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IACM-Bulletin of 12 June 2005

USA: Supreme Court declares legal the prosecution of medical cannabis users by federal authorities

A 6-to-3 decision of the Supreme Court overturned a 2003 ruling by a federal appeals court that had shielded California's medical cannabis law of 1996, from the reach of federal drug enforcement. The appeals court had ruled that Congress lacked constitutional authority to regulate the noncommercial cultivation and use of cannabis that does not cross state lines. The Supreme Court disagrees.

The ruling of the Supreme Court is a firm reassertion of federal authority and revealed a deep fissure within the judges that over the past decade has provided the majority for a series of decisions curbing the power of the Federal Congress and elevating the role of the states. The decision was not necessarily the last word on medical cannabis, either from the courts or from other branches of government.

Justice John Paul Stevens, noting that "perhaps even more important than these legal avenues is the democratic process," suggested that the executive branch might reclassify cannabis for medical purposes or that Congress might take up the matter. Advocates for medical cannabis, meanwhile, stressed that the state laws remain in effect and that the influence of federal enforcement was fairly negligible. Allen Hopper, a lawyer with the American Civil Liberties Union's Drug Law Reform Project, noted that the federal government handles only about one percent of cannabis prosecutions.

Justice Sandra Day O'Connor, one of the three dissenters, said that while she would not have voted for California's medical marijuana initiative and did not support it as public policy, it represented the kind of innovation and "experiment" that came within the latitude that the Constitution permits to the states. "The states' core police powers have always included authority to define criminal law and to protect the health, safety, and welfare of their citizens," she said.

Mrs. Angel Raich, one of the two plaintiffs, told reporters, said she would continue to use the cannabis that was prescribed by her doctor and is grown for her by friends. "I don't have a choice but to continue," she said.

(Sources: New York Times of 6 June 2005, Reuters of 6 June 2005)

UK: GW Pharmaceuticals has to wait for approval of Sativex in the UK

On 9 June GW Pharmaceuticals was informed that the responsible authorities (MHRA, Medicines and Healthcare products Regulatory Agency) uphelds its decision that a further clinical study in spasticity of multiple sclerosis sufferers would be required prior to the grant of a UK product licence for GW's cannabis extract Sativex. In December 2004, the MHRA decided that the evidence of efficacy of Sativex in MS spasticity is not yet sufficiently compelling. GW appealed against this decision to the Medicines Commission, the senior advisory body to the MHRA.

Professor Mike Barnes, President of the World Federation of Neuro-rehabilitation and Chairman of the Royal College of Physicians Rehabilitation Committee, said, "It is my view that there is excellent clinical evidence to support the regulatory approval of Sativex in the UK. I am very disappointed that the Medicines Commission did not follow the recommendation of myself and other leading experts in the treatment of MS. People with MS have considerable unmet medical needs and I am deeply saddened that the regulators do not yet feel in a position to licence this important product."

In December 2004, GW announced its intention to start an additional MS spasticity study in parallel to the Medicines Commission process. This 280 patient study has now commenced and is due to report results in Spring 2006.

(Source: Press release by GW Pharmaceuticals of 10 June 2005)

News in brief

Science: Cannabinoid receptors in the skin
German researchers investigated the occurrence of cannabinoid receptors in cells of the human skin. CB1 and CB2 receptors were found in nerve fibres of the skin, skin cells (keratinocytes), cells of the hair follicles, sweat glands and other cells present in the skin. Authors note that the "abundant distribution of cannabinoid receptors on skin nerve fibers and mast cells provides implications for an anti-inflammatory, anti-nociceptive action of cannabinoid receptor agonists." (Source: Stander S, et al. J Dermatol Sci 2005;38(3):177-88.)

USA: Rhode Island and Connecticut
On 4 June the state Senate of Connecticut and on 7 June the state Senate of Rhode Island passed bills that would legalize the medical use of cannabis in the two states. Both bills will likely not become law due to strong opposition. In Rhode Island Governour Don Carcieri has already said he will veto the bill if it makes it to his desk. (Sources: The Stamford Advocate of 5 June 2005, Associated Press of 7 June 2005)

UK: Scotland Yard
The new chief of Scotland Yard, Sir Ian Blair, opposes the government’s plan to re-upgrade the possession of cannabis to an arrestable offence. "Arresting people for small quantities is a waste of time and resources", he said. (Source: The Independent of 20 May 2005)

Science: Depression
The synthetic cannabinoid HU-210 and the endocannabinoid uptake inhibitor AM404 showed antidepressant effects in a rat model of depression. This effect was blocked by a CB1 receptor antagonist suggesting that this action was mediated by CB1 receptors. (Source: Hill MN and Gorzalka BB. EUR Neuropsychopharmacol 2005 May 22; [Electronic publication ahead of print])

USA: Cannabis regulation debate
In a report released on 2 June, Dr. Jeffrey Miron, professor of economics at Harvard University, estimates that replacing marijuana prohibition with a system of taxation and regulation similar to that used for alcoholic beverages would produce combined savings and tax revenues of between 10 billion and 14 billion US-Dollars per year. In response, a group of more than 500 economists – led by Nobel Prize-winner Dr. Milton Friedman – released an open letter to President Bush calling for "an open and honest debate about marijuana prohibition." The report is available at: www.prohibitioncosts.org. (Source: Press release of Marijuana Policy Project of 2 June 2005)

Science: Immune system in multiple sclerosis
During the CAMS study (Cannabis in Multiple Sclerosis) led by Dr. John Zajicek in the UK the effect of THC and cannabis on immune parameters were investigated in 100 participants. There was no evidence for cannabinoid influence on blood levels of the investigated parameters interferon-gamma, interleukin-10, interleukin-12 and C-reactive protein. (Source: Katona S, et al. Clin Exp Immunol 2005;140(3):580-5.)

Science: Ajulemic acid
The synthetic cannabinoid ajulemic acid (IP-751, CT-3) was investigated in animal models of neuropathic pain. It was demostrated to reduce pain without reduction of motor performance that usually follows the application of THC and other CB1 receptor agonists. (Source: Mitchell VA, et al. Neurosci Lett 2005;382(3):231-5.)

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