Source: International Association for Cannabinoid Medicines (IACM)

6 June 2010

Economy/Germany: Volcano Medic launched as the first
approved medical cannabinoid inhaler

Science: Cannabis effective in the treatment of Tourette
Syndrome and attention deficit hyperactivity disorder (ADHD)

USA: Medical doctors in Montana who sign cannabis
authorization forms at travelling clinics may be disciplined

1. Economy/Germany: Volcano Medic launched as the first
approved medical cannabinoid inhaler

The German company Vapormed launched the world’s first
officially approved medical cannabinoid inhaler, the Volcano
Medic Vaporizer. The Volcano Medic Vaporization System is
intended to vaporize and facilitate the inhalation of dronabinol
(THC) dissolved in alcohol or cannabinoids from cannabis flowers
(cannabis flos). In their press release of 2 June the company
notes that “the Volcano Medic Vaporization System resolves two
medical-technical problems at the same time. On the one hand,
for the first time the Volcano Medic Vaporization System allows
for the medical inhalation therapy with liquid, in alcohol dissolved
cannabinoids. On the other hand, it allows for the inhalation
therapy with cannabinoids directly from dried hemp flowers. (…)
In the Volcano Medic Vaporization System the cannabinoids are
solved (vaporized) by heat impact only. A combustion as it takes
place while smoking does not occur.” This avoids the formation of
noxious combustion products.

The main advantages of the inhalation of cannabinoids compared
to oral administration would be the rapid onset of effects and cost
reduction due to considerably higher efficiency of vaporized
cannabinoids. “The systemic bioavailability of inhaled cannabinoids
is approx. 29% – 40%. For comparison: The systemic
bioavailability of cannabinoids administered orally is below 15%.”
The manufacturer of the Volcano Medic Vaporization System is
the company Storz & Bickel. According to the press release the
Volcano Medic will first be available in the Netherlands and in
Germany. It is certified by TUEV SUED in Munich in compliance
with the applicable directives and laws for medical devices. “The
availability of the Volcano Medic in further countries depends on
the availability of authorized and vaporizable cannabinoids or
cannabis flowers in these countries,” the company writes.

(Source: Press release by Vapormed of 2 June)

2. Science: Cannabis effective in the treatment of Tourette
Syndrome and attention deficit hyperactivity disorder (ADHD)

German scientists from the universities of Goettingen, Hamburg
and Dresden reported of the treatment of a 15-year-old boy with
treatment refractory Tourette Syndrome (TS) and attention deficit
hyperactivity disorder (ADHD) leading to severe physical and
psychosocial impairment. Administration of THC resulted in a
considerable improvement of tics without adverse effects,
allowing parallel stimulant treatment of comorbid ADHD. Along
with THC treatment, intracortical inhibition, that is inhibition of
signal transmission between nerve cells in the cortex of the brain,
was increased.

Authors concluded that “our observation suggests that delta-9-
THC might be a successful alternative in patients with severe TS
refractory to classic treatment. Particularly in the case of
stimulant-induced exacerbation of tics, delta-9-THC might enable
successful treatment of comorbid ADHD. The enhancement of
intracortical inhibition might be mediated by modulating release of
several neurotransmitters including dopamine and gamma-
aminobutyric acid.”

(Source: Hasan A, Rothenberger A, Münchau A, Wobrock T,
Falkai P, Roessner V. Oral delta9-tetrahydrocannabinol improved
refractory gilles de la tourette syndrome in an adolescent by
increasing intracortical inhibition: a case report. J Clin
Psychopharmacol 2010;30(2):190-2.)

3. USA: Medical doctors in Montana who sign cannabis
authorization forms at travelling clinics may be disciplined

Doctors working at mass medical cannabis clinics could be
disciplined by the Montana Board of Medical Examiners under a
policy the board adopted in May. Recommending a course of
treatment after a brief consultation and without any follow-up
does not meet the standard of care expected of Montana
physicians, board members decided. They approved by unanimous
vote a position paper that will allow them to sanction doctors for
providing substandard care to medical cannabis users.

That could include signing medical cannabis authorization forms at
travelling clinics or over the Internet. “The Board of Medical
Examiners takes no position on the general suitability of marijuana
in the treatment of medical disorders, but does have an obligation
to protect the public by ensuring that physicians provide medical
services via a bona-fide physician-patient relationship that meets
the generally accepted standards of care,” the paper states.
Medical doctors across the state are angered by the way
hundreds of citizens have secured medical cannabis cards at mass
clinics staffed by out-of-state doctors. “I think it’s being
corrupted,” said Dr. Jim Guyer, director of a medical clinic in
Billings. “The people coming through the door are exploiting it.
The people who are going to get hurt are the people the law was
intended for.” The number of card holders for medical cannabis
has considerably increased in the past 1.5 years in Montana and
other states of the USA.

