Monthly Archives: September 2018

Joint culpability: The effects of medical marijuana laws on crime

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Journal of Economic Behavior & Organization

“Most U.S. states have passed medical marijuana laws. In this paper, we study the effects of these laws on violent and property crime. We first estimate models that control for city fixed effects and flexible city-specific time trends. To supplement this regression analysis, we use the synthetic control method which can relax the parallel trend assumption and better account for heterogeneous policy effects.

Both the regression analysis and the synthetic control method suggest no causal effects of medical marijuana laws on violent or property crime at the national level. We also find no strong effects within individual states, except for in California where the medical marijuana law reduced both violent and property crime by 20%.”

https://www.sciencedirect.com/science/article/pii/S016726811830180X?via%3Dihub

“Legalising medical marijuana shows no effect on crime rates in US states”  https://theconversation.com/legalising-medical-marijuana-shows-no-effect-on-crime-rates-in-us-states-102030

“Study shows that medical cannabis use does not lead to rise in rate of crimes committed” https://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=12130350

“Study shows that medical marijuana use DOES NOT lead to a significant increase in the rate of crimes committed” https://www.dailymail.co.uk/news/article-6197313/Study-shows-medical-marijuana-use-DOES-NOT-lead-significant-increase-crime-rate.html

A review of the effects of baclofen and of THC:CBD oromucosal spray on spasticity-related walking impairment in multiple sclerosis.

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Publication Cover

“Multiple sclerosis (MS) is a complex disease with a heterogeneous and unpredictable clinical course. Mobility impairment after progressive paralyses and muscle tone spasticity is common.

Areas covered: The prevalence, assessment, and pharmacological management of gait impairment and spasticity in MS and their effects on health-related quality of life (HRQoL) are discussed.

The roles of oral and intrathecal baclofen and of delta-9-tetrahydrocannabinol/cannabidiol (THC:CBD) oromucosal spray in treating MS spasticity-related gait impairment are reviewed.

Expert commentary: Mobility impairment and spasticity are experienced by approximately 90% and 80% of MS patients, respectively, during the disease course. Prevalence and severity of gait impairment and spasticity increase as disease progresses. The symptoms are related and both impact negatively on HRQoL.

Oral baclofen and tizanidine are generally used for first-line treatment of MS spasticity but are ineffective in approximately 40% of cases.

Second-line therapy includes add-on THC:CBD spray for patients with resistant MS spasticity. Results of studies evaluating baclofen for treating MS spasticity gait impairment are equivocal.

In studies of patients with resistant MS spasticity, THC:CBD spray consistently improved the timed 10-meter walk test and significantly improved multiple spatial-temporal and kinematic gait parameters.

THC:CBD oromucosal spray warrants further investigation as a treatment for MS spasticity-related gait impairment.”

https://www.ncbi.nlm.nih.gov/pubmed/30235965

https://www.tandfonline.com/doi/abs/10.1080/14737175.2018.1510772?journalCode=iern20

Cannabinoid WIN 55,212-2 induces cell cycle arrest and apoptosis, and inhibits proliferation, migration, invasion, and tumor growth in prostate cancer in a cannabinoid-receptor 2 dependent manner.

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The Prostate banner

“Cannabinoids have demonstrated anticarcinogenic properties in a variety of malignancies, including in prostate cancer.

In the present study, we explored the anti-cancer effects of the synthetic cannabinoid WIN 55,212-2 (WIN) in prostate cancer.

RESULTS:

WIN significantly reduced prostate cancer cell proliferation, migration, invasion, induced apoptosis, and arrested cells in Go/G1 phase in a dose-dependent manner. Mechanistic studies revealed these effects were mediated through a pathway involving cell cycle regulators p27, Cdk4, and pRb. Pre-treatment with a CB2 antagonist, AM630, followed by treatment with WIN resulted in a reversal of the anti-proliferation and cell cycle arrest previously seen with WIN alone. In vivo, administration of WIN resulted in a reduction in the tumor growth rate compared to control (P < 0.05).

