Sequoiacrone
August 17th, 2008, 05:59 PM
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IACM-Bulletin of 17 August 2008
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* Science: Smoked cannabis effective against neuropathic pain of
HIV patients
* Germany: Health Ministry tightens requirements for medical
cannabis exemptions
* Science: Cannabinoids as effective as other medications against
neuropathic pain in a prospective observational study
1.
Science: Smoked cannabis effective against neuropathic pain of
HIV patients
Researchers at the University of California in San Diego, USA,
investigated the effects of smoked cannabis in HIV patients
suffering from neuropathic pain. All patients experienced pain
despite receiving pain medication. Of 34 subjects included, 28
completed the placebo controlled study. Participants received both
cannabis cigarettes with a dronabinol content between 1 and 8 per
cent four times daily for five days and placebo cigarettes. Both
treatment phases where interrupted by two weeks of no
medication. On the first day of each treatment phase the
appropriate dose was determined by starting with a cannabis
cigarette containing 4 per cent dronabinol and then gradually
decreasing or increasing according to side effects and pain relief.
The 34 patients continued to use their current pain medication
during the whole study, 22 using opioids and 21 using
anticonvulsants.
Pain relief was significantly greater by cannabis than by placebo
according to the so-called Descriptor Differential Scale (DDS).
During the cannabis phase 46 per cent of the 28 patients who
completed the study gained a pain relief of more than 30 per cent,
compared to 18 per cent during the placebo phase. During the
cannabis treatment week most subjects needed cannabis with a
THC content of 2 per cent (n = 9) or 4 per cent (n = 10), while
during the placebo week most participants increased up to the
maximum nominal THC dose of 8 per cent (n = 26). Side effects
were usually mild to moderate, but two subjects experienced
severe side effects. Authors concluded that "smoked cannabis
was generally well tolerated and effective when added to
concomitant analgesic therapy in patients with medically
refractory pain due to HIV DSPN" [distal sensory predominant
polyneuropathy].
(Source: Ellis RJ, Toperoff W, Vaida F, van den Brande G,
Gonzales J, Gouaux B, Bentley H, Atkinson JH. Smoked
medicinal cannabis for neuropathic pain in HIV: a randomized,
crossover clinical trial. Neuropsychopharmacology. 2008 Aug 6.
[Electronic publication ahead of print])
2.
Germany: Health Ministry tightens requirements for medical
cannabis exemptions
The Federal Institute for Pharmaceuticals and Medical Products
(BfArM, Bundesinstitut für Arzneimittel und Medizinprodukte), an
office of the federal health ministry, changed in July the rules for
patients who plan to apply for an exemption of cannabis use for
medical purposes. So far, one of the requirements for an
exemption was the ineffectiveness of dronabinol (THC) or the
refusal by the health insurance to pay for dronabinol treatment.
Under the new guidelines, such refusal will no longer be accepted
as a sufficient cause and only the ineffectiveness of dronabinol
will be considered.
A 19 May 2005 ruling by the Federal Administrative Court based
on which to date some 10 applications for medical cannabis use
have been approved, explicitly states that the BfArM cannot claim
that dronabinol is available as an "equivalent" drug. The ruling
states: "The [BfArM's] reference to a drug, which is not readily
available nor affordable for the normal citizen does not represent
an alternative that would eliminate the general public interest in
the medical use of cannabis." In a letter to the Federal Drug
Commissioner, Sabine Baetzing, Dr. Franjo Grotenhermen,
chairman of the German Association for Cannabis as Medicine,
writes: "Given these conditions, would you please clarify whether
the guidelines for an application for the medical use of cannabis
still comply with the stipulations of the Federal Administrative
Court."
(Source: Application guidelines for patients seeking an exemption
(§ 3, 2 law on narcotics) for the purchase of cannabis extract for
use in a medicinally supervised self-therapy.
BfArM, Update July 2008)
3.
Science: Cannabinoids as effective as other medications against
neuropathic pain in a prospective observational study
Scientists at the University of Calgary, Canada, compared the
effects of different medications used in the treatment of
neuropathic pain in an observational study with 182 patients. From
July 2003 until December 2005 patients with neuropathic pain of
different causes, taking no other medication than weak analgesics
(non-steroidal anti-inflammatory drugs), and referred to the
Neuromuscular Clinic were included into the study.
More than one third of patients was given gabapentin (37 per
cent) as first medication. Other medications given first in more
than 10 per cent of patients were pregabalin, topirimate and
amitryptiline. Cannabinoids (nabilone and Sativex) were given to 5
per cent of patients as first line therapy. Authors stated that
"reasons for selecting gabapentin were typically because of
anticipation of minor side effects, familiarity with its use, and
nearly universal coverage through third party insurance agencies".
