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IACM-Bulletin of 07 November 2010

Science/UK: Drug experts say in the scientific journal Lancet that alcohol is more dangerous than heroin, cannabis and other illegal drugs

Alcohol is a more dangerous drug than heroin when the combined harms to the user and to others are assessed, British scientists said on 1 November. Presenting a new scale of drug harm that rates the damage to users themselves and to wider society, the scientists rated alcohol the most harmful overall and almost three times as harmful as cocaine or tobacco. According to the scale, devised by a group of scientists including Britain's Independent Scientific Committee on Drugs (ISCD) and an expert adviser to the EURopean Monitoring Centre for Drugs and Drug Addiction (EMCDDA), heroin and crack cocaine rank as the second and third most harmful drugs.

Professor David Nutt, chairman of the ISCD, whose work was published in the Lancet medical journal, said the findings showed that "aggressively targeting alcohol harms is a valid and necessary public health strategy." He said they also showed that current drug classification systems had little relation to the evidence of harm. Drugs were scored out of 100, with 100 given to the most harmful drug and zero indicating no harm at all. The scientists found alcohol was most harmful, with a score of 72, followed by heroin with 55 and crack with 54. Among some of the other drugs assessed were cocaine (27), tobacco (26), amphetamine or speed (23), cannabis (20), benzodiazepines, such as Valium (15), ecstasy (9), anabolic steroids (9), LSD (7) and magic mushrooms (5).

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(Sources: Reuters of 1 November 2010; Nutt DJ, King LA, Phillips LD; on behalf of the Independent Scientific Committee on Drugs. Drug harms in the UK: a multicriteria decision analysis. Lancet. 2010 Oct 29. [in press])

Science: Cannabis extract effective in preventing chemotherapy-induced nausea and vomiting

Several Spanish scientific institutions participated in a small randomized, double-blind, placebo-controlled clinical study of a cannabis extract (Sativex) in the treatment of nausea and vomiting caused by different forms of chemotherapy. Sativex contains nearly equal amounts of THC (dronabinol) and CBD (cannabidiol). Patients suffering from nausea despite prophylaxis with standard anti-emetic treatment were randomized to cannabis or placebo during 5 days post-chemotherapy period, added to standard anti-emetic treatment. The endpoint for the preliminary efficacy analysis was the proportion of patients showing complete or partial response.

Seven patients were randomized to Sativex and nine to placebo. One patient in the cannabis arm was withdrawn due to adverse effects. A higher proportion of patients in the cannabis group experienced a complete response during the overall observation period (71.4 per cent) compared to placebo (22.2 per cent). The incidence of adverse effects was higher in the Sativex group (86 per cent vs. 67 per cent). No serious side effects were reported. The mean daily dose was 4.8 sprays in both groups (corresponding to 12 mg THC for the cannabis group). Authors concluded that cannabis "added to standard antiemetic therapy was well tolerated and provided better protection" against delayed nausea and vomiting.

(Source: Duran M, Pérez E, Abanades S, Vidal X, Saura C, Majem M, Arriola E, Rabanal M, Pastor A, Farré M, Rams N, Laporte JR, Capellŕ D. Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. Br J Clin Pharmacol 2010;70(5):656-63.)

Israel: Soon cannabis in pharmacies

According to the Newsletter of the embassy of Israel in Germany a committee of the health ministry for the medical use of cannabis has recommended on 3 November to include the drug in the official list of medicinal drugs. Already within half a year cannabis should be available in Israelian pharmacies. Following the recommendation of the committee's chair, Dr. Yehuda Baruch, it is intended to form an interministerial committee to clarify open questions.

Baruch said that cannabis is helpful in pain therapy, in illnesses such as multiple sclerosis and helps against nausea for example in cancer chemotherapy. In September 2010 the health ministry authorized five more doctors to prescribe cannabis, which so far was restricted to one doctor (Dr. Baruch). The ministry estimates that in 2010 there will be an increase of 66 percent in the permits for cannabis, allowing treatment for about 5000 patients. In the future, the ministry expects tens of thousands of patients to be treated with cannabis.

