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IACM-Bulletin of 24 May 2020

USA: Citizens of states with recreational cannabis laws view the legislation as a success

In a survey more than 32,000 US citizens were asked whether they believe cannabis legislation for use by adults has been more of a success or failure in the states that have legalized it. In many states where recreational cannabis is legal, a plurality of citizens believes these laws have been more of a success than a failure overall.

That is a particularly strong belief in Colorado, where citizens were among the first-in-the-nation to vote in favour of recreational cannabis in 2012. Today, about a quarter (26%) of Coloradans say the state-level recreational cannabis laws have been a “success only” and another 45 percent say they have been “more of a success than a failure.” Fewer than one in five (17%) believe the laws have been “more of a failure.” Today, cannabis is legal for adult non-medical use in 11 states—Washington, Oregon, Nevada, California, Colorado, Michigan, Illinois, Massachusetts, Maine, Alaska, and Vermont—with more states considering the legislation this year.

YouGov of 13 May 2020

Science/Human: Legalisation of cannabis use for adults may reduce opioid use

Researchers of the Geisinger Commonwealth School of Medicine in Scranton and the University of New England in Portland, USA examined the association between the legalization of cannabis for adult use and prescription opioid distribution in Colorado. Utah and Maryland, two states that had not legalized recreational marijuana, were selected for comparison.

Analysis of the interval pre (2007-2012) versus post (2013-2017) cannabis legalization revealed statistically significant decreases for Colorado and Maryland, but not Utah, for pain medications. There was a larger reduction from 2012 to 2017 in Colorado (-31.5%) than the other states (-14.2% to -23.5%). Colorado had a significantly greater decrease in codeine and oxymorphone than the comparison states. The most prevalent opioids by morphine equivalents were oxycodone and methadone.

Kropp Lopez AK, Nichols SD, Chung DY, Kaufman DE, McCall KL, Piper BJ. Prescription Opioid Distribution after the Legalization of Recreational Marijuana in Colorado. Int J Environ Res Public Health. 2020;17(9).

Science/Human: Cannabis use by regular users may have only minimal effects on cognition

In a placebo controlled study with 91 healthy young adults, who received either cannabis with a THC concentration of 12.5% or a placebo cannabis Canadian researchers from the University of Toronto and the Centre for Addiction and Mental Health in Toronto investigated the effects on mood and cognition. Participants were allowed to use as much cannabis as they wanted. Based on blood THC concentrations cannabis users were divided into High and Low THC groups.

One hour after smoking cannabis, compared to Placebo, in both the High and Low THC groups, there were increases in positive mood , and in the High THC group only, increases in confusion , friendliness, and elation , and a decrease in fatigue. Increases in friendliness and elation in the High THC group remained significant for 24 h. The only significant acute effect of cannabis on cognition was a decrease in the percent of words retained in a specific test in the High THC group compared to placebo. Authors concluded that cannabis use by regular users may have only “minimal effects on cognition, and no evidence of residual cognitive impairment.”

Matheson J, Mann RE, Sproule B, Huestis MA, Wickens CM, Stoduto G, George TP, Rehm J, Le Foll B, Brands B. Acute and residual mood and cognitive performance of young adults following smoked cannabis. Pharmacol Biochem Behav. 2020;194:172937.

News in brief

Science/Human: CBD cream was effective in 2 cases of back pain
Physicians from Portsmouth Anesthesia Associates in Virginia, USA, presented two cases of patients with back pain, one with lumbar compression fracture and one with thoracic discomfort and dysesthesia secondary to a surgically resected meningioma, who found relief by using a CBD cream. The cream contained 400 mg of CBD per 2 ounces (about 57 g), which is about 1.4 % CBD in the cream. Authors wrote that “hemp-derived CBD in a transdermal cream provided significant symptom and pain relief for the patients described in this case series.”
Eskander JP, et al. J Opioid Manag. 2020;16(3):215-218.

Science/Human: Even high doses of CBD are safe in humans
A new CBD preparation was administered to 24 healthy volunteers in doses up to 20 mg per kilogram bodyweight compared to 5 mg/kg, 10 mg/kg bodyweight and placebo. Authors noted that “CBD was well tolerated in the healthy volunteers (mean age: 24 years) treated with a single oral dose of CBD. There were no safety concerns with increasing the dose and the safety profiles of the CBD-treated and placebo-treated subjects were similar.” They concluded that this “new CBD formulation demonstrated a favourable safety and tolerability profile in healthy volunteers that was consistent with the profiles reported for other purified CBD products.”
Department of Health and Human Services, Office of Medicinal Cannabis, Melbourne, Australia.
Perkins D et al. EUR J Drug Metab Pharmacokinet. 2020 May 14. [in press]

