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IACM-Bulletin of July 27, 2014

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Germany — Court allows seriously ill patients to grow their own cannabis

On 22 July the Administrative Court of Cologne ruled that some people suffering from chronic pain should be able to cultivate their own cannabis for therapeutic purposes. Five people suffering from chronic pain and other diseases brought the complaint to the court after Germany's Federal Institute for Drugs and Medical Devices (BfArM) refused them permission to grow the plant at home.

The court said the BfArM had to reconsider three of the requests that it had rejected. While the plaintiffs all had permits to buy and consume cannabis for therapeutic purposes from a pharmacy they wanted to cultivate their own because they could not afford to purchase the drug produced by the Dutch company Bedrocan and their health insurance did not cover it. "Until now it has not been legal for anyone to grow cannabis at home but these seriously ill people will now be allowed to," court spokeswoman Stefanie Seifert said, adding that it nonetheless remained illegal for others to grow it.

“This is a court battle, which we started in 1999,” Dr Franjo Grotenhermen, chairman of the German Association for Cannabis as Medicine, explained. “We have reasons to believe that the Federal Government will appeal the ruling before the Higher Administrative Court in Munster and that a final decision may only be achieved before the Federal Administrative Court in Leipzig.” Currently about 300 Germans with therapy resistant severe medical conditions are allowed to buy cannabis with a special permission by the BfArM, which was forced by the Federal Administrative Court in 2005 to issue such approvals. So far, the Government did not comment on the ruling. “We are confident and the Government needs some time to adapt to the idea that the patients finally will win their battle given the wording of the court’s decision in 2005.”

Reuters of 22 July 2014

Associated Press of 22 July 2014

Science/Human — THC safe for therapeutic use in older persons

THC appeared to be safe and well tolerated by healthy older individuals. This is the result of a placebo controlled study by researchers of several hospitals in the Netherlands. They evaluated the safety and pharmacokinetics of three oral doses of Namisol, a novel THC preparation in tablet form, in older subjects. Twelve healthy older subjects with a mean age of 72 years randomly received a single oral dose of 3mg, 5mg, or 6.5mg of THC or matching placebo, in a crossover manner, on each intervention day.

THC was safe and well tolerated. The most frequently reported adverse events were drowsiness (27%) and dry mouth (11%). There was a wide inter-individual variability in plasma concentrations of THC. Overall, the pharmacological effects of THC were smaller than effects previously reported in young adults. Authors wrote that “Data on safety and effectiveness of THC in frail older persons are urgently required, as this population could benefit from the therapeutic applications of THC.”

Ahmed AI, van den Elsen GA, Colbers A, van der Marck MA, Burger DM, Feuth TB, Rikkert MG, Kramers C. Safety and pharmacokinetics of oral delta-9-tetrahydrocannabinol in healthy older subjects: A randomized controlled trial. Eur Neuropsychopharmacol. 2014 Jun 28. [in press]

Science/Animal — How THC could slow tumour growth

Scientists at the University of East Anglia in Norfolk, UK, have shown how THC, the main psychoactive ingredient in cannabis, could reduce tumour growth in cancer patients. Research reveals the existence of previously unknown signalling platforms which - in addition to already know mechanisms - are responsible for the drug's success in shrinking tumours. The research was co-led by scientists of Complutense University of Madrid, Spain.

The team used samples of human breast cancer cells to induce tumours in mice. They then treated the tumours with THC and found that two cell receptors in particular were responsible for the drug's anti-tumour effects. "We show that these effects are mediated via the joint interaction of CB2 and GPR55 -- two members of the cannabinoid receptor family. Our findings help explain some of the well-known but still poorly understood effects of THC at low and high doses on tumour growth,” Dr Peter McCormick, from UEA's school of Pharmacy, said. "By identifying the receptors involved we have provided an important step towards the future development of therapeutics that can take advantage of the interactions we have discovered to reduce tumour growth."

