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IACM-Bulletin of 26 September 2021

South Africa: A first patient is officially allowed to use cannabis to ease his pain

In South Africa, a cannabis prescription was issued for the first time. The 32-year-old Mtetwa is now an activist for medical cannabis after the plant helped him overcome the horror pains he endured after a road accident. The Gauteng man was involved in a motorcycle crash back in 2011 and later needed a safer and more effective way to treat himself. He began to grow his own cannabis before it was permitted in South Africa.

Mtetwa has now finally earned a legal medical prescription from a doctor for cannabis. “The process is not easy, I would like to thank SAHPRA [South African Health Products Regulatory Authority] for making this possible. I did not think it would be possible in my lifetime,” Mtetwa said.

The South African of 10 September 2021

Science/Human: Cannabis may be beneficial in neuropathic pruritus in amyotrophic lateral sclerosis according to a case report

Cannabis effectively reduced pruritus due to damaged small fibres in a 60-year-old male with amyotrophic lateral sclerosis according to a report by investigators of the University of British Columbia in Vancouver, Canada. Symptoms were treatment resistant to standard medication. They wrote that a “balanced oral cannabinoid from a licensed producer“ was used.

“The patient showed improvement to his pruritus score from 7/10 to 3/10. There was initial increased sedation but tolerance developed quickly.” The authors concluded that “cannabinoids are possibly safe and effective in management of neuropathic pruritus.”

Lou K, Murphy S, Talbot C. Cannabinoids for the treatment of refractory neuropathic pruritus in amyotrophic lateral sclerosis: A case report. Palliat Med. 2021:2692163211045314

Science/Human: Cannabis may improve pain and sleep in fibromyalgia

Cannabis had a favorable effect on pain level and quality of sleep among all spectrums of problems at a rheumatology clinic, according to a survey with 319 completed questionnaires conducted by investigators of the Rheumatology Unit at Laniado Hospital in Netanya, Israel.

Of all responders 82% had fibromyalgia, 9% had mechanical problems, 4% had inflammatory problems, 4% had neurological problems, and 1% had other problems. The average monthly consumed dose of cannabis was 31, 35, 36, and 32 g, with mean pain level reduction of 77%, 82%, 83%, and 57%, and mean sleep quality improvement of 78%, 71%, 87%, and 76% among patients with fibromyalgia, mechanical, neuropathic, and inflammatory problems, respectively.

Habib G, Khazin F, Artul S. The Effect of Medical Cannabis on Pain Level and Quality of Sleep among Rheumatology Clinic Outpatients. Pain Res Manag. 2021:1756588.

Science/Human: Many women use cannabis to help ease menopause symptoms

Would inhaling cannabis help women deal with these common symptoms of menopause? A good number of middle-aged women apparently think so, because they've been turning to cannabis to help handle the change of life, a new study reports. "Midlife women within the menopause transition period of their life are using cannabis, and they're using it for symptoms that tend to overlap with menopause," said lead researcher Katherine Babyn, a graduate student at the University of Alberta in Canada.

For this study, Babyn and her colleagues surveyed nearly 1,500 middle-aged women in the Canadian province of Alberta. Of the current users, 75% reported that they'd been using cannabis for medical purposes, even though only 23% had it medically prescribed to them. They used cannabis in a number of forms, including 52% who use edibles, 47% who use oils, 41% who smoked flower and 26% who used a vape. Cannabis was used to treat troubling (74%), anxiety (59%), difficulty concentrating ( 58%), irritability (55%), muscle and joint aches (53%). The study was presented on 22 September at the annual meeting of the North American Menopause Society, in Washington, D.C.

UPI of 22 September 2001

News in brief

USA: Connecticut allows patients to grow their own cannabis
Patients who are registered with the state’s medical cannabis access program can begin home cultivating cannabis for their own personal use on 1 October.
NORML of 21 September 2021

Italy: Referendum for legalisation of cannabis for personal use
Cannabis advocates in Italy said they had gathered enough signatures to hold a referendum on liberalising the use of cannabis, setting the stage for a nationwide vote on the issue early next year. The referendum proposal seeks to legalise the growing of weed for personal use and ease sanctions on other cannabis-related crimes. Organisers of the petition gathered the required 500,000 signatures in seven days.
Reuters of 18 September 2021

Uruguay: The government wants to make cannabis available for tourists
The Uruguayan government decided to increase the percentage of tetrahydrocannabinol (THC) in cannabis sold in the country's pharmacies since 2017 and is considering modifying regulations to allow its access also to tourists.
Rio Times of 31 August 2021

Science/Human: Cannabis may allow to reduce the use of opioids in chronic pain
In a retrospective study using medical files of 68 patients with chronic pain the use of cannabis was associated with a small reduction of opioids prescription medication during study time.
Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
Sznitman S, Mabouk C, Said Z, Vulfsons S. Opioid and healthcare service use in medical cannabis patients with chronic pain: a prospective study. BMJ Support Palliat Care. 2021:bmjspcare-2020-002661.

