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IACM-Bulletin of 30 April 2017

Mexico: Parliament approved the medical use of cannabis

Mexico's Congress passed a bill on 28 April to legalize the use of cannabis for medical and scientific purposes. The bill had already passed the Senate in December 2016 and will now be sent to President Enrique Pena Nieto, who is expected to sign it.

"The ruling eliminates the prohibition and criminalization of acts related to the medicinal use of marijuana and its scientific research, and those relating to the production and distribution of the plant for these purposes," the Congress said in a statement. The measure passed in a vote with 371 in favour, seven against and 11 abstentions, and now classifies THC as "therapeutic."

Reuters of 28 April 2017

Science/Human: Cannabis use is associated with a lower prevalence of non-alcoholic fatty liver disease according to a large study

In a population-based case-control study with 5,950,391 patients of the 2014 Healthcare Cost and Utilization Project (HCUP) cannabis use was associated with a significantly reduced prevalence of non-alcoholic fatty liver disease. This is the result of research by scientists from several scientific institutions in the USA and Canada.

After identifying patients with non-alcoholic fatty liver disease (1% of all patients), they identified three exposure groups: non-cannabis users (98.0%), non-dependent cannabis users (1.7%), and dependent cannabis users (0.2%). They found an about 20% (adjusted odds ratio: 0.82) reduced prevalence of the disease in all cannabis users compared to non-users. The effect was even stronger in dependent users with a reduction by 52% (adjusted odds ratio: 0.49).

Adejumo AC, Alliu S, Ajayi TO, Adejumo KL, Adegbala OM, Onyeakusi NE, Akinjero AM, Durojaiye M, Bukong TN. Cannabis use is associated with reduced prevalence of non-alcoholic fatty liver disease: A cross-sectional study. PLoS One. 2017 Apr 25;12(4):e0176416.]

Science/Human: The medical use of cannabis may reduce medical costs of Medicaid in the USA by about one billion dollars

Using quarterly data on Medicaid prescriptions in the period 2007-2014, researchers of the University of Georgia in Athens, USA, tested the association between medical cannabis laws and the average number of prescriptions filled by Medicaid beneficiaries.

They found that the use of prescription drugs was lower in states with medical cannabis laws than in states without such laws in five of the nine broad clinical areas they studied. If all states had had a medical cannabis law in 2014, they estimated that total savings could have been 1.0 billion dollars (about 0.9 billion EURos). Medicaid in the USA is a social health care program for families and individuals with limited resources.

Bradford AC, Bradford WD. Medical Marijuana Laws May Be Associated With A Decline In The Number Of Prescriptions For Medicaid Enrollees. Health Aff (Millwood). 2017 Apr 19. [in press]

Science/Human: In states with medical cannabis laws illegal use of cannabis is higher than in states without these laws in the USA

Where the medical use of cannabis is legal in the USA, adults are more likely to use the drug illegally and are at an increased risk of cannabis use disorder. The risks of medical cannabis laws are important to convey, said lead author Deborah Hasin, of Columbia University’s Mailman School of Public Health in New York. Previous research that focused on adolescents' use and didn't find an increase in that age group, she said. "The laws may not be too relevant and salient to teenagers so we thought it was important to look at adults," said Hasin.

In states that never legalized medical cannabis, the average prevalence of illicit use was 4.5% in 1991 and 1992, rising to 6.7% in 2012 and 2013. By comparison, in states where the drug did become legal for medical use, the rate of illicit use went from 5.6% to 9.2%. The pattern was similar for drug use disorders. The average rate went from 1.4% in 1991-1992 to 2.3% in 2012-2013 in states that didn't enact medical cannabis laws, and from 1.5% to 3.1% in states that did.

Hasin DS, Sarvet AL, Cerdá M, Keyes KM, Stohl M, Galea S, Wall MM. US Adult Illicit Cannabis Use, Cannabis Use Disorder, and Medical Marijuana Laws: 1991-1992 to 2012-2013. JAMA Psychiatry. 2017 Apr 26. [in press]

Reuters of 26 April 2017

News in brief

Science/Human: New report by the WHO on the health effects of cannabis use
A new report by the World Health Organisation on the “the health and social effects of nonmedical cannabis use” edited by Wayne Hall, Maria Renström & Vladimir Poznyak is now available online.
The health and social effects of nonmedical cannabis use

