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IACM-Bulletin of 09 November 2008

USA: Michigan becomes the thirteenth state to legalize the medical use of cannabis

Voters in Michigan overwhelmingly approved a measure on the medical use of cannabis on 4 November, making it the 13th state to allow severely ill patients to use the drug for medicinal purposes. The measure was supported by 63 percent of voters. It removes state penalties for registered patients to buy, grow and use small amounts of cannabis. Of the 12 other states with medical cannabis laws, eight stemmed from ballot initiatives as in Michigan; four were enacted by state legislatures. Alaska, Arizona, California, Colorado, Hawaii, Maine, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington have legalized the medical use of cannabis.

While the measure will remove state-level penalties for registered patients using cannabis, it won't create legal dispensaries for the drug. Nor will it affect the federal ban on cannabis, which makes possessing cannabis for any purpose illegal. However, Barak Obama, the new president, has announced several times during his campaign for presidency that he would end federal raids on medical cannabis suppliers in states with their own laws.

More at:

Results of all ten ballot initiatives on cannabis use of 4 November 2008 at:

(Sources: Associated Press of 5 November 2008, San Francisco Chronicle of 12 May 2008)

Science/Europe: Recommendation of suspension of the marketing authorisation of rimonabant and discontinuation of clinical research into cannabinoid receptor antagonists

The EURopean Medicines Agency (EMEA) has recommended the suspension of the marketing authorisation for Acomplia (rimonabant), a cannabinoid receptor antagonist developed and marketed by Sanofi-Aventis. The agency has concluded that the benefits of rimonabant no longer outweigh its risks and the marketing authorisation should be suspended across the EURopean Union. Acomplia has been authorised in the EURopean Union since June 2006 as a treatment of overweight patients. The EMEA stated that according to new research there is an approximate doubling of the risk of psychiatric disorders in obese or overweight patients taking Acomplia compared to those taking placebo. In addition, the agency noted, that the effectiveness of Acomplia in clinical practice is more limited than was expected on the basis of the clinical trials.

The company Sanofi-Aventis said on 5 November that it is halting all research on rimonabant and the company Pfizer hours later said it is ending research on a similar drug. Both drugs work by blocking cannabinoid-1 receptors, that are activated by endocannabinoids and THC. If activated they induce an increased appetite. If blocked they reduce it. A few years ago, many scientists considered rimonabant as a remarkable medicinal drug, saying it showed promise in helping people lose weight, control blood sugar and other aspects of diabetes, lower cholesterol, quit smoking and stop abusing alcohol, cannabis and cocaine. But there were also warnings that blocking of the CB1 receptor may increase the risk for depression and suicide. Sanofi-Aventis said in a brief statement it was stopping ongoing clinical trials with rimonabant for all uses, "in light of recent demands by certain national health authorities."

More at:

(Sources: Press release by the EURopean Medicines Agency of 23 October 2008, Associated Press of 5 November 2008)

Science: Cannabis extract did not have psychopathological or cognitive effects on MS patients in a clinical study

According to a placebo-controlled clinical study conducted at the University of Rome, Italy, the cannabis extract Sativex did not cause psychopathological states or cognitive deficits in patients with multiple sclerosis. In this 8-week crossover trial 17 patients received Sativex and placebo for three weeks each.

Scores of investigated variables of psychopathology and cognition after cannabis and placebo showed no significant differences. A significant positive correlation was found between THC blood levels and scores of aggressive behaviour and paranoiac tendencies. Researchers concluded that "cannabinoid treatment did not induce psychopathology and did not impair cognition in cannabis-na´ve patients with MS. However, the positive correlation between blood levels of delta-9-tetrahydrocannabinol and psychopathological scores suggests that at dosages higher than those used in therapeutic settings, interpersonal sensitivity, aggressiveness, and paranoiac features might arise."

(Source: Aragona M, Onesti E, Tomassini V, Conte A, Gupta S, Gilio F, Pantano P, Pozzilli C, Inghilleri M. Psychopathological and cognitive effects of therapeutic cannabinoids in multiple sclerosis: a double-blind, placebo controlled, crossover study. Clin Neuropharmacol. 2008 Oct 23. [Electronic publication ahead of print])

News in brief

USA: Massachusetts
On 4 November 65 percent of voters approved a measure, which replaces criminal penalties for the possession of up to one ounce of cannabis (28.5 grams) by a civil fine of no more than 100 Dollars (about 78 EURos). Massachusetts is the thirteenth state to decriminalize the personal use and possession of cannabis. (Source: NORML of 5 November 2008)

Science: Pain
It was demonstrated in animal studies that pain associated with bone cancer resulted in a decrease in levels of anandamide in the skin. This decrease was associated with an increased degradation of anandamide by fatty acid amide hydrolase (FAAH). Local injections of anandamide reduced pain. Researchers concluded that the "manipulation of peripheral endocannabinoid signalling is a promising strategy for the management of bone cancer pain." (Source: Khasabova IA, et al. J Neurosci 2008;28(44):11141-52.)

Science: Schizophrenia
People who have long-lasting psychotic episodes after cannabis use may be exhibiting early signs of schizophrenia, researchers of Aarhus University, Denmark, reported. Between 1994 and 2005, 609 individuals received treatment of a cannabis-induced psychosis and 6476 received treatment of a schizophrenia spectrum disorder. Predisposition to both psychiatric disorders contributed equally to the risk of later treatment because of schizophrenia and cannabis-induced psychoses. Researchers concluded from the results of their study that "cannabis-induced psychosis could be an early sign of schizophrenia rather than a distinct clinical entity." (Source: Arendt M, et al. Arch Gen Psychiatry 2008;65(11):1269-74.)

Science: Weight reduction
According to Italian researchers weight reduction in 49 men resulted in changes of endocannabinoid blood concentrations. After one year of lifestyle modification and an average decrease in body weight of 6.4 kg plasma levels of 2-arachidonoyl glycerol was decreased by 62 per cent and of anandamide by 7 per cent. (Source: Di Marzo V, et al. Diabetologia. 2008 Oct 30. [Electronic publication ahead of print])

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