Plants or pills, which do you prefer? A recent worldwide study of medicinal cannabis patients makes their penchant clear. And the answer is hardly a surprise.

According to a first-of-its-kind worldwide survey of medicinal cannabis users in over 30 nations, patients clearly prefer herbal cannabis and herbal cannabis derived products to pharmaceutical products containing cannabinoids, such as Marinol (the FDA-approved synthetic THC pill) or Sativex (a Canadian and European-approved oral spray containing various organic cannabinoid extracts).

An international team of investigators from Canada, Germany, the Netherlands and the United States conducted a web-based, cross-sectional survey to assess patients’ perceptions of different types of cannabinoid-based medicines as well as their preferred modes of administration. The survey consisted of 21 structured questions. Participants answered the questions by providing yes/no responses, multiple-choice lists and rating scales. Over 950 subjects took part in the survey. Participants mean age was 41-years-old and most subjects reported having had used cannabinoid-specific products therapeutically for several years.

“In general, herbal non-pharmaceutical CBMs (cannabinoid-based medicines) received higher appreciation scores by participants than pharmaceutical products containing cannabinoids,” researchers reported.

Regarding participants’ preferred method of delivery, most subjects said that they rated inhaling cannabis as opposed above oral administration. “Cannabis smoking, closely followed by vaporizing, scored highest for satisfaction with ease of dose titration, while oral use of cannabinoids scored lowest,” authors concluded. “This [result] may be because rapid onset of effects of inhaled cannabinoid use allows easier titration of dose.”

Participants in the study also said that they were more likely to experience unwanted side-effects when consuming pharmaceutical cannabinoid preparations. Researchers wrote: “Here, more than for any other parameter that we assessed, the differences between preparations … were very distinct. The herbal cannabis-based products received mean scores in the range of 7.2 - 8.5 (meaning high overall satisfaction with side-effect profiles), while the pharmaceutical preparations scored notably lower with a range of 4.8 - 6.0.” Subjects were also more likely to rate cannabis plant products as more cost-effective than cannabis-derived pharmaceuticals.

Although the study’s authors cautioned that their findings may be biased toward the use of herbal cannabis -- most subjects participating in the study reported having experience with smoked cannabis prior to the onset of any medical condition -- researchers nonetheless acknowledged: “[D]espite these limitations, we believe that these results contribute to our understanding of patient preferences for specific methods of intake (administration forms) for cannabinoids. … The reported data may be useful to guide the development of safe and effective cannabinoid-based medications that meet the needs of patients. Besides the need for such products to be standardized and quality controlled, our data suggest that overall there is good satisfaction with whole plant preparations that are affordable and administered in an inhaled manner, or in the form of a tincture.

In other words, most patients prefer their medicine in the form that nature -- not Big Pharma -- intended it to be: as a plant that can be readily and cheaply grown in one’s own backyard.