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IACM-Bulletin of 26 July 2015

Science/Human: Cannabis use improved the treatment outcome in patients, who were treated for opioid dependence

The severity of opioid withdrawal was reduced by THC (dronabinol) and patients using cannabis had better treatment outcomes. This is the result of a study with 60 opioid dependent patients conducted by scientists of Columbia University in New York. Participants were randomized to receive THC 30mg daily (n=40) or placebo (n=20), under double-blind conditions, while they underwent detoxification in a clinic. THC or placebo was given while in the clinic and for 5 weeks afterwards.

The severity of opioid withdrawal during the phase in the clinic was lower in the THC group relative to placebo group. Rates of successful completion of treatment (THC 35%, placebo 35%) were not significantly different. An analysis showed that the 32% of participants who smoked cannabis regularly during the outpatient phase had significantly lower ratings of insomnia and anxiety and were more likely to complete the 8-week trial. Authors concluded that “dronabinol reduced the severity of opiate withdrawal during acute detoxification.” Participants who elected to smoke cannabis during the trial “were more likely to complete treatment regardless of treatment group assignment.” Thus, cannabis was more effective than the administered THC dose.

Bisaga A, Sullivan MA, Glass A, Mishlen K, Pavlicova M, Haney M, Raby WN, Levin FR, Carpenter KM, Mariani JJ, Nunes EV. The effects of dronabinol during detoxification and the initiation of treatment with extended release naltrexone. Drug Alcohol Depend. 2015 Jul 8. [in press]

USA: Retirees increasingly move to states, where the medical use of cannabis is legal

When choosing retirement locales, a few factors are considered: climate, proximity to grandchildren, access to quality healthcare. But many retirees prefer states where they can be treated with cannabis. Figuring out how many people are retiring to states that let you use cannabis is challenging since retirees do not have to check off a box on a form saying why they chose a particular location to their final years.

But "there is anecdotal evidence that people with health conditions which medical cannabis could help treat, are relocating to states with legalized cannabis," said Michael Stoll, a professor of public policy at University of California in Los Angeles who studies retiree migration trends. He cited data from United Van Lines, which show the top U.S. moving destinations in 2014 was Oregon. The Mountain West - including Colorado, which legalized medical cannabis in 2000, and recreational use in 2012 - boasted the highest percentage of people moving there to retire, United Van Lines said. One-third of movers to the region said they were going there specifically to retire.

Reuters of 22 July 2015

News in brief

USA: Hawaii establishes a licensing system for medical cannabis dispensaries
Governor David Ige signed a law relating to medical cannabis, which establishes a licensing system for medical cannabis dispensaries.
Press release by the governor of Hawaii of 15 July 2015

Science/Human: The number of allergies to cannabis is on the rise
For about a decade, cannabis allergy seems to be on the rise. Both active and passive exposure to cannabis allergens may lead to a cannabis allergy. The clinical manifestations of a cannabis allergy can vary from mild to life-threatening reactions.
Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.
Decuyper I, et al. Arch Immunol Ther Exp (Warsz). 2015 Jul 16. [in press]

USA: Case report on traumatic death after cannabis use in Colorado
A police report indicated that initially a 19-year-old man ate only a single piece of his cookie, as directed by the sales clerk. Approximately 30-60 minutes later, not feeling any effects, he consumed the remainder of the cookie. During the next 2 hours, he reportedly exhibited erratic speech and hostile behaviours. Approximately 3.5 hours after initial ingestion, and 2.5 hours after consuming the remainder of the cookie, he jumped off a fourth floor balcony and died from trauma.
Hancock-Allen JB, et al. MMWR Morb Mortal Wkly Rep 2015;64(28):771-772.

