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IACM-Bulletin of 26 November 2017

Science/Human: The use of cannabis in addition to opioids decreased opioid use and improved quality of life

In 37 pain patients, who received opioids and in addition were treated with cannabis, use of opioids decreased and quality of life improved compared to 29 patients, who only received opioids. This is the results of research conducted at the University of New Mexico (USA). Over a period of 21 months scientists compared the development of opioid prescriptions.

Patients, who used cannabis, stopped opioid use more often and had a lower intake of opioids one year after enrolment in the medical cannabis program (MCP). Survey responses also indicated improvements in pain reduction, quality of life, social life, activity levels, and concentration, and few side effects from using cannabis. Authors concluded: “The clinically and statistically significant evidence of an association between MCP enrolment and opioid prescription cessation and reductions and improved quality of life warrants further investigations on cannabis as a potential alternative to prescription opioids for treating chronic pain.”

Vigil JM, Stith SS, Adams IM, Reeve AP. Associations between medical cannabis and prescription opioid use in chronic pain patients: A preliminary cohort study. PLoS One. 2017;12(11):e0187795.

Science/Human: In patients with heart failure cannabis use is associated with lower mortality in hospital

According to an US wide study with more than 6 million hospital stays due to heart failure over a period of 7 years cannabis use was associated with a reduced risk to die in hospital. Study results were published in the journal Circulation. Cannabis users had lower rates of atrial fibrillation (irregular heartbeat).

Among 6,065,000 heart failure hospitalizations, there were 1,213 (0.02%) cannabis dependent users and 23,737 (0.40%) cannabis non-dependent users. When compared to non-users researchers observed significantly reduced odds of atrial fibrillation among cannabis users by about 30% in dependent users and by about 20% in non-dependent users. Mortality during the hospital stay was reduced by 58% in cannabis dependent users and by 46% in non-dependent users. Authors wrote, that “this study provides important opportunity to explore the preventive mechanism of cannabis on atrial fibrillation and its therapeutic potential in heart failure patients.”

Adegbala O, Akinjero A, Adejumo A, Alliu S, Akintoye E, Edo-Osagie E, Akinyemiju T. Among Patients With Heart Failure, Cannabis Use is Associated With Reduced Occurrence of Atrial Fibrillation and In-hospital Mortality; Evidence From the Nationwide Survey 2007-2014. Circulation. 2017;136:A14752.

News in brief

Peru: Legalisation of the medical use of cannabis
Peru joins the ranks of several other Latin American countries moving towards the legalization of cannabis for medicinal purposes. Peru's President Pedro Pablo Kuczynski has signed a bill to legalize the use of cannabis and cannabis products, such as cannabis oil, to treat diseases such as Parkinson's disease, cancer and epilepsy. Now the government will discuss the regulations accompanying the law with other sectors of civil society.
Telesur of 17 November 2017

USA: Legalisation of cannabis in Oregon did not increase cannabis use in young people, but increased use in those, who were already using it
According to a study with 444 adolescents in Oregon legalization of recreational cannabis did not increase cannabis use for youth who did not use cannabis but did increase use in youth who were already using the drug.
Oregon Research Institute, Eugene, USA.
Rusby JC, et al. Psychol Addict Behav. 2017 Nov 16. [in press]

Science/Cells: Activation of the CB1 receptor protects nerve cells
The activation of the CB1 receptor by a synthetic cannabinoid protected nerve cells, which were stressed by inflammation or stress on the endoplasmatic reticulum within the cells, reduced programmed cell death (apoptosis) and improved survival. Authors wrote, that “these data suggest that the endocannabinoid system is a potential therapeutic target in neurodegenerative processes.”
University of São Paulo, Brazil.
Vrechi TA, et al. Neurotox Res. 2017 Nov 13. [in press]

Science/Animal: CBD had little effect on behaviour following THC administration in rats
In a study with rats CBD given together with THC inhibited degradation of THC and had very little effects on behaviour caused by THC. After administration of CBD alone THC could be detected in blood and brain suggesting some conversion of CBD to THC in the body.
Charles University and General University Hospital in Prague, Czech Republic.
Hložek T, et al. EUR Neuropsychopharmacol. 2017 Nov 9 [in press]

Science/Human: Cannabis may cause allergies due to a certain cannabis protein
Cannabis contains a protein of the family of so-called lipid transfer proteins (LTP). This cannabis protein is called Can s 3. LTPs are widespread in vegetables and fruits, for example peaches, walnuts and tomatoes and may be responsible for allergies against these plants. It may be possible to become allergic against cannabis by a mechanism of cross-allergy to other LTPs.
Département de Pneumologie, Oncologie Thoracique et Allergologie, CHU, Angers Cedex, France.
Drouet M, et al. Rev Pneumol Clin. 2017 Nov 6. [in press]

Science/Cells: CBD may bind to the CB2 receptor to influence the effects of other cannabinoids binding to this receptor
Low concentrations of CBD were able to reduce the effects of a synthetic cannabinoid (JWH132), which binds to the CB2 receptor. And this CBD effect may be due to a so-called allosteric modulation of the cannabinoid-2 receptor.
Facultad de Medicina, Universidad de Oviedo, Spain.
Martínez-Pinilla E, et al. Front Pharmacol. 2017;8:744.

Science/Human: Influence of the synthetic cannabinoid JWH-018 on subjective experience in humans
In a placebo-controlled study with 6 healthy cannabis users the synthetic cannabinoid JWH-018 in doses of 2 and 3 mg caused subjective effects, which are similar to those after cannabis use. The strongest effects were observed at 1 and 2 hours after administration.
Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.
Theunissen EL, et al. Br J Pharmacol. 2017 Nov 22. [in press]

Science/Cells: Activation of the GPR55 receptor causes relaxation of the arteries
A body’s own substance (l-alpha-lysophosphatidylinositol) binds to the GPR55 receptor, a probable cannabinoid receptor. And this substance was able to relax lung arteries taken from humans. This effect involved the endothelium, the inner lining of arteries.
Medical University of Białystok, Poland.
Karpińska O, et al. Life Sci. 2017 Nov 16. [in press]

Science/Human: Cannabis use in pain patients was associated with a higher risk for opioid misuse
In a survey with 371 patients, who were on long-term opioid therapy, 18% also used cannabis against their pain. The additional use of cannabis was associated with a significantly increased risk of prescription opioid misuse.
VA Portland Health Care System, USA.
Nugent SM, et al. Gen Hosp Psychiatry. 2017;50:104-110

Science/Human: Cannabis, alcohol and nicotine have an impact on brain connectivity, but effects differ
In 534 people with different drug use patterns (cannabis, alcohol, nicotine and combinations of 2 or all 3 drugs) functional magnetic resonance imaging of the brain was performed to investigate possible brain connectivity alterations. Authors “concluded that all of the substances have an impact on brain connectivity, but the effect differs.” Functional brain connectivity refers to a pattern of connections between distinct units within the brain.
The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, USA.
Vergara VM, et al. Neuropsychopharmacology. 2017 Nov 14. [in press]

Science/Human: Heavy cannabis use was associated with increased risk of dropout from opioid agonist therapy
In a study with 644 patients undergoing opioid agonist therapy, of whom 328 were cannabis users at the beginning of the study and 256 were considered as heavy users, male patients with heavy cannabis use had a higher risk of stopping the opioid therapy.
Northern Ontario School of Medicine, Sudbury, Canada.
Franklyn AM, et al. PLoS One. 2017;12(11):e0187633.

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