Albania: Government plans to legalise the medical use of cannabis
Albanian Prime Minister Edi Rama announced on 19 May that the government is preparing a draft law that would legalize the cultivation of cannabis for medicinal purposes. During a joint conference with EU ambassador Luigi Soreca, Rama said that the government has been working with foreign and local advisers for a year and the draft law would be made public soon. He also highlighted the importance of learning from other countries’ experiences with medical marijuana.
Exit.al of 9 May 2020

Science/Human: No relevant effect on children, whose mothers used cannabis during pregnancy
A review analysed longitudinal studies examining the impact of prenatal cannabis exposure on multiple domains of cognitive functioning in individuals aged 0 to 22 years. An examination of the total number of statistical comparisons (n = 1,001) revealed minor differences. Authors summarised that the “clinical significance of these findings appears to be limited because cognitive performance scores of cannabis-exposed groups overwhelmingly fell within the normal range when compared against normative data adjusted for age and education.” They concluded that the “current evidence does not suggest that prenatal cannabis exposure alone is associated with clinically significant cognitive functioning impairments.”
School of Social Work, Columbia University, New York, USA.
Torres CA, et al. Front. Psychol. 2020 May 8. [in press]

Europe: EURopean Industrial Hemp Association submits consolidated Novel Food application for CBD containing extracts
A consortium led by the EURopean Industrial Hemp Association (EIHA), will resort to the current EU food safety approval process for hemp foods and extracts while continuing to challenge those rules. Stakeholders in the consortium, which is being organized as a limited liability company, EIHA projects, disagree with changes made in January 2019 to the EU’s Novel Food catalogue which re-classified hemp leaves and flowers as well as extracts derived from those plant parts – including CBD – as Novel Foods, making it illegal to market them in the EU.
Hemp Today of 5 May 2020

Science/Canada: Study on the potential of cannabis to reduce coronavirus infection is underway
University of Lethbridge researcher Igor Kovalchuk is leading a study on medical cannabis as a potential therapy for COVID-19. The scientist emphasized the findings wouldn't lead to a vaccine — something 'less specific and precise' but nonetheless another possible weapon against COVID-19 Cannabis extracts are showing potential in making people more resistant to the novel coronavirus. There are first results, which suggest that some cannabis strains may reduce the number of receptors needed for infection by the virus by up to 73% reducing the risk of an infection.
Calgary Sun of 6 May 2020

Israel: government approves exports of cannabis for medical use
Israel gave approval on 13 May for exports of medical cannabis, paving the way for sales abroad that the government expects to produce hundreds of millions of dollars in revenue. „This is a significant step for exporters and the Israeli industry, which will enable both expansion of export opportunities as well as rising employment ... in the field,” said Economy Minister Eli Cohen.
Reuters of 13 May 2020

Science/Animal: Whole hemp plant extract reduced neuropathic pain in mice
In a mouse model of neuropathic pain “full-spectrum” whole plant extracted hemp oil was effective in reducing pain sensitivity. Six animals were exposed to 5 microlitres of whole plant extracted hemp oil combined with a peanut butter vehicle. Three animals received the peanut butter only. Mechanical pain was reduced within one hour after administration of the extract and remained reduced significantly for 6 hours.
Department of Psychology, University of New Mexico, Albuquerque, USA.
Jacob M et al. Life 2020;10(5):69

Science/Human: An age of 19 years may be the minimal legal age for cannabis use, the Canadian experience suggests
Researchers investigated the choice of minimal legal age (MLA) for cannabis. They used Canadian surveys to compare educational attainment, cigarette smoking, self-reported general and mental health associated with different ages of first cannabis use. They concluded that their “study indicated that there is merit in setting 19 years as MLA for non-medical cannabis.”
School of Pharmacy, Memorial University of Newfoundland, St. John's, Canada.
Nguyen HV, et al. BMC Public Health. 2020;20(1):557

Science/Animal: CBD may reduce the detrimental effects on the mucosa by a chemotherapeutic agent
In a study with mice, which received the chemotherapeutic agent 5-fluorouracil (5-F U) CBD administered in different doses reduced the inflammatory response by the toxic agent on the mucosa leading to mucositis. They concluded from their research that “CBD seems to exert an anti-inflammatory and antioxidant activity favoring a faster resolution of oral mucositis in this animal model.”
Clinical Lecturer of Oral Medicine, Paranaense University, Francisco Beltrão, Brazil.
de Freitas Cuba L, et al. Oral Dis. 2020 May 13. [in press]

Science/Uruguay: No effect of cannabis legalisation on adolescent cannabis use
Researchers compared self-reported cannabis use before and after the legalisation of cannabis in Uruguay. They did not find “evidence of an impact on cannabis use or the perceived risk of use.“ They concluded that their “findings provide some support for the thesis that Uruguay's state regulatory approach to cannabis supply may minimize the impact of legalization on adolescent cannabis use.“
Department of Emergency Medicine, UC Davis School of Medicine, USA.
Laqueur H, et al. Int J Drug Policy. 2020;80:102748.

