Marijuana is a currently illegal psychoactive drug that many physicians believe has substantial therapeutic uses. The medical literature contains a growing number of studies on cannabinoids as well as case studies and anecdotal reports suggesting therapeutic potential. Fifteen states have passed medical marijuana laws, but little is known about the growing population of patients who use marijuana medicinally. This article reports on a sample of 1,746 patients from a network of nine medical marijuana evaluation clinics in California. Patients completed a standardized medical history form; evaluating physicians completed standardized evaluation forms. From this data we describe patient characteristics, self-reported presenting symptoms, physician evaluations, other treatments tried, other drug use, and medical marijuana use practices. Pain, insomnia, and anxiety were the most common conditions for which evaluating physicians recommended medical marijuana. Shifts in the medical marijuana patient population over time, the need for further research, and the issue of diversion are discussed.

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Drug policies may have less impact on cannabis use than is currently thought.

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Like current drug prohibition, alcohol prohibition in the 1920s produced a large criminalized industry. Post-repeal alcohol regulation, which tended to limit overall consumption, suggests that the legal regulated sale of currently illicit substances is technically practical and reasonable. However, no such radical change in drug policy will be politically feasible until well into the twenty-first century. Nevertheless, the failures and costs of the War on Drugs make moderate reform a more promising prospect.

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