatrist said at a Glasgow conference on 15 July. Dr Cyril D'Souza, assistant professor of psychiatry at Yale University School of Medicine, and colleagues also tried to find out why schizophrenic patients use cannabis. "Even though it actually worsens the symptoms there is a lack of commensurate increase in anxiety or distress and as THC disrupts memory, subjects may also forget the negative aspects of the experience." (Source. PA News of 15 July 1998) ****USA: A federal indictment unsealed in Los Angeles on 24 July accuses leading medical marijuana advocates of conspiring to cultivate large amounts of marijuana for commercial sale. The nine-count indictment names Todd McCormick and best-selling self-help author Peter McWilliams. The alleged conspirators intended to distribute the marijuana to California Buyers' Clubs for medical purposes according to the Los Angeles Times. Federal law enforcement agents arrested McCormick in 1997 after finding thousands of marijuana plants growing on the premises. (Source: UPI of 24 July 1998, NORML of 24 July) ****Australia: From 1 September, Victorians found with less than 50g of cannabis could choose to be cautioned by police instead of facing court. Health Minister Michael Moore of the Australian Capital Territory (ACT) said the move appeared to be in line with the territory's thinking that drug-taking should be treated as a health problem. Besides Victoria some other Australian states use caution systems, ACT, South Australia, and the Northern Territory. A 12-month trial of a cannabis cautioning system resembling the Victorian model was introduced in Tasmania in July. (Sources: Australian AP of 7 and 8 July 1998) ****Canada: The London Cannabis Compassion Centre has quietly opened the doors to its first medical marijuana buyers' club. Although there is no sign on the storefront, police indicated they know it's there and said they'll move in at the right time. Mike Harichy, who manages the pot outlet, said generally the centre's 40 or so clients don't come in to pick up their marijuana. "Most of our customers aren't well enough to come in. So I deliver to them," said Harichy. The centre accepts clients with HIV, AIDS, cancer, multiple sclerosis and epilepsy, among other conditions. They must provide a doctor's letter of diagnosis. Last February, a Toronto buyers' club announced it was opening seven Ontario locations. (Source: London Free Press of 19 July 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 9 August 1998 ------------------------------------------------------------------------------- * ICRS (I): 1998 Symposium on the Cannabinoids of the ICRS * ICRS (II): Marihuana in spinal cord injury * Great Britain: Research with inhaled cannabis to start next year 1. ICRS (I): 1998 Symposium on the Cannabinoids of the ICRS About 185 members of the ICRS (International Cannabinoid Research Society) and some other interested held their eight annual meeting from 23 to 25 July in La Grande Motte, France. The ICRS has been founded in 1991 as International Cannabis Research Society and renamed into International Cannabinoid Research Society in 1995. Most of the scientists of different disciplines who deal with cannabis and the cannabinoids are members of the ICRS. In three days the participants of the meeting mastered an extensive program of about 75 short lectures, each of which lasted about 15 minutes. Furthermore there were about 50 posters with more research results. Most of the presentations consisted of cellular and animal research. The topics of the symposium were cannabinoid receptors and endocannabinoids, effects on the immune system, on the brain, on reproduction hormones and development, dependence and tolerance, pain, therapeutic potential and others. A part of it has already been published in journals in recent months, as e. g. the observation of a possibly brain cell protecting effect of THC and CBD in stroke and head trauma (ACM-Bulletin of 12 July 1998) and the involvement of endocannabinoids in peripheral control of pain (ACM-Bulletin of 26 July 1998). Professor Raphael Mechoulam from Hebrew University has been elected as new President of the ICRS. 2. ICRS (II): Marihuana in spinal cord injury At the ICRS Symposium American scientists presented results of an anonymous survey among patients with spinal cord injury who consumed cannabis. A questionnaire, consisting of 10 pages and 35 questions with multiple sub-questions, was mailed out via an intermediate bulk mailing to the Alliance for Cannabis Therapeutics (ACT) of the USA. Of the 190 mailed questionnaires 106 were returned as valid. Those were the basis of the following results. 87% were male and 13% were female with a mean age of 40 years (range: 18 to 61 years). 73% were completely or mostly confined to a wheelchair. In 66% the only cause of disability was SCI (spinal cord injury), in 13% SCI and another cause, and in 21% non-SCI causes. All patients had taken various antispastic and analgesic medications, and many of them reported a lack of efficacy or side effects. Patients smoked marijuana for an average of 12 years, a mean of 4 marijuana cigarettes per day, mostly to relieve symptoms. Over 70% of patients took marijuana together with their other spasmolytic and analgesic medications. 82% reported that symptoms worsened when stopping their use of cannabis. Improvement with marijuana was reported from 99% to 70% of patients (in descending order) for spasms of legs, arms and bladder, muscle and phantom pains, headache, urinary urgency, and paralysis. In less than 70% improvement was noticed for other bladder dysfunctions, bowel dysfunctions, weakness, and paresthesias. "The results indicate that SCI patients have specific therapeutic reasons for smoking marijuana," the abstract says. (Source: Consroe P, et al: Reported marijuana effects in patients with spinal cord injury. 1998 Symposium on the Cannabinoids, Burlington, Vermont, International Cannabinoid Research Society, p 64.) 3. Great Britain: Research with inhaled cannabis to start next year About two dozen patients will legally be allowed to inhale cannabis next year at the start of a large-scale study into the drug's medicinal effects. The initial phase one trial will test tolerability and dose levels. The trials are being conducted by GW Pharmaceuticals, which has been licensed by the Home Office to grow cannabis plants for research. The patients will not smoke the drug. Instead they will breathe in carefully controlled amounts of cannabis vapour from specially designed inhalers. Patients in the pilot study are likely to suffer from multiple sclerosis, spinal cord injuries and phantom pains. Some will already have experience of cannabis while others will be taking the drug for the first time. The cannabis used will be highly potent seedless varieties, containing large amounts of THC (tetrahydrocannabinol) and CBD (bidiol). Seeding is about to begin at GW Pharmaceuticals' 4 million greenhouse complex at a secret location in the south of England, protected by high security, and containing up to 20,000 cannabis plants. On 27 July, Dr. Geoffrey Guy, chairman of GW Pharmaceuticals, gave evidence to the House of Lords Science and Technology Select Committee, which is investigating the possible therapeutic applications of cannabis. Asked about synthesizing the chemicals found in the plant in order to produce a safe medicine, he said, "I don't see the value in taking apart something that seems at the moment to work." To applique the drug he is favouring "something between an aerosol and a vaporizer." There were, however, people who claimed the effects of cannabis lasted longer if they ingested it orally. Guy hopes the drug would be licensed as a medicine within five years. By that time his company will have spent around 10 million on cannabis research. Guy has also invested in the Dutch medicinal marijuana breeding company HortaPharm BV, which has the biggest "living library" of marijuana plants in the world. Home Office officials said before the House of Lords subcommittee that they are making arrangements with the Department of Health and the Medicines Control Agency (MCA) for a conference to discuss aspects of research licensing with representatives of the research community. The aim would be to highlight some of the complex issues involved such as the supply of standardised cannabis and the adoption of sound methodologies. The Medical Research Council said that it would consider special treatment for clinical trials. If and when the benefits of a cannabis based medicine had been scientifically proved and a marketing authorisation issued by the MCA, the Home Office said that it would be willing to come forward with a change in the law to allow the prescribing of such a medicine. (Sources: PA of 27 July 1998, Guardian of 28 July 1998, British Medical Journal of 1 August 1998) 4. News in brief ****USA: A citizens initiative to legalize the use of marijuana for medicinal purposes will appear on the statewide ballot in November in Washington state and in Nevada. State election officials said they had certified enough signatures as valid. Washington's Initiative 692 and the Nevada proposal seek to exempt seriously ill patients from state criminal marijuana penalties if they use marijuana under the supervision of their physician. State officials in Alaska and Oregon previously certified similar initiatives for the November 3 ballot. (Sources: NORML of 6 August 1998, Los Angeles Times of 31 July 1998) ****New Zealand: Dr. Nick Judson, the Ministry of Health's deputy director of mental health, told a parliamentary select committee that cannabis caused fewer problems than tobacco and alcohol. The committee is holding an inquiry into the mental health effects of cannabis and will report to Parliament and make recommendations to the Government. Judson said, that people who occasionally used cannabis had few health problems. Long-term and heavier users could suffer subtle cognitive impairment. Research had not shown that cannabis use damaged the brain structure. Cannabis did not cause schizophrenia, but it might trigger the illness in people at risk. Dr John Marks, who heads Capital Coast Health's drug and alcohol unit, told the committee that cannabis use caused no significant harm. Studies of cannabis, dating back to the last century, had all exonerated the drug. It was therapeutic for diseases such as glaucoma, multiple sclerosis, cancer and HIV. (Sources: NZ Herald of 30 July 1998, Evening Post of 30 July 1998, The Dominion of 30 July 1998) ****Great Britain: An international symposium, titled "Regulating cannabis - options for control in the 21st century", will take place on 5 September in London, organized by The Lindesmith Center/USA and Release/Great Britain. The symposium intends to bring together leading experts from Europe, Australia and North America in the fields of science, jurisprudence, sociology and government to examine recent experiences and possible options for regulating the world's most popular illicit drug. More information: Mireille Jacobson at the Lindesmith Center (mjacobson@sorosny.org) or Vicki Charles at Release (info@release.org.uk). (Source: Lindesmith Center) ****Canada: Stephen Jay Gould told a judge in Ontario General Division Court about his experience with marijuana, which helped him to survive cancer. Geologist Gould's books crowd best-seller lists, he holds 40 honorary degrees, and in legendary lectures that combine poetry with the study of ancient fossils, he has taught generations of Harvard students how life evolved on Earth. Gould was one of the first people on earth to beat a rare and incurable cancer called abdominal mesothelioma, thanks to surgery, radiation, years of torturous chemotherapy and marijuana. He is one in a chorus of patients and experts whose stories and studies were heard before the court, where Jim Wakeford, a 53-year-old Toronto AIDS patient, is suing the federal government for the right to smoke marijuana as part of his medical treatment. The medical experts include Lester Grinspoon, professor of psychiatry at Harvard Medical School. (Source: Ottawa Citizen of 5 August 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 23 August 1998 ------------------------------------------------------------------------------- * South Africa: THC preparation Elevat and discussions about the legalization of dagga * Switzerland: Acquittal in case of cannabis use for medical purposes * USA: Staff of Cannabis Buyers' Club designated as city agents * ICRS (III) More from the meeting of the International Cannabinoid Research Society on 23 to 25 July in France 1. South Africa: THC preparation Elevat and discussions about the legalization of dagga A South African multinational company has put into the market a drug that contains the psychotropic compound