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IACM-Bulletin of 26 January 2014

IACM/USA: Cannabis is no more dangerous than alcohol Obama says

President Barack Obama believes smoking cannabis is a "bad habit" but thinks legal penalties now fall disproportionately on minorities and that states legalizing cannabis should go ahead with their plans, he said in a profile released on 19 January. "As has been well documented, I smoked pot as a kid, and I view it as a bad habit and a vice, not very different from the cigarettes that I smoked as a young person up through a big chunk of my adult life," he is quoted as saying in a New Yorker magazine article. "I don't think it is more dangerous than alcohol."

He said he is concerned that cannabis-related arrests fall far more heavily on minorities than on others. Legalization of cannabis should go forward in the states of Colorado and Washington because "it's important for society not to have a situation in which a large portion of people have at one time or another broken the law and only a selected few get punished," he said. The Obama administration said last year that federal law enforcement will not target users in Colorado and Washington, as long as they comply with their respective states' laws. The Department of Justice says it will not interfere with states' efforts to regulate and tax cannabis provided they are able to meet a set of requirements, including keeping it from children and restricting its flow into other states.

Reuters of 19 January 2014

Science/Human: Sativex effective in peripheral neuropathic pain in large clinical study

In peripheral neuropathic pain the cannabis extract Sativex may cause clinically important improvements in pain and sleep quality. This is the result of a clinical study with 246 patients at Gartnavel General Hospital of the University of Glasgow, UK. In total, 303 patients with peripheral neuropathic pain were screened; 128 were randomized to Sativex (THC/CBD spray) and 118 to placebo, in addition to their current analgesic therapy.

There was a statistically higher percentage of patients with a pain improvement of more than 30% in the Sativex group compared to the placebo group. There was also a reduction in mean pain scores in both treatment groups that was numerically higher in the THC/CBD spray group, but which failed to reach statistical significance. Secondary measures of sleep quality and Subject Global Impression of Change also demonstrated statistically significant treatment differences in favour of THC/CBD spray treatment.

Serpell M, Ratcliffe S, Hovorka J, Schofield M, Taylor L, Lauder H, Ehler E. A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment. EUR J Pain. 2014 Jan 13. [in press]

Science/Human: THC changes brain waves in patients with obstructive sleep apnea

THC treatment yielded a shift in EEG (electroencephalogram) power toward delta and theta frequencies and a strengthening of normal rhythms in the sleep EEG of 15 patients with obstructive sleep apnea. This is the result of research at the University of Illinois in Chicago, USA. Obstructive sleep apnea is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe.

Dronabinol (THC) was associated with significantly increased theta power, which may be seen in drowsiness or arousal or in meditation. At increasing THC doses, there was a greater fraction of EEG power variance in the delta band. Delta is the frequency range up to 4 Hz, which is seen normally in adults in deep sleep. Authors wrote that THC causes “a strengthening of ultradian rhythms in the sleep EEG,” the 90-120 minute cycling of the sleep stages during human sleep. Previous animal studies suggest that THC may be a treatment option for sleep apnea.

Farabi SS, Prasad B, Quinn L, Carley DW. Impact of Dronabinol on Quantitative Electroencephalogram (qEEG) Measures of Sleep in Obstructive Sleep Apnea Syndrome. J Clin Sleep Med 2014;10(1):49-56.

News in brief

Science/Human: Legalizing medical cannabis reduces suicides
The legalization of medical cannabis in certain states of the USA was associated with a 10.8% and 9.4% reduction in the suicide rate of men aged 20 through 29 years and 30 through 39 years, respectively. Estimates for females were less precise. Authors wrote that the “relationship between legalization and suicides among young men is consistent with the hypothesis that marijuana can be used to cope with stressful life events.”
Department of Agricultural Economics and Department of Economics, Montana State University, Bozeman, USA.
Anderson DM, et al. Am J Public Health. 2014 Jan 16. [in press]

