The Denial of Organ Transplants to Medical Marijuana Patients

Cannabis must be removed from Schedule I so that it may be treated like other medicines, including the prohibition on discrimination against a transplant patient for the use of his or her doctor's prescriptions.
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Medical marijuana activists like to claim that cannabis has never killed anyone. While it is true that cannabis is remarkably non-toxic ("the safest therapeutically-active substance known to man," according to a DEA judge), medical marijuana use has actually killed many people in the United States.

For in the now fourteen states that allow legal medicinal use of cannabis, a registered patient in need of a life-saving organ transplant will be disqualified for "abuse of illicit substances." For people like Tim Garon of Seattle, that was a death sentence.

Recently the Los Angeles City Council held hearings on the thorny issue of medical marijuana dispensary regulation. For years city officials have abandoned their duty to create sensible regulations for the dispensaries that have proliferated across the Los Angeles basin. The number of dispensaries has ballooned to over 500 (not the 1,000+ often claimed) following an ineffective moratorium on the retail medical marijuana outlets.

As usual, the hearings were packed, with medical marijuana patients and activists flooding the chambers to add their testimony to the record. One citizen petitioning her government for a redress of grievances was the Executive Director of the new Beverly Hills NORML 90210 (http://www.norml90210.org/become-a-member.php), Cheryl Shuman. In sixty seconds of testimony, Cheryl recounts her own personal medical marijuana tragedy, one that has befallen many desperately ill patients who use cannabis -- even legally -- and require life-saving organ transplants:

Cheryl's case is not unique. All across America, hospitals are booting patients off of organ transplant lists because of their use of cannabis. Being a legal user of cannabis for medicinal purposes in the now fourteen states that recognize that right is of no help; even legal medical marijuana patients are essentially given a death sentence by hospital and insurance bureaucracies for their use of a safe, non-toxic herbal remedy.

Timothy Garon was a Seattle musician who had contracted Hepatitis C. Garon was on a waiting list for a life-saving liver transplant. The state of Washington recognizes Hep C as a qualifying condition for the medical use of cannabis. Garon's physician, Dr. Brad Roter, authorized Garon to smoke pot to alleviate his nausea and abdominal pain and to stimulate his appetite while he awaited. Garon had become dangerously thin and malnourished and the cannabis therapy helped bring him back from the brink of death.

But unbeknown to Dr. Roter, hospital transplant programs have strict rules that forbid "substance abusers" from qualifying for organ transplants. Seattle's University of Washington Medical Center told Garon that if he ceased his marijuana use and tested clean for 60 days, he could have his liver transplant. Another medical center specified six months of marijuana abstinence before they'd save his life with surgery.

Doctors had told Garon he had about two weeks to live and he died on May 1, 2008. The cruelest irony is that cannabis is one of the few therapies Garon could have taken for pain and nausea that is not hepatoxic (liver-killing) and laden with a list of other nasty side effects.

In Hawaii, Kimberley Reyes suffered from cirrhosis and hepatitis and was given thirty days to live. She applied for and received approval for a life-saving liver transplant, only to have the rug pulled out from under her three days later when her insurance company, Hawaii Medical Service Association, discovered cannabis in her system, which she had used to relieve feelings of nausea, disorientation and pain. Ten days later she, too, was dead.

In Washington, Jonathan Simchen suffers from kidney failure. Doctors at Virginia Mason and University of Washington medical centers deny him a life-saving kidney transplant because of his participation in the Washington State medical marijuana program. According to Alisha Mark, a spokeswoman for Virginia Mason, "any patient who smokes any product -- tobacco, cloves, medical marijuana -- would be precluded from receiving a transplant here."

In Georgia, a man named Walter emailed me after reading these transplant stories:

My name is Walter and my kidney transplant was denied by Blue Cross Blue Shield of Georgia due to the fact I smoke marijuana.

In January I went to the University of Minnesota/Fairview Transplant Center for an evaluation. In order to be completely honest with all the doctors I made them aware of the fact that I smoke marijuana and have for quite some time. I also made them aware that the use of marijuana has helped me with the decline of my appetite due to end stage of renal disease. With the exception of the hospital shrink, no one seemed to have a problem with it and even commented that my smoking had nothing to do with my kidney.

Blue Cross Blue Shield approved the evaluation but [after] having received the paperwork from Minnesota has declined my transplant, stating "Kidney transplantation has not been shown to be more beneficial than other alternative treatments for patients with ongoing substance abuse. Thus, I recommended denial of kidney transplantation" (Ronald Hunt MD - Medical Director).

Jim Klahr is a well-known medical marijuana activist here in Oregon who also suffers from cirrhosis and hepatitis C. In an ironic twist, he sits on the state's advisory committee on medical marijuana, yet hasn't used his most effective medicine for his pain and nausea since 2004 because he's terrified of losing his chance for a liver transplant. "I've capitulated because basically I don't have much of a choice," says Klahr. Paul Stanford of The Hemp & Cannabis Foundation, the state's largest medical marijuana clinic, estimates at least 30 Oregonians who use medical weed have died in the past 10 years after hospitals denied them new organs.

We understand why hospitals have strict qualifying criteria for transplant candidates. Transplant organs are in high demand and doctors want every recipient to have the best chance at survival possible. Hospitals screen their transplant lists for "substance abusers" because it really doesn't make much sense to put a new liver into an alcoholic who will just go out and drink that organ into cirrhosis and failure as well. It's foolhardy to give a new kidney to a heroin addict who would then possibly share needles and come down with another life-threatening disease.

But in the case of cannabis users, the concern for the chance of post-transplant survival is misplaced. According to new research at the University of Michigan, cannabis use has no impact on the long-term survival rates of liver transplant recipients. After studying 1,489 liver transplant patients, 155 of whom were cannabis users, over a span of eight years, researchers concluded, "Patients who did and did not use marijuana had similar survival rates. Current substance abuse policies do not seem to systematically expose marijuana users to additional risk of mortality."

The cases of Cheryl Shuman and all these victims of a cruel and needless discrimination against desperately ill cannabis consumers illustrate why existing medical marijuana laws, while commendable, do not go far enough. Cheryl Shuman, Tim Garon, Jim Klahr and others are all legal medical marijuana patients in their state, yet powerless under the law to force hospitals to keep them on the transplant lists. This discrimination exists because cannabis is considered an "illicit drug of abuse" in the same category as heroin and LSD. This is why cannabis must be removed from Schedule I, legalized for prescription by any doctor in any state, so that it may truly be treated like other medicines, including the prohibition on discrimination against a transplant patient for the use of his or her doctor's prescriptions.

"Radical" Russ Belville is the Outreach Coordinator for the National Organization for the Reform of Marijuana Laws in Washington DC. He hosts "NORML SHOW LIVE", a 60-minute news and interviews program for the cannabis community every weekday at 4pm Eastern at http://live.norml.org, archive and blog available at http://stash.norml.org.

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