of the cannabis plant, THC resp. dronabinol. The brand Elevat owned by Pharmacare is the second legal THC preparation besides Marinol which is manufactured in the USA by Unimed Pharmaceuticals. Unlike Marinol that contains synthetic THC, the dronabinol for Elevat is extracted from the hemp plant. Already in 1993, South African Druggists (which trades as Pharmacare) patented dronabinol. The Drugs and Drug Trafficking Act was quickly amended to exclude dronabinol. Elevat can only be prescribed by a doctor. It limits the side-effects of chemotherapy and stimulates the appetite of AIDS patients. According to Pharmacare the dronabinol for Elevat is imported from an unspecified "overseas country". Commentators say it is ironic that South Africa - almost as rich in high-quality dagga (the South African name for marijuana) as it is in gold - imports the drug. Local production could make Elevat cheaper and more widely available. According to the US Drug Enforcement Agency the illicit South African sales of dagga are said to be worth some $18-billion a year. Reports suggest that the illegal trade in dagga is twice that of the legal liquor industry. South Africa is the world's leading marijuana producer, ahead of countries like Mexico, the US and Colombia. Lawyer and drug researcher Jenny Wild argues that dagga must be legalised so that farmers can benefit from the existing and potential pharmaceutical demand. The human rights commission's Helen Suzman says that poor governments (like South Africa's) are spending valuable resources on an impotent fight against drugs while they could be earning revenue from cannabis. The Pharmaceutical Manufacturers Association disagrees: "Our position will be to oppose the legalisation of dagga. We will be very concerned about the blatant legalisation of habit-forming drugs. Sure, we make money from it [drugs like Elevat]. But it is only organised crime that makes big money out of its sale." Dr. Helen Rees of the Medicines Control Council (MCC) says: "The scheduling of drugs is meant to control but not to stop people accessing the drug." She says the abuse potential means that dronabinol will always be treated with care, but that if approached with a credible proposal for medical research and development, the MCC would "seriously consider" it. (Source: Comtex Newswire of 14 August 1998) 2. Switzerland: Acquittal in case of cannabis use for medical purposes The district court of Sense acquitted a man who self-reportedly used marijuana as a medicine. One year ago, on 18 September 1997, the police confiscated 6 kilograms of cannabis. The owner was ordered to pay 1,000 Swiss francs (about $1,500), "because of the consumption and possession of marijuana". The prosecutor spoke of an exceeding of the "allowed THC content". The accused appealed. He had used the cannabis for the therapy of his asthma, only. He pointed out that in Switzerland there are no THC limits for hemp and that every Swiss is allowed to produce his own remedy for personal use. There were no legal limitations concerning the composition of these remedies. The narcotic act dealt exclusively with the handling of remedies manufactured for the public. The district court followed this argumentation and abrogated the punishment. The private medical use of hemp was not forfeitable. Besides Switzerland also the small principality Lichtenstein has laws that - unique in the world - warrant this practice. (Source: ots, Verein Schweizer Hanffreunde (Club of Swiss Friends of Hemp) of 18 August 1998) 3. USA: Staff of Cannabis Buyers' Club designated as city agents At a ceremony at Oakland City Hall on 13 August, officials proclaimed staff of the Oakland Cannabis Buyers' Cooperative to be "officers of the city". With this new move in the fight for a legal access to medical marijuana it is intended to shield the staff of the club that is distributing the drug to some 1,800 people from federal prosecution. "The Oakland Cannabis Buyers' Cooperative runs a clean, legitimate business, contributes to Oakland's downtown revitalization, and prevents seriously ill people from turning to the streets to buy their medicine," said Vice Mayor Nate Miley, who chairs the city council's Public Safety Committee. "We're delighted to offer the cooperative all the support we can, and hope that other cities will follow suit." Robert Raich, an attorney for the club, said designating staff as city agents will protect them under the Controlled Substances Act of 1970, which gives immunity from federal and criminal liability to agents enforcing an ordinance relating to controlled substances. Federal prosecutors are moving to shut down the Oakland club, along with several others which sprang up after voters approved Proposition 215, the medical marijuana initiative, in November 1996. This spring, a federal judge ruled the initiative did not override federal law against distributing marijuana. A number of northern California medical marijuana clubs have folded already under the legal pressure. "This designation will permit the Oakland Cannabis Buyers' Cooperative to distribute medical cannabis within federal law," said Professor Gerald Uelmen of the University of Santa Clara School of Law. But it is unclear whether it will ultimately protect the cooperative from criminal prosecution. Federal officials had no immediate comment on Oakland's move. "We're aware of the decision, and we are in the process of reviewing it," said Gregory King, a spokesman for the Justice Department. Oakland officials said, however, they were aware that the city's effort to protect the cannabis club might not stop the federal suit: "If that's not good enough, we'll go the next step. And maybe then everybody at the club will receive a City of Oakland paycheck." (Sources: Reuters of 13 August 1998, AP of 14 August 1998, Orange County Register of 14 August 1998, Boston Globe of 14 August 1998) 4. ICRS (III) More from the meeting of the International Cannabinoid Research Society on 23 to 25 July in France (1) Cannabinoids potently and selectively inhibit human breast cancer cells. In cellular experiments the endogenous cannabinoid anandamide dose-dependently inhibited the proliferation of human breast cancer cells of different lines. The other endogenous cannabinoid 2-arachidonoylglycerol (2-AG) and the synthetic cannabinoid HU-210 were active as well. The growth of several other non-mammary tumoural cell lines was not affected. The cytostatic effect of anandamide was inhibited by the cannabinoid receptor antagonist SR141716A. (Di Marzo et al.). (2) Delta-9-THC enhances the analgesic effects of opiates. It was demonstrated in animal studies with mice, that THC enhances the pain relieving effects of the opiates morphine, codeine, methadone, oxymorphone, and hydromorphone. The cannabinoid receptor antagonist SR141716A blocked the enhancement of morphine analgesia by THC. Different opiate antagonists showed varying effects. More studies are aimed to examine whether low doses of THC decrease or prevent morphine tolerance. These studies might have important consequences for the improvement of pain therapy. (Cichewicz and Welch). (Source: 1998 Symposium on the Cannabinoids, Burlington, Vermont, International Cannabinoid Research Society, Abstracts. ) 5. News in brief ****Science: Writing in the American Journal of Psychiatry, genetic influences play a major role in explaining why some women become hooked on marijuana, Dr. Kenneth S. Kendler and colleagues say. The study looked at 1,934 twins, interviewed to assess lifetime cannabis use. It says, that "in women, genetic risk factors have a moderate impact on the probability of ever using cannabis and a strong impact on the liability to heavy use, abuse and probably dependence. By contrast, the family and social environment substantially influence risk of ever using cannabis, but play little role in the probability of developing heavy cannabis use or abuse." (Source: UPI of 3 August 1998) ****Australia: West Australia wants to introduce a cautioning system for marijuana users found with less than 50 grams of cannabis for the first time instead of sending them to court. The new policy will take effect on 1 October on a trial basis in two police districts and will be extended state-wide in case of success. West Australia is following the states of Victoria, Australian Capital Territory, South Australia, Northern Territory and Tasmania, that have undertaken similar moves. (Sources: NORML of 20 August 1998, Australian AP of 8 July 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 6 September 1998 ------------------------------------------------------------------------------- * Great Britain: International conference on cannabis * Australia: Prospect of government-regulated sale of marijuana 1. Great Britain: International conference on cannabis More than 150 cannabis experts from around the world gathered on 5 September in Regent's College in London to turn over a new leaf in the marijuana discussion. The Lindesmitb Center and Release had invited representatives from all sides of the debate. The conference allowed policy makers and advisers to compare different methods of regulating the drug in different countries, the coffee shop system in Holland, the medical marijuana law in California and the hardline approach in countries like Germany. The main form of regulation discussed at the conference was the Californian model, in which recognised "buyers clubs" are allowed to supply cannabis to those who need it for medical reasons. "This conference marks an historic turning point in the cannabis debate, with implications for drug policies around the globe," said Mike Goodman, director of Release. "We expect the debate to shift away from 'should it be decriminalised' to how cannabis should be regulated responsibly," he said. "The public is demanding legal access to cannabis for therapeutic and other responsible uses and we plan to advise them on how the drug can best be regulated," said Ethan Nadelmann, director of the Lindesmith Center. The Lindesmith Center with offices in New York and San Francisco is a drug policy research institute founded in 1994 as a project of the Open Society Institute, a private foundation that encourages public debate and policy alternatives in complex and often controversial fields. Release is the UK based drugs and legal advice charity which was founded in 1967. The organisation's range of innovative services, pioneering work with young people as well as its commitment to the civil rights of drug users, has contributed to its unique credibility in the drugs and legal advice field. (Sources: PA News of 5 September 1998, Australian AP of 5 September 1998, Lindesmith Center) 2. Australia: Prospect of government-regulated sale of marijuana The prospect of the government-regulated sale of marijuana appears closer to being placed on the agenda of state and federal governments, according to some of Australia's most influential advisers on drug policy. In an interview on the fringes of the conference on cannabis in London, Professor David McDonald of the Australian National University said that there was a growing body of opinion amongst Australians, as seen in recent opinion polls, that total prohibition of cannabis may not be the best approach to regulating the drug. "We now have the situation in Australia where there is a huge cannabis market but it is not regulated by government," he said. "But here we are talking about government getting control of the market in the interest of the people and in the interest of the government, through taxation." Opinion polls showed Australians were not necessarily in favour of completely legalising marijuana, but that more than three quarters of the population was in favour of "dealing with it in another way". "What we have not got in Australia is a clearly thought-through range of other ways of dealing with cannabis," McDonald said. Robert Ali, chairman of the Australian National Illicit Drugs Expert Committee, said that "nationally there is a lot of interest in looking at alternative models" for the regulation of marijuana. He said, however, that greater research into the medical benefits of marijuana must be undertaken before federal and state governments could look at following the Californian model. (Source: Australian AP of 5 September 1998) 3. News in brief ****Germany: About 50,000 participants of the HANFPARADE'98 on 31 August in Berlin demanded the legalization of hemp for all purposes, as a recreational drug, for medicinal use and for the production of fibre and seeds. Speakers at the final manifestation said that the repressive policy towards marijuana use has failed and is more harmful than the use of marijuana itself. ****USA: Use of marijuana and other drugs among adolescents has not increased in California since the