As a physician I must dispute the exaggerated claims of marijuana's harmful
effects put forth by Ms. Susan Garcia-Swain in the 29 August 1997 "Other
Voices" column.

Let's do the balancing of cost, risk and benefits that she rightly cites as a
requisite for responsible prescribing of marijuana for treatment of nausea
and vomiting due to cancer chemotherapy.

Benefits: Smoked marijuana relieves nausea and vomiting in 60 to 90 percent
of chemotherapy patients in whom conventional anti nausea medications had
failed to do so. (Studies carried out in six states: N. M., N. Y., Cal., Ga.,
Tenn., and Mich. in the 1980's, see "Marijuana, Medicine and the Law" Series,
R.C. Randall, Ed., Galen Press, 1990). This allows patients to continue
potentially life-saving anticancer therapy. And once the nausea has started,
Marinol (synthetic THC) pills are vomited up well within the one hour it
takes to produce results. Smoked marijuana, on the other hand, by-passes the
upset stomach and goes directly to the blood stream, producing nausea relief
within minutes. The proper dosage is achieved when the patient starts to feel
the "high."

Listen to world renowned biologist Stephen Jay Gould, a cancer survivor:
"Absolutely nothing in the available arsenal of anti-emitics worked at
all...I was reluctant to try [marijuana] because I have never smoked any
substance habitually (and didn't even know how to inhale). Moreover, I had
tried marijuana twice...and had hated it...Marijuana worked like a
charm...The sheer bliss of not experiencing nausea...was the greatest boost
I received in all my year of treatment, and surely the most important effect
upon my eventual cure." (See the "NY Times," May 4, 1993, for Gould's entire
story).

Risks: The only conceivable significant risk to a cancer patient would be the
irritation produced by smoking. Claims that marijuana might produce lung
cancer are meaningless in this setting because lung cancers from smoking take
25 or more years to develop--well beyond the life expectancy of most cancer
patients at risk. Despite more than 30 years of marijuana use by large
populations, no epidemic of lung cancers due to marijuana has occurred. Since
the 60 million regular tobacco smokers develop 150,000 lung cancers annually,
at similar rates we would expect the 10-17 million regular marijuana smokers
to develop 25 to 40,000 per year. I challenge Ms. Garcia-Swain to show me
evidence of any such epidemic. My review of the medical literature shows
none.

My reading of the above risk-benefit analysis overwhelmingly favors the
beneficial medicinal use of marijuana.

David L. Edwards, M.D.
Olympia, WA