Benzinga | Sep 13, 2021 08:01AM EDT

CB1 Antagonists as a Solution to the Complicated Problems of Cannabis Over-intoxication

The legalization of recreational cannabis in a number of states is associated with the increasing problem of acute cannabis intoxication (ACI). Data gathered by the Nationwide Emergency Department Sample (NEDS) found over 1.5 million estimated ER visits associated with cannabis in 2017, the latest year with data, with a annual growth rate of over 13% per year. This implies over 2 million ER visits related to cannabis in 2021.

A potential solution to this problem that is being investigated is the use of cannabinoid receptor antagonists, which can block the effects of marijuana, THC, and synthetic cannabinoids and potentially reverse ACI. THC binds to the CB1 receptor in the brain causing the feelings commonly called a "high". CB1 antagonists can block the CB1 receptor reversing cannabis intoxication.

A number of CB1 antagonists have been developed. They were previously researched primarily for weight loss, but these programs were discontinued due to side effects that emerged during long-term administration. Acute administration as in the case of ACI doesn't have these issues, opening up the possibility to use these molecules as a rescue medication.

CB1 antagonists have previously been tested for their ability to prevent intoxication from cannabis. Administration of a CB1 antagonist before a person smokes cannabis will prevent them from getting as high.

In addition to the costs of ACI to the medical system, it is also associated with a range of complications that a CB1 antagonist could address. For instance, young children exposed to large amounts of cannabis are at risk for respiratory depression severe enough to require ventilation and even death. Cannabis intoxication in adults is associated with a number of psychiatric complications including acute psychosis, anxiety, and panic attacks.

Anebulo is working to bring a CB1 antagonist to market

Anebulo Pharmaceuticals (NASDAQ:ANEB) is a pharmaceutical company that was founded on the premise of developing a CB1 antagonist to address the issues of ACI. The same principle has been used with drugs like Narcan (naloxone) which is a opiate receptor antagonist, and can be used to reverse opiate overdose. The hope is to provide a similar solution for ACI. The company's lead compound ANEB-001 is a CB1 antagonist that has previously been tested in Phase I clinical studies and demonstrated to be safe across a range of doses.

The company will be testing ANEB-001 in a randomized, double-blind, placebo controlled Phase II clinical study that will investigate the potential to inhibit the effects of THC in cannabis users. Inhibition activity has been demonstrated with other molecules of this class, and ANEB-001 is known to bind to CB1 strongly, approximately 70 times stronger than THC, but it does not activate the receptor.