passage of Proposition 215, according to data released on 21 August by the government's National Household Survey on Drug Abuse. Among youth age 12 to 17, less than seven percent of Californians reported using marijuana monthly versus ten percent nationwide. Proposition 215 allows the medical use of marijuana since November 1996. Opponents feared that marijuana use would increase. (Source: NORML of 27 August 1998) ****Great Britain: Many young British doctors drink much alcohol and use cannabis and other illegal drugs, according to a survey of the University of Newcastle released on 4 September. The poll of 114 junior doctors in north-eastern England, published in a letter in The Lancet medical journal, showed that more than 60 percent drank more alcohol than the recommended safe limits. Over 35 percent of male doctors and 19 percent of female physicians also admitted using cannabis. The British Medical Association said the findings were consistent with its own research. (Source: Reuters of 4 September 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 20 September 1998 ------------------------------------------------------------------------------- * USA: House against the medical use of marijuana * Canada: Judgments in Vancouver and Toronto 1. USA: House against the medical use of marijuana By a vote of 310 to 93 the House of Representatives approved a resolution on 15 September declaring its opposition against the legalization of marijuana for medicinal use. The high number of noes surprised the majority of Republicans. In a forty minute debate seven Democrats and one Republican spoke against the resolution. Joint House Resolution 117 expresses a "sense of the Congress ... [in] support of the existing federal legal process for determining the safety and efficacy of drugs, and opposes efforts to circumvent this process by legalizing marijuana." It is a response to initiatives in several states for the possibility of using marijuana to treat symptoms of severe illnesses. The resolution was sponsored by Rep. Bill McCollum, chair of the House Judiciary Committee's crime panel. He said that state efforts to circumvent federal anti-drug laws are "a backdoor way of legalizing marijuana" and were sending the wrong message to teen-agers and the nation as a whole. But Rep. Henry Waxman said the resolution was a slap at his state. He said supporters of the measure "think we should just say no to sick and dying patients because it looks like we're getting tough on drugs." Longtime supporter for medical marijuana reform, Rep. Barney Frank, criticized the resolution for failing to separate the medical use of marijuana from the issue of recreational drug use. Such a policy diminishes the credibility of our nation's overall anti-drug campaigns, he argued. NORML Executive Director R. Keith Stroup voiced a mixed reaction to the vote. "On the down side, this vote demonstrates how out of touch Congress is with the American people on this issue," he said. "On the positive side, we now have a significant base of support for medical marijuana on which to build in the next Congress." (Sources: San Francisco Examiner of 16 September 1998, Orange County Register of 16 September 1998, NORML of 17 September 1998) 2. Canada: Judgments in Vancouver and Toronto Stanley Czolowski, a 44 year old man from Vancouver, received a conditional discharge -- no jail sentence, no fines -- for using and selling marijuana for health purposes. He must agree to "keep the peace" for one year. He used marijuana to treat problems of glaucoma and sold his home-grown pot to the local cannabis club -- police estimate the value of his plants at up to $50,000 -- although Czolowski disputes the figure. Czolowski is not happy about the mild ruling: "I live basically a life of poverty. I'm struggling to keep my head above water, and cannabis has always helped me with my situation ... it's difficult now." Judge Jane Godfrey said: "I have no difficulty whatsoever in understanding his personal motivation and I have extreme sympathy for his personal situation." Down at the Compassion Club that distributes pot to ill people the ruling is being greeted with joy. But the decision shocked Vancouver RCMP Sgt. Chuck Doucette, the provincial co-ordinator with the force's drug-awareness program. "I can understand a judge being supportive, but it's another issue altogether when he's selling to other people," said Doucette. "It [trafficking] is clearly against the present Canadian laws." The second judgement was made in Toronto. Jim Wakeford, a 53 year old man with AIDS, has lost a bid on 8 September to have an Ontario court exempt him from the law controlling the use of marijuana. "I feel that the government has deprived me of my constitutional right to use marijuana as medicine to deal with AIDS," Wakeford said at a press conference on 9 September. Justice Harry LaForme said that while the law does infringe upon Wakeford's Charter rights of both his "liberty" and "security of the person" -- those infringements are in accordance with the "principles of fundamental justice." "The infringement is not unconstitutional because the judge believes that there is a provision available in the CDSA [Controlled Drug and Substance Act] to obtain lawful access to marijuana," Wakeford's lawyer, Alan Young, said. That mechanism is a little-known special application directly to the federal minister of health for an exemption. Young says Wakeford plans to make the application. (Sources: The Province of 9 September 1998, Toronto Sun of 10 September 1998) 3. News in brief ****USA: The voters of Colorado will decide whether to legalize marijuana for medical use in November. The Colorado initiative seeks to allow seriously ill patients who have a doctor's recommendation to possess up to two ounces of marijuana or grow three plants for medical use. Similar initiatives are expected to be on the November ballot in Alaska, Colorado, Nevada, Oregon and Washington, and possibly the District of Columbia. (Sources: San Francisco Examiner of 16 September 1998, NORML of 17 September 1998) ****Germany: The costs for a therapy with Marinol have not to be paid by the health insurances. "Drugs not approved in Germany do basically not belong to the catalogue of the health insurances," the Ministry of Health told the Association for Cannabis as Medicine in a letter. Since 1 February 1998 the active principle of the hemp plant, THC or dronabinol resp., can be prescribed by doctors in Germany, but there is no preparation on the European market. The THC-medicament Marinol may be imported from the USA by pharmacies. (Source: Letter of the Ministry of Health to the ACM on 14 September 1998) 4. THE COMMENT ... on the resolution of the US-Congress on 15 September: "What this resolution is saying is that we are willing to allow patients to suffer excruciating, debilitating conditions so as to not send a signal to others who might wish to use marijuana recreationally. (...) With all due respect, I do not believe that anyone who has watched an AIDS or cancer patient suffer ... could make such a statement. That is not the signal that we want to send." William Delahunt, Member of the US Congress ------------------------------------------------------------------------------- ACM-Bulletin of 4 October 1998 ------------------------------------------------------------------------------- * Germany: Petition Committee of the House of Representatives of Berlin supports cannabis as medicine * Science: Pain circuit in the brain is influenced by cannabinoids * Switzerland: Federal Department of Health proposes exemption from punishment 1. Germany: Petition Committee of the House of Representatives of Berlin supports cannabis as medicine The Parliamentary Petition Committee of the House of Representatives of the State of Berlin unanimously endorsed the medical use of cannabis on 29 September. The resolution follows a petition submitted by the Self Help Group Cannabis as Medicine in Berlin and the parliamentary group of the Greens on 25 March 1998. The petition committee consists of members of all parties of the State Parliament of Berlin, the Christian Democrats (CDU), the Social Democrats (SPD), the Party of Democratic Socialism (PDS) and the Green Party. "The first step is taken towards the establishment of the natural product cannabis as a medicine," Dietmar Volk from the Green Party, member of the petition committee, said. Speakers of the self help group and of the Association for Cannabis as Medicine (ACM) welcomed the resolution. Dr. Franjo Grotenhermen, chairman of the ACM, said: "What is most encouraging is the fact, that the petition has been supported by the members of all parties. This increases the chance for a realistic and all party treatment of the topic on the federal level of politics as well." The petition says: "In addition to the burden of a chronic or incurable disease, we have to endure the consequences of the general prohibition of the marijuana plant." It demands the support of clinical research, the possibility to obtain natural cannabis products and single cannabinoids on prescription in every pharmacy, and the possibility to grow marijuana with a physician's approval. Prior to the resolution, the petition committee requested statements from the Federal Institute for Drugs and Pharmaceutical Products (comparable to the FDA in the USA) as well as from the Medical Association of Berlin. In its statement the Medical Association pointed out that even though synthetic THC can be prescribed legally in Germany since February 1998, the compound has to be imported from abroad through a procedure lasting several weeks. Furthermore, the preparation is very expensive with monthly treatment costs of several thousands of Marks, that have not to be reimbursed by the health insurances. According to Dietmar Volk, the Petition Committee of Berlin is now going to get the Federal Petition Committee involved: "We hope that a political party will start a legal initiative to legalize the substance and to have it available in every pharmacy." (Sources: Berliner Zeitung from 30 September 1998, TAZ from 1 October 1998, personal communications) 2. Science: Pain circuit in the brain is influenced by cannabinoids A pain suppressing circuit in the brainstem, that plays a major role in the pain mitigating effects of opioids, is activated by cannabinoids as well. This was demonstrated in a study conducted by scientists of the University of California in San Francisco, published in Nature on 24 September. Cannabinoid receptors are, among others, found in brain regions that have a great importance for pain perception, among them the so-called rostral ventromedial medulla (RVM) in the brainstem. The RVM contains so-called 'off' and 'on' nerve cells. 'Off' cells inhibit the transmission of pain signals from the spinal cord to the brain and show a pause in activity in case of peripheral pain stimuli. Conversely, 'on' cells facilitate pain transmission and show a burst of activity following pain stimuli. It is well-known that the powerful pain suppressing opioids act by eliminating the 'off' cell pause and the 'on' cell burst. Ian D. Meng and colleagues revealed that cannabinoids act in the same way, but using a different mechanism on the cellular level. Furthermore, inactivation of the RVM prevented the pain inhibiting effect but not the effect on movements produced by cannabinoids. The researchers used the synthetic cannabinoid WIN55,212-2. Like THC it acts on the cannabinoid-1-receptors in the brain, causing the same effects as the natural cannabis compound. Measurements of activity of nerve cells in the RVM of rats, that had received a standardised pain stimulus, demonstrated that the cannabinoid showed the same action on the 'off' and 'on' cells as morphine. However, morphine and WIN55,212-2 acted through different receptors. Simultaneous administration of a cannabinoid antagonist inhibited the cannabinoid effect, but not the effect of morphine. Administration of an opiate antagonist inhibited the morphine effect, but not that of WIN55,212-2. "Given their unique side effect profile (for example, cannabinoids increase appetite, whereas opioids can cause nausea and respiratory depression) cannabinoids may be useful in the treatment of pain," the Nature article says. (Source: Meng, I. D., Manning, B. H., Martin, W. J., Fields, H. L.: An analgesia circuit activated by cannabinoids. Nature (1998) 395:381-383) 3. Switzerland: Federal Department of Health proposes exemption from punishment The Federal Department of Health (BAG, Bundesamt für Gesundheit) proposes two versions for the revision of the narcotics act. One provides for the total exemption from punishment for the use of cannabis as well as for heroine and cocaine. Pursuant to the other punishment would be retained, exceptions