Pubdate: Sat, 08 May 1999
Source: Washington Post (DC)
Copyright: 1999 The Washington Post Company
Page: A17
Address: 1150 15th Street Northwest, Washington, DC 20071
Feedback: http://washingtonpost.com/wp-srv/edit/letters/letterform.htm
Website: http://www.washingtonpost.com/
Author: Richard Karel
Note: The OPED is at:
http://www.mapinc.org/drugnews/v99.n457.a04.html

MARIJUANA IS MEDICINE

Robert L. DuPont's April 27 op-ed on the medical marijuana issue
unfortunately perpetuates a misconception regarding the Food and Drug
Administration (FDA) approval process for medication.

It is not necessary for a medicine to "show superiority" (DuPont's
words) to existing medicines in order to gain approval and an accepted
place in the U.S. pharmacopeia. Rather, the medication must merely be
superior to a placebo when tested in a controlled trial.

If DuPont's suggested standard for smoked marijuana were imposed on
other categories of medications, we would never have seen the
development of Tylenol and other alternatives to aspirin. Neither
would we have seen the explosion in the selective serotonin reuptake
inhibitors similar to Prozac, such as Zoloft and Paxil (all brand names).

Tylenol is not "superior" to aspirin, although it is better for some
patients under some circumstances; Zoloft is not "superior" to Prozac,
although it may prove more acceptable to some patients than other
alternatives.

Similarly, smoked marijuana need not "show superiority" to existing
medications in order to earn a place in the pharmacopeia. Rather, it
need merely be better than a placebo, reasonably safe and prove
acceptable to some patients and their physicians.

The issue is efficacy, not superiority. What is superior for one
patient may be ineffective or intolerable for others.

Richard Karel

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MAP posted-by: Richard Lake