Science/Human: Cannamedical plans open study in the treatment of pain with cannabis
The company Cannamedical is working with experts to analyse data sets from 500 patients in Germany to be collected in the non-interventional ESCAPE PAIN study will support both patient safety and the ongoing improvement and standardization of individualized therapy with cannabinoids.
Apotheke Adhoc of 13 September 2021

Science/Human: The legalisation of cannabis did not change traffic injuries and Canada
The legalisation of cannabis in Canada was not associated with evidence of significant post-legalisation changes in traffic injury emergency department visits in Ontario or Alberta among all drivers or youth drivers, in particular.
University of Northern British Columbia, Northern Medical Program, Prince George, Canada.
Callaghan RC, et al. Drug Alcohol Depend. 2021;228:109008.

Science/Human: Low doses of CBD had no effect on pain in patients with hand osteoarthritis
In a placebo-controlled study with 129 patients suffering from hand osteoarthritis or psoriatic osteoarthritis CBD in a daily dose of 20 to 30 mg had no effect on pain intensity when compared to placebo.
Department of Rheumatology, Aalborg University Hospital, Denmark.
Vela J, et al. Pain. 2021 Aug 27. [in press]

Science: How to decarboxylate cannabinoids
An article presents information on the decarboxylation of acid cannabinoids. “Understanding how acidic cannabinoid decarboxylation occurs naturally as well as how it can be promoted or prevented during harvesting or storage is important for the various stakeholders in Cannabis cultivation.”
PerkinElmer Health Sciences Inc., Waltham, Massachusetts, USA
Filer CN, et al. Cannabis Cannabinoid Res. 2021 Sep 22. [in press]

Science/Human: Small effect of cannabis on sleep in pain patients
According to a review of available data “cannabis and cannabinoids may improve impaired sleep among people living with chronic pain, but the magnitude of benefit is likely small.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
AminiLari M, et al. Sleep. 2021:zsab234. [in press]

Science/Animal: The number of CB2 receptors increases in synovium of joints after injury
According to a study with mice the number of CB2 receptors increases in synovium, the fluids producing tissue in joints, after injury and mediates anti-inflammatory effects.
Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA.
Rzeczycki P, et al. Osteoarthritis Cartilage. 2021:S1063-4584(21)00888-8.

Science/Cells: A reduction in the enzyme MAGL slows tumour growth in lung cancer cells
A reduction in the enzyme MAGL (monoacylglycerol lipase), which degradates the endocannabinoid 2-AG (2-arachidonoyl glycerol), in the tumour environment slows tumour growth in non-small lung cancer cells.
Division Of Pharmacology, Otto Loewi Research Center, Medical University Of Graz, Austria.
Kienzl M, et al. Oncoimmunology. 2021;10(1):1965319.

Science/Human: The number of CB1 receptors is higher in muscle cells of elder men compared to young men
A new study shows for the first time that the CB1 receptor “is differentially expressed with aging and that changes in CB2 expression upon resistance exercise training correlate with changes in mediators that play a central role in muscle plasticity. These data confirm earlier work in cells and mice showing that the cannabinoid system might orchestrate muscle growth.”
Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001, Leuven, Belgium.
Dalle S, et al. Sci Rep. 2021;11(1):18349.

Science/Human: Cannabis use during pregnancy may increase the risk for low birth weight
In a study with 32,600 mothers in the USA the use of cannabis during pregnancy was associated with a 27% higher risk for low birthweight, but not with preterm birth.
School of Public Health, University of California, Berkeley, USA.
Nguyen VH, et al. J Pediatr. 2021:S0022-3476(21)00878-7

Science/Human: The use of cannabis for medical purposes may increase the risk for heart attack men
In a study with 18,700 cannabis patients, who were compared to 51,200 controls, male cannabis users had a 77% higher risk for the development of acute coronary syndrome and stroke. There was no increased risk for female cannabis patients.
Faculty of Pharmacy, Université Laval, Quebec City, QC, Canada.
Zongo A, et al. BMC Cardiovasc Disord. 2021;21(1):426

Science/Human: Exercise with blood flow restriction causes an increase in circulating levels of an endocannabinoid
A certain form of aerobic exercise, which is done with blood flow restriction, results in an increase of circulating levels of the endocannabinoid 2-AG (2-arachidonoyl glycerol) and beta-endorphin.
Faculty of Sport, Health and Applied Sciences, St Mary's University Twickenham London, UK .
Hughes L, et al. Otol Neurotol. 2021 Jul 9. [in press]

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