admitted. Production and sale will be forbidden in both variants. The department had the opinion that with regard to punishment all substances should be treated equally, Thomas Zeltner, Director of the BAG, told the "SontagsZeitung". General legalization of cannabis including production and sale is objected by the BAG. The second model wants to retain punishment but define more exactly, in which cases punishment could be remitted. Clear guide lines should lead to a uniform jurisdiction. Courts should have discretion to refrain from punishment in case of possession of small amounts of drugs. The Working Group Drug Policy of the Upper House of Parliament proposes to test the exemption from punishment in some cities first. In the opinion of Marie-Louise Baumann from the secretariat of the Working Group such an intermediate step is necessary to achieve a majority for liberalisation. The proposals of the BAG for the revision of the narcotics act now go to the Upper House of Parliament. On 29 November the people will vote on the "Droleg-Initiative", a referendum demanding general legalisation. (Source: sda/rk of 20 September 1998) 4. News in brief ****Science: Dexanabinol (HU-211), a synthetic non-psychotropic THC-derivative with neuroprotecting properties, might neutralize the damaging effects of nerve-gas. The substance is studied by Pharmos Ltd., an Israeli biotechnology concern, and U.S. military scientists. So far the compound is regarded as a possible new medicament in the treatment of brain trauma and stroke. A test sample of 67 head-trauma victims treated with the drug has shown encouraging results. The Pentagon is aggressively pursuing antidotes and vaccines to protect troops from seizures that accompany nerve-gas and biological attacks. In a study brain damage to lab rats exposed to nerve gas and treated with dexanabinol five minutes later was reduced by 75%. (Source: Dow Jones of 28 September 1998) ****Germany: About 6,500 people visited the "CannaBusiness'98" from 25 to 27 September in Hennef near Cologne. Again the exhibitors on the worlds largest hemp fair presented manifold products from industrial hemp like clothes and food from pasta till hemp ice, as well as products for the recreational use of marijuana like pipes and lighting systems for cultivation. Parallel there were lectures about hemp economy, cannabis as medicine and cannabis as a drug/legal issues. ****Science: Dr. Lester Grinspoon and Co-author William Novak are planning a book about Uses of Marijuana. They hope to hear from articulate recreational and medical users about the ways they find marijuana beneficial (enhancing, therapeutic, etc.). Selected contributions will be included in their book. Anonymity is available upon request. The following website offers guidelines for authoring of contributions as well as some examples of previous submissions: http://www.marijuana-uses.com/. Contributions can be sent by mail to: GrinspL@warren.med.harvard.edu 5. THE COMMENT ... on the marijuana initiatives on the November ballot in some states of the USA: "Physicians who prescribe morphine to relieve intense pain are not seen as promoting drug addiction, even though morphine is a terribly addictive drug. Yet a proposal to allow doctors to prescribe marijuana is criticized as promoting drug abuse, even though marijuana is far more benign than many widely accepted prescription drugs. Oregonians should understand that they can support humane medical practices without undermining efforts to control dangerous drugs." Olafur Brentmar, Editorial, The Register-Guard (Oregon) of 26 September 1998 ------------------------------------------------------------------------------- ACM-Bulletin of 18 October 1998 ------------------------------------------------------------------------------- * USA: Federal judge orders to close down the Oakland Cannabis Club * Switzerland: Judge ruled selling of cannabis in aroma sachets illegal 1. USA: Federal judge orders to close down the Oakland Cannabis Club In a surprise injunction, a federal judge on 13 October ordered the Oakland Cannabis Buyers' Cooperative to close for violating federal narcotics laws. Two other clubs in California are still struggling to distribute the drug under the terms of California's 1996 state law that legalized medical marijuana use are under similar pressure. The order to close the Oakland club came as a particular blow. Boasting some 2,000 members and bright, downtown offices that resemble a pharmacy, the Oakland cooperative has been repeatedly praised by health officials as one of the most responsible marijuana distribution organizations. In a news conference, Oakland city officials and patients of the cooperative said U.S. District Judge Charles Breyer's decision against the club would have a devastating effect. "Closing the cooperative will force patients with AIDS, cancer and other debilitating diseases to turn to street dealers for the medicine they need," said Oakland City Council member Nate Miley. Breyer, while noting that closing the club would likely cause "human suffering," said club lawyers had failed to demonstrate that enforcing a federal ban on marijuana distribution would violate the constitutional right of sick people to relieve pain -- a cornerstone of the medical marijuana movement's legal strategy. Lawyers for the club said they would appeal. Ten of the original 13 clubs have already closed under federal pressure. The Oakland Cannabis Buyers' Cooperative will have to close on 19 October. Jeff Jones, the club's executive director said: "Whatever happens Monday, I will continue in my efforts to implement Proposition 215 and ensure our patients have access to this critical medicine." (Sources: Washington Post of 15 October 1998, Reuters of 15 and 17 October 1998, AP of 17 October 1998) 2. Switzerland: Judge ruled selling of cannabis in aroma sachets illegal A Zurich district judge ruled on 16 October that selling cannabis in aroma sachets, long in legal limbo, was clearly against the law. The ruling in a test case, although likely to be appealed, could spell the end of a three-year boom in marijuana selling in Switzerland based on an apparent loophole in the wording of the law. "It is quite clear that cannabis is a narcotic and falls under the narcotics law," Zurich district judge Thomas Meyer told a courtroom packed with friends of shop owner Bruno Hiltebrand and supporters of legalising marijuana. Consumption of drugs made from the hemp plant is illegal in Switzerland, as in most countries, but hemp enthusiasts in the mid-1990s discovered what they saw as a turn of phrase that bans marijuana only if it is sold specifically as a narcotic. The Swiss law against narcotics refers only to "hemp when it is cultivated in order to produce a narcotic," not to the hemp plant as such, which is also grown for its fibre and other agricultural uses. Swiss hemp growers started selling the dried leaves and buds packed as aroma sachets and labelled "not for consumption" about three years ago, and hemp shops now number over 200, with 50 in the Zurich area alone. But judge Meyer ruled that other parts of the law and decisions by the Swiss supreme court said that dried hemp was an illegal narcotic regardless of how it is labelled. Hiltebrand was sentenced to a suspended 14 month sentence and fined 120,000 Swiss francs. "I am shocked by the sentence. I had counted on an acquittal," said 39-year-old Hiltebrand after appearing in court. Hiltebrand's lawyer said they would probably appeal, a process that could go all the way to the supreme court in one or two years. (Sources: Reuters of 16 October 1998, dpa of 17 October 1998) 3. News in brief ****Great Britain: United Kingdom Drug Czar Keith Hellawell said the use of marijuana as a medicine may be justified in some cases, according to The Daily Mail. "Mr. Hellawell's remarks were taken as a powerful hint that Ministers are prepared to back legalization if trials now underway support doctors' claims that cannabis can help those suffering from serious diseases," the newspaper said. (Source: The Daily Mail, quoted according to NORML of 8 October 1998) ****Germany: In a memorandum released on 13 October the German AIDS Help together with other associations demands the legalisation of cannabis and a controlled distribution of heroin. The dealing with drugs should be decriminalized stepwise: "The criminal law is not an instrument to regulate the use of drugs." Repression and prohibition should be replaced by factual information about benefits and dangers of drugs. Among the signers of the declaration are the Federal Association for Accepting Drug Work and Human Drug Policy, and the Society for Drug and Addiction Medicine. (Source: AP of 13 October 1998) ****USA: About 40,000 people gathered in Boston on the 3 October for the 9th Annual Freedom Rally supporting legalization of marijuana, about 10,000 more people than last year. Mushroom-shaped hats and marijuana-leaf motifs were everywhere, as was the unmistakable odour of pot. Richard Elrick, a councilman in the Cape Cod town of Barnstable, said: "Marijuana is less of a public health threat than alcohol or tobacco. I can't think of a more counterproductive way for society to spend its resources than to arrest marijuana users." (Source: AP of 4 October 1998) ****Germany: After the elections the Social Democrats and the Green Party will constitute the next government. In the coalition agreement that will be signed next week they agreed on the controlled distribution of heroin to the seriously ill. The Greens could not succeed with their claim to legalise soft drugs such as marijuana. 4. THE COMMENT ... on a federal judge's order closing down an Oakland medical marijuana club: "This reefer foolishness among state and federal drug warriors has gone on long enough. Where are the state lawmakers with the creativity and guts to set up a plan for the distribution of medical pot the voters approved two years ago?" Editorial, San Francisco Chronicle (California) of 16 October 1998 ------------------------------------------------------------------------------- ACM-Bulletin SPECIAL of 25 October 1998 ------------------------------------------------------------------------------- In the first week of December 1998 two meetings about the medical use of cannabis products will take place in Germany. FRANKFURT: "Medical Marijuana" from 2 to 4 December 1998 COLOGNE: "Cannabis and Cannabinoids as Medicine '98" on 5 December 1998 In between, in the afternoon of the 4th of December, the general meeting of the Association for Cannabis as Medicine will take place. ********* MEDICAL MARIJUANA ********* Wednesday, 2 December, 3 p.m. , until 4 December, 1.30 p.m. Congress Centre, Floor C 3, Ludwig-Erhard-Anlage 1 Frankfurt am Main Organizers: Hessian Society for Democracy and Ecology (HGDÖ) with the metropolitan AIDS support groups Cologne, Munich, Dusseldorf and Frankfurt am Main. Protector: Daniel Cohn-Bendit, Member of the European Parliament Cooperation Partners: Association for Cannabis as Medicine (ACM) European Cities on Drug Policy The congress aims at collecting the world-wide knowledge about the medical use of marijuana and the presentation of current research projects and results. The goal is to bring about an amendment to the BTMG (German Narcotics Act) and to have the medical prescription of THC products and original products taken up into accepted medical treatment. The present level of knowledge confirms the justification for a liberalization of this kind of criminal law on narcotics. The congress is aimed at physicians, health care and social workers for instance in AIDS support centres etc. It is also targeted at lawyers, politicians and practitioners in drug support programs and the staff in health authorities on the federal, regional and district levels. Congress design: Wednesday, 2 December 3.00 p.m. Opening of the conference and project exhibition 3.30 p.m. History of marihuana as a medicine Dr. Christian Rätsch 4.30 p.m. History and function of the international ban policy Prof. Dr. Sebastian Scheerer, University of Hamburg 5.30 p.m. State of the scientific debate and worldwide experiences Dr. Franjo Grotenhermen, Chairman of the Association for Cannabis as Medicine Thursday, 3 December 9.00 a.m. Greetings 9.15 a.m. Legal aspects Prof. Dr. Lorenz Böllinger, University of Bremen 10.00 a.m. Medical aspects Prof. Robert Gorter, European Institute for Oncological and Immunological Research, Berlin 10.45 a.m. Pharmacology of marijuana Dr. Roger Pertwee, International Secretary of the International Cannabinoid Research Society, University of Aberdeen 11.30 a.m. Medical Marihuana - A commentary on health policy N.N., Ministry of Health of the Netherlands (inquired) 12.15 a.m. Medical Marihuana? Never ever! A counter position N.N., WHO