PDA

View Full Version : IACM Bulletin 7-20-2008 Sativex pain study, Nabilone Alzheimer's study


Sequoiacrone
July 20th, 2008, 09:41 AM
--------------------------------------------------------
IACM-Bulletin of 20 July 2008
--------------------------------------------------------

* Science: Sativex improves objective neurophysiological marker
of pain intensity in a
clinical study
* Science: Nabilone effective in the treatment of agitation in
Alzheimer's disease in a case report
* Austria: Decriminalization of cannabis for personal use
regardless of quantity

1.

Science: Sativex improves objective neurophysiological marker of
pain intensity in a clinical study

Researchers of the University of Rome, Italy, investigated
changes in the so-called flexion reflex in a group of 17 patients
with multiple sclerosis, who received either the cannabis extract
Sativex or placebo. The flexion reflex or nociceptive withdrawal
reflex is a reflex intended to protect the body from damaging
stimuli. The classic example is when you touch something hot and
withdraw your body part from the hot object. The flexion reflex is
a widely used technique to assess the pain threshold and to
investigate neurotransmitter systems involved in pain control. It
constists of an early response (RII reflex) and a late response
(RIII reflex). The RIII reflex threshold is thought to correspond to
the pain threshold and the reflex size is related to the level of pain
perception.

After patients used the cannabis extract the RIII reflex threshold
increased and RIII reflex area decreased. Authors concluded that
"the cannabinoid-induced changes in the RIII reflex threshold and
area in patients with MS provide objective neurophysiological
evidence that cannabinoids modulate the nociceptive system in
patients with MS."

(Source: Conte A, Bettolo CM, Onesti E, Frasca V, Iacovelli E,
Gilio F, Giacomelli E, Gabriele M, Aragona M, Tomassini V,
Pantano P, Pozzilli C, Inghilleri M. Cannabinoid-induced effects
on the nociceptive system: A neurophysiological study in patients
with secondary progressive multiple sclerosis. Eur J Pain, 2008
Jul 4. [Electronic publication ahead of print])

2.

Science: Nabilone effective in the treatment of agitation in
Alzheimer's disease in a case report

A physician of the Department of Psychiatry of the University of
British Columbia, Canada, reported of a dramatic improvement
of agitation in a 72 year-old man with Alzheimer's disease with
low doses of nabilone. The patient developed behavioural
symptoms including wandering, agitation and aggression three
years after diagnosis. He was transfered to a nursing home and
numerous medication trials were undertaken to control the
behaviour, including gabapentin, trazodone and quetiapine.
These drugs had no or minimal impact on his symptoms, but the
patient developed severe side effects. He was hospitalized. His
severe aggression towards stuff during personal care required
regular dosing with the sedative lorazepam, with variable effect.
After trazodone was swiched to citalopram some improvement
was noted in his agitation, but severe restlessness persisted.

The synthetic THC derivative nabilone was started at a dose of
0.5 mg in the evening with prompt reduction in the severity of
agitation and restlessness during evening personal care. The
dose of nabilone was increased to 0.5 mg 2 times daily to
facilitate personal care provision and his restlessness continued
to improve, with no emergent side effects. After 6 weeks of
dramatic improvement in all aspects of the behavioural
symptoms, the patient was discharged to the nursing home.
Three months later the patient's behavioural symptoms remained
well controlled. The author of this case report noted that "there
are few, if any, options currently available for patients with
persistent dementia-related agitation and aggression who require
prompt relief from medication that is well-tolerated and safe for
long-term use."

(Source: Passmore MJ. The cannabinoid receptor agonist
nabilone for the treatment of dementia-related agitation. Int J
Geriatr Psychiatry 2008;23(1):116-7.)

3.

Austria: Decriminalization of cannabis for personal use
regardless of quantity

A recent court ruling highlights the impacts of the new narcotics
law. Although he had harvested more than 10 kg of cannabis
leaves, an Austrian man was not sentenced and the public
prosecutor recently dismissed the case - with a two-year
probation period. According to the new law the prosecutor must
refrain from prosecution if the suspect possessed the drug
exclusively for personal use. However, if the suspect is again
found to possess cannabis within the probation period he is
threatened by prosecution since cannabis possession is not legal
under the new law.

Prior to January 1, 2008, dismissal of a case was only possible if
the suspect had been in possession of a "minor quantity" of a
drug. For cannabis, that quantity was, as in Germany, in the
range of a few grams. The revised law now no longer considers
the quantity but the personal use of a drug. In the current case
where the defendant had harvested leaves from allegedly
discovered hemp field there was no evidence for his intent to sell
the material. The main motivation for the recent amendment to
the law was, according to responsibles at the Ministry of Justice
an EU decision regarding the fight against drugs. It had tightened
measures against drug dealers. However, it was felt that this
amendment required a stronger separation of drug dealing from
personal use.