(Source: Billings Gazette of 24 May and 1 June 2010)

4. News in brief

USA: Arizona

For the fourth time, the voters of Arizona will decide in November
whether people with certain ailments should be able to legally use
cannabis. State officials confirmed that backers of the latest
medical cannabis initiative had enough valid signatures on their
petitions to be on the ballot. Arizonans have approved a similar
measure twice. But that never took effect because of the way it
was worded. (Source: The Sun of 1 June 2010)

USA: Washington D.C.

A tax on medical cannabis could generate some 400,000 US
Dollars (about 330,000 Euros) for the city over the next five
years, according to an estimate from financial officials of the city.
The city council passed legislation earlier this year that permits
residents with certain medical conditions to purchase cannabis.
Now the budget council members are expected to vote on June 15
includes a provision that would impose the city’s 6 percent sales
tax on medical cannabis sold in the city. (Source: Associated
Press of 1 June 2010)

Science: Amyotrophic lateral sclerosis

A clinical study with 27 patients suffering from amyotrophic
lateral sclerosis (ALS) and cramps was conducted at the
Kantonsspital St Gallen, Switzerland. In a double-blind, placebo-
controlled crossover trial they received 5 mg THC twice daily for
2 weeks and a placebo for 2 weeks interrupted by a 2 week wash-
out period. THC was well tolerated. There was “no evidence for
a treatment effect on cramp intensity, number of cramps,
fasciculation intensity or any of the other secondary outcome
measures.” (Source: Weber M, et al. J Neurol Neurosurg
Psychiatry 2010 May 24. [in press])

Science: Motion sickness

According to research at the University of Munich, Germany,
stress and motion sickness in humans are associated with
impaired endocannabinoid activity. They concluded that enhancing
endocannabinoid signalling “may represent an alternative
therapeutic strategy for motion sickness in individuals who do not
respond to currently available treatments.” (Source: Choukèr A, et
al. PLoS One 2010;5(5):e10752.)

Science: Essential fatty acids

Research at the University of Cordoba, Argentina, shows that the
endocannabinoid system can be modulated by ingested
polyunsaturated fatty acids since these fatty acids serve as
precursors of the endocannabinoids. (Source: Dain A, et al. Front
Biosci (Elite Ed) 2010;2:1432-47.)

Science: Cancer

According to research at the University of New York THC
inhibits cellular respiration of human oral cancer cells. The
scientists noted that their “results show that cannabinoids are
potent inhibitors of Tu183 cellular respiration and are toxic to this
highly malignant tumor.” (Source: Whyte DA, et al. Pharmacology
2010;85(6):328-335.)

Science: Cancer

According to research of the University of Bristol, UK, the
endocannabinoid anandamide induces cell death in colon cancer
cells, which are resistant to apoptosis. This effect depended of
cyclooxygenase-2 (COX-2). They noted that “as COX-2 is not
expressed in the normal colorectal epithelium, but highly
expressed in colorectal tumours (…) anandamide has the potential
to be an effective therapeutic in colorectal cancer.” (Source:
Patsos HA, et al. Int J Oncol 2010;37(1):187-93.)

Science: Food intake

Basic research at the University of Manchester, UK,
demonstrates that the peptide hemopressin decreases food intake
in rats and mice. This effect was mediated by antagonism at the
CB1 receptor. The scientists speculate “that hemopressin may act
as an endogenous functional antagonist at CB1 receptors and
modulate the activity of appetite pathways in the brain.” (Source:
Dodd GT, et al. J Neurosci 2010;30(21):7369-76.)

Science: Neuropathic pain

Researchers at the University of Frankfurt, Germany, investigated
the mode of action of R-flurbiprofen in neuropathic pain. They
found out that this substance inhibited the enzyme fatty acid amide
hydrolase (FAAH) responsible for the degradation of
anandamide. They concluded that R-flurbiprofen “improves the
endogenous mechanisms to regain stability after axonal injury and
to fend off chronic neuropathic pain by modulating the
endocannabinoid system.” (Source: Bishay P, et al. PLoS One
2010;5(5):e10628.)

International Association for Cannabinoid Medicines (IACM)

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 D-59602 Ruethen

 Germany

 Phone: +49 (0)2952-9708571

 Fax: +49 (0)2952-902651

 Email: info@cannabis-med.org

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