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Medicine's Moral Micromanagers

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Mar. 27, 00
Washington Post
By Ethan Russo
I was distressed by Joyce Nalepka's March 19 letter in which she asserted that some unspecified National Institutes of Health publication recommends avoidance of marijuana by people with HIV. That is perhaps true, but it is also the case that an extensive workshop on medical marijuana convened by NIH in 1997 presented a great deal of positive information on its benefits.
The Institute of Medicine has recommended that cannabis be made available to people with HIV, cancer and other serious illnesses. Ms. Nalepka, who said that only the Food and Drug Administration should dictate approval of medicine, may be interested to know that FDA recently recognized medical indications for cannabis by virtue of its approval as an Orphan Drug for treatment of AIDS wasting syndrome. Also, FDA approved my Investigational New Drug application for cannabis in migraine treatment last year, only to have progress derailed by the refusal of the National Institute on Drug Abuse to provide the drug for the trial. It is false to assert that cannabis is ineffective in treatment of glaucoma. Many patients who have failed standard treatments have preserved their vision through such treatment. Cannabis may worsen balance in some, but not all, multiple sclerosis patients. In contrast, it has had demonstrable benefit on the disease's associated tremor and spasticity (muscle tightness). Recent studies also suggest that with cannabis, deteroriation may be slowed. The moral micromanagers should step aside and leave this debate where it belongs: with the FDA, patients and their doctors.

Ethan Russo Missoula, Mont.
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