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IACM-Bulletin of 22 July 2018

IACM: Nomination of IACM Ambassadors

In order to establish a wider network that will work together toward its aims as mentioned in the statutes, the IACM has nominated ambassadors in different countries around the world. There are both Professional Ambassadors and Patient Ambassadors, as well as Partner Organizations

The list of ambassadors is as follows:

Professional Ambassadors
Alex Mabou Tagne (Cameroon)
Daniela Parolaro (Italy)
Donald Abrams (USA)
Ethan Russo (USA)
Francesco Crestani (Italy)
Franjo Grotenhermen (Germany)
Gastone Zanette (Italy)
Gianpaolo Grassi (Italy)
Ilya Reznik (Israel)
Kirsten Müller-Vahl (Germany)
Manuel Guzman (Spain)
Mark Ware (Canada)
Marlon Germon (South Africa)
Marry Lynn Mathre (USA)
Natalie Krapivensky (Australia)
Raquel Peyraube (Uruguay)
Roger Pertwee (UK)
Rudolf Brenneisen (Switzerland)
Steve Goldner (USA)

Patient Ambassadors
Alison Myrden (Canada)
Carola Pérez Gómez (Spain)
Hana Vágnerová (Czech Republic)
Marian Hutten (Netherlands)
Max Plenert (Germany)
Michael Krawitz (USA)
Sarah Martin (UK)
Sébastien Béguerie (France)

For more details about the ambassadorship program, you may contact our Partnership and Network Coordinator Yuval Zolotov at network@cannabis-med.org

Science/Human: Legalization of cannabis for medical use in the US is associated with reduced opioid prescriptions

“Statewide medical cannabis legalization appears to have been associated with reductions in both prescriptions and dosages of Schedule III (but not Schedule II) opioids received by Medicaid enrollees in the US,” scientists from the Department of Family Medicine and Public Health of the University of California in San Diego, USA, wrote. They analysed state-level opioid prescription records from 1993 to 2014 of data from Medicaid. Medicaid is a program that helps with medical costs for some people with limited income and resources.

For Schedule III opioid prescriptions, medical cannabis legalization was associated with a 29.6% reduction in number of prescriptions, 29.9% reduction in dosage, and 28.8% reduction in related Medicaid spending. No evidence was found to support the associations between medical cannabis legalization and Schedule II opioid prescriptions Authors estimated that, if “all the states had legalized medical cannabis by 2014, Medicaid annual spending on opioid prescriptions would be reduced by 17.8 million dollars.” Schedule II opioids are morphine, fentanyl and others. Schedule III opioids are buprenorphine, tramadol and others.

Liang D, Bao Y, Wallace M, Grant I, Shi Y. Medical Cannabis Legalization and Opioid Prescriptions: Evidence on US Medicaid Enrollees during 1993-2014. Addiction. 2018 Jul 10. [in press]

Science/Human: Cannabis use is associated with decreased mortality in hospital after a heart attack

In a study with 1,273,897 patients with acute myocardial infarctions cannabis use was associated with decreased in-hospital deaths. Furthermore, cannabis use was not associated with increased risk of adverse short-term outcomes following a heart attack. In total 3854 patients reported cannabis use. Researchers of the Division of Cardiology of the University of Colorado Anschutz in Aurora, USA, analysed hospital records from 8 states between 1994 and 2013.

Cannabis users were more likely to be placed on mechanical ventilation (odds ratio 1.19). They were significantly less likely to die (OR 0.79), experience shock (OR 0.74) or require an intra-aortic balloon pump (OR 0.80) after acute myocardial infraction (AMI) than patients with no reported cannabis use. Authors wrote that these “results suggest that, contrary to our hypothesis, marijuana use was not associated with increased risk of adverse short-term outcomes following AMI. Furthermore, marijuana use was associated with decreased in-hospital mortality post-AMI.”

Johnson-Sasso CP, Tompkins C, Kao DP, Walker LA. Marijuana use and short-term outcomes in patients hospitalized for acute myocardial infarction. PLoS One. 2018;13(7):e0199705.

