Voth and Schwartz [1] sound like patriarchal moralists, not scientists. They conveniently ignore scientific studies, patient anecdotes, court decisions, and voters who disagree with them when discussing a 5000-year-old herbal medicine. Many physicians and organizations-including Dr. Kassirer, Editor of The New England Journal of Medicine [2]; the National Institutes of Health [3]; the American Public Health Association; the San Francisco Medical Society; the California Academy of Family Physicians; Harvard professor Dr. Grinspoon; the Federation of American Scientists; and the National Academy of Sciences [4] -believe that cannabis may be beneficial and that further research should be done. Users of medical cannabis are not criminals. If this issue is controversial, then suffering patients deserve the benefit of the doubt so that they can have access to medical cannabis while more research is being done. The National Institute on Drug Abuse has even impeded medical research on medical cannabis [5].

Voth and Schwartz also seem to encourage the use of Marinol, an oral product produced by a large pharmaceutical firm (Unimed, Inc., Buffalo Grove, Illinois) and containing only the psychoactive cannabinoid (delta-5-tetrahydrocannabinol) instead of the cannabis plant. Is it possible that they have a conflict of interest? What is the International Drug Strategy Institute? Do they directly or indirectly get any pharmaceutical money? The Annals Editors may have been negligent by failing to disclose to their readers information about financial incentives to promote the agenda of the large pharmaceutical companies over the agenda of suffering patients.

The "War on Drugs" is a political war on compassionate U.S. physicians and their patients. The "War" spills into our examination rooms and influences how we prescribe. Even when clinical practice guidelines on pain management have been followed (U.S. Department of Health and Human Services publication AHCPR-0032), I have found that appropriate narcotic prescriptions can trigger an investigation by the state Board of Medical Examiners. Calling off the "War on Drugs" will be good for science, physicians, and patients. Accurate (not DARE propaganda) methods for prevention and harm reduction need to be instigated.

Voth and Schwartz do not present a compelling reason to oppose the desires of our patients, the scientists who disagree with the authors, and the democratic process of voter initiatives.