There were no serious adverse events for patients by any of the
medications. Prevalence of intolerable side effects was similar
among the different groups of medications. Mean pain relief three
and six months after beginning of treatment was also similar
among the different medications.
(Source: Toth C, Au S. A prospective identification of neuropathic
pain in specific chronic polyneuropathy syndromes and response
to pharmacological therapy. Pain. 2008 Aug 6. [Electronic
publication ahead of print])
4.
News in brief
***France: Illegal cannabis market
The annual sales figure for cannabis in France is estimated by the
French Monitoring Centre of Drugs and Drug Addiction to be
between 746 and 832 million Euros (1.11-1.24 billion US dollars).
Consumers' average annual expenditure on cannabis was
estimated to be around 202 Euros in France, compared to
estimates obtained for New Zealand and the Netherlands (124
Euros) and the United States (362 Euros). (Source: Legleye S, et
al. Drug Alcohol Rev 2008;27(5):466-72.)
***USA: California
The Fourth District Court of Appeal in San Diego upheld
California's medical cannabis law, rejecting arguments by San
Diego and San Bernardino counties that allowing patients to use
the drug with their doctor's approval violates federal narcotics
laws. (Source: San Francisco Chronicle of 1 August 2008)
***Spain: Seminar
The second European Seminar on Neuroimaging and Addiction
with the title "Brain effects of cannabis use in humans" will be
held on 4 September in Barcelona, organized by the Section of
Neuroimaging of the Association of European Psychiatrists
(AEP) and other organizers. For more information please send an
e-mail to: egelabert@imim.es (egelabert@imim.es). (Source: Personal communication
by Estel Gelabert)
***Science: Cannabis withdrawal
Inhibitors of endocannabinoid degradation were suggested as
therapeutic drugs for the treatment of cannabis withdrawal.
(Source: Clapper JR, et al. Neuropharmacology. 2008 Jul 19.
[Electronic publication ahead of print])
5.
ONE YEAR AGO:
- Germany: MS patient receives a certificate of exemption for the
medical use of cannabis by the Federal Health Ministry
- Canada: Health Ministry approves cannabis extract for the use
in cancer pain
- USA: The Health Department of New Mexico does not intend
to grow and distribute cannabis
TWO YEARS AGO:
- Spain/Belgium: Cannabis clubs in Spain legal, first formation of a
club in Belgium
- Science: Cannabis use not associated with risk factors for
diseases of heart and circulation
- Science: THC inhibits primary marker of Alzheimer's disease
(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/)".
IACM-Bulletin of 17 August 2008
--------------------------------------------------------
* Science: Smoked cannabis effective against neuropathic pain of
HIV patients
* Germany: Health Ministry tightens requirements for medical
cannabis exemptions
* Science: Cannabinoids as effective as other medications against
neuropathic pain in a prospective observational study
1.
Science: Smoked cannabis effective against neuropathic pain of
HIV patients
Researchers at the University of California in San Diego, USA,
investigated the effects of smoked cannabis in HIV patients
suffering from neuropathic pain. All patients experienced pain
despite receiving pain medication. Of 34 subjects included, 28
completed the placebo controlled study. Participants received both
cannabis cigarettes with a dronabinol content between 1 and 8 per
cent four times daily for five days and placebo cigarettes. Both
treatment phases where interrupted by two weeks of no
medication. On the first day of each treatment phase the
appropriate dose was determined by starting with a cannabis
cigarette containing 4 per cent dronabinol and then gradually
decreasing or increasing according to side effects and pain relief.
The 34 patients continued to use their current pain medication
during the whole study, 22 using opioids and 21 using
anticonvulsants.
Pain relief was significantly greater by cannabis than by placebo
according to the so-called Descriptor Differential Scale (DDS).
During the cannabis phase 46 per cent of the 28 patients who
completed the study gained a pain relief of more than 30 per cent,
compared to 18 per cent during the placebo phase. During the
cannabis treatment week most subjects needed cannabis with a
THC content of 2 per cent (n = 9) or 4 per cent (n = 10), while
during the placebo week most participants increased up to the
maximum nominal THC dose of 8 per cent (n = 26). Side effects
were usually mild to moderate, but two subjects experienced
severe side effects. Authors concluded that "smoked cannabis
was generally well tolerated and effective when added to
concomitant analgesic therapy in patients with medically
refractory pain due to HIV DSPN" [distal sensory predominant
polyneuropathy].
(Source: Ellis RJ, Toperoff W, Vaida F, van den Brande G,
Gonzales J, Gouaux B, Bentley H, Atkinson JH. Smoked
medicinal cannabis for neuropathic pain in HIV: a randomized,
crossover clinical trial. Neuropsychopharmacology. 2008 Aug 6.
[Electronic publication ahead of print])
2.
