O CANNABIS!

IT'S EFFECTIVE AGAINST CHRONIC PAIN, AND IT'S CHEAP TO BOOT:

Matt Smith's recent article raised some worrisome issues concerning the
operation of San Francisco's cannabis-medicines program, based almost
exclusively on the statements of former S.F. Health Department worker
Hank Schulz ["Hey, Man, Got Any ID?," June 11].

Although it's certainly true that some fired, disgruntled employees
are legitimate whistle-blowers, others are simply, well, disgruntled.
Unfortunately, it's impossible to distinguish between these two
possibilities from Smith's piece with regard to Schulz. Aside from
Smith's well-known bias against Proposition 215 (and those who would
implement it), obviously false statements in his article make the
whole story untrustworthy.

For one thing, I can assure Mr. Smith that most physicians who provide
approvals of cannabis medicines under Proposition 215 charge far less
than $250. But a far more serious error is Smith's claim that "medical
science as a whole is actually a long way" from demonstrating the
effectiveness of cannabis medicines.

On the contrary, cannabis is probably the most-studied therapeutic
substance in the world. In addition to thousands of years of use by
hundreds of cultures, dozens of studies have demonstrated its clinical
effectiveness, a fact that can easily be verified by anyone with
access to the Internet. As one such resource I have assembled a
summary of findings from several recent major academic and
governmental studies
(http://www.davidhadorn.com/cannabis/mjcannabis.html#meduse).

Additional evidence of the effectiveness of cannabis medicines was
recently provided by GW Pharmaceuticals in support of its bid to win
marketing approval for its whole-cannabis extract (SativexRegistered )
in England later this year. Four placebo-controlled, randomized,
double-blinded trials documented significant relief from pain and
spasticity in patients with multiple sclerosis and chronic neuropathic
pain. See www.gwpharm.com for details. (I am a part-time consultant to
this company, but am writing as a private physician.)

Collectively, this body of evidence is far greater than what exists
for many commonly used drugs, including aspirin, codeine, or penicillin.

Finally, Mr. Smith is mistaken in believing that "there are plenty of
medications that are considered more effective" for the treatment of
nausea and vomiting resulting from cancer chemotherapy. At least 10
percent of people on common chemotherapeutic regimens are resistant to
conventional anti-nausea drugs, and many of these patients receive
relief from cannabis, as documented in several studies.

Moreover, in this era of ever-rising health care costs -- much of it
fueled by the expensive pharmaceutical products apparently preferred
by Mr. Smith -- society must consider cost-effectiveness, not simply
"effectiveness at whatever cost." It is here that cannabis clearly
outshines its rivals, even at its present prohibition-inflated prices.
Under an appropriate system of regulated availability, cannabis would
be much less expensive than it is now and would completely blow away
most conventional single-compound drugs used for the same conditions
in terms of cost-effectiveness.

David Hadorn, M.D.

Berkeley