More at:
http://www.nachrichten.at/regional/705256?PHPSESSID=7bcf2 (http://www.nachrichten.at/regional/705256?PHPSESSID=7bcf2)
b7f4067d1e6acf5009be45df31a

(Source: www.nachrichten.at (http://www.nachrichten.at/) of 2 July 2008)

4.

News in brief:

***Science: Cannabis extract
According to research by the University of Milano, Italy, a
cannabis extract (Sativex) was more effective in reducing
neuropathic pain in animals than single dronabinol (THC). This
additional effect was not mediated by cannabinoid receptors but
by vanilloid receptors. Since cannabidiol (CBD) was the only
component present at a high level in the extract able to bind to
this receptor, researchers assume that CBD was responsible for
this additional analgesic effect. (Source: Comelli F, et al.
Phytother Res. 2008 Jul 10. [Electronic publication ahead of
print])

***Switzerland: Hemp Initiative
On 30 November 2008 Swiss citizen will decide in a
referendum on a ballot initiative on "a rational hemp policy
providing effective youth protection". It will exempt from
punishment the acquisition, possession and consumption of the
psychoactive constituents of the hemp plant. The Christian
Democratic Peoples Party (CVP) recommends to their voters a
rejection, the Social Democrats (SP) and the Liberal Democrats
recommend voting in favor of it. (Source: 20min.ch of 28 June
2008).

***USA: Drug policy
According to an essay by the former budget director of the
White House Office of National Drug Control Policy (ONDCP)
claims by the ONDCP that the USA is making "progress" in the
so-called 'war on drugs' are not based on evidence. The
ONDCP "claims that America has reached a turning point in the
war on drugs. In reality, we have little reason to believe a
significant change has occurred," John Carnevale writes.
"Though Congress created ONDCP to formulate research-
driven and performance-based policy, assess and modify policy
through performance measures, ... ONDCP fails at all of those
tasks," he continues. (Source: NORML of 17 July 2008)

***Italy: Rastafari
Italy's Court of Cassation ruled on 10 July that since the
Rastafari religion considers cannabis a sacrament, its members
should be given special consideration when it comes to
possession -- and how much makes a drug trafficker. The case
before the judges dealt with a reggae musician who was
sentenced to 16 months in prison by a lower court in Perugia
after being found in possession of enough cannabis to roll 70
cigarettes. The Court of Cassation annulled his sentence, saying
the amount appeared appropriate for personal use considering
the heavy amounts that Rastafarians smoke, and ordered an
appellate court in Florence to review the case. (Source: Reuters
of 10 July 2008)

***Argentina: Personal use
Recently a court of appeal (Cámara Federal) overruled the
conviction of a man by a lower court, who cultivated cannabis
on his balcony for personal use. The conviction was declared
unconsitutional. (Source: www.asteriscos.tv (http://www.asteriscos.tv/) of 10 June 2008)

***Science: Leukemia
Researchers of the University of London, UK, found synergistic
effects of dronabinol (THC) and cytotoxic agents used in the
treatment of leukemia. Dronabinol sensitized leukemic cells to
these cytotoxic drugs. They concluded that "a combination
approach with THC and established cytotoxic agents may
enhance cell death in vitro." (Source: Liu WM, et al. Leuk
Lymphoma. 2008 Jun 30:1-10. [Electronic publication ahead of
print])

***Science: Pain
Danish researchers compared the analgesic effects of low doses
of a synthetic cannabinoid (WIN55,212-2) in cancer and
neuropathic pain in animals. 18 days of treatment reduced pain
related behaviour in the cancer pain model but not in the
neuropathic pain model. (Source: Hald A, et al. Pharmacol
Biochem Behav. 2008 Jun 20. [Electronic publication of print])

***Science: New prodrug of THC
Researchers at the University of Mississippi, USA, investigated
possibilities to stabilize a heat-labile novel prodrug of THC,
THC-hemiglutarate (THC-HG). This THC compound was
produced by hot-melt fabrication for systemic delivery of THC
through the oral transmucosal route. (Source: Thumma S, et al.
Eur J Pharm Biopharm. 2008 Jun 18. [Electronic publication of
print])

***Science: Violent television
According to research by the University of New York watching
violent television programs in late adolescence was associated to
later nicotine dependence and later dependence from illegal
drugs. (Source: Brook DW, et al. Am J Addict 2008;17(4):271-
7.)

5.

ONE YEAR AGO:
- Science: Rimonabant suggested for the treatment of cannabis
addiction

TWO YEARS AGO:
- Science: Low doses of THC and cannabis ineffective in
appetite and weight loss due to cancer in large clinical study
- USA: Judge strikes down part of a new Alaska law that
criminalizes the possession of small amounts of cannabis.