Science/Human: Sativex had no relevant long-term effect on cannabis dependence in clinical study
In a double-blind clinical study with 51 cannabis-dependent treatment seekers, Sativex reduced withdrawal symptoms. Both groups showed reduced cannabis use at follow-up, with no advantage of Sativex over placebo for self-reported cannabis use or cannabis dependence.
National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia.
Allsop DJ, et. al. JAMA Psychiatry. 2014 Jan 15. [in press]

Science/Human: Cannabis may improve sleep of patients with post traumatic stress disorder
According to an analysis of 170 patients with post traumatic stress disorder of a medical cannabis dispensary in California those with high PTSD scores were more likely to use cannabis to improve sleep, and for coping reasons more generally, compared with those with low PTSD scores. Authors wrote that “sleep improvement appears to be a primary motivator for coping-oriented use.”
Center for Innovation to Implementation and National Center for PTSD, VA Palo Alto Health Care System, USA.
Bonn-Miller MO, et al. Drug Alcohol Depend. 2013 Dec 31. [in press]

Holland: There is no reason why cannabis should remain prohibited, report concludes
Commissioned by the Dutch Ministry of justice, the independent policy research organisation RAND EURope wrote a review on the effects of cannabis policies. The report says that “it is clear that the report offers no significant reasons why cannabis should remain prohibited. Nor does the report show any findings that prohibition of cannabis has ever reduced consumption. The report certainly does recognise the emerging international consensus that cannabis has important medical qualities that are being recognised and commercially exploited.”
Multinational overview of cannabis production regimes

France/UK: The pharmaceutical company Ipsen will market Sativex in Latin America
Ipsen, a French pharmaceutical company, and the British company GW Pharmaceuticals announced that they have entered into an exclusive agreement for Ipsen to promote and distribute Sativex, a sublingual cannabis extract spray intended for the treatment of spasticity due to multiple sclerosis in Latin America (excluding Mexico and the Islands of the Caribbean).
GW Pharmaceuticals of 14 January 2014

Italy: The city of Turin decriminalised cannabis
The northern Italian city of Turin has legalized cannabis for medical purposes in a new law and in the second part of the law overruled the restrictive 2006 Fini-Giovanardi law on drugs, which abolished any distinction between soft and hard drugs and introduced the same penalties for possession/use of cannabis and heroin. Now this part of the law may pave the way for legalization of recreational cannabis use in Italy. The medical use of cannabis has been already allowed in some Italian regions like Liguria, Tuscany and Veneto, but the recreational consumption of the drug is still taboo.
Eturbonews of 15 January 2014

Science/Human: THC influences endocannabinoid concentrations
The endocannabinoid blood concentrations were influenced in 25 healthy volunteers, who received a large dose of THC (0.1 mg/kg intravenously). Mean anandamide increased slightly from 0.58 ng/ml at baseline to 0.64 ng/ml and mean 2-AG from 7.60 ng/ml to 9.50 ng/ml within some hours. Then they were reduced to a mean of 0.32 ng/ml for anandamide and to 5.50 ng/ml for 2-AG. Levels returned to normal within 48 hours.
Department of Anaesthesiology, Ludwig-Maximilians University of Munich, Germany.
Thieme U, et al. Drug Test Anal 2014;6(1-2):17-23.

Science/Animal: How THC reduces viral load in monkeys infected with the monkey version of the HIV
It is known that THC reduces viral load in male rhesus macaques infected with SIV, the monkey equivalent of the human HI virus. New research indicates that “chronic THC treatment modulated duodenal T cell populations, favored a pro-Th2 cytokine balance, and decreased intestinal apoptosis.”
Louisiana State University Health Sciences Center, Department of Physiology, New Orleans, USA.
Molina PE, et al. AIDS Res Hum Retroviruses. 2014 Jan 8. [in press]

Science/Human: Certain variants of the CB1 receptor associated with irritable bowel syndrome
A certain variation in the gene, which encodes the CB1 receptor, the so-called “(AAT)n repeat of the CNR1 gene” conferred an increased risk for developing irritable bowel syndrome.
Department of Gastroenterology Hepatology, Guangzhou First People's Hospital, Guangzhou Medical University, China.
Jiang Y, et al. J Gastroenterol Hepatol. 2014 Jan 20. [in press]

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