Over Half Of Cannabis Users With Parkinson’s Disease Report Clinical Benefits

A survey in Germany found over 8% of patients with Parkinson’s disease are using cannabis products and more than half experienced beneficial clinical effects, reports the Journal of Parkinson’s Disease

NETHERLANDS:  With medicinal cannabis now legalized in many parts of the world, there is growing interest in its use to alleviate symptoms of many illnesses including Parkinson’s disease (PD). According to results of a survey of PD patients in Germany in the Journal of Parkinson’s Disease, over 8% of patients with PD reported using cannabis products and more than half of those users (54%) reported a beneficial clinical effect.

Cannabis products containing THC (tetrahydrocannabinol, the main psychoactive compound of cannabis) can be prescribed in Germany when previous therapies are unsuccessful or not tolerated, and where cannabis can be expected with not a very unlikely chance to relieve disabling symptoms. CBD (pure cannabidiol, derived directly from the hemp plant, a cousin of the marijuana plant) is available without a prescription from pharmacies and on the internet.

“Medical cannabis was legally approved in Germany in 2017 when approval was given for therapy-resistant symptoms in severely affected patients independent of diagnosis and without clinical evidence-based data,” explained lead investigator Prof. Dr. med. Carsten Buhmann, Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. “PD patients fulfilling these criteria are entitled to be prescribed medical cannabis, but there are few data about which type of cannabinoid and which route of administration might be promising for which PD patient and which symptoms. We also lack information about the extent to which the PD community is informed about medicinal cannabis and whether they have tried cannabis and, if so, with what result.”

Investigators aimed to assess patient perceptions of medicinal cannabis as well as evaluate the experiences of patients already using cannabis products. They performed a nationwide, cross-sectional, questionnaire-based survey among members of the German Parkinson Association (Deutsche Parkinson Vereinigung e.V.), which is the largest consortium of PD patients in German-speaking countries with nearly 21,000 members. Questionnaires were sent out in April 2019 with the association’s membership journal and were also distributed in the investigators’ clinic.

Over 1,300 questionnaires were analyzed; results showed that interest in the PD community in medical cannabis was high, but knowledge about different types of products was limited. Fifty-one percent of respondents were aware of the legality of medicinal cannabis, and 28% were aware of the various routes of administration (inhaling versus oral administration), but only 9% were aware of the difference between THC and CBD.

More than 8% of patients were already using cannabinoids and more than half of these users (54%) reported that it had a beneficial clinical effect. The overall tolerability was good. Over 40% of users reported that it helped manage pain and muscle cramps, and more than 20% of users reported a reduction of stiffness (akinesia), freezing, tremor, depression, anxiety, and restless legs. Patients reported that inhaled cannabis products containing THC were more efficient in treating stiffness than oral products containing CBD but were slightly less well tolerated.

Patients using cannabis tended to be younger, living in large cities, and more aware of the legal and clinical aspects of medicinal cannabis. Sixty-five percent of non-users were interested in using medicinal cannabis, but lack of knowledge and fear of side effects were reported as main reasons for not trying it.

“Our data confirm that PD patients have a high interest in treatment with medicinal cannabis but lacked knowledge about how to take it and especially the differences between the two main cannabinoids, THC and CBD,” noted Prof. Dr. med. Buhmann. “Physicians should consider these aspects when advising their patients about treatment with medicinal cannabis. The data reported here may help physicians decide which patients could benefit, which symptoms could be addressed, and which type of cannabinoid and route of administration might be suitable.”

“Cannabis intake might be related to a placebo effect because of high patient expectations and conditioning, but even that can be considered as a therapeutic effect. It has to be stressed, though, that our findings are based on subjective patient reports and that clinically appropriate studies are urgently needed,” he concluded.

Bastiaan R. Bloem, MD, PhD, Director, Radboudumc Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands, and Co-Editor-in Chief of the Journal of Parkinson’s Disease, added: “These findings are interesting in that they confirm a widespread interest among patients in the use of cannabis as a potential treatment for people living with PD. It is important to emphasize that more research is needed before cannabis can be prescribed as a treatment, and that guidelines currently recommend against the use of cannabis, even as self-medication, because the efficacy is not well established, and because there are safety concerns (adverse effects include among others sedation and hallucinations). As such, the present paper mainly serves to emphasize the need for carefully controlled clinical trials to further establish both the efficacy and safety of cannabis treatment.”

Tilray Announces Agreement To Export First Shipment Of Medical Cannabis From Portugal To Germany

CANADA: Tilray, a global pioneer in cannabis research, cultivation, production and distribution, today announced it has entered into an agreement with Cannamedical Pharma GmbH (“Cannamedical”) through its wholly-owned subsidiary Tilray Portugal Unipessoal Lda. (“Tilray Portugal”), to export a wholesale shipment of $3.3 (€3) million worth of medical cannabis from Portugal to Germany. The shipment, which is expected to be completed in fall 2019, will be Tilray’s first from its state-of-the-art EU campus in Portugal to supply patients in Germany.

 tilray

“This is a significant milestone for Tilray as we ramp up our capacity to serve international markets and generate revenue from our EU campus through the end of 2019,” says Tilray CEO Brendan Kennedy. “We believe our 2.5 million square feet of cultivation and state-of-the-art processing space in Europe is an important differentiator, which will enable us to reduce costs and improve margins while hedging against regulatory risk.”