Science/Human: Passive smoking of cannabis may result in positive blood tests for THC
In a study with 6 experienced cannabis users and 6 non-smokers extreme passive smoking resulted in positive tests for THC in oral fluid and blood up to 3 h following exposure. Authors concluded that “extreme second-hand cannabis smoke exposure mimicked, though to a lesser extent, active cannabis smoking.”
Johns Hopkins University School of Medicine, Baltimore, USA.
Cone EJ, et al. J Anal Toxicol. 2015 Jul 2 [in press]

Science/Cells: How CBD may protect genes
In tests with THC, CBD (cannabidiol) and CBN (cannabinol) CBD increased most potently the activity of CYP1A1. This enzyme was shown to degrade the carcinogen benzo(a)pyrene. Previous research had shown that CYP1A1 may have a protective effect on genes which was attributed to the fact that CYP1A1 is highly active in the mucosa of the bowel, and thus inhibits infiltration of ingested benzo(a)pyrene carcinogen into the blood.
Department of Pharmacy, Shinshu University Hospital, Matsumoto, Japan.
Yamaori S, et al. Life Sci. 2015 Jul 15.[in press]

Science/Animal: Endocannabinoid system involved in fever
A study with mice shows that degradation of the endocannabinoid 2-AG (2-arachidonoylglycerol) is necessary for the production of prostaglandin E2 (PGE2) in the hypothalamus, which is essential for the development of fever.
Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan.
Kita Y, et al. PLoS One 2015;10(7):e0133663.

Science/Animal: Endocannabinoids reduce bladder over-activity
URB937, a peripherally-restricted inhibitor for FAAH (fatty acid amide hydrolase), reduces bladder over-activity and hyperactivity of bladder afferent nerve fibres in rats. This inhibition of FAAH results in an increase of the endocannabinoid anandamide, which then exhibits its effects on the bladder.
The University of Tokyo Graduate School of Medicine, Japan.
Aizawa N, et al. BJU Int. 2015 Jul 18. [in press]

Science/Animal: The endocannabinoid 2-AG may be used for the treatment of neurodegenerative diseases
Alpha/beta-hydrolase domain 6 (ABHD6) is an enzyme, which degrades 2-AG (2-arachidonoylglycerol) and thus can fine-tune the endocannabinoid signalling in the central nervous system. New research suggests “that inhibition of ABHD6 might be used as an ideal strategy for the treatment of MS and other neurodegenerative diseases.”
Uniformed Services University of the Health Sciences, Bethesda, USA.
Wen J, et al. Neuropharmacology. 2015 Jul 16. [in press]

Science/Animal: Activation of the CB2 receptor may be beneficial in stroke
In a study with rats researchers found out that early treatment with cannabinoids, which activate the CB2 receptor, suppress nerve cell degeneration in stroke animals.
Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Taiwan.
Yu SJ, et al. PLoS One 2015;10(7):e0132487

Science/Animal: Anandamide causes relaxation of arteries in hypertensive rats
A new study demonstrates that the endocannabinoid anandamide enhances the endothelium-dependent relaxation of the aorta through activation of both CB1 and CB2 receptors. The scientists tested this effect in rats with hypertension.
Department of Physiology, Hebei Medical University, Shijiazhuang, China.
Guo Z, et al. Clin Exp Pharmacol Physiol. 2015 Jul 14. [in press]

Science/Animal: A synthetic CB2 receptor inverse agonist shows promise for neuroprotection
In studies with mice the synthetic CB2 receptor inverse agonist SMM-189 shows promise for the treatment of traumatic brain injury and possibly neurodegenerative disorders.
College of Pharmacy, University of Tennessee Health Science Center Memphis, USA.
Presley C, et al. Pharmacol Res Perspect. 2015 Aug;3(4):e00159.

Science/Animal: The CB2 receptor is involved in bone changes associated with breast cancer
Researchers used mouse models to demonstrate “that both, CB2 selective activation and antagonism have potential efficacy in cancer associated bone disease but further studies are warranted and ongoing.”
University of Edinburgh, UK.
Sophocleous A, et al. J Biol Chem. 2015 Jul 20. [in press]

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