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IACM-Bulletin of 27 May 2018

Thailand: The government wants to make cannabis available for medical use

A bill to allow limited use of cannabis for medical purposes was approved by the interim cabinet. More than just cannabis, the bill would decriminalize consumption of other narcotics including kratom and opium to enable medical research to be conducted – a necessary step toward broader availability for therapeutic uses.

“The approval of this bill is an important matter,” government spokesman Sansern Kaewkamnerd said. “Class 5 narcotics were allowed for cultivation and extraction … but not for consumption, which made it impossible to use them for research on humans.” If passed by the Parliament, the new law would authorize the Narcotics Control Board to set up plantations for growing and conducting experiments.

Khaosod English of 16 May 2018

Science/Human: CBD improves seizure frequency in patients with Lennox-Gastaut syndrome in large clinical study

In a placebo-controlled study with 225 patients suffering from Lennox-Gastaut syndrome CBD reduced seizure frequency. Scientists from 30 US and EURopean centres, including the Mayo Clinic in Rochester, the New York University, the Ohio State University and the University of Glasgow, published these results in the New England Journal of Medicine. Patients between the age of 2 and 55 years received either a placebo, 10 mg per kilogram bodyweight or 20 mg/kg of CBD divided into 2 equal doses daily for 14 weeks. Their current medication was continued.

76 patients were assigned to the 20-mg cannabidiol group, 73 to the 10-mg cannabidiol group, and 76 to the placebo group. The median percent reduction in seizure frequency during the treatment period was 41.9% in the 20-mg CBD group, 37.2% in the 10-mg CBD group, and 17.2% in the placebo group. The most common adverse events were somnolence, decreased appetite, and diarrhoea. Six patients in the 20-mg CBD group and 1 patient in the 10-mg CBD group discontinued the trial medication because of adverse events. Authors concluded, that “among children and adults with the Lennox-Gastaut syndrome, the addition of cannabidiol at a dose of 10 mg or 20 mg per kilogram per day to a conventional antiepileptic regimen resulted in greater reductions in the frequency of drop seizures than placebo.”

Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, Greenwood SM, Roberts C, Checketts D, VanLandingham KE, Zuberi SM; GWPCARE3 Study Group. Effect of Cannabidiol on Drop Seizures in the Lennox-Gastaut Syndrome. N Engl J Med. 2018;378(20):1888-1897.

News in brief

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IACM: New publications in Cannabis and Cannabinoid Research
New articles have been published in the CCR, the partner journal of the IACM:
Cannabis for the Management of Cancer Symptoms: THC Version 2.0? by Manuel Guzmán.
Cannabis and the Opioid Crisis by Daniele Piomelli, Susan Weiss, Graham Boyd, Rosalie Liccardo Pacula, and Ziva Cooper.
a href="www.liebertpub.com/doi/10.1089/can.2017.0047">Prolonged Cannabidiol Treatment Effects on Hippocampal Subfield Volumes in Current Cannabis Users by Camilla Beale, Samantha J. Broyd, Yann Chye, Chao Suo, Mark Schira, Peter Galettis, Jennifer H. Martin, Murat Yücel, and Nadia Solowij.

Germany: Drug Commissioner suggests decriminalisation of cannabis possession
In an interview the Drug Commissioner Marlene Mortler suggested an end to criminal procedures for cannabis possession for personal use and introduces a system of fines. In the future, people caught with cannabis for personal use should be allowed to choose between a fine and treatment of drug abuse.
Süddeutsche Zeitung of 15 May 2018

Science/Human: British Medical Journal calls for drug legalisation
In an editorial the British Medical Journal calls for drug legalisation. “This is not about whether you think drugs are good or bad. It is an evidence based position entirely in line with the public health approach to violent crime… The BMJ is firmly behind efforts to legalize, regulate, and tax the sale of drugs for recreational and medicinal use. This is an issue on which doctors can and should make their voices heard”, they wrote.
Editor's Choice. Drugs should be legalised, regulated, and taxed. BMJ 2018;361:k2057.

Science/Human: A cannabis spray has no detrimental effects on driving ability in patients
In a review of articles published between January 2000 and June 2017 authors did not find any evidence of an increase in motor vehicle accidents associated with the use of the cannabis spray Sativex. The majority of patients reported an improvement in driving ability after starting cannabis treatment. It was speculated that this may be related to the reduced spasticity and/or better cognitive function.
Department of Neurology, Oslo University Hospital, Norway.
Celius EG, Vila C. Brain and Behaviour. 2018 April 6. [in press]

Science/Human: Cannabis impairs driving ability in healthy occasional cannabis users
In a study with healthy occasional cannabis users, aged 25 to 35 years, a cannabis cigarette containing 20 mg of THC reduced driving ability in real driving conditions and simulated driving conditions. The effect was stronger in the simulated driving test.
Assistance Publique Hôpitaux de Marseille, France.
Micallef J, et al. Fundam Clin Pharmacol. 2018 May 12. [in press]

Science/Animal: Long-term treatment with THC is not associated with overuse headache
It is well known that many analgesics including morphine and NSAIDs may cause headaches after repeated administration. In a rat model of migraine repeated administration of morphine caused headaches, while THC remained effective against this pain.
Washington State University, USA.
Kandasamy R, et al. Behav Pharmacol. 2018 Feb 16. [in press]

Science/Animal: A peripheral agonist at the CB1 receptor may reduce cancer pain
A synthetic cannabinoid, which only activates the peripheral CB1 receptor, reduced spontaneous pain behaviours in a murine model of cancer-induced bone pain.
College of Medicine, University of Arizona, Tucson, USA.
Zhang H, et al. Pain. 2018 May 16. [in press]

Science: A new way to quantify cannabinoids in the cannabis plant
Researchers developed a method to faster quantify 11 cannabinoids in cannabis flower extracts. Authors wrote that it will facilitate potential expansion to include additional compounds.
University of British Columbia Okanagan, Kelowna, Canada.
Noestheden M, et al. Phytochem Anal. 2018 Mar 30. [in press]

Science: Anandamide forms complexes with cholesterol and ceramide
Researchers demonstrated that the endocannabinoid anandamide forms a molecular complex with cholesterol and binds to ceramide. Authors wrote that the “cholesterol may regulate the entry and exit of anandamide in and out of CB1” and that “ceramide forms a tight complex with anandamide which blocks the degradation pathway of both lipids and could be exploited for anti-cancer therapies.”
Parc Scientifique de Luminy, Marseille, France.
Scala CD, et al. Biomolecules. 2018;8(2).

Science/Animal: Chronic treatment with high CBD doses may negatively influence male fertility
In a study young, 21-day-old male mice received 15 or 30 mg CBD per kilogram bodyweight for 34 days. After a recovery period researchers found a reduced number of sperms and increased numbers of sperm abnormalities. After a 35 day recovery, they concluded, that high CBD doses in young mice may result in impairment of male fertility.
Universidade Federal de Goiás, Brazil.
Carvalho RK, et al. J Appl Toxicol. 2018 May 16. [in press]

Science/Human: CBD did not improve memory or impulsivity during tobacco abstinence
In a placebo-controlled study with 30 dependent tobacco smokers 800 mg oral CBD did not improve verbal or spatial working memory or impulsivity during abstinence from tobacco compared to placebo.
University College London, UK.
Hindocha C, et al. Sci Rep. 2018;8(1):7568.

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