(More at the IACM-Bulletin archives: http://www.cannabis (http://www.cannabis/)-
med.org/)

International Association for Cannabis as Medicine (IACM)
Am Mildenweg 6
D-59602 Ruethen
Germany
Phone: +49 (0)2952-9708571
Fax: +49 (0)2952-902651
Email: info@cannabis-med.org (info@cannabis-med.org)
http://www.cannabis-med.org (http://www.cannabis-med.org/)

If you want to be deleted from or added to the IACM-Bulletin
mailing list or if you want to change your e-mail address please
visit
www.cannabis-med.org/english/subscribe.htm (http://www.cannabis-med.org/english/subscribe.htm). You may choose
between different languages (English, German, French, Dutch,
Italian and Spanish).

The articles of the IACM-Bulletin can be printed, translated and
distributed freely for any non-commercial purposes, provided
the original work is properly cited. The source of the IACM-
Bulletin is "IACM, www.cannabis-med.org (http://www.cannabis-med.org/)".

Sequoiacrone
August 3rd, 2008, 08:44 AM
--------------------------------------------------------
IACM-Bulletin of 3 August 2008
--------------------------------------------------------

A 25 page list of STUDIES and case reports on the medical
effectiveness of cannabis and single cannabinoids, grouped
according to indication, preparation and kind of study is available
at:
http://www.cannabis-med.org/english/studies.htm (http://www.cannabis-med.org/english/studies.htm)

* USA: New Mexico is working on rules for manufacturing
cannabis for medical use
* Science/USA: Rapid rise seen in fatal medication errors at home
* Science/UK: According to a report by the British Drug Policy
Commission drug law enforcement is not working

1.

USA: New Mexico is working on rules for manufacturing
cannabis for medical use

The Department of Health of New Mexico announced on 24 July
that it will hold a public hearing on 8 September to take comments
on regulations that would set up rules for patient identification
cards and a regulated system for licensing, distributing and
manufacturing medical cannabis. The state law that took effect in
July 2007 allows the medical use of cannabis for serious illnesses.
So far, the department has approved 169 people for medical
cannabis.

New Mexico has been careful in drafting its regulations because
no other state has developed rules for a distribution and production
system, Dr. Alfredo Vigil of the Health Department said. The
state proposes two types of licensed producers: a qualified patient
who can produce up to four mature plants for personal use only
and a non-profit private entity operating a facility limited to 95
mature plants and seedlings at any time. The regulations include
measures to prevent unauthorized cannabis use by requiring
criminal background checks for applicants and security measures
for facilities.

(Source: Associated Press of 24 July 2008)

2.

Science/USA: Rapid rise seen in fatal medication errors at home

Deaths from medication mistakes at home rose dramatically
during the past two decades, an analysis of U.S. death certificates
finds. The authors blame soaring home use of prescription
painkillers and other potent medicinal drugs. The findings, based
on nearly 50 million U.S. death certificates, are published in
Archives of Internal Medicine. Deaths from medication mistakes
at home increased from 1,132 deaths in 1983 to 12,426 in 2004.
Adjusted for population growth, that amounts to an increase of
more than 700 per cent during that time.

In contrast, there was only a 5 per cent increase in fatal
medication errors away from home, including hospitals. Abuse of
prescription drugs plays a role, but it's unclear how much. Valid
prescriptions taken in error, especially narcotics (opioids), account
for a growing number of deaths, said experts who reviewed the
study. Multiple prescription drugs such as sleeping pills and pain
medication taken at once, as well as the intake together with
alcohol and illegal drugs also play a part. There were no
significant increases in other poisonings like suicidal overdoses or
murder.

More at:
http://hosted.ap.org/dynamic/stories/M/MED_FATAL_DRUG_E (http://hosted.ap.org/dynamic/stories/M/MED_FATAL_DRUG_E)
RRORS?SITE=VTBEN&SECTION=HOME&TEMPLATE=DE
FAULT

(Sources: Associated Press of 29 July 2008; Phillips DP, Barker
GEC, Eguchi MM. A steep increase in domestic fatal medication
errors with use of alcohol and/or street drugs. Arch Intern Med
2008;168:1561-6.)

3.

Science/UK: According to a report by the British Drug Policy
Commission drug law enforcement is not working

In their study "Tackling drug markets and distribution networks in
the UK: a review of the recent literature" the UK Drug Policy
Commission reported that British illegal drug markets are
"extremely resilient" and that increasing seizures of drugs had had
only little impact on the availability of illegal drugs. The Drug
Policy Commission is a non-governmental institution. Latest
figures estimate the size of the UK illicit drug market to be 5.3
billion British Pounds (about 6,7 billion Euros or 10,5 billion US
Dollars).

