To All Patients Recently the media has been covering the most recent round of DEA "busts" of Los Angeles Medical Marijuana Caregiver clubs. Although Medical Marijuana is legal in California, the DEA continues in its attempts to override this decision made by the people of California in 1996. These attempts will ultimately be decided in the courtroom. Political and financial issues are driving this turf war. Quite unfortunately, legitimate qualified patients who may find great benefit in the use of this medicine are the ones who lose in this battle. I'd like to leave the political situation aside and take a look at the issue as a medical one, from the perspective of a physician. As a Board-certified Internist, a physician licensed to practice in the State of California, I believe Medical Marijuana is a powerful and yet extremely safe medication. Anything that interferes with patients getting the best possible medication compromises care and is a violation of the "Doctor Patient Privilege". After thirty years of practice and serving two decades as a Clinical Instructor of Medicine at a prestigious University Hospital, I believe I am qualified to decide whether a given patient might benefit from Medical Marijuana. Whether suffering with cancer, AIDS, depression, anxiety, nausea or chronic pain, all patients should have the option of discussing their symptoms and treatment plan with a Physician. If this plan includes Medical Marijuana as determined by the Patient/Physician partnership AND is legal (as it is has been since 1996 in California) any qualified "Care Giver" should be permitted to dispense the medication to this physician-verified patient. Most people don't know that Marijuana is far safer than both Aspirin and Tylenol. It has highly predictable effects and has no known lethal dose. The "Therapeutic Ratio" (the "Benefits to Side Effects" ratio), is the highest of any known medication. There are also predictable side effects as no medication is entirely without side effects. Various strains of Marijuana have very different physiological and psychoactive effects. If a patient medicates with an activating form, he might become over-stimulated. If a patient medicates with a sedating strain, she might become sleepy. Knowing how to take a medication is always critical and the same applies to Medical Marijuana. And the great news is that all strains of Marijuana can be effective, safe and non-addicting when taken as directed by a knowledgeable physician. Marijuana is in fact a "medicine" and should not be used without adequate professional advice. Remember, Marijuana is a "restricted" drug for political reasons - not for medical safety or efficacy issues. The current California Medical Marijuana System is emerging as a significant force in alternative care for patients who have not been by traditional methods. Many individuals have dedicated their lives to this end. Without these pioneers risking incarceration to help patients who truly benefit, we would still be groping in the dark. Although Marijuana has been used medicinally for thousands of years, it was not until recently that physicians and patients have learned that the myriad strains of the plant have entirely different actions and therefore, diverse applications. Many Marijuana strains are mind activating and are used for conditions such as depression and ADD/ADHD. Other strains can be as sedating as sleep medications. With the assistance of a medical doctor, the various strains can be used for specific patient needs. For example: SATIVA STRAINS: The THC molecule in these Marijuana strains has been genetically altered over many years. They have stimulant, activating, focusing and anti-depressant activity. An individual can be medicated with a Sativa strain achieving an increased level of focus, alertness, mood elevation and increased creativity. I have many patients who have unsuccessfully tried numerous medications for mood disorders who are currently using Sativa Marijuana strains to alleviate their depression. These patients do not look or act "stoned". Contrary to popular belief, on a properly determined dose they can function at or above where they usually function. INDICA STRAINS: These strains have very different biological effects than the Sativas. Indicas are sedating, calming and muscle relaxing. These are the strains best used for pain, anxiety and insomnia. The patient, however, may look and feel "stoned". These can be used at bedtime or during an acute migraine headache or acute back spasm. Even with the sedating Indicas, if the dosage is correct, this medicine can achieve its desired effect without the patient having the undesired psycho-physiological side effects. On the "street", most Marijuana strains are NEVER IDENTIFIED. I recently saw a Breast Cancer patient on chemotherapy who was told by her well-meaning chemotherapy nurse to go "try Hollywood Blvd…" to find some Marijuana to help her with her nausea, weight loss and pain symptoms. Not only is it unsafe and unsavory, but the patient also has no idea whether she is purchasing a stimulant or relaxant. These are major issues when it comes to proper treatment. I think we can all agree that there are strong opinions on either side of this debate. There are financial, political, moral and ethical issues to sort out. But what could be more moral or ethical than to allow a patient access to the best possible medicine for his or her condition as determined by a well-educated physician? Who would deprive an AIDS patient with a wasting syndrome a medication proven to revive his appetite? Who would prosecute a cancer center for allowing their patients a Medical Marijuana Recommendation giving them access to a gentle and non-toxic medicine to address their appetites, nausea, depression/anxiety and pain? What is seemingly immoral is the fact that most people who could most benefit from Medical Marijuana have no idea that it is even an option - a safe, effective and legal option in the State of California. This needs to be remedied. Suggestions anyone?