Expert Committee (inquired) 1.00 p.m. Lunch break 2.15 p.m. Experience/effects and clinical success with AIDS patients Dr. Dale Gieringer, NORML, California, USA 3.00 p.m. Use and experiences in pain therapy Dr. Andreas Ernst, Society of Pain Therapists 3.30 p.m. Break 4.00 p.m. Working groups Use in multiple sclerosis Prof. Dr. Rudolf Brenneisen, University Bern and Dr. Ulrike Hagenbach of REHAB Basel self help group Use in AIDS and cancer (chemotherapy), Dr. Dale Gieringer and Prof. Robert Gorter, Friday, 4 December 9.00 a.m. State of debate in the USA Dr. Lester Grinspoon, Harvard Medical School 10.00 a.m. State of debate in the UK Dr. Geoffrey Guy, GW Pharmaceuticals, Guernsey, UK 11.00 a.m. Necessary further research projects / Studies in Europe and the Federal Republic of Germany Prof. Dr. Rainer Saller, Zurich 12.00 a.m. Final discussion round / panel with political party representatives Presentation of the Frankfurt Resolution of the AIDS support centres Rezzo Schlauch (Green Party), Heide Moser (SPD), N.N. (FDP), N.N. (CDU), N.N., Federal Institute for Medicinal Products and Medical Devices, Moderator: Daniel Riegger, Frankfurter Rundschau (all inquired). End around 1.30 p.m. Contact und information: Hessian Society for Democracy and Ecology (HGDÖ) Regional Foundation of the Heinrich Böll Foundation Niddastrasse 64 D-60329 Frankfurt am Main Tel.: ++49 (0)69 23 06 74 Fax: ++49 (0)69 23 94 78 e-mail: hgdoe@oeko-net.de More information: http://www.oeko-net.de/hgdoe ***** CANNABIS AND CANNABINOIDS AS MEDICINE '98 ***** Saturday, 5 December 1998, 10-18 h Cologne, KOMED-Saal, Im Mediapark 7 Organizer: Association for Cannabis as Medicine (ACM) in kind cooperation with: - German Society for Drug and Addiction Medicine, - Society of Pain Therapists (STK), - German Society for Therapists of the HIV Infected (DAGNE), - German AIDS Support (DAH), - German Association for Epilepsy. Especially we are looking forward to hear Prof. Raphael Mechoulam from Israel, one of the most renowned cannabis researchers for more than three decades, discoverer of the THC, who will present new research results from his working group, Dr. Roger Pertwee from the UK, International Secretary of the International Cannabinoid Research Society (ICRS), and Dr. Lester Grinspoon from the USA, well-known book writer and competent inspirator of the discussion about cannabis as medicine. 10.00 a.m. A plea for the medical use of marijuana Dr. Lester Grinspoon Harvard Medical School, Boston/USA 10.30 a.m. About the ethnopharmacology of cannabis Dr. Christian Rätsch ethnopharmacologist, Hamburg 11.15 a.m. Review of the therapeutic value of the hemp plant Prof. Robert Gorter Institute for Oncological and Immunological Research, Berlin 12.00 a.m. Cannabis and cannabinoids in the treatment of multiple sclerosis and spinal chord injury Dr. Roger Pertwee Institute for Medical Sciences, University of Aberdeen/Scotland 12.45 a.m. Lunch break 2.00 p.m. A special guest with a special topic Prof. Raphael Mechoulam Medical Faculty of the Hebrew University of Jerusalem/Israel 2.45 p.m. Marijuana and THC in movement disorders Dr. med. Kirsten Müller-Vahl Medical University of Hanover 3.30 p.m. Break 4.00 p.m. Culture, spiritualism und therapy - about the use of the psychoactive effects of cannabis Dipl. Päd. Jörg Fachner Institute for Music Therapy of the University of Witten/Herdecke 4.45 p.m. Therapy with THC and cannabis in practice Dr. Franjo Grotenhermen nova-Institute Huerth/Cologne 5.30 p.m. Experiences with the medical use of hemp products Some Patients Video films from the REHAB in Basel (spasticity) and the University of Hanover (Tourette syndrome) 6.00 p.m. End of the meeting Contact und information: Association for Cannabis as Medicine (ACM) Maybachstrasse 14 D-50670 Cologne Germany Fon: ++49-221-9123033 Fax: ++49-221-1300591 e-mail: ACMed@t-online.de ------------------------------------------------------------------------------- ACM-Bulletin of 1 November 1998 ------------------------------------------------------------------------------- * USA: Medical marijuana proposals on November ballots 1. USA: Medical marijuana proposals on November ballots Just as it opposed California's 1996 medical marijuana initiative, the White House is lobbying against medical marijuana measures that will be on the ballot of 3 November in four states and the District of Columbia. The initiatives in Alaska, Nevada, Oregon, Washington state and Washington, D.C. seek to allow doctors to recommend the smoking of marijuana for seriously ill patients. California and Arizona both passed similar measures in 1996, but neither has gone into effect. In California, state and federal authorities have made a persistent effort to prevent people from selling marijuana to individuals who obtain a doctor's prescription. Arizona's referendum was blocked by the state legislature when it discovered that the measure also allowed doctors to prescribe 116 other drugs, including LSD, heroin and PCP. Jim Gonzalez from Santa Monica-based Americans for Medical Rights - which is coordinating the ballot drives - said lessons from the 1996 ballots in California and Arizona had helped organizers to craft proposals that focus voter attention on the potential benefits of controlled marijuana use by the very sick. Unlike the earlier propositions, this year's ballot measures are designed to minimize controversy and head off federal challenges. But critics still say the medical marijuana movement promotes drug abuse and criminal behavior by ushering young people into what one judge has called "the kindergarten of the drug industry". Federal anti-drug officials fear that medicinal marijuana initiatives will undermine their drug prevention programs. "To be blunt, these initiatives would result in the quasi-legalization of marijuana," Barry McCaffrey, White House drug policy director, said on 27 October. Dave Fratello, spokesman for Americans for Medical Rights (AMR) said in a statement that his group hoped to put the medical marijuana initiatives on ballots in more states in the future. "The goal is to change national policy, but we know we will have to win more battles in 1999 and 2000 before that happens," said Fratello, whose group will spend $2 million on advertisements supporting the state initiatives. AMR is bankrolled by three multimillionaires: financier George Soros, insurance magnate Peter Lewis and John Sperling, who owns a successful chain of adult education centres. (Sources: Reuters of 28 and 29 October 1998, San Francisco Examiner of 28 October 1998) 2. News in brief ****USA: Officials of Oakland City/California declared a state of emergency on 21 October after the Oakland Cannabis Buyers' Cooperative was forced to shut under a federal court order on 19 October. The council's move, believed to be the first of its kind, marked the latest salvo in the battle between federal authorities and supporters of Proposition 215, the 1996 voter-approved state law that legalized medical marijuana use. The 5-4 City Council vote allows officials to develop other means of selling marijuana to people who can no longer get the drug at the Oakland Cannabis Club. (Sources: Reuters of 21 October 1998, AP of 22 October 1998) ****Canada: A Saskatchewan man fighting for the right to use marijuana for medical treatment has been spared a jail term. Grant Krieger, who has multiple sclerosis, was convicted in June of possession of marijuana for the purposes of trafficking. The offence normally carries a jail sentence but Judge Robert Davie imposed a $500 fine on 21 October. (Source: Toronto Star of 22 October 1998) ****Germany: The Association for Cannabis as Medicine has started a campaign to support a petition submitted by the Self Help Group Cannabis as Medicine in Berlin on 25 March 1998. It was endorsed by the Parliamentary Petition Committee of the House of Representatives of the State of Berlin on 29 September. It demands the support of clinical research, the possibility to obtain natural cannabis products and THC on prescription in every pharmacy, and the possibility to grow marijuana with a physician's approval. The Petition Committee of Berlin is now going to get the Federal Petition Committee involved. ****Australia: Drivers who use marijuana are less likely to cause road accidents than drunk drivers or even drug-free drivers. This is a result of an Australian study of the University of Adelaide's pharmacology department and Transport South Australia with 2,500 drivers, injured in accidents in South Australia. Researchers analysed blood samples and used information from the police report on each crash to determine whether the injured driver was culpable in their attempt to define whether cannabis and other drugs played a large role in road accidents. Drug-free drivers caused the accidents in 53.5 per cent of cases, while injured drivers with a blood alcohol concentration over 0.05 per cent were culpable in nearly 90 per cent of accidents they were involved in. Drivers with traces of tranquillisers in their blood at or above the therapeutic level were culpable in nearly 70 per cent of accidents. But drivers with cannabis in their blood were less likely to cause an accident, with a culpability rate of 50.6 per cent. (Source: Australian AP of 20 October 1998) ****Africa/World: In its just-published 1998 report, the Observatoire Geopolitique des Drogues (OGD -- Geopolitical Observatory for Drugs) says that Africa is becoming an increasingly important hub in the international drug trade. More and more cannabis is being grown in all regions of Africa in response to the economic crisis in general, and the crisis in the agriculture sector in particular. Cannabis is grown worldwide on some 35,000 hectares which can yield a total of 22,000 tons with a street value of around $4.2 billion, the OGD report says. (Source: COMTEX Newswire of 19 October 1998) 3. THE COMMENT ... on the statement of Helmut Butke from the section of narcotics in the German Ministry of Health, that "it would be irresponsible, to admit the medical use of cannabis". "I'd like to give these people 24 hours of my life. I think, the problem would be solved quickly, than." Michael Boos, multiple sclerosis patient on German TV on 22 October 1998 (ARD-series "Kontraste", 9 p.m., http://www.kontraste.de/9812/frames/txt4.html) ------------------------------------------------------------------------------- ACM-Bulletin of 15 November 1998 ------------------------------------------------------------------------------- * Great Britain: Lords say, legalise cannabis for medical use * USA: Voters demand the use of marijuana as medicine * Germany: Mixed statements from the government on cannabis 1. Great Britain: Lords say, legalise cannabis for medical use British doctors should be freed quickly to prescribe cannabis for their patients, even before trials can prove that it has clear medical benefits, a committee of the House of Lords says. It is the conclusion of their report "Cannabis: the scientific and medical evidence", that was released on 11 November. The House of Lords' Committee of Science and Technology set up a sub-committee, consisting of 12 Lords, to look into scientific cases for and against continuing to ban the medical and recreational uses of cannabis in February 1998. Peers took evidence from March until July. Among the witnesses were the Alliance for Cannabis Therapeutics, the British Medical Association, the Multiple Sclerosis Society, the National Addiction Centre and some 60 more individuals and institutions. In the 54-page report the Committee, chaired by Lord Perry of Walton, a former professor of pharmacology and a fellow of the Open University, said at present hundreds of Britons suffering from pains caused by multiple sclerosis and neuralgia were flouting the drugs laws to get relief. The Lords recommend that cannabis should be moved from "Schedule 1" to "Schedule 2", that would allow doctors to prescribe it and pharmacists to supply it. The report sets out evidence that cannabis can be effective in multiple sclerosis and certain forms of pain. The Lords are less convinced about its effectiveness in other conditions, including epilepsy, glaucoma and asthma. A press information of the House of Lords of 11 November says: "The Lords welcome the fact that clinical trials of cannabis are currently being launched, by the Royal Pharmaceutical Society, and by Dr. Geoffrey Guy of GW Pharmaceuticals, with a view to the eventual licensing of cannabis as a medicine. The Lords say, however, that cannabis should be rescheduled now, rather than waiting several years for the results of these trials." Patients groups, politicians and even anti-drugs campaigners have welcomed the conclusions. The Standing Conference on Drug Abuse, which represents more than 500 groups working to prevent