Founded in 2016 in Cologne, Germany, Cannamedical is fully licensed and GDP-certified (Good Distribution Practice) to import and distribute high quality medical cannabis products. The privately owned company is a leading independent supplier of medical cannabis products to 2,500 pharmacies and clinical facilities across Germany.

 “We at Cannamedical Pharma are committed to helping doctors, medical specialists and pharmacists improve their patients’ quality of life,” says Cannamedical CEO David Henn. “Tilray’s product has passed our strict quality control standards, and we’re excited to have found a partner able to deliver medical cannabis products for use in Cannamedical’s own brands. We look forward to increasing access for patients in need across the country.”

Tilray has a pioneering track record as a company committed to making pharmaceutical-grade medical cannabis products available to patients in need around the world. Tilray was the first licensed medical cannabis producer to successfully export medical cannabis from North America and import medical cannabis products into the EU in 2016 and the first company to import cannabis oils into the German market in 2017.

“We are pleased to enter into an agreement with a partner who shares Tilray’s commitment to product quality and safety and patient access,” says Sascha Mielcarek, Tilray’s Managing Director, Europe. “This initial shipment will be the first of many from

Acreage Announces Listing On The Frankfurt Stock Exchange

NEW YORK: Acreage Holdings announced that its subordinate voting shares have been listed on the open market of the Frankfurt Stock Exchange under the symbol “0VZ.”

Acreage-HoldingsThe Company’s subordinate voting shares continue to be listed on the Canadian Securities Exchange under the symbol “ACRG.U” and on the OTC under the symbol “ACRGF.”

Aphria Completes Acquisition Of German Pharmaceutical & Medical Cannabis Distributor CC Pharma

CANADA: Aphria Inc. announced that it had completed its acquisition of CC Pharma GmbH, a leading distributor of pharmaceutical products, including medical cannabis, to more than 13,000 pharmacies in Germany, as well as throughout Europe. The Company continues to strengthen its end-to-end cannabis operations and infrastructure in Germany.

aphria logo“As one of the most promising medical cannabis markets in the world, Germany is a top strategic priority for Aphria. With today’s acquisition of CC Pharma, Aphria is creating a German and ultimately pan-European platform that brings together demand, supply and distribution.” said Vic Neufeld, CEO of Aphria. “We’re excited to welcome the CC Pharma team and the pharmacists they serve to the Aphria family.”

Dr. Manfred Ziegler, Managing Director of CC Pharma, added, “We’re thrilled to be joining forces with Aphria. Access to Aphria’s innovative products creates significant opportunities for CC Pharma’s customers to experience more medical cannabis treatment options.”

CC Pharma is a leading importer and distributor of EU-pharmaceuticals for the German market. Founded in 1999, today it has over 230 employees and offices in Germany, Denmark, Poland and the Czech Republic. CC Pharma holds 318 active German national pharmaceutical licenses and 692 active EU pharmaceutical licenses, and also operates a production, repackaging and labeling facility at its headquarters in Densborn, Germany. During 2018, CC Pharma generated revenue of approximately €262 million, with EBITDA of approximately €10.5 million.

“Through a series of deliberate and strategic partnerships, investments and appointments over the past 18 months, Aphria is a front runner in the German medical cannabis market,” said Hendrik Knopp, Managing Director of Aphria Germany. “CC Pharma’s shared values, deep relationships and local regulatory and logistical experience are a perfect complement to Aphria’s expertise. One of our first steps will be to create a new division of CC Pharma dedicated to medical cannabis.”

In addition to today’s acquisition of CC Pharma, other previously announced strategic milestones for Aphria and its wholly owned subsidiaries in Germany include:

A significant supply agreement to provide CC Pharma approximately 1,200 kilograms of medical cannabis products, exported from Canada and Denmark to Germany.

A 2018 investment in Berlin-based Schöneberg Hospital, a first step in Aphria’s plans to build and operate pain treatment centres throughout Germany.

The construction of a state-of-the-art, GMP certified cannabis vaults (5,000 kg storage capacity), in Bad Bramstedt, Germany, to be completed by late spring 2019.

The start of construction of a Research and Development indoor growing facility in Neumünster, Germany, in preparation for in-country cultivation.

Aphria paid €18.92 million in cash to the former shareholders of CC Pharma with an earn-out multiple on future EBITDA of up to another €23.5 million, if certain performance milestones are met.

