Lifesaving Medicine or a Lifesaving Organ – Which Would You Choose?

The legalization of both medical and recreational marijuana in the United States is moving at breakneck speed. In fact, over 26 states in the US have adopted regulations in recent years that approve some type of medical marijuana program, with several more states soon to follow.

And it’s about time – because when it comes to relief from painful symptoms caused by various chronic diseases, medical marijuana is a lifesaver for many patients.

Another lifesaver for these patients is making it onto the organ transplant list. And while an organ transplant can quite literally save a patient’s life, it can often take months to years to actually receive an organ.

Which is exactly why thousands of patients use medical marijuana as a survival tool while they anxiously await their organ transplant.

Unfortunately, this puts these medical marijuana users in a bit of a catch-22. The very thing that efficiently eases symptoms and makes it bearable for patients to wait for a life-saving organ, may also disqualify them from ever receiving one.

Although there are no federal laws governing the denial of medical marijuana users from receiving an organ transplant, many patients find themselves being denied consideration for an organ transplant based solely on their medical marijuana use.

But, why?

n the simplest terms, because organs that are suitable for an organ transplant are in short supply – while also being in high demand.

In fact, close to 22 people die on a daily basis waiting for an organ transplant, according to data gathered by the U.S Department of Health and Human Services.

This unfortunate combination of transplantable organs being in such short supply and such high demand has caused hospitals and transplant centers to be stringent about the requirements that a patient must meet to receive an organ.

Organ Transplant Basics

Within the United States, most transplant programs are evaluated through the UNOS (United Network for Organ Sharing) and the Centers for Medicare and Medicaid Services.

But that evaluation is actually pretty loose.

Dr. David Klassen, Chief Medical Officer at the UNOS, says “The decision on whether to list the patient or not is really up to the transplant program. We don’t have any real policy that says a patient like this must be accepted or must be denied.” (Howard, 3 April 2017)

And while the UNOS and agencies like Medicare and Medicaid do periodically check up on hospitals and transplant facilities to ensure that they are following basic procedures and adhering to any set requirements that do exist, there’s widespread inconsistency as to what deems a patient eligible for the organ transplant list or not.

Dr. James Whiting, surgical director of the Maine Transplant Program at Maine Medical Hospital, admits that “…there is a lot of local variability allowed in those inclusion and exclusion criteria. So, across the country, someone who gets turned down in one program may actually be able to go to another program.” (Howard, 3 April 2017)

That being said, things like gender or racial discrimination are strictly prohibited in terms of a patient’s eligibility for the organ transplant list.

And while less concrete than gender and racial policies, policies on things like having an active malignant cancer, are widely accepted as deeming a patient ineligible for transplant.

However, beyond that, the rules get a bit fuzzy.

Dr. John Fung, chief of transplantation surgery and director of the Transplantation Institute at the University of Chicago Medicine, shares that “no rule says you have to transplant any given population. But each center basically evolves their own criteria. The decisions for a center to accept anything — (for example) some people say I’m not going to transplant anybody over the age 50 or 60 — they’re allowed to do that.” .” (Howard, 3 April 2017)

Which means that any center or facility electing to make medical marijuana users ineligible to receive an organ transplant is acting well within their rights – no matter unfair it may seem.

The Conflict Between Medical Marijuana and Organ Transplants

For the majority of transplant centers nationwide, any trace of marijuana in a patient’s system – medical or otherwise – is an instant disqualifier for making the transplant list.

This leaves many patients with an impossible decision to make – use medical marijuana in order to cope with painful symptoms and function on a daily basis and risk losing the ability to receive an organ transplant; or live in unbearable pain and suffering while hoping to live long enough to see an organ transplant.

Seems like a bit of a Sophie’s Choice situation, doesn’t it?

It’s no wonder that thousands of medical marijuana patients are outraged at having to make such an impossible decision regarding their health and wellness.

However, those who support these policies argue that it’s based upon several reliable medical studies examining the relationship between marijuana use and organ transplant failure rates.

According to Dr. David Klassen, marijuana users are at higher risk for developing infections, specifically in their lungs.

He says, “The thing that comes up with marijuana is the risk of pulmonary infections, (specifically) fungal infections with Aspergillosis.” (Howard, 3 April 2017)

Klassen goes on to say that these infections “can be an absolutely devastating complication but, you know, how often does that really happen? How likely is it? Those questions are less well understood. It’s a question of how much risk does that really impose versus the benefit that the patient potentially gets from getting the transplant.” (Howard, 3 April 2017)

Which only leads to more questions like, does an increased likelihood for lung infections only apply to patients who smoke their medical marijuana? Or does this also apply to patients who only use edibles or cannabinoid oil?