CONCLUSIONS:

The following study provides evidence supporting the use of WIN as a novel therapeutic for prostate cancer.”

https://www.ncbi.nlm.nih.gov/pubmed/30242861

https://onlinelibrary.wiley.com/doi/abs/10.1002/pros.23720

Combined CB2 Receptor Agonist and Photodynamic Therapy Synergistically Inhibit Tumor Growth in Triple Negative Breast Cancer.

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Photodiagnosis and Photodynamic Therapy

“Triple negative breast cancer (TNBC) is the deadliest form of breast cancer because compared with other types of breast cancer, it is more aggressive, diagnosed at later stage and more likely to develop recurrence.

Many patients do not experience adequate tumor control after current clinical treatments involving surgical removal, chemotherapy and/or radiotherapy, leading to disease progression and significantly decreased quality of life.

Here we report a new combinatory therapy strategy involving cannabinoid-based medicine and photodynamic therapy (PDT) for the treatment of TNBC.

This combinatory therapy targets two proteins upregulated in TNBC: the cannabinoid CB2 receptor (CB2R, a G-protein coupled receptor) and translocator protein (TSPO, a mitochondria membrane receptor). We found that the combined CB2R agonist and TSPO-PDT treatment resulted in synergistic inhibition in TNBC cell and tumor growth.

This combinatory therapy approach provides new opportunities to treat TNBC with high efficacy. In addition, this study provides new evidence on the therapeutic potential of CB2R agonists for cancer.”

https://www.ncbi.nlm.nih.gov/pubmed/30240926

https://www.sciencedirect.com/science/article/pii/S1572100018301571?via%3Dihub

Marijuana is not associated with progression of hepatic fibrosis in liver disease: a systematic review and meta-analysis.

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“An estimated 22 million adults use marijuana in the USA. The role of marijuana in the progression of hepatic fibrosis remains unclear.

AIMS:

We carried out a systematic review and meta-analysis to evaluate the impact of marijuana on prevalence and progression of hepatic fibrosis in chronic liver disease.

PATIENTS AND METHODS:

We searched several databases from inception through 10 November 2017 to identify studies evaluating the role of marijuana in chronic liver disease. Our main outcome of interest was prevalence/progression of hepatic fibrosis. Adjusted odds ratios (ORs) and hazards ratios (HRs) were pooled and analyzed using random-effects model.

RESULTS:

Nine studies with 5 976 026 patients were included in this meta-analysis. Prevalence of hepatic fibrosis was evaluated in nonalcoholic fatty liver disease (NAFLD), hepatitis C virus (HCV), and hepatitis C and HIV coinfection by two, four, and one studies. Progression of hepatic fibrosis was evaluated by two studies. Pooled OR for prevalence of fibrosis was 0.91 (0.72-1.15), I=75%. On subgroup analysis, pooled OR among NAFLD patients was 0.80 (0.75-0.86), I=0% and pooled OR among HCV patients was 1.96 (0.78-4.92), I=77%. Among studies evaluating HR, pooled HR for progression of fibrosis in HCV-HIV co-infected patients was 1.03 (0.96-1.11), I=0%.

CONCLUSION:

Marijuana use did not increase the prevalence or progression of hepatic fibrosis in HCV and HCV-HIV-coinfected patients. On the contrary, we noted a reduction in the prevalence of NAFLD in marijuana users. Future studies are needed to further understand the therapeutic impact of cannabidiol-based formulations in the management of NAFLD.”

https://www.ncbi.nlm.nih.gov/pubmed/30234644

Care After Chemotherapy: Peripheral Neuropathy, Cannabis for Symptom Control, and Mindfulness.

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ASCO Educational Book

“As cancer therapies improve, patients are living longer. With these improvements in therapy comes a responsibility to optimize patients’ quality of life during cancer therapy and beyond. This report reviews three timely and important topics.