Science/Human: Cannabis increases the reaction to erotic stimuli
In a study with 21 heterosexual casual cannabis users cannabis use increased activation of the right nucleus accumbens, a certain brain region, to erotic stimuli. This effect was limited to users whose prolactin concentration was not elevated in response to cannabis intake. Authors wrote that “this effect may be useful in the treatment of low sexual desire.”
National Institute of Mental Health, Klecany, Czech Republic.
Androvicova R, et al. Psychopharmacology (Berl). 2017 Apr 12. [in press]

Science/Animal: Cannabinoids could help infertile women
Research with cells and mice shows that activation of the CB1 receptor enhances the maturation of oocytes, immature egg cells. Researchers wrote that their data “suggest that cannabinoid agonists may be useful in vitro maturation supplements. For in vitro fertilization patients intolerant to gonadotropins, this could be a promising and only option.”.
Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Madrid, Spain.
López-Cardona AP, et al. FASEB J. 2017 Apr 20. [in press]

Science/Human: CBD extract reduces seizures in patients with Lennox-Gastaut syndrome
The third large clinical trial with the CBD extract Epidiolex of the British company GW Pharmaceuticals in children and adults with Lennox-Gastaut syndrome confirmed the efficacy of CBD in this disease. Adding Epidiolex to patients’ current treatment significantly reduced the frequency of seizures at both the 10 mg/kg/day and 20mg/kg/day doses. During the 14-week treatment period, patients taking both doses of Epidiolex saw a significantly greater median reduction in monthly seizures (37% and 42%, respectively) compared with a 17% reduction for placebo.
Press release by GW Pharmaceuticals of 18 April 2017

Science/Human: Cannabis use may increase the risk for heart attacks in HIV positives
In a study with 558 HIV-infected men the use of cannabis was associated with an increased risk of cardiovascular events independent of tobacco smoking and other risk factors. The risk was increased by 2.5-fold.
Massachusetts General Hospital, Boston, USA.
Lorenz DR, et al. Clin Infect Dis. 2017 Apr 25. [in press]

Science/Animal: A cannabinoid together with a standard anti-epileptic drug improved epilepsy outcome
In a study with mice with epilepsy the combination of the synthetic cannabinoid arachidonyl-2'-chloroethylamide (ACEA) and valproic acid improved treatment outcome. In addition the combination of the cannabinoid and valproic acid stimulated the creation of new nerve cells, which was not the case for valproic acid alone.
Institute of Rural Health, Lublin, Poland.
Mach M, et al. Int J Mol Sci. 2017;18(5).

Science/Human: The endocannabinoid system acts as a regulator of immune homeostasis in the gut
The endocannabinoid system plays a major role in immune functions of the bowel. For example, oral administration of the endocannabinoid anandamide provided in certain mice (non-obese diabetic mice) protection from type 1 diabetes. Authors wrote that their research “unveils a role for the endocannabinoid system in maintaining immune homeostasis in the gut/pancreas.”
University of Connecticut School of Medicine, Farmington, USA.
Acharya N, et al. Proc Natl Acad Sci USA. 2017 Apr 24. [in press]

Science/Human: Fatal allergic reaction to cannabis
As other plants cannabis may cause allergies. Researchers reported a fatal allergic reaction (anaphylactic reaction) in a 33-year-old woman, who had injected a cannabis solution into her veins.
Forensic Science, Adelaide, Australia.
Gilbert JD, et al. Med Sci Law. 2017;57(2):91-94

Science: THC preparation, which may be used as nasal spray
Researchers developed a THC preparation as an aqueous nasal spray to make the THC effect quickly happen. They wrote that “by adding additional chemical stabilizers, and producing under protective conditions, a commercial formulation for patient seems feasible.”
Free University of Berlin, Germany.
Hommoss G, et al. EUR J Pharm Biopharm. 2017 Apr 19. [in press]

Science/Animal: Both CBD and CBDA reduce anxiety
In a study with rats both cannabidiol (CBD) and cannabidiol acid (CBDA) reduced anxiety, but only if the animals were stressed. Authors wrote that “these results suggest the anxiolytic effects of CBDA and CBD may require the presence of a specific stressor.”
Department of Psychology and Collaborative Neuroscience Program, University of Guelph, Canada.
Rock EM, et al. Psychopharmacology (Berl). 2017 Apr 20. [in press]

Science/Human: CBD may be helpful in the treatment of anxiety even in low doses
At the Psychedelic Science Conference from 19-24 April in San Francisco a large case series of 136 patients was presented, which shows that CBD even in low doses of 40-50mg may be useful in the treatment of anxiety.
Children’s Hospital, University of Colorado, Denver, USA.
Shannon S. Cannabidiol in the Treatment of Anxiety: A Large Case Series. Presented on 21 April 2017.

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