To the Editor: While we did not mention the Center for Medicinal Cannabis Research at the University of California, ably headed by Dr. Grant for the past decade, we did not suggest that the “evidence for marijuana’s efficacy is anecdotal”—just the large majority of it! We did say that “indications with the most evidence include spasticity secondary to neurological diseases such as multiple sclerosis (and) pain management, especially neuropathic pain.” These in fact are the subject of the references cited by Grant et al. to prove their point about marijuana efficacy. These also are the relatively rare conditions that most applicants claim as the reason they need medical marijuana cards, and less than 3% of applicants claim such conditions.

Finally, as we noted in our commentary, in 2011 daily marijuana use among high school seniors reached the highest level in 30 years, according to the Monitoring the Future survey conducted annually by researchers at the Institute for Social Research at the University of Michigan. Researchers found, as we pointed out, that “the rate of marijuana use in youths is inversely related to ‘perceived risk’ and ‘perceived social disapproval.’” Surely Grant et al. are not suggesting that the “medical marijuana” referenda and the dispensaries are unrelated to this increase.

We commend Grant et al. for their attempt to evaluate marijuana scientifically and look forward to the day when there will be FDA submissions.