And, is there any real proof that these fungal infections are directly caused by medical marijuana use?

Questions like these are what make the topic of medical marijuana use and organ transplants so controversial – not to mention, confusing.

But with over 118,000 people in the United States anxiously awaiting a life-saving organ transplant, finding a solution to this frustrating catch-22 is desperately needed.

Dying for a Policy Change

All across America, patients are quite literally being given a death sentence by being kicked off the organ transplant list for their legal use of medical marijuana.

Timothy Garon, a Seattle musician, was dying from Hep C and anxiously awaiting a life-saving liver transplant. He was prescribed medical marijuana to cope with nausea, chronic pain, and weight loss while he waited. Unfortunately, even though the state of Washington recognizes Hep C as a qualifying condition for medical marijuana use, Garon was taken off the transplant list when it was found in his system. He was told he must stop smoking marijuana for two to six months if he hoped to be put back on the transplant list.

He died May 1, 2008.

Kimberly Reyes, a Hawaii resident, was given thirty days to live. Luckily, she promptly applied for and was approved to receive a liver transplant, which would save her life. But three days later, when cannabis was found in her system, that life-saving liver that she was set to receive, was quickly revoked.

She died ten days later. (Bellville, 25 May 2011)

Garry Godfrey, who has been waiting for a kidney for over a decade, was booted from the transplant list in 2012 due to his use of medical marijuana. He was told to stop smoking marijuana for a year if he ever hoped to receive that life-saving kidney that he desperately needed.

Infuriated with his lack of options, Godfrey began speaking out, hoping to elicit a major policy change.

“As I saw it, I only had one choice,” Godfrey told lawmakers. “Marijuana made it possible for me to function daily and take care of my family. I should have never had to choose between a lifesaving organ transplant and a lifesaving medicine.” (Miller, 30 March 2017)

Really, no one should have to make that choice.

But every day, thousands of patients are forced to decide between a life-saving organ and a life-saving medicine, just as Godfrey was.

Thanks to his speaking out, though, medical marijuana users in Maine hoping for a transplant will no longer have to make this impossible choice. It seems that Godfrey’s voice has finally been heard as he is the inspiration for a new bill, I.D. 764, that would prohibit hospitals in Maine from denying potential organ recipients based solely on their use of medical marijuana.

Though nothing is official yet, the bill received strong support from medical marijuana patients and other supporters of medical marijuana in the state of Maine.

Hope for Medical Marijuana Patients Requiring an Organ Transplant

As the acceptance of medical marijuana as a legitimate treatment for countless medical conditions continues to grow more and more widespread, hope remains that policies surrounding organ transplants and medical marijuana use will continue to shift.

And the outlook is actually pretty good.

Several states have already taken action and put various policies and bills into effect protecting potential organ recipients who use medical marijuana.

In July of 2015, Governor of California, Jerry Brown, signed a bill that prohibited hospitals and transplant facilities from disqualifying organ transplant patients from making the list based solely on their use of medical marijuana.

New Hampshire has also offered some relief to medical marijuana users waiting for an organ by publicly stating that, “authorized use of cannabis … shall be considered the equivalent of the authorized use of any other medication used at the direction of a provider” (in regard to transplants and other medical care). (Miller, 30 March 2017)

And the list keeps growing.

Illinois, Washington, Minnesota, Arizona, and Delaware have all offered some form of official protection for medical marijuana users hoping to receive an organ transplant, keeping them from being discriminated against based solely on their use of the medicine.

Even the director of the United Network for Organ Sharing, Dr. Klassen, believes that a growing number of transplant programs will continue to re-evaluate their transplant policies as the acceptance of medical marijuana progresses.

“There is an increasing acceptance of medical marijuana as an acceptable and relatively commonly prescribed medication,” Klassen says. “I think programs are incorporating that into their assessment of patients.” (Howard, 3 April 2017)

While freely allowing medical marijuana users to receive organ transplants is still a minority viewpoint, hope remains that as the climate surrounding medical marijuana use changes, patients will no longer have to decide between a lifesaving medication and a lifesaving organ – they will finally be able to have both.

Resources:

Bangor Daily News
Delaware Government
Huffington Post
Press Herald
CNN
Alternet
Medscape

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