Germany: Health Ministry tightens requirements for medical
cannabis exemptions
The Federal Institute for Pharmaceuticals and Medical Products
(BfArM, Bundesinstitut für Arzneimittel und Medizinprodukte), an
office of the federal health ministry, changed in July the rules for
patients who plan to apply for an exemption of cannabis use for
medical purposes. So far, one of the requirements for an
exemption was the ineffectiveness of dronabinol (THC) or the
refusal by the health insurance to pay for dronabinol treatment.
Under the new guidelines, such refusal will no longer be accepted
as a sufficient cause and only the ineffectiveness of dronabinol
will be considered.
A 19 May 2005 ruling by the Federal Administrative Court based
on which to date some 10 applications for medical cannabis use
have been approved, explicitly states that the BfArM cannot claim
that dronabinol is available as an "equivalent" drug. The ruling
states: "The [BfArM's] reference to a drug, which is not readily
available nor affordable for the normal citizen does not represent
an alternative that would eliminate the general public interest in
the medical use of cannabis." In a letter to the Federal Drug
Commissioner, Sabine Baetzing, Dr. Franjo Grotenhermen,
chairman of the German Association for Cannabis as Medicine,
writes: "Given these conditions, would you please clarify whether
the guidelines for an application for the medical use of cannabis
still comply with the stipulations of the Federal Administrative
Court."
(Source: Application guidelines for patients seeking an exemption
(§ 3, 2 law on narcotics) for the purchase of cannabis extract for
use in a medicinally supervised self-therapy.
BfArM, Update July 2008)
3.
Science: Cannabinoids as effective as other medications against
neuropathic pain in a prospective observational study
Scientists at the University of Calgary, Canada, compared the
effects of different medications used in the treatment of
neuropathic pain in an observational study with 182 patients. From
July 2003 until December 2005 patients with neuropathic pain of
different causes, taking no other medication than weak analgesics
(non-steroidal anti-inflammatory drugs), and referred to the
Neuromuscular Clinic were included into the study.
More than one third of patients was given gabapentin (37 per
cent) as first medication. Other medications given first in more
than 10 per cent of patients were pregabalin, topirimate and
amitryptiline. Cannabinoids (nabilone and Sativex) were given to 5
per cent of patients as first line therapy. Authors stated that
"reasons for selecting gabapentin were typically because of
anticipation of minor side effects, familiarity with its use, and
nearly universal coverage through third party insurance agencies".
There were no serious adverse events for patients by any of the
medications. Prevalence of intolerable side effects was similar
among the different groups of medications. Mean pain relief three
and six months after beginning of treatment was also similar
among the different medications.
(Source: Toth C, Au S. A prospective identification of neuropathic
pain in specific chronic polyneuropathy syndromes and response
to pharmacological therapy. Pain. 2008 Aug 6. [Electronic
publication ahead of print])
4.
News in brief
***France: Illegal cannabis market
The annual sales figure for cannabis in France is estimated by the
French Monitoring Centre of Drugs and Drug Addiction to be
between 746 and 832 million Euros (1.11-1.24 billion US dollars).
Consumers' average annual expenditure on cannabis was
estimated to be around 202 Euros in France, compared to
estimates obtained for New Zealand and the Netherlands (124
Euros) and the United States (362 Euros). (Source: Legleye S, et
al. Drug Alcohol Rev 2008;27(5):466-72.)
***USA: California
The Fourth District Court of Appeal in San Diego upheld
California's medical cannabis law, rejecting arguments by San
Diego and San Bernardino counties that allowing patients to use
the drug with their doctor's approval violates federal narcotics
laws. (Source: San Francisco Chronicle of 1 August 2008)
***Spain: Seminar
The second European Seminar on Neuroimaging and Addiction
with the title "Brain effects of cannabis use in humans" will be
held on 4 September in Barcelona, organized by the Section of
Neuroimaging of the Association of European Psychiatrists
(AEP) and other organizers. For more information please send an
e-mail to: egelabert@imim.es (egelabert@imim.es). (Source: Personal communication
by Estel Gelabert)
***Science: Cannabis withdrawal
Inhibitors of endocannabinoid degradation were suggested as
therapeutic drugs for the treatment of cannabis withdrawal.
(Source: Clapper JR, et al. Neuropharmacology. 2008 Jul 19.
[Electronic publication ahead of print])
5.
ONE YEAR AGO:
- Germany: MS patient receives a certificate of exemption for the
medical use of cannabis by the Federal Health Ministry
- Canada: Health Ministry approves cannabis extract for the use
in cancer pain
- USA: The Health Department of New Mexico does not intend
to grow and distribute cannabis
TWO YEARS AGO:
- Spain/Belgium: Cannabis clubs in Spain legal, first formation of a
club in Belgium
- Science: Cannabis use not associated with risk factors for
diseases of heart and circulation
- Science: THC inhibits primary marker of Alzheimer's disease
(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/)".