drug misuse, said the Lords proposals sprang from "an overwhelming scientific case". Chief executive Roger Howard conceded cannabis was not a "benign" drug but called on the Government to respond positively to the report. But the Home Office rejected the committee's recommendation. Minister George Howarth said: "The Government would not be prepared to countenance any move to allow prescription before clinical trials and safety tests have been completed. The safety of patients is our priority, and the Government would not allow prescription of any drug which had not been tested for safety, efficacy and quality through that clinical process." The British Medical Association says making cannabis available on prescription would be a misguided move which could prevent new, more effective drugs being developed. The BMA wants more trials to discover which of the 60-plus cannabinoids contained in the plant have therapeutic uses and which may have adverse effects. British doctors were allowed to prescribe cannabis up to 1973. Then it was removed from a list of prescription drugs. But the committee's special adviser, Oxford University pharmacology professor Leslie Iverson, said since the 1970s scientific knowledge of the drug's advantages had grown. The report is on the Internet, accessible via the UK Parliament home page at >>http://www.parliament.uk<< or directly: >>http://www.parliament.the-stationery-office.co.uk/pa/ld199798/ldselect/ldsctech/151/15101.htm<< Printed copies are available at: The Publications Centre, PO Box 276, London SW8 5DT, Fax: ++44-171-8738200, ISBN: 0 10 4151986. (Sources: Cannabis: the scientific and medical evidence, report of the Select Committee on Science and Technology of the House of Lords; Press information of the House of Lords of 11 November 1998; Reuters of 11 November 1998, PA of 8 and 11 November 1998, Australian AP of 11 November 1998, dpa of 11 November 1998) 2. USA: Voters demand the medical use of marijuana Voters in Alaska, Oregon, Nevada, and Washington overwhelmingly approved ballot initiatives on 3 November exempting patients from criminal penalties when they use marijuana under the supervision of a physician. Voters in Arizona reaffirmed a medical marijuana initiative passed two years ago, and rejected a legislative requirement banning physicians from prescribing marijuana until the drug receives approval from the Food and Drug Administration. State law in Nevada requires voters to reapprove medical marijuana again in the year 2,000 before the measure can officially become law. In each state, the measures were passing with at least 55 percent of the vote. The election results in detail: ALASKA (Proposition 8): 57.75% for the medical use of marijuana, 42.25% against it. ARIZONA (Proposition 300): 57.4% for the medical use of all Schedule I drugs, 42.6% against it. NEVADA (Question 9): 59% for the medical use of marijuana, 41% against it. OREGON (Measure 67): 55% for the medical use of marijuana, 45% against it. WASHINGTON (Initiative 692): 58.70% for the medical use of marijuana, 41.30% against it. For example, under Initiative 692 (Washington), patients with certain illnesses, or their designated caregivers, could grow and possess a 60-day supply of marijuana, although the exact amount wasn't specified. Physicians who advised qualifying patients about the risks and benefits of marijuana use were protected from prosecution. Officials at the White House's office of drug policy said they were unfazed by the election results. "It does not cause us to believe that marijuana is a safe substance," said Jim McDonough, director of strategy for the Office of National Drug Control Policy. "The bottom line: It's not science." Initiative backers, though, said the votes demonstrate strong mainstream support, which federal officials will find hard to ignore. "I don't think anybody, especially the drug office, thought every one of them would pass," said Dave Fratello, spokesman for Americans for Medical Rights. The group said it expects to resurrect an invalidated initiative in Colorado next year, and to have one on the ballot in Maine as well. Also in its sights are Massachusetts, Florida, Ohio, Illinois and Michigan. "First it was California, and maybe people wrote off California as an anomaly," Fratello said. "Now it's the entire West, which is convincing, but it's still not the Midwest." (Sources: Different US-newspapers) 3. Germany: Mixed statements from the government on cannabis The new social democratic Interior Minister Otto Schily has no plans to legalise soft drugs, despite initial interpretations of an interview conducted with the German news magazine "Der Spiegel". He explained this to journalists on the 9 November in Berlin and said his statements were overrated. A quote from the Spiegel-Interview of 9 November: "As far as so-called soft drugs are concerned, I have not yet reached a conclusion. I shall get informed about the actual facts, and will not allow myself any prejudices." In response to the final question, whether or not this meant that "the consumption and trade of cannabis in small amounts" may possibly be legalised, he said: "In any case, we want to test it. There have been some interesting essays on the subject and an EU-Report. Moreover I shall have all the aspects explained to me again in detail by consultants." He has now explained in Berlin that the Social Democrats are against the legalisation of hashish and marihuana. "At present, I see no reason to change this position." It was however clear that he would reconsider his position, if experts' statements were to give good reason for such action. The new Health Minister Andrea Fischer from the Greens compared cannabis products such as hashish and marijuana to alcohol. "Those who manage to keep within bounds, perhaps drinking a small glass every evening, can stay in good health throughout a whole life. Some people are successful, but many others are not," Fischer said in "Der Spiegel" to be published on 16 November. Together with her colleagues of the German states she wants to come to an agreement on a uniform sentence for the possession of cannabis. (Sources: Der Spiegel of 9 November 1998, dpa of 7, 9 und 14 November 1998, AP of 9 November 1998, Reuters of 8 November 1998) 4. THE COMMENT "3 years ago, a Lancet editorial began, "The smoking of cannabis, even long term, is not harmful to health" (Nov 11, 1995). (...) We will qualify our opinion of 3 years ago and say that, on the medical evidence available, moderate indulgence in cannabis has little ill-effect on health, and that decisions to ban or to legalise cannabis should be based on other considerations." Dangerous habits, The Lancet of 14 November 1998, >>http://www.thelancet.com<< ------------------------------------------------------------------------------- ACM-Bulletin of 29 November 1998 ------------------------------------------------------------------------------- * USA: DEA proposes reclassifying synthetic THC * Great Britain: Founder of Medical Marijuana Club charged with drug offences 1. USA: DEA proposes reclassifying synthetic THC The Drug Enforcement Administration (DEA) issued a "Notice of Proposed Rulemaking" on 5 November in which the DEA is proposing to reclassify Marinol from Schedule II to Schedule III, a ruling that would provide increased patient access to this FDA-approved synthetic THC preparation. Marinol, manufactured by Unimed Pharmaceuticals, is an oral medication approved for patients requiring appetite stimulation and for patients undergoing chemotherapy. Marinol also is being tested to assess its positive effects on behaviour in people diagnosed with Alzheimer's disease and other dementias. Schedule II drugs are those that are recognized to have medical indications, but have a high potential for abuse (examples include morphine, cocaine, methadone and methamphetamine). Schedule III drugs have accepted medical uses and a lesser potential for abuse (examples of drugs in this class include codeine with aspirin or codeine with Tylenol. The DEA consulted extensively with the FDA before making this recommendation. A study presented in June of this year at the College of Problems of Drug Dependency's Annual Meeting showed that because Marinol has a gradual onset of action, it has a very low potential for abuse. Adoption of the DEA proposal would represent a real pharmacoeconomic benefit to both patients and to the healthcare system as a whole by reducing the number of costly office visits by patients for whom Marinol is a medical necessity,'' said Dr. Ronald Goode, president of Unimed Pharmaceuticals. "Furthermore, because the proposed change would allow prescriptions for Marinol to be refilled up to three times per prescription, patient convenience would be greatly enhanced." The public has until December 7, 1998 to file comments, objections and requests for a hearing on the proposed reclassification. The DEA will then rule on the proposed reclassification. (Source: Business Wire of 5 November 1998) 2. Great Britain: Founder of Medical Marijuana Club charged with drug offences A man who set up a network to supply cannabis as a medicine to sick and dying people was charged on 18 November with drugs offences. Colin Davies, 41, of Romney Way, near Stockport, Greater Manchester was charged after police found 26 cannabis plants during a raid on 17 November. Davies is one of the founder members of the Medical Marijuana Co-Operative, launched two weeks ago to distribute good quality stocks of the drug to those who need cannabis to treat symptoms of serious diseases. Mr Davies, who claims to have a spinal condition, faces charges of cultivating cannabis, possession of a controlled drug with intent to supply, offering to supply a controlled drug and possession of a controlled drug. He has been bailed by police to appear before Stockport magistrates on 15 December. "I have never denied growing cannabis to relieve my own pain and suffering and for those within the co-operative," he said. "We are putting ourselves on the line to try and find a compassionate way to distribute this medicine to sick and ill people and this is the way I get treated - banged up for hours in a cell and charged like a criminal. The non-profit making Medical Marijuana Co-Operative, which he set up with two associates, is based on a similar group in Los Angeles and has strict rules. A letter of diagnosis is required from a doctor, and members have to agree to a code of practice requiring them to use the drug in private and forbidding them from selling it on. Mr Davies' arrest came less than a week after the House of Lords Committee on Science and Technology published a report calling for the use of cannabis for medicinal purposes to be legalised quickly. The Government said such a move was out of the question. (Source: PA News of 18 November 1998) 3. News in brief ****USA: On 19 November, Marvin Chavez, medical cannabis patient and Director of the Orange County Patient-Doctor-Nurse Support Group, was found guilty of furnishing marijuana, sales of marijuana, and transportation of marijuana. He could face years of prison when he is sentenced on 8 January 1998. Chavez has ankylosing spondylitis, a degenerative spinal arthritis. Medical marijuana patient Linda Jean Marlowe was released from jail and sentenced to six months of home confinement on 24 November. Marlowe suffers from several serious diseases including porphyria, rheumatoid arthritis, and fibromyalgia. (Sources: NORML of 24 November 1998, The Lindesmith Center) ****Switzerland: On 29 November Swiss voters rejected a sweeping proposal to legalize narcotics that backers said would eliminate the drugs mafia but critics said would make Switzerland a drugs haven. The plan would have made Switzerland the only country in the world where anyone aged 18 or older could buy the narcotics of their choice, from marijuana to heroin, from state-run outlets or pharmacies after consultation. According to first results about 26.1 percent of the voters supported this liberalisation of drug use. (Sources: dpa of 25 November 1998, PA of 29 November 1998, Reuters of 29 November 1998) ****Austria: On 25 November, the Socialists, the Greens and the Liberal Forum submitted a motion in the municipal council of Vienna backing the legalization of cannabis for medical use. Therein the Federal Government is asked to take steps towards allowing the prescription of cannabis for certain diseases. The People's Party and the Liberal Party opposed the motion. (Source: Wiener Zeitung [Vienna's Newspaper] of 26 November 1998) ****ACM: Still three days until the congress in Frankfurt (2 to 4 December), five days until the General Meeting of the ACM (4 December), six days until the Congress in Cologne (5 December). 