Case Report: Daily CBD Administration Associated With Remission Of Schizophrenic Symptoms

GERMANY: The adjunctive use of cannabidiol is associated with a remission in schizophrenic symptoms in a patient previously unresponsive to conventional treatment, according to a case report published in the Australian & New Zealand Journal of Psychiatry.

Investigators from the University of Leipzig in Germany assessed the use of twice-daily dosing of 750mg of CBD in conjunction with clozapine in a patient with treatment-resistant schizophrenia. Cannabidiol dosing was associated with remission criteria and improvements remained consistent over eight months.

“Our case report contradicts the assumption that CBD is not likely to be any superior than existing antipsychotics,” authors concluded. “In fact, CBD might be particularly suitable for those patients [who are] resistant to antipsychotics due to its different mode of action.”


For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “Remission of severe, treatment-resistant schizophrenia following adjunctive cannabidiol,” appears in the Australian & New Zealand Journal of Psychiatry.

Review Identifies 140 Controlled Clinical Trials Related to Cannabis

GERMANY: Scientists have conducted over 140 controlled clinical trials since 1975 assessing the safety and efficacy of either whole-plant cannabis or specific cannabinoids, according to a literature review published in the journal Critical Reviews in Plant Sciences.

A pair of German researchers identified 140 clinical trials involving an estimated 8,000 participants. Of these, the largest body of literature focuses on the use of cannabis or cannabinoids for the treatment of chronic or neuropathic pain. Authors identified 35 controlled studies, involving 2,046 subjects, assessing the use of marijuana or cannabinoids in pain management. In January, the National Academy of Sciences acknowledged that “conclusive or substantial evidence” exists for cannabis’ efficacy in patients suffering from chronic pain.

Cannabinoids have also been well studied as anti-emetic agents and as appetite stimulants. Researchers identified 43 trials evaluating marijuana or its components for these purposes, involving a total of 2,498 patients. They identified an additional 14 trials examining the role of cannabis or cannabis-derived extracts for the treatment of multiple sclerosis.

Researchers also identified several additional trials evaluating the use of cannabis or cannabinoids for a number of other diseases, including Crohn’s disease, Tourette’s syndrome, Parkinson’s disease, glaucoma, and epilepsy.

A 2014 study published in the Journal of the American Medical Association reported that pharmaceutical drugs typically gain FDA approval on the basis of one or two pivotal clinical trials.

 

Marijuana Legalization In Germany: Berlin Strikes Down Recreational Pot, Coffee Shops

GERMANY: A German pharmaceutical authority struck down proposed plans Monday that would have allowed for the creation of “coffee shops” in Berlin similar to those in Amsterdam in the Netherlands where customers can recreationally buy different kinds of marijuana alongside a cup of coffee. Despite the setback, proponents of the law are still hopeful for the future of marijuana legalization in Germany.

“For us, the rejection of the plans was no surprise, and as such, it’s also not a setback,” said Georg Wurth, a spokesperson for a pro-marijuana group in Germany, to the Local. Hamburg, Bremen, Münster and Düsseldorf have similar proposals on the table, and politicians are beginning to come around, according to the activists.

European laws on marijuana consumption and sale differ greatly throughout the continent and have shifted throughout the past 15 years, with one country having decriminalized all drugs.

German Opposition Leader Faces Cannabis Plant Investigation

GERMANY: A German opposition party says one of its leaders’ immunity from prosecution has been lifted amid an investigation by prosecutors after he was filmed with a cannabis plant on his balcony.

The Greens said Sunday that co-chairman Cem Ozdemir’s parliamentary immunity from prosecution was lifted last month. The Bild am Sonntag newspaper reported that Berlin prosecutors opened an investigation into suspected growing of drugs after an Ice Bucket Challenge video last summer showed Ozdemir dousing himself in cold water with a cannabis plant in the background.

Prosecutors couldn’t immediately be reached for comment Sunday.

 

German Court Allows Patients To Grow Medical Marijuana

GERMANY:  A German court ruled for the first time on Tuesday that seriously ill patients may grow their own marijuana for medical purposes in certain cases.

The administrative court in the western city of Cologne said that while cannabis remained illegal for general use in Germany, it may be cultivated at home by some patients with medical permits for the drug.

The court said in a statement that applications must be reviewed on a case-by-case basis, adding that a key condition was that “access by third parties to the plants and products must be sufficiently restricted”.

The decision came as many parts of the world are relaxing laws on cannabis use and medicinal marijuana is gaining popularity to ease suffering from cancer, glaucoma, HIV or AIDS, Hepatitis C, Parkinson’s disease and other serious conditions.

Cannabis Cafes Could Set Up Shop In Berlin

GERMANY: When Monika Herrmann took office as Berlin Kreuzberg’s mayor in August, she made cannibis legalization a priority. It’s a topic igniting controversy in the city’s capital, especially with German federal elections set for Sept. 22. [Read more…]