The first section reviews the mechanism underlying chemotherapy-induced peripheral neuropathy and evaluates the evidence for interventions to prevent and treat peripheral neuropathy. It also provides a framework for approaching the diagnosis and management of this common and bothersome side effect.

The second section addresses the controversial but effective use of cannabinoids for cancer and chemotherapy symptoms. Although clinical trials are difficult to conduct because of the political and social stigma of this class of drugs, this review provides evidence of the efficacy of cannabinoids for treatment of pain and nausea.

The last section addresses the mind-body connection, with a focus on the negative emotions patients with cancer often experience. This section assesses the literature regarding mindfulness-based programs to improve cancer-related stress. These three topics may appear unrelated, but all address one common goal: treating the body and the mind to optimize quality of life during and after cancer therapy.”

 https://www.ncbi.nlm.nih.gov/pubmed/30231411
“Although commercially available dronabinol is not superior to other antiemetics and oromucosal nabiximols is not very effective for treating cancer pain, cannabis has been shown to be effective for treating pain and may help patients reduce opioid intake.”
http://ascopubs.org/doi/10.1200/EDBK_209437

Inflammation and CB2 signaling drive novel changes in the ocular lipidome and regulate immune cell activity in the eye.

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Prostaglandins & Other Lipid Mediators

“Uveitis is inflammation of the uvea which consists of the iris, ciliary body and the choroid of the eye. Uveitis can lead to impaired vision and is responsible for 10% of all cases of blindness globally.

Using an endotoxin-induced uveitis (EIU) rodent model, our previous data implicated the endogenous cannabinoid system (ECS) in the amelioration of many of the components of the inflammatory response.

Here, we test the hypothesis that the reduction in inflammatory mediators in the EIU model by the CB2 agonist, HU308, is associated with changes in ECS endogenous ligands as well as related lipids, prostaglandins (PGs), 2-acyl glycerols, and lipoamines.

These data implicate ocular CB2 as a key component of lipid signaling in the eye and part of the regulatory processes of inflammation.”

https://www.ncbi.nlm.nih.gov/pubmed/30232034

https://www.sciencedirect.com/science/article/pii/S109888231830025X?via%3Dihub

Cannabinoids and spinal cord stimulation for the treatment of failed back surgery syndrome refractory pain

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“This study aimed to evaluate pain and its symptoms in patients with failed back surgery syndrome (FBSS) refractory to other therapies, treated with a combination of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), in association with spinal cord stimulation (SCS).

Results: Effective pain management as compared to baseline result was achieved in all the cases studied. The positive effect of cannabinoid agonists on refractory pain was maintained during the entire duration of treatment with minimal dosage titration. Pain perception, evaluated through numeric rating scale, decreased from a baseline mean value of 8.18±1.07–4.72±0.9 by the end of the study duration (12 months) (P<0.001).

Conclusion: The results indicate that cannabinoid agonists (THC/CBD) can have remarkable analgesic capabilities, as adjuvant of SCS, for the treatment of chronic refractory pain of FBSS patients.”

https://www.ncbi.nlm.nih.gov/pubmed/30233233

https://www.dovepress.com/cannabinoids-and-spinal-cord-stimulation-for-the-treatment-of-failed-b-peer-reviewed-article-JPR

“Outcomes indicate remarkable analgesic capabilities of cannabinoid agonists (THC/CBD) as an adjuvant to SCS for treating chronic refractory pain in FBSS patients, since all the cases studied achieved effective pain management compared to baseline.”

https://www.mdlinx.com/journal-summaries/cannabinoids-delta-9-tetrahydrocannabinol-thc-cannabidiol/2018/09/13/7544234/

A Comparative Study on Hemp (Cannabis sativa) Essential Oil Extraction Using Traditional and Advanced Techniques.

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“A comparative study of Cannabis sativa (Hemp) essential constituents obtained by using Supercritical Fluid Extraction (SCFE), Steam Distillation (SD) and Hydrodistillation (HD) is presented here.