4. THE COMMENT ... on the reaction of federal officials on the results of the November ballots "To hear the uproar in official circles, you would have thought marijuana, even in small quantities and prescribed by doctors for AIDS and chemotherapy patients, was demon rum itself, and that the ghosts of the temperance society ladies had risen from their graves to smash open the doors of the cannabis clubs." The drug war isn't about combating use, Los Angeles Times of 17 November 1998 ------------------------------------------------------------------------------- ACM-Bulletin SPECIAL of 7 December 1998 ------------------------------------------------------------------------------- Germany: ***Congresses in Frankfurt and Cologne*** Demand for impunity in case of medical use of cannabis In their general meeting on Friday, 4 December, the Association for Cannabis as Medicine demanded impunity for seriously ill patients who use cannabis for medicinal purposes. It was unacceptable that patients must endure the judicial consequences of their self-treatment along with the symptoms of their illnesses. Despite certifications of their physicians and expert opinions about the therapeutic uses of cannabis, patients in Germany suffering from epilepsy, AIDS, hepatitis C, spinal cord injury and poliomyelitis had been convicted of infringement of the narcotics act. The ACM demands amnesty for these patients. The convictions contradicted the sense of justice of almost all citizens who have heard about these court proceedings and their circumstances. Judges repeatedly found themselves in a situation where they had to convict people according to the letter of the law though they felt much sympathy for their actions. "We support clinical studies that are planned or already underway in Great Britain, Switzerland and Germany, since they can further improve our knowledge of the therapeutic qualities of cannabis and its pharmacologically active ingredients," Dr. Franjo Grotenhermen, chairman of the 650-strong association, said. "But the available evidence should already be reason enough to allow seriously ill patients an exception from the general prohibition of cannabis." Cannabis products brought about less side-effects than many legally available medicines. They have been used with success for example for the therapy of organically caused spasticity in multiple sclerosis and spinal cord injury, in painful conditions, and in vomiting and lack of appetite in AIDS and cancer. The general meeting made reference to a report of 11 November this year from the British House of Lords concluding that doctors should be allowed to prescribe natural cannabis products. Patients should not have to wait many years until official licensing of appropriate medicines. Detailed information about the current scientific level of knowledge was offered during the conference "Cannabis and Cannabinoids '98" in Cologne, organised by the ACM in cooperation with various other medical societies, the German Society for Drug and Addiction Medicine, the Society of Pain Therapists (STK), the German Society for Therapists of the HIV Infected (DAGNE), the German AIDS Support Organisation (DAH) and the German Association for Epilepsy. Great interest was attracted by Dr. Christian Rätsch's speech about the ethno-pharmacological uses of cannabis, the lecture by Prof. Raphael Mechoulam of the Hebrew University of Jerusalem about the nerve-protecting effects of the synthetic THC-derivative Dexanabinol which may be used to treat brain damage, and the primary results of a standardised patient survey conducted in the German-speaking countries about the experiences with medicinal uses of THC and natural cannabis products. The survey was brought about by the ACM and the European Institute for Oncological and Immunological Research in Berlin under the guidance of Prof. Robert Gorter. The participants were particularly impressed with a video shown by Dr. Kirsten Müller-Vahl from the University of Hanover. The video showed a patient suffering from Tourette-syndrome, a serious movement disorder, before and after small doses of THC, which led to an marked improvement of symptoms. A clinical study of ten Tourette patients will be finished this month. Both meetings in Cologne followed the congress "Medical Marijuana" from 2 to 4 December in Frankfurt, organised by the Hessian Society for Democracy and Ecology, Regional Foundation of the Heinrich Böll Foundation, and several metropolitan AIDS support centres. The congress provided a platform for political discussion along with medical information provided by specialists such as Dr. Lester Grinspoon from Harvard University in Boston, Dr. Roger Pertwee from the University of Aberdeen, Prof. Rudolf Brenneisen from the University of Bern, Dr. Franjo Grotenhermen from the nova-Institute in Cologne and Dr. Geoffrey Guy from GW Pharmaceuticals. Members of the German Parliament from the Social Democratic Party, the Free Democratic Party and The Greens spoke for a judicial re-evaluation of Cannabis, given that studies have proved its medicinal value. Rüdiger Kriegel from the board of Directors of the German AIDS-support organisation spoke up for a rapid end of the inhumane conditions concerning procurement of Cannabis for seriously ill patients, thereby expressing the wishes of the majority of the Congress' participants. The ACM emphasised that legislators are already in a position to offer impunity to patients in the case of medically substantiated consumption of Cannabis. Medical approval was by no means compulsory. This has already been ascertained for Great Britain by the House of Lords. In Germany, jurists are increasingly considering it "injustice" that seriously ill patients are denied cannabis products. For example an article in the German law magazine "Juristenzeitung" of February 1998, written by Jürgen Schwabe, Professor of Law at Hamburg University, described the judicial situation as "scandalous". It was considered at the ACM General Meeting to bring an action to the Federal Constitutional Court of Germany. The legislative correction of this injustice should happen as quickly as possible, independently of lengthy processes for the approval of a cannabis medicament. ------------------------------------------------------------------------------- ACM-Bulletin of 13 December 1998 ------------------------------------------------------------------------------- * Germany: Frankfurt Resolution for the medical use of marijuana * Science: THC induces programmed cell death in certain brain tumour cells 1. Germany: Frankfurt Resolution for the medical use of marijuana At the congress "Medical Marijuana" of the Hessian Society for Democracy and Ecology and the metropolitan AIDS support centres in Cologne, Frankfurt/Main, Dusseldorf and Munich from 2 to 4 December the "Frankfurt Resolution" for the legalisation of marijuana for medical purposes was presented. It says: "We believe that all possible humane medical means ought to be utilised for the cure of the ill and the alleviation of their suffering, and therefore we request the German Parliament: 1. to allow the medical use of marijuana, 2. also to permit the inhalative application of natural marijuana for therapeutic purposes, 3. to scientifically accompany the medical uses of marijuana and to subsidise this research." Among the first signers of the resolution are well-known actors and other artists, journalists and other persons from the media, university professors and scientists, politicians of the Social Democrats and the Greens, the parties that form the German government. Among them are: Dirk Bach, actor, Cologne; Daniel Cohn-Bendit, Member of the European Parliament, The Greens, Frankfurt/Main; Herbert Feuerstein, Bruhl; William Forsythe, ballet, Frankfurt/Main; Susanne Froehlich, moderator at the Hessian Broadcast, Frankfurt/Main; Prof. Robert Gorter, Berlin; Hubertus Heil, Member of the German Parliament, Social Democrats, Bonn; Dr. Ellis Huber, President of the Medical Association of Berlin; Guenter Pfitzmann, actor, Berlin; Rupert von Plottnitz, Hessian Minister for Justice and for European Affairs, The Greens, Wiesbaden; Daniel Riegger, journalist, Frankfurt/Main; Gudrun Schaich-Walch, Member of the German Parliament, Social Democrats, Frankfurt/Main; Prof. Sebastian Scheerer, Hamburg ; Prof. Volkmar Sigusch, Frankfurt/Main; Hella von Sinnen, Köln; Prof. Rolf Verres, Heidelberg; Dr. Roger Willemsen, Hamburg. The resolution is supported by the Association for Cannabis as Medicine. More medical associations have signalled their support. For the support of the resolution signatures will be collected. They will be handed over to the German government in March 1999. 2. Science: THC induces programmed cell death in certain brain tumour cells According to cell studies at the Complutense University of Madrid/Spain delta-9-tetrahydrocannabinol (THC) induces apoptosis in glioma cells and to a lesser extent in other types of brain tumour cells, but not in healthy brain cells. This effect is probably not mediated by the cannabinoid receptor and involves the sphingomyelin cycle. Apoptosis is the name for a programmed cell death that differs from necrotic cell death. For example, apoptosis is used by the body in case of serious damage of the genetic material or in case of hypoxia to prevent disturbed cell growth and the development of cancer. Alterations in the control of apoptosis are involved in the origin of several human diseases. An example of a pathological apoptotic hypoactivity is the inactivation of the p53 tumour suppressor gene due to mutation, leading to a decreased rate of apoptosis in damaged cells and an increased risk to develop cancer. On the other hand an increased rate of apoptosis that affects healthy cells may as well lead to severe diseases. For example, the toxic epidermal necrolysis (or Lyell's syndrome) with a mortality rate of about 30 percent is associated with a high rate of apoptosis due to an increased activation of a cell-surface death receptor in dermal cells. It is desirable to have a substance that induces programmed cell death in tumour cells but not in healthy cells for the treatment of cancer. It has been demonstrated by the Spanish scientists in cooperation with colleagues of the French INSERM institute that THC could be such a substance. They used glioma cells (the C6.9 subclone) and added a high concentration of THC (1 micromole). THC led to a dramatic drop of mitochondrial oxidative metabolism within 4 to 5 days in these brain tumour cells, accompanied by cell death. This effect was dose-dependent and induced ladder-patterned DNA fragmentation in the glioma cells, a process that is typical of cell death by apoptosis. It was shown that THC led to hydrolysis of sphingomyelin (a certain cell lipid), a key process in the control of many physiological events related to cellular regulation. Apoptosis by THC was not restricted to glioma cells. A tested astrocytoma cell line as well as neuroblastoma cells, cells of other types of brain tumours, ensued THC-mediated cell death, although they were not as sensitive as the glioma cells. In contrast healthy brain cells, astrocytes and neurons, were not sensitive to the apoptotic action of THC even after 15 days of challenge to the cannabinoid. Concentration of THC in each test was 1 micromole. Examinations with the cannabinoid receptor antagonist SR141716 showed that this THC effect was not mediated by the cannabinoid receptor in spite of the presence of the CB1 receptor. But the existence of a SR141716-insensitive cannabinoid receptor distinct of CB1 and CB2 could not be excluded. The authors argue from their findings that the "antiproliferative effect of THC described in the recent report might provide the basis for a new therapeutic application of cannabinoids, especially since primary astrocytes and neurons are resistant to the apoptotic action of THC." But one has to note that the THC concentrations found in the blood of cannabis users are much lower, in the nanomolar range, than those used in these cell studies. (Sources: Sanchez C, Galve-Roperh I, Canova C, Brachet P, Guzman M: Delta-9-Tetrahydrocannabinol induces apoptosis in C6 glioma cells. FEBS Letters 436:6-10, 1998; Viard I, Wehrli P, Bullani R, Schneider P, Holler N, Salomon D, Hunziker T, Saurat J-H, Tschop J, French LE: Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science 282:490-493, 1998) 3. News in brief ****Germany: The federal drug czar, Christa Nickels, has asked for a debate on the acceptance of cannabis for medical use. The discussion should be engaged without "ideological blinkers", the member of the Greens said. The severe suffering of patients with illnesses such as Multiple Sclerosis, Cancer or AIDS could eventually be eased with cannabis. She welcomed the recent initiative of the British House of Lords to admit the use of cannabis