Voth and Schwartz's perspective on medicinal use of marijuana [1] is significant for several reasons. Most disturbing to me is that it represents a departure from principle by a medical journal.

The federal government responded to "medical marijuana" by threatening physicians. Unlike Jerome Kassirer, in his straight-forward editorial objection in The New England Journal of Medicine [2], you've chosen to obliquely endorse marijuana prohibition by publishing a slanted review article by two of marijuana's most infamous doctrinaire opponents.

Anyone unaware that the politics of this issue have overshadowed science for six decades is not in touch with reality. This purported review of the literature clearly supports continued listing of "crude" marijuana on schedule 1, while allowing its synthetic analogue, Marinol, to be legally prescribed on schedule 2.

This is logical sleight of hand: Schedule 1 cites three criteria: (lack of) safety, potential for addiction, and (lack of) medical utility. Because the two agents are nearly identical, neither efficacy nor potential for addiction can justify their separate listing. Furthermore, because acute toxicity of marijuana is nonexistent, the major justification for continued listing on schedule 1 while leaving Marinol on schedule 2 would have to be fear of chronic harm from a delivery system requiring smoking. This argument loses all validity when used by a government that allows tobacco use.

The selective nature of Voth and Schwartz's perspective can be inferred from their choice of 92 references claiming to examine "relevant research published between 1975 and 1996" but that ignores Hollister's exhaustive 1986 review article [3]. The latter cited twice as many references as did Voth and Schwartz and reached quite different conclusions. Voth and Schwartz submitted their modern "scientific" version of a 1930s "reefer madness" article, and you published it. For shame.