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Thursday, June 11, 2015

Medical Marijauna: All Formulations Now Legal; Cannabis Harms Brain, Fails in Cancer Pain Study


1. You  might have heard the news by now:
- Ruling in Canada this AM:

Medical marijuana legal in all forms, Supreme Court rules (via CBC)

Excerpt:
"Medical marijuana patients will now be able to consume marijuana — and not just smoke it — as well as use other extracts and derivatives, the Supreme Court of Canada ruled today."

This is an important ruling for patients as we see more and more form - for instance, with cannabis oil  being all the buzz these days.
2. That's the "good" news for patients; now for some sobering updates:

Cannabis Harms Brain, Imaging Shows (via Medscape)

Excerpts:
" The heavy, long-term use of cannabis is associated with negative changes in parts of the brain not previously implicated, and is linked to deficits in learning and memory, new research suggests."
"Cannabis shares a negative impact on dopaminergic transmission with other drugs, only with a different regional profile," explained Dr Abi-Dargham. An exploratory analysis showed a significant association between lower dopamine release capacity in the associative striatum and decreased cognitive measures in probabilistic category learning and working memory tasks, Dr Weinstein reported.
In their study, the team compared 11 heavy cannabis users with 12 healthy control subjects, all approximately 28 years of age."

"The blunting of dopamine release that they find fits with other studies showing reduced dopamine synthesis in cannabis users. This could be linked to the addictive potential of cannabis and other problems, such as lack of motivation, seen in regular users," Dr Howes told Medscape Medical News."
3. From January, but relevant when considering prescribing Sativex (which has refractory advanced cancer pain as indication in Canada):

GW Pharma's cannabis drug [Sativex] fails in cancer pain study, shares fall (via Reuters)

Excerpts:

"An experimental cannabis drug failed to alleviate pain in cancer patients as hoped in a clinical study, sending shares in its British maker GW Pharmaceuticals as much as 21 percent lower on Thursday. GW, which is developing the drug Sativex for pain in collaboration with Japan's Otsuka, said the first of three late stage trials found no statistically significant difference between subjects using its product and those given a placebo.

GW Chief Executive Justin Gover said the findings were both disappointing and surprising, given encouraging results in earlier tests, but the company's scientists had not given up hope. Results from two further Phase III trials are due later this year and, if positive, could still allow the drug to be submitted for treating pain in patients with advanced cancer, where it is designed to be given on top of opioids.

"Although we missed the primary endpoint in this trial, based upon the positive data seen in the Phase II programme, we remain confident in the ability for Sativex to relieve cancer pain in this patient population,” Gover said."

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Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

From Wikipedia: http://en.wikipedia.org/wiki/Pharmacy#History_of_pharmacy

Journal of Palliative Medicine - Table of Contents

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