The extent to which medical cannabis users discontinue or reduce their use of pharmaceutical and over-the-counter drugs is a recurring theme in a recent survey of pro-cannabis (PC) California doctors. The drug-reduction phenomenon has obvious scientific implications. Medicating with cannabis enables people to lay off stimulants as well as sedatives -suggesting that the herb's active ingredients restore homeostasis to various bodily systems. (Lab studies confirm that cannabinoids normalize the tempo of many other neurotransmission systems.) The political implications are equally obvious. Legalizing herbal cannabis would devastate the pharmaceutical manufacturers and allied corporations in the chemicals, oil, "food," and banking sectors. Put simply, the synthetic drug makers stand to lose half their sales if and when the American people get legal access to cannabis.

In the 10 years since Proposition 215 made it legal for California doctors to approve cannabis use by patients, the PC docs did not adopt a common intake questionnaire, and, with one exception, did not collect systematic data on which pharmaceutical drugs their patients had chosen to stop taking. However, the consistency with which the doctors describe this phenomenon has a force as impressive as any slickly presented "hard" data.

This summer I surveyed 19 PC doctors who, between them, had approved and monitored cannabis use by more than 140,000 patients. Herewith some replies to a question about patients reporting reduced reliance on pharmaceuticals.

Frank Lucido, MD: "Chronic pain patients report reduced use of opioids, NSAIDs, muscle relaxants, sleeping pills. Psychiatric and insomnia patients reduce use of tranquilizers, SSRI antidepressants, and sleeping pills. Neurologic patients reduce use of opioids, muscle relaxants, NSAIDS, triptans and other migraine headache remedies." Marian Fry, MD: "Medications discontinued or reduced include Oxycontin, Norco, Percoset, Vicodin, Flexerol, Soma, Valium, SSRI antidepressants, and blood-pressure medications Norvasic and Hydrochlorothiazide. Approximately 1% of my patients report reduced reliance or discontinuation of seizure medication by substituting Cannabis for Dilantin and remaining seizure free. Many of my Glaucoma patients no longer require their Timoptic drops and are able to maintain normal pressures with the use of Cannabis. Many of my patients who have lost hope in conventional pharmaceutical treatments report enhanced health, decreased pain, decrease depression and an overall sense of well being despite chronic illness."

Helen Nunberg, MD is medical director of MediCann, a statewide chain of clinics through which 53,000 patients have received approvals. Nunberg reviewed records of 1,800 patients seen at nine clinics. "Prescription drug substitution is very significant," she writes. "51% of the 1,800 patients report using cannabis as a substitute for prescription medications; 48% report using cannabis to prevent prescription medication side effects; 67% report using cannabis to reduce dosage of prescription medication; 49% of patients using cannabis for chronic pain were previously prescribed an opioid (such as hydrocodone) by their personal physician."

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