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(Source: Newsletter of the Israelian embassy in Germany of 4 November 2010)

News in brief

USA: California
On 2 November Californian voters decided not to make cannabis legal in the state. The California initiative, which would have allowed adults age 21 and older to possess and grow small amounts of cannabis, failed 54 to 46 percent. (Source: Associated Press of 3 November 2010)

USA: South Dakota and Oregon
In South Dakota, voters rejected for the second time a medical cannabis measure - a step first taken by California in 1996 and by 13 other states since. Oregon voters refused to expand their medical cannabis program to create a network of state-licensed non-profit dispensaries. (Source: Associated Press of 3 November 2010)

New Zealand: Sativex
Following the UK, Spain and Canada Sativex was now approved in New Zealand for the treatment of spasticity due to multiple sclerosis. (Source: Press release by GW Pharmaceuticals of 3 November 2010)

Science: HIV
According to research with rhesus macaques at the Louisiana State University Health Sciences Center in New Orleans, USA, the administration of THC may decrease disease progression in a HIV-model. The monkeys were infected with the SI-virus, which is the equivalence to the HI-virus in humans. THC administration was started 30 days before infection. THC administration decreased early mortality from SIV infection, and this was associated with decreased viral load and retention of body mass. Authors speculate "that reduced levels of SIV, retention of body mass, and attenuation of inflammation are likely mechanisms for THC-mediated modulation of disease progression that warrant further study." (Source: Molina PE, et al. AIDS Res Hum Retroviruses. 2010 Sep 28. [in press])

Science: Allergy
According to research at the Taipei Medical University, Taiwan, the administration of cannabidiol (CBD) reduced delayed-type hypersensitivity reactions in mice to a protein (ovalbumin). Scientists found out that CBD curbs delayed-type hypersensitivity reactions by suppressing the infiltration and functional activity of certain immune cells (T cells and macrophages) in the inflammatory site, "suggesting a therapeutic potential for CBD for the treatment of type IV hypersensitivity", a certain type of allergic reaction. (Source: Liu DZ, et al. Acta Pharmacol Sin. 2010 Nov 1. [in press])

Science: Epilepsy
A group at the Virginia Commonwealth University in Richmond, USA, investigated the effects of acetaminophen (paracetamol) in cell experiments with nerve cells on epileptiform discharges. Acetaminophen blocked the epilepsy-like activity, an effect blocked by a CB1 receptor antagonist. Researchers concluded that "acetaminophen was mediating its anticonvulsant effects through CB1 receptors." (Source: Deshpande LS, Delorenzo RJ. Neuroreport. 2010 Oct 28. [in press])

Science: Hemp seed
Researchers at the Department of Human Nutritional Sciences of the University of Toronto, Canada, investigated the composition and quality of protein of hemp seed. They concluded that their data provide evidence that hemp proteins have a protein digestibility equal to or greater than certain grains, nuts, and some pulses. (Source: House JD, et al. J Agric Food Chem. 2010 Oct 26. [in press]).

Science: Parkinson's disease
According to research at the University of Exeter and Plymouth, UK, THC and cannabidiol (CBD) were neuroprotective in a human cell culture model of Parkinson's disease. (Source: Carroll C, et al. J Neurol Neurosurg Psychiatry. 2010;81(11):e60.)

Science: Dyskinesia in Parkinson's disease
According to research at the Toronto Western Research Institute, Canada, the inhibition of fatty acid amide hydrolase (FAAH) inhibited dyskinesia-like hyperactivity in a monkey model of Parkinson's disease. FAAH is responsible for the degradation of the endocannabinoid anandamide. FAAH inhibition increases the concentration of this endocannabinoid. The treatment of Parkinson's disease with L-DOPA is often associated with side effects, including dyskinesia, a movement disorder which is difficult to treat. (Source: Johnston TH, et al. J Pharmacol Exp Ther. 2010 Oct 25. [in press])

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