PRELIMINARY DATA FROM AN ONGOING SURVEY ON THE THERAPEUTIC USE OF CANNABIS IN ITALY Luciano Angelucci, Mauro Bianchi, Claudio Cappuccino, Francesco Crestani, Salvatore Grasso, Lucia Palmisano and Massimiliano Verga on behalf of the Scientific Committee of ACT (Associazione Cannabis Terapeutica - Italy) Introduction: in November 2003, ACT started a survey to collect information on the medical use of cannabis derivatives in Italy. The survey targeted both the users of natural derivatives, still illegal in our country, as well as the users of synthetic derivatives, unavailable on the market but obtainable through a cumbersome importation process from other European countries. Methods: data were collected through an anonymous questionnaire sent to ACT members and downloadable to all interested patients on our association’s site ( Results: 70 questionnaires were filled by the patients (38 males, 32 females; average age 36 years). The oldest participant was 87, the youngest less than 2 year-old. Remarkably, 12 patients were of pediatric age. Conclusions: data emerging from the analysis of this first sample of Italian medical cannabis users present both resemblances with similar surveys conducted in other countries, as well as features that can be considered specific for the Italian reality. Further data will be collected to complete the survey and improve our knowledge on the therapeutic use of cannabis in Italy. A low incidence of side effects was reported: in 36 cases there were no notable side effects at all, in 33 cases only minor side effects were reported, while only in 1 case side effects were considered serious enough as to justify a discontinuation of the therapy. Among the side effects it should be pointed out that 9 patients suffered legal problems related to the use of “illicit” cannabis. Survey responders spent about 170 Euros per month in the average. One patient mentioned excessive cost of treatment as the main reason for its discontinuation. In most cases, therapy with cannabis derivatives took place under medical surveillance. 31 patients reported they were followed by a specialist, 10 by a general practitioner. 29 patients, however, were not referring to any medical professional. Finally, 71% of the patients reported they had not used cannabis before falling sick. The most frequent conditions in this first group of patients were the following: multiple sclerosis (21 patients), epilepsy (17 pts) and chronic pain (13 pts, of whom 3 affected with rheumatoid arthritis, 2 with migraine, 1 each with phantom limb syndrome, vertebral collapse from osteoporosis, post- traumatic osteoarticular pain, IV stage hemorrhoids, chronic arachnoiditis, post-mielitis neuropathic pain, gastro- esophageal pain, Camerati-Engelmann disease). In addition, 5 patients reported to use cannabis to treat chemotherapy-induced nausea and vomiting, 5 to be affected with marrow lesion-induced spasticity, 3 with depressive syndrome, 2 with AIDS-related wasting syndrome, 2 with insomnia, 1 with spasticity as a sequel of brain ischemia, and 1 with bronchial asthma. 42 patients reported to use “raw” cannabis (hashish and/or marijuana) acquired either in the black market (20 patients), or self-grown (10), or both (12). 14 patients used a natural CBD extract, obtained from plants of a legally authorized plantation. Finally, 12 patients used a synthetic derivative legally imported from abroad. “RAW” CANNABIS 20 pz 10 pz 12 pz SINTETIC CANNABINOIDS NATURAL EXTRACTS 14 pz 2 pz n=17 n=13 n=5 n=21 n=5 n=3 n=2