The optimized extraction temperatures were 130，110 and 50 ℃ for hydrodistillation, steam distillation and supercritical fluid extraction respectively. The essential oil of C. sativa was analyzed by using Gas chromatography mass spectrometry (GC-MS). A total of 33, 30 and 31 components have been identified in HD, SD and SCFE respectively. Yield of essential oil using SCFE (0.039%) was more than HD (0.025%) and SD (0.035%) extraction respectively.

The main component of sesquiterpenes obtained by hydrodistillation at 130 ℃ with their percentages included caryophyllene (40.58%), trans-α-bergamotene (5.41%), humulene (10.97%), cis-β-farnesene (8.53%) and monoterpenes included α-pinene (2.13%), d-limonene (6.46%), p-cymol (0.65%) and cineole (2.58%) respectively.

The main component of sesquiterpenes obtained by SD steam distillation at 110 ℃ including caryophyllene (38.60%) trans-α-bergamotene (4.22%), humulene (10.26%), cis-β-farnesene (6.67%) and monoterpenes included α-pinene (3.21%), d-limonene (7.07%), p-cymol (2.59%) and cineole (3.88%) whereas the more percentages of major components were obtained by SCFE at 50 ℃ included caryophyllene (44.31%), trans-α-bergamotene (6.79%), humulene (11.97%) cis-β-farnesene (9.71%) and monoterpenes included α-pinene (0.45%), d-limonene (2.13%) p-cymol (0.19%) and cineole (1.38 %) respectively.

We found yield/efficiency, chemical composition, quality of the essential oils by supercritical fluid extraction superior in terms of modern, green, saving energy and a rapid approach as compared to traditional techniques.”

https://www.ncbi.nlm.nih.gov/pubmed/30221908

Effect of cannabidiolic acid and ∆9-tetrahydrocannabinol on carrageenan-induced hyperalgesia and edema in a rodent model of inflammatory pain.

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“Cannabidiol (CBD), a non-intoxicating component of cannabis, or the psychoactive Δ9-tetrahydrocannabiol (THC), shows anti-hyperalgesia and anti-inflammatory properties.

OBJECTIVES:

The present study evaluates the anti-inflammatory and anti-hyperalgesia effects of CBD’s potent acidic precursor, cannabidiolic acid (CBDA), in a rodent model of carrageenan-induced acute inflammation in the rat hind paw, when administered systemically (intraperitoneal, i.p.) or orally before and/or after carrageenan. In addition, we assess the effects of oral administration of THC or CBDA, their mechanism of action, and the efficacy of combined ineffective doses of THC and CBDA in this model. Finally, we compare the efficacy of CBD and CBDA.

RESULTS:

CBDA given i.p. 60 min prior to carrageenan (but not 60 min after carrageenan) produced dose-dependent anti-hyperalgesia and anti-inflammatory effects. In addition, THC or CBDA given by oral gavage 60 min prior to carrageenan produced anti-hyperalgesia effects, and THC reduced inflammation. The anti-hyperalgesia effects of THC were blocked by SR141716 (a cannabinoid 1 receptor antagonist), while CBDA’s effects were blocked by AMG9810 (a transient receptor potential cation channel subfamily V member 1 antagonist). In comparison to CBDA, an equivalent low dose of CBD did not reduce hyperalgesia, suggesting that CBDA is more potent than CBD for this indication. Interestingly, when ineffective doses of CBDA or THC alone were combined, this combination produced an anti-hyperalgesia effect and reduced inflammation.

CONCLUSION:

CBDA or THC alone, as well as very low doses of combined CBDA and THC, has anti-inflammatory and anti-hyperalgesia effects in this animal model of acute inflammation.”

https://www.ncbi.nlm.nih.gov/pubmed/30225659

https://link.springer.com/article/10.1007%2Fs00213-018-5034-1