"The authors were unable to locate any comprehensive published
UK evidence of the relative effectiveness of different
enforcement approaches. They were also not able to identify any
published comparative cost-benefit or value-for-money analysis
for different interventions within the UK," researchers wrote.
Despite spending hundreds of millions of pounds each year on
drug enforcement, "there is remarkably little evidence of its
effectiveness in disrupting markets and reducing availability," the
authors concluded. "Enforcement can have a significant and
unintended negative impact on the nature and extent of harms
associated with drugs and this should be recognised and
minimised," they also noted.

More at:
http://www.ukdpc.org.uk/Publications.shtml (http://www.ukdpc.org.uk/Publications.shtml)

(Source: UK Drug Policy Commission. Tackling drug markets and
distribution networks in the UK: a review of the recent literature.
30 July 2008)

4.

News in brief

***Science: Schizophrenia
A Cochrane review was conducted by the Cochrane
Schizophrenia Group at the University of Nottingham, UK, to
evaluate the effects of cannabis use on people with schizophrenia
and schizophrenia-like illnesses. Only one randomised trial was
identified, which did not find a significant effect of cannabis on
schizophrenia. Researchers concluded that "at present, there is
insufficient evidence to support or refute the use of
cannabis/cannabinoid compounds for people suffering with
schizophrenia." (Source: Rathbone J, et al. Cochrane Database
Syst Rev 2008;(3):CD004837.)

***Science: Schizophrenia
Researchers at Flinders University of Adelaide, Australia, asked
patients with schizophrenia, why they used cannabis despite the
drug may worsen the course of the disease. Patients responded
that they used cannabis for "control of symptoms, to feel normal,
perceived improvement in cognitive function, reduced
psychological pain and increased energy." Authors noted that "this
research has implications for clinical practice as clinicians may
lack insight into the importance of the phenomenological beliefs of
a person with schizophrenia." (Source: Costain WF. Int J Ment
Health Nurs 2008;17(4):227-35.)

***Spain: Cannabis harvest
A group called Association of Vigo for the Study of Marijuana
(Asociación Viguesa de Estudios de María, AVE María) reported
that their collective harvest of cannabis is under way and that
some of the cannabis will be given to patients who use it
medicinally. The association produces cannabis only for their
members. According to decisions by courts in Catalonia and the
Basque region in 2006 cannabis clubs such as AVE Maria are
legal, since the possession of cannabis for personal use is legal in
Spain. (Source: www.farodevigo.es (http://www.farodevigo.es/) of 1 August 2008)

***Science: Neuropathic pain
Researchers of the University of Georgia reported that the
selective activation of cannabinoid CB2 receptors suppressed
neuropathic pain induced by the chemotherapeutic agent paclitaxel
in rats. (Source: Rahn EJ, et al. J Pharmacol Exp Ther. 2008 Jul
29. [Electronic publication ahead of print])

***Science: Hemp foods
US researchers investigated the presence of THC in 79 hemp
products and noted that THC levels in "currently marketed hemp
products are significantly lower than in those products available
before 2003". THC concentrations ranged from none detected to
117.5 mg/kg material. No THC was detected in 58 per cent of the
products marketed before a change of the Code of Federal
Regulations (CFR) concerning the listing of THC and 86 per cent
of the products produced after the change of the CFR. (Source:
Holler JM, et al. J Anal Toxicol 2008;32(6):428-32.)

5.

ONE YEAR AGO:
- Science/UK: A widely cited new review supports earlier studies
that the use of cannabis is associated with an increased risk of
psychosis
- Europe: Withdrawal of current regulatory application for Sativex
- Science: With the use of cannabis tea only a small proportion of
THC in the cannabis is ingested

TWO YEARS AGO:
- Science: Nabilone effective in the treatment of chronic pain in
clinical study
- Canada: Health Canada looking for a new supplier of cannabis
for medical use
- Science: Topical application of a natural endocannabinoid
effective in reducing pruritus in clinical study

(More at the IACM-Bulletin archives: http://www.cannabis (http://www.cannabis/)-
med.org/)

International Association for Cannabis as Medicine (IACM)
Am Mildenweg 6
D-59602 Ruethen
Germany
Phone: +49 (0)2952-9708571
Fax: +49 (0)2952-902651
Email: info@cannabis-med.org (info@cannabis-med.org)
http://www.cannabis-med.org (http://www.cannabis-med.org/)

If you want to be deleted from or added to the IACM-Bulletin
mailing list or if you want to change your e-mail address please
visit
www.cannabis-med.org/english/subscribe.htm (http://www.cannabis-med.org/english/subscribe.htm). You may choose
between different languages (English, German, French, Dutch,
Italian and Spanish).

The articles of the IACM-Bulletin can be printed, translated and
distributed freely for any non-commercial purposes, provided the
original work is properly cited. The source of the IACM-Bulletin
is "IACM, www.cannabis-med.org (http://www.cannabis-med.org/)".