Science/Human: CBD reduces seizures in several further childhood-onset epilepsy forms according to an open-label study

In an open study with 46 patients with CDKL5 deficiency disorder or Aicardi, Doose, and Dup15q syndromes a treatment with CBD reduced the frequency of convulsive seizures. Investigators of New York University School of Medicine, USA, included patients aged 1-30 years with these severe childhood-onset epilepsy forms. They were treated with CBD for at least 10 weeks.

The percent change in median convulsive seizure frequency for all patients taking CBD decreased from baseline to week 12 by 51.4% and week 48 by 59.1%. CBD was generally well tolerated. Authors wrote that the study “provides class III evidence for the long-term safety and efficacy of CBD administration in patients with treatment-resistant epilepsy” associated with these disorders.

Devinsky O, Verducci C, Thiele EA, Laux LC, Patel AD, Filloux F, Szaflarski JP, Wilfong A, Clark GD, Park YD, Seltzer LE, Bebin EM, Flamini R, Wechsler RT, Friedman D. Open-label use of highly purified CBD (Epidiolex®) in patients with CDKL5 deficiency disorder and Aicardi, Dup15q, and Doose syndromes. Epilepsy Behav. 2018 Jul 10. [in press]

News in brief

Lebanon: Parliament considers cultivation of cannabis for medical use
Lebanon’s parliament is considering legalizing the cultivation of cannabis for medical purposes, Parliament Speaker Nabih Berri said on 18 July. Although growing the plant is illegal in Lebanon, landowners nevertheless have for decades openly grown cannabis in the fertile Bekaa Valley.
Reuters of 18 July 2018

Science/Human: Legalisation of cannabis in some US states is associated with improvement in some clearance rates by the police
Scientists assessed crime clearance rates in Colorado and Washington before and after the enactment of cannabis legalization for recreational use. Their findings suggest no negative effects of legalization on crime clearance rates. “Our findings suggest legalization has resulted in improvements in some clearance rates,” they wrote.
Department of Criminal Justice and Criminology, Washington State University, Pullman, USA.
Makin DA, et al. Police Quarterly. 2018 Jul 4. [in press]

Science/Animal: Endocannabinoids produced from omega-3 fatty acids have anti-cancer effects
The intake of omega-3 fatty acids increased the production of endocannabinoid substances (DHEA, EDP-EA) with anti-cancer effects in osteosarcoma, a bone cancer, by several mechanisms, including reduction of tumour growth, metastasis and the production of new blood vessels in the tumour. These effects were partially mediated through the cannabis receptor 1.
University of Illinois, Urbana, USA.
Science Daily of 13 July 2018
Roy J, et al. J Med Chem. 2018;61(13):5569-5579.

Science/Human: Large variation of plasma concentrations of THC and CBD after oral intake
In a study with 12 multiple sclerosis patients, who received 2 sprays of the cannabis extract Sativex containing 2.7 mg THC and 2.5 mg CBD in 1 spray, maximum concentrations in blood plasma varied considerably. Maximum THC plasma levels varied from 0.60 to 13.29 ng/mL and CBD plasma levels range from 0.55 to 11.93 ng/mL. Time to peak plasma concentrations ranged from 150 to 240 minutes for THC and 90 to 240 minutes for CBD.
IRCCS, Institute of Neurological Sciences, Bologna, Italy.
Contin M, et al. Clin Neuropharmacol. 2018 Jul 18. [in press]

Science/Cells: CBD may be effective in several breast cancer types
CBD induces apoptosis (programmed cell death) in several breast cancer cells, including ER -positive and triple negative breast cancer cells.
Department of Biochemistry, Faculty of Science, Alexandria University, Egypt.
Sultan AS, et al. 2018;41:34-41.

Science/Human: CBD was effective in several epilepsy forms in the long-term
In a long-term observational study with 607 patients treated at 25 sites in the US with CBD up to a maximum dose of 25 to 50 mg/kg bodyweight treatment effects after 96 weeks were similar to those after 12 weeks.
University of Alabama, Birmingham, USA.
Szaflarski JP, et al. Epilepsia. 2018 Jul 12. [in press]

Science/Human: The effect of cannabis on insomnia depended on the cannabis variety
In a study with 409 people with a specified condition of insomnia CBD was associated with greater symptom relief than THC. Flowers from sativa subtypes were associated with more negative side-effects than flowers from indica or hybrid plant subtypes.
Department of Psychology, University of New Mexico, Albuquerque, USA.
Vigil JM, et al. Medicines (Basel). 2018;5(3).