Moreno E, et al. J Biol Chem. 2014 Jun 18. [in press]

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Science Daily of 14 July 2014

News in brief

Australia — Majority supports the medical use of cannabis

Almost two-thirds of Australians support the legalization of cannabis for medicinal purposes, according to a new poll. It comes as the Prime Minister of New South Wales Mike Baird indicated that he supported the use of medical cannabis, despite having concerns about its supply and regulation.

The Age of 23 July 2014

USA — Oregon will vote on legalisation of cannabis

An initiative seeking to legalize, tax and regulate recreational cannabis in Oregon has collected enough signatures for a referendum in November 2014, the state says on its website. Only two U.S. states, Washington and Colorado, currently allow recreational cannabis, which remains illegal under federal law.

Reuters of 22 July 2014

Spain — Increasing numbers of cannabis clubs

According to an analysis by the New York Times about 300 new cannabis clubs have opened in Barcelona and the surrounding Catalan region, in recent years, a result, at least in part, of Spanish citizens looking for new ways to earn a living in a country with a high unemployment rate, experts say. Many of them offer membership over the Internet or by phone.

New York Times of 11 July 2014

Science/Human — Cannabis use does not influence adherence to HIV treatment

In a large study regular cannabis use was not associated with adherence to antiretroviral therapy (ART) of HIV positive patients. Authors concluded that “these findings suggest cannabis may be utilized by PLWHA for medicinal and recreational purposes without compromising effective adherence to ART.”

St. Paul's Hospital, Vancouver, Canada.

Slawson G, et al. AIDS Behav. 2014 Jul 11. [in press]

Science/Human — Cannabis use had no major negative effects on patients with schizophrenia

In a study with 110 patients with schizophrenia “there was no evidence of a specific association between cannabis use and positive symptoms, or negative symptoms, relapse or hospital admissions. However, a greater dose of cannabis was associated with subsequent higher depression and anxiety.”

School of Psychological Sciences, University of Manchester, UK.

Barrowclough C, et al. Schizophr Bull. 2014 Jul 9. [in press]

Science/Human — Only small increased risk for schizophrenia by cannabis use

In a large study with 5456 individuals with an initial diagnosis of schizophrenia cannabis use was associated with a small increase of risk for the disease by a factor of 1.6 after controlling for other risk factors. The use of stimulants and cocaine was also associated with a small increase in risk.

Center for Primary Health Care Research, Lund University, Malmö, Sweden.

Giordano GN, et al. Psychol Med. 2014 Jul 3:1-8. [in press]

Science/Cells — CBD and CBDV activate vanilloid receptors

The non-psychotropic plant cannabinoids, cannabidivarin (CBDV) and cannabidiol (CBD), activate vanilloid receptors (TRPV1) in cell experiments. Researchers propose a “potential for the treatment of neuronal hyperexcitability”, such as epilepsy.

Endocannabinoid Research Group, Pozzuoli, Italy.

Iannotti FA, et al. ACS Chem Neurosci. 2014 Jul 16. [in press]

Science/Animal — Low levels of anandamide are associated with increased susceptibility to stress

Animal studies with mice indicate that the brain levels of the endocannabinoid anandamide predict acute stress-induced anxiety. Authors concluded that these studies "provide further support that eCB-augmentation is a viable pharmacological strategy for the treatment of stress-related neuropsychiatric disorders.”

Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, USA.

Bluett RJ, et al. Transl Psychiatry. 2014 Jul 8;4:e408.

Science/Human — Certain variants of the CB1 receptor are associated with impulsivity

In 323 adolescents certain variants of the gene, which encodes the CB1 receptor “may play a role in determining adolescent impulsive behavior.”

Central Institute of Mental Health, Mannheim, Germany.

Buchmann AF, et al. J Neural Transm. 2014 Jul 1. [in press]

Science/Cells — Cannabinoid receptor antagonists inhibit hepatitis C virus production

Cannabinoid receptor-1 antagonists inhibited hepatitis C virus production in a cell model, “providing a novel class of antiviral host targeting agents.”

University of Sydney at Westmead Hospital, Australia.

Shahidi M, et al. J Gen Virol. 2014 Jul 22. [in press]