for therapeutic purposes. That should be considered in Germany as well. (Source: dpa of 29 November 1998) ****Great Britain: The chairman of a House of Lords committee, which last month unanimously recommended that cannabis should be legalised for medical use, tonight attacked ministers for dismissing the call "out of hand". Home Office minister George Howarth had said: "The safety of patients is our first priority and the Government would not allow prescription of any drug which had not been tested for safety, efficacy and quality through a clinical process." Lord Perry said of this response: "Even if we accept that safety of the patient is the first priority, our report says that if cannabis is used to treat patients on the prescription of a doctor, the risk to the patient is vanishingly small." (Source: PA News of 4 December 1998) ****USA: Legislation approved by Congress last month allocates $23 million toward developing a new fungus aimed at destroying drug-producing plants like marijuana. U.S. officials stated that they hope to introduce the soil-borne fungi to foreign nations such as Columbia, Peru, and Bolivia. (Source: NORML of 10 December 1998) 4. THE COMMENT ... on the rejection of the recommendation of a British House of Lords committee to legalise cannabis for medical use by the British government: "If the Government is not prepared to take wise notice of this committee, to ignore the careful and well-considered findings of a committee such as this, it would diminish an important function of the House of Lords. It could also damage the esteem and respect which the Government might be held in as well." Lord Winston, member of the committee, that had authored the report on cannabis, during a debate in the House of Lords (PA News of 4 December 1998) ------------------------------------------------------------------------------- ACM-Bulletin of 27 December 1998 ------------------------------------------------------------------------------- * Science: Cannabinoid receptor system may play a role in regulation of sperm function * New Zealand: Negative effects of marijuana have been overstated 1. Science: Cannabinoid receptor system may play a role in regulation of sperm function Scientists at the University at Buffalo in New York have shown that endocannabinoids like anandamide may play a role in regulating functions of human sperm and influence their ability to fertilize eggs. Five years ago Herbert Schuel, professor of anatomy and cell biology, and colleagues had already demonstrated that sea urchin sperm contains cannabinoid-receptors and that cannabinoids can block the acrosome reaction. At the meeting of the American Society of Cell Biology on 15 December the group presented new study results showing that cannabinoids can affect three key fertilization processes in humans: - Inhibition of acrosome reaction, the normal release of the sperm enzymes that enable sperm to penetrate the egg. - Regulation of very active sperm swimming patterns, called hyperactivation. - Prevention of sperm binding to the egg cover, or zona pellucida. During normal reproduction, fluids within the female reproductive tract prepare the sperm to fertilize the egg -- to swim vigorously and to undergo the acrosome reaction when they arrive at the egg's zona. The researchers mimicked these processes in vitro. They investigated the effect of THC and AM-356, a synthetic equivalent of anandamide. A press release of the University at Buffalo said: "Results showed that after six hours, sperm exposed to THC or AM-356 had a 67 percent reduction in premature acrosome reactions, compared to controls. Motility studies showed that higher levels of AM-356 inhibited hyperactivated swimming, while lower concentrations actually stimulated hyperactivation. In the zona experiments, AM-356 inhibited sperm binding by 75 percent." "Our new findings suggest that anandamides and THC in marijuana smoke may ... affect sperm functions required for fertilization in the female reproductive tract," Dr. Schuel says in the press release. "The additional load of cannabinoids in the systems of people who abuse marijuana floods the natural cannabinoid receptors and appears to have adverse consequences for reproduction in both males and females." It is now of interest to have information about the used concentrations to assess if these observations are really of relevance for the therapeutic or recreational use of THC or marijuana. Low nanomolar concentrations of THC are observed in the blood in this case. But the meeting abstract only says "sub microM concentrations". A "sub microM concentration" could mean e.g. 0.1 or 0.01 micromol. On request of the ACM Dr. Schuel did not want to provide additional details, to not compromise chances to publish their findings in peer-reviewed journals. He used between 0.1 and 100 microM THC in his former experiments with sea urchin sperm and revealed a dose-response relationship. Dr. Franjo Grotenhermen from nova-Institute in Hürth/Rhineland said: "I feel reminded of warnings about the influence of marijuana use on hormones and the immune system in the 70s, after high THC concentrations had caused severe immunsuppressive effects and a marked influence on sex hormones, cortisone and thyroid hormones in cell and animal experiments. Today this view has changed and there is a more differentiated judgement. Because even heavy marijuana use does not have an evident contraceptive effect, sensation-seeking conclusions from the actual sperm research seem to be inappropriate." Among others four questions are of interest: - What concentrations of THC can be found in the female reproductive tract of heavy marijuana users? The concentrations may be lower than in the blood. - Does THC at these concentrations exert a measurable effect on sperm functions? - If there are any effects does tolerance develop to these effects? - What is the natural function of the cannabinoid receptor system in sperm? The observation of a biphasic effect in the motility studies looks quite interesting. Table: THC-concentrations and abbreviations 1 microM THC (1 micromol THC) = approx. 0.3 microg/ml THC 1 microM THC (1 micromol THC) = 1000 nM THC 1 nM THC (1 nanomol THC) = approx. 0.3 ng/ml THC (Sources: Schuel H, et al: 1998 Meeting of the American Society for Cell Biology, Abstract 1793; Press release of the University at Buffalo from 15 December 1998; Schuel H: Personal communication of 23 December 1998; Chang MC, et al: Mol Reprod Dev (1993) 36:507-516; Schuel H, et al: Mol Reprod Dev (1991) 29:51-59; UPI of 15 December 1998; Reuters of 16 December 1998) 2. New Zealand: Negative effects of marijuana have been overstated After eight months of deliberation, a health select committee of the parliament tabled its report into the mental health effects of cannabis on 17 December, finding that the drug has probably been unduly criticised. "Based on the evidence we have heard in the course of this inquiry," the committee concluded, "the negative mental health impact of cannabis appears to have been overstated, particularly in relation to occasional adult users of the drug." "Evidence received in the course of this inquiry has raised serious doubts about commonly held beliefs about cannabis," wrote the committee. But the committee has been careful that it does not underplay the serious consequences of use of the drug for some people. "Moderate use of the drug does not seem to harm the majority of people though we do not deny the serious impact cannabis use may have on certain individuals, particularly those with schizophrenia or those with a vulnerability to psychotic illness." The chairman of the committee, Brian Neeson, said the inquiry found that there was inadequate research into some areas. "We are concerned that cannabis use may accelerate the onset of schizophrenia in predisposed individuals and may be a complicating factor in the treatment of people with mental illnesses." "Evidence received during the inquiry supports the view that there can be subtle cognitive impairment in cannabis users," the report says. In this respect, the committee drew to a large extent on the work of Prof. Wayne Hall of the Australian National Drug and Alcohol Research Centre, who was commissioned to report on scientific research in this area. He found that long-term use of cannabis may cause subtle impairment in the higher cognitive functions of memory, attention and the organisation and integration of complex information. "Hall and the Health Funding Authority pointed out that cannabis should be viewed as a lesser threat to cognitive functioning than alcohol." The committee said the evidence also suggested that cannabis did not cause behavioural difficulties, rather that cannabis was frequently used by youths who misbehaved. Neither was it a cause of suicide. The 18 recommendations contained in the report call for increased funding of research, particularly among Maori, and for greater provision and coordination of services to help people seeking drug treatment. It was also believed that a change in the law may help to draw more people who need help. "Those who develop problems are less likely to seek help because they use an illegal substance and may spiral into alienation, anti-social behaviour, criminality, mental illness or violence." (Source: New Zealand Herald from 18 December 1998) 3. News in brief ****Germany: Until now, the "Frankfurt Resolution" for the medical use of marijuana is supported by the AIDS support groups in Frankfurt/Main, Dusseldorf, Cologne and Munich, akzept, Association for Cannabis as Medicine, Deutsche AIDS-Hilfe (Federal AIDS support organization), German Association for Epilepsy, German Society for Algesiology, German Society for Drug and Addiction Medicine, German Society for Poliomyelitis, SCHMERZtherapeutisches Kolloquium (Society of pain therapists). ****Great Britain: Britain's Prince Charles has expressed an interest in the effectiveness of cannabis in relieving the pain of diseases such as multiple sclerosis. During his annual visit to the Sue Ryder Home in Cheltenham, Gloucestershire, the 50-year old heir to the throne asked wheelchair-bound Karen Drake, who has MS: "Have you tried taking cannabis? I have heard it's the best thing for it." A spokesman for the Prince said that the conversation had been private: "If the Prince does have a view on this matter, he is not making it known." (Source: The Times of 24 December 1998, Reuters of 24 December 1998, PA News of 23 December 1998) ****Germany: Health Minister Andrea Fischer is ready to take new steps in drug policy. Among them are considerations to sell cannabis in pharmacies. Through the free sale of small amounts of hashish in selected pharmacies the markets for soft and hard drugs could be separated, Fischer said. This would be a fussy debate but the topic should be discussed less excited in the future. The health spokesman of the Christian Democrats, Wolfgang Lohman, strictly disagreed. A sale in pharmacies would be a wrong signal to children and teenagers. Also, the chairman of the federal organisation of physicians (Bundesärztekammer), Dr. Karsten Villmar, dismissed the considerations. (Sources: Press release of the CDU/CSU Bundestag party of 23 December 1998, AP of 23 and 24 December 1998) ****USA: Will Foster will spend another Christmas in jail despite unanimous approval from the state's parole board to release him. In 1997 an Oklahoma jury sentenced Foster to 93 years in jail for cultivating marijuana in a 25-square foot underground shelter and other lesser marijuana-related charges. Foster maintains that he grew the marijuana to alleviate the pain of rheumatoid arthritis. This fall, an appeals court judge found Foster's sentence excessive and reduced the term to 20 years. (Source: NORML of 22 December 1998) ****ACM: At http://www.cannabis-med.org the new web site of the Association for Cannabis as Medicine will be builded up. 4. THE COMMENT ... in the course of the debate about Prince Charles question to a multiple sclerosis sufferer "We recognise that some people who use cannabis to relieve symptoms find themselves on the wrong side of the law but we do not feel they should be treated as criminals." A spokesman of the UK Multiple Sclerosis Society, The Times of 24 December 1998 International Association for Cannabis as Medicine (IACM) Arnimstrasse 1a D-50825 Cologne Germany Phone: +49-221-9543 9229 Fax: +49-221-130 05 91 Email: info@cannabis-med.org Internet of the ACM: http://www.cannabis-med.org If you want to be deleted from or added to the IACM-Bulletin mailing list please send a message to: info@cannabis-med.org. Please choose between German version: IACM-Informationen English version: IACM-Bulletin French version: IACM-Bulletin en Francais Dutch version: IACM-Berichten Italian version: Bollettino della IACM