Science/Human: Pain patients who use cannabis have greater pain severity than non-users
According to a survey with 1514 pain patients contacted by phone cannabis use was associated with a greater pain severity score compared to non-users. Authors wrote that there “was no evidence that cannabis use reduced pain severity or interference or exerted an opioid-sparing effect.” However, it may also be possible, that patients with more severe pain are more likely to use cannabis.
National Drug and Alcohol Research Centre, Sydney, Australia.
Campbell G, et al. Lancet Public Health. 2018;3(7):e341-e350.

Science/Cells: Cannabis compounds interact synergistically for anti-cancer activity against colon cancer
Colon cancer cells were exposed to several ethanol extracts from cannabis. Researchers found that some cannabis compounds acted synergistically to produce toxic effects on these cancer cells, induce cell cycle arrest and apoptosis (programmed cell death). Among these compounds is cannabigerolic acid.
Agricultural Research Organization, Volcani Center, Bet Dagan, Israel.
Nallathambi R, et al. Cannabis Cannabinoid Res. 2018;3(1):120-135.

Science/Animal: A mechanism of action of CBD’s antidepressant effects
Researchers investigated the effects of CBD on a certain brain region (hippocampus) of mice. They wrote that the investigation suggests “that the hippocampal BDNF-TrkB-mTOR pathway is vital for cannabidiol-induced antidepressant-like effect.”
Department of Physics and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil.
Sartim AG, et al. J Psychopharmacol. 2018:269881118784877.

Science/Human: Cannabis may have therapeutic effects in patients with sickle cell disease
An analysis of 44 patients, who received cannabis for medical reasons, showed that cannabis products may be beneficial in this patient group.
Yale Cancer Center, Yale University, New Haven, USA.
Roberts JD, et al. Cannabis Cannabinoid Res. 2018;3(1):162-165.

Science/Human: CBD is mostly used against pain, sleep disorders, anxiety and depression
In an online survey with 2409 participants recruited through social media almost 62% of CBD users reported using the cannabinoid to treat a medical condition. The top medical conditions were pain, sleep disorders, anxiety, and depression. Almost 36% of respondents reported that CBD treats their medical condition "very well.”
The Center for Medical Cannabis Education, Del Mar, USA.
Corroon J and Phillips JA.Cannabis Cannabinoid Res. 2018;3(1):152-161.

Science/Human: Cannabis users need higher doses of opioids after surgery
In an analysis of 434 patients, who underwent weight reduction surgeries, those with cannabis use (36 patients) need higher doses of opioids. Authors assume that this is due to the development of cross tolerance.
Saint Joseph Hospital, Denver, USA.
Bauer FL, et al. Perm J. 2018;22.

Science/Cells: Cannabigerol has anti-inflammatory and neuroprotective properties
The plant cannabinoid cannabigerol (CBG) protected nerve cells against the toxicity induced by stimulated macrophages. It counteracted the production of pro-inflammatory messengers.
IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.
Gugliandolo A, et al. J Mol Sci. 2018;19(7).

Science/Animal: Activation of the peripheral CB1 receptor may be beneficial in chemotherapy-induced peripheral neuropathy
In a study with rats with cisplatin-induced peripheral neuropathy the administration of a synthetic cannabinoid, which does not penetrate into the brain, suppressed allodynia. Allodynia refers to a pain sensation from a stimulus (e.g. touch, cold), which usually does not cause pain.
Laboratory of Neuropharmacology, University of California, Los Angeles, USA.
Mulpuri Y, et al. Neuropharmacology. 2018;139:85-97.

Science/Cells: Activation of the CB2 receptor decreases viability of leukaemia cells
A new synthetic cannabinoid with high affinity to the CB2 receptor inhibits cell survival in leukaemia cells, but it did not damage normal healthy lymphocytes.
Department of Experimental Medicine, University of Rome "La Sapienza", Italy.
Capozzi A, et al. Int J Mol Sci. 2018;19(7).

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