Science/Animal: THCV may be helpful in L-DOPA-induced dyskinesia in Parkinson’s disease
In a mouse model for L-DOPA-induced dyskinesia in Parkinson’s disease the natural cannabinoid THCV reduced symptoms. Authors wrote that their data “support the anti-dyskinetic potential of Δ9-THCV, both to delay the occurrence and to attenuate the magnitude of dyskinetic signs.”
Instituto Cajal-CSIC, Madrid, Spain.
Espadas I, et al. Neurobiol Dis. 2020;141:104892.

Science/Cells: Activation of the CB2 receptor causes anti-inflammatory effects in certain white blood cells from cystic fibrosis
Researchers used macrophages, certain white blood cells, from patients with cystic fibrosis to investigate the effects of Lenabasum, a synthetic cannabinoid, which activates the CB2 receptor. The cannabinoids reduced the secretion of the pro-inflammatory cytokines interleukin-8 and tumour necrosis-alpha (TNF-alpha). There was also an improvement in phagocytic activity. Authors concluded that Lenabasum should have effects “in vitro in a way that would reduce inflammation in vivo.”
Child Health Research Centre (CHRC), The University of Queensland, Brisbane, Australia.
Tarique AA, et al. J Cyst Fibros. 2020 May 6 [in press]

Science/Animal: THC reduces inflammatory response and organ damage after infection
Mice, which were treated with a toxin causing inflammation, received THC to investigate its effect on inflammation and organ injury. Administration of THC “dramatically” increased the concentration of the anti-inflammatory cytokine interleukin-10, while reducing the concentrations of pro-inflammatory interleukin-6 and CCL-2, which attenuated inflammation and organ injury. Authors concluded that their “results indicate that Δ9-THC potently induces IL-10, while reducing proinflammatory cytokines, chemokines, and related organ injury in endotoxemic mice via the activation of CB1R.”
Department of Anesthesia and Perioperative Care, University of California, San Francisco School of Medicine, USA.
Joffre J, et al. J Immunol. 2020 May 8. [in press]

Science/Cells: CBD reduces the inflammatory reactions in macrophages
Investigations of the effects of CBD on the so-called NLRP3 inflammatosome in macrophages showed, that the anti-inflammatory effects of CBD were similar to those by known NLRP3 inflammatosome inhibitors and involved the P2X7 receptor. Authors concluded that “CBD inhibitory effects on the NLRP3 inflammasome may contribute to the overall anti-inflammatory effects reported for this phytocannabinoid.”
College of Pharmacy, University of Rhode Island, Kingston, USA.
Liu C, et al. J Nat Prod. 2020 May 6. [in press]

Science/Animal: A new method of cannabis administration with prolonged delivery over 14 days
A new preparation of a CBD rich full-spectrum cannabis extract was injected subcutaneously in mice and resulted in sustained-release of cannabinoids over a 2-week period. Researchers used a mouse model of epilepsy. Authors noted, that the microdepots reduced seizures and increased survival rate. They concluded that these results “suggest that a long-term full-spectrum Cannabis delivery system may provide a new form of Cannabis administration and treatments.”
Shenkar College of Engineering, Design and Art, Israel.
Uziel A, et al ACS Appl Mater Interfaces. 2020 May 15. [in press]

Science/Animal: A treatment with CBD improves behavioural deficits associated with type-1 diabetes
In a study with diabetic rats the effects of different doses were investigated on depression and anxiety. CBD reduced anxiety-like and depression -like behaviour and high doses “also induced a significant increase in weight gain and the insulin levels (and consequently reduced glycemia).” Authors concluded that this “approach provided evidence that CBD can be useful for treating psychiatry comorbidities in diabetic patients.”
Department of Pharmacology, Biological Science Sector, Federal University of Paraná, Brazil.
Chaves YC, et al. Neurosci Lett. 2020;729:135020.

Science: Researchers describe the potential effects of cannabinoids on SARS-CoV2 induced respiratory distress
In a scientific journal researchers intended “to highlight the potential effects of cannabinoids, in particular, the non-psychotropic cannabidiol (CBD), that has shown beneficial anti-inflammatory effects in pre-clinical models of various chronic inflammatory diseases.”
University of Nebraska Medical Center, Omaha, USA.
Byrareddy SN, et al. Brain Behav Immun. 2020 Apr 28. [in press]

Science/Human: Cannabis does not only reduce the spasticity in multiple sclerosis but also improves other symptoms
According to data from 1432 patients with multiple sclerosis, who received the cannabis extract Sativex 43.8% showed an improvement in at least one other symptom beyond spasticity. Authors concluded that there study “confirmed that the therapeutic benefit of cannabinoids may extend beyond spasticity, improving spasticity-related symptoms.”
Department "G.F. Ingrassia", section of Neurosciences, University of Catania, Catania, Italy.
Patti F, et al. Neurol Sci. 2020 Apr 25. [in press]

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