During the 1800’s cannabis use was described as a treatment for a variety of metabolic disorders but its recreational use in the twentieth century resulted in laws which made the usage of cannabis illegal despite its medicinal properties. Cannabis usage has been reported to be useful in the treatment of Type 2 diabetes but unfortunately conflicting results are often published and its mechanism of action is still unknown. The aim of this project was to investigate the effect of phytocannabinoid treatment on adipogenesis and lipolysis in 3T3-L1 cells, to unravel their mechanism of action and also to test for potential anti-diabetic properties. The studies showed that phytocannabinoid treatment promoted higher glucose uptake and significantly less fat accumulation when compared to Rosiglitazone. Rosiglitazone is an anti-diabetic drug that has recently been withdrawn from the market since its usage has been associated with severe side effects. It was also found that during the 1800’s cannabis use was described as a treatment for a variety of metabolic disorders but its recreational use in the twentieth century resulted in laws which made the usage of cannabis illegal despite its medicinal properties. Cannabis usage has been reported to be useful in the treatment of Type 2 diabetes but unfortunately conflicting results are often published and its mechanism of action is still unknown. The aim of this project was to investigate the effect of phytocannabinoid treatment on adipogenesis and lipolysis in 3T3-L1 cells, to unravel their mechanism of action and also to test for potential anti-diabetic properties. The studies showed that phytocannabinoid treatment promoted higher glucose uptake and significantly less fat accumulation when compared to Rosiglitazone. Rosiglitazone is an anti-diabetic drug that has recently been withdrawn from the market since its usage has been associated with severe side effects. It was also found that phytocannabinoid treatment was able to reverse the insulin-resistant state of 3T3-L1 cells. The study indicates that the mechanism of action occurs at the mitochondrial level where enzymes such as succinate dehydrogenase and glycerol-3-phosphate dehydrogenase are modulated thereby affecting oxidative phosphorylation involved in the respiratory chain. In addition the effect observed with phytocannabinoid treatment is time dependent and affects the cells differently at different developmental stages. Therefore it can be concluded that phytocannabinoid treatment not only helps to maintain the balance between adipogenesis and lipolysis in 3T3-L1 cells but its use may also be helpful in the treatment of Type 2 diabetes and/or obesity-related insulin resistance.phytocannabinoid treatment was able to reverse the insulin-resistant state of 3T3-L1 cells. The study indicates that the mechanism of action occurs at the mitochondrial level where enzymes such as succinate dehydrogenase and glycerol-3-phosphate dehydrogenase are modulated thereby affecting oxidative phosphorylation involved in the respiratory chain. In addition the effect observed with phytocannabinoid treatment is time dependent and affects the cells differently at different developmental stages. Therefore it can be concluded that phytocannabinoid treatment not only helps to maintain the balance between adipogenesis and lipolysis in 3T3-L1 cells but its use may also be helpful in the treatment of Type 2 diabetes and/or obesity-related insulin resistance.

Background: Cannabis among patients admitted in psychiatric units is higher than the general population and this has been shown in various countries where studies on cannabis use have been undertaken. Such an observation has been made by psychiatrists in South Africa and the association between cannabis use and psychotic presentation among these patients has also been observed. Cannabis use by patients with severe or chronic medical illnesses to ameliorate the symptoms of such illnesses has been documented in the literature. A study to explore use of cannabis among psychiatric inpatients as well as medical patients was undertaken. Purpose: The purpose of this study was to firstly determine the prevalence of cannabis use in psychiatric patients admitted to an acute admissions unit in King Edward VIII Hospital and to correlate it with the psychiatric diagnosis. Secondly, it was to compare the cannabis use in psychiatric patients admitted to an acute admissions unit to patients admitted in a medical ward at King Edward VIII Hospital. Thirdly, to assess self reporting of cannabis use by psychiatric and medical patients. Methods: A case control study was conducted at King Edward VIII Hospital, Durban, where cannabis use among 64 subjects included in the study admitted in a psychiatric ward was compared with a control group of 63 control subjects admitted in a medical ward. Both groups were tested for urinary cannabinoids and a questionnaire was filled. The questionnaire contained demographic details as well as a question on use of substances including cannabis. Results: 17 subjects (26.6%) in the study group tested positive for urinary cannabinoids and 2 subjects (3.2%) in the control group tested positive. Cannabis use was significantly higher among males when compared to females in both the study group and the control group. Only 7 subjects in the study group reported cannabis use and out of those 7 subjects, 4 subjects tested positive for urinary cannabinoids. The commonest diagnosis among the study group subjects were the psychotic disorders and schizophrenia being the most common psychotic disorder. Conclusion: Cannabis use is significantly higher among psychiatric patients as compared to medical patients and it is probably higher than in the general population. Self reporting of cannabis use among psychiatric patients is low and unreliable and psychiatrists treating these patients must continue to use objective measures such as objective testing as well as collateral information to determine such use. In this study most subjects who tested positive for urine cannabis were likely to have a psychotic disorder and tended to be of younger age groups. The low prevalence of cannabis use in the control group makes it unlikely that there was a significant number of subjects in this group who were using cannabis for medicinal purposes. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2008.

Since the first so-called “medical marijuana” legislation was passed in California in 1996, a total of twenty states and the District of Columbia have passed laws permitting limited use of cannabis. Despite the changes in state laws, cannabis remains illegal for any purpose under federal law. Changes in state laws have coincided with a renewed interest in the substance for the treatment of a variety of conditions. There has been a significant increase in published data over the past twenty years examining the efficacy of cannabis as an appetite stimulant, antiemetic agent, and analgesic adjuvant. The purpose of this meta-analysis was to synthesize published data on cannabis use as an analgesic agent. Five studies meeting inclusion criteria were located through searches of online databases, review of reference lists, author correspondence, and review of clinical trials databases. Meta-analysis was conducted using fixed-effects modeling. The overall effect of mean reduction of pain intensity was -4.895 (Z-score) with an associated p value of 0.003. The combined standardized mean difference (SMD) was -0.362 (CI -0.507 to -0.217), indicating on average a moderate significant reduction in pain intensity for patients with chronic pain. As the legal status of the substance evolves, additional research is needed to establish evidence-based clinical recommendations regarding the use of medicinal cannabis in pain management.