Oregon Health & Science University Transplant Program (no medical marijuana patients need apply...)

I have been covering the cruelty of denying organ transplants to medical marijuana patients since the unfortunate story of Tim Garon.  He was a Seattle musician who was using cannabis with a doctor’s recommendation legally under Washington law to cope with his severe pain and nausea.  He was given two weeks to live when he was next to receive a life-saving liver transplant.  He was then found to have THC metabolites in his urine and told he must demonstrate 60 days of clean urine tests before he’d be given the organ.  Tim Garon died days later.

(Portland Tribune) Jim Klahr needs a new liver. And he wants to take medical marijuana to help with the nausea he fights every morning as he battles hepatitis and cirrhosis. He says his body can’t tolerate most drugs that physicians have prescribed for his symptoms, but pot does the trick.

Southeast Portland resident Klahr has a medical marijuana card, but he hasn’t smoked since 2004, because Oregon Health & Science University, the state’s only liver transplant center, won’t provide organs for people with marijuana compounds in their blood, even if the patients are medical marijuana cardholders. Klahr is on the OHSU transplant waiting list.

The tragic irony is that the drugs other than cannabis that doctors would prescribe for symptoms of liver failure are often hepatoxic – harmful in long-term doses to the liver – or, as in Klahr’s case, ineffective.  Cannabis is non-toxic to healthy cells and organs and has not been found to be damaging to diseased ones.  The acetaminophen we get over-the-counter in pain relievers is more damaging to the liver than cannabis.

Mike Seely, OHSU’s director of transplant and procurement services, cites two reasons for the transplant policy. First, he says, federal rules trump state law. OHSU is part of a consortium with the Portland Veterans Affairs Medical Center, and federal law does not recognize medicinal marijuana. OHSU could be in danger with federal authorities if it allowed marijuana users to receive organs.

This doesn’t seem to jibe with the Veteran’s Administration’s recent change in policy to no longer void “pain contracts” with veterans in states where they have a valid doctor’s recommendation to use cannabis medicinally.  See, the VA had been forcing vets to sign contracts to receive their opioid prescription painkillers (think: oxycontin and such) that required urine screening and if they found cannabis metabolites, no pills for you!  It forced vets to give up the medical cannabis that relieved the PTSD and cut their addictive hepatoxic opioid painkiller dosages if they wanted to have any pain medication at all.

That same federal law that finds Oregon’s Medical Marijuana Act to be null and void, that Seely uses to defend discrimination against cannabis patients, still applies to these veterans, yet the federal government is looking the other way now.  Is the government that allows medical marijuana-using vets to get liver-killing opioids really going to step in and force OHSU to deny that same vet a life saving liver transplant?  (Well, probably. In five years on the front lines of the drug war, nothing the government would do surprises me.  But shouldn’t doctors and hospitals be fighting for the lives of patients, not cowering before the government?)

Seely says that, in addition, transplant doctors are afraid of a fungal infection occurring in patients who smoke marijuana.

This is the tired old Aspergillus argument.  This is a mold that can occur when someone cures harvested cannabis improperly.  How much of a real risk is that?  As I wrote back in March:

That deadly mold which causes 0.88255 deaths per 1 million people in the United States, with 261 deaths in 2004, is something we’re supposed to fear more than “accidental suffocation and strangulation in bed” (327 deaths), “acute appendicitis” (371 deaths), and “acid reflux disease” (721 deaths) (and that’s just the “A’s”).

Aspergillus is something the community should be aware of, just as people should know eating undercooked eggs, shellfish, and meat can lead to salmonella or e coli poisoning.  But the way we protect diners from these diseases (which, by the way, kill 5,000 a year) is with warnings about undercooked food on menus and rules for food preparation and sanitization for workers.

If we’re denying livers to cannabis consumers because of the tiny risk of Aspergillus, we should be denying livers to all but vegetarians for fear of the risk of salmonella and e coli.

John Niemitz, manager of transplant services for Legacy Health System, Oregon’s other transplant center, says Legacy maintains a similar policy. Niemitz cites the infection risk and adds that “there is a risk of altered consciousness,” which might interfere with a patient’s ability to follow a rigorous post-transplant regimen of medications and appointments.

Really, your fear is that a medical marijuana patient post-transplant is going to be too stoned to remember to take his medications or show up for the appointments that improve his chances of surviving with that new organ?  But then you’re going to prescribe to him blood-pressure meds as part of that “regimen”, like Clonidine and Norvasc*, that sap energy and cause depression, and painkillers in the first weeks after transplant that fog the mind.

Niemitz doesn’t think Legacy’s transplant policy is costing lives, as marijuana activists claim. He says that as far as he knows, every cardholder Legacy has dealt with has been willing to give up their medical marijuana as the price of getting a transplanted organ.

“People have found that pretty reasonable,” Niemtiz says.

Kind of like when you hold a gun to someone’s head they suddenly find your request for their wallet pretty reasonable.

Fears of rare Aspergillus and patients too medicated to take care of their new organ aside, what is the actual science on the issue of medical marijuana and organ transplants?  There’s this 2009 study in the American Journal of Transplant entitled “Marijuana use in potential liver transplant candidates” that looked at almost 1,500 cannabis-using and non-cannabis-using liver transplant patients over an eight-year span and concluded “patients who did and did not use marijuana had similar survival rates.”

So the only possible reason Legacy and OHSU have to deny transplants to medical marijuana patients is simply institutional bias against medical marijuana patients.  Every day Jim Klahr and others have to do without their medical marijuana is a day they’ve been blackmailed not to use “the safest therapeutically active substance known to man”, which Oregon law says is to be “treated like other medicines”.  Some won’t live long enough to get their transplant, which, to be fair to Niemitz (a courtesy he won’t give us) doesn’t mean the no-transplant-for-medical-marijuana-patients policy cost their lives.

It just means Mike Seely and John Niemitz would rather people suffer unnecessarily than give an organ to a “pothead”.

Visit http://bit.ly/6swz0I to read Russ's first post at Huffington Post

Stashers, I am beyond excited to announce that my latest post, “The Denial of Organ Transplants to Medical Marijuana Patients” has been picked up at the influential Huffington Post blog!  it is basically just a re-packaging of my earlier post here, “Beverly Hills NORML Executive Director Cheryl Shuman testifies to Los Angeles City Council on medical marijuana”, but on HuffPo we are going to be read by more than just “the choir” here at the Stash.

Please click over to the story on HuffPo and leave your comments.  The more response we get the longer we’ll stay on the front page and the more likely my future posts will be picked up.  And thank you so much, Cheryl Shuman, for your incredible testimony that started this whole thing in motion.

Man, I get a Huffington Post account, Vikings’ #4 throws an ill-advised INT in the NFC Championship when his team could have won the game with a FG*, and another extra special surprise this month, and my birthday isn’t until Sunday.  It’s been the best January ever!

(*Hey Vikings fans, live by the Favre, die by the Favre.  At least he didn’t dash your Super Bowl hopes with a stupid pick in overtime at home.)

Cheryl, you just made me cry.  What kind of society are we that we’ll cast a death sentence on someone for legally using a non-toxic herb?

Click here to view the embedded video.

Sometimes I hear or read people groaning, “What does NORML do?”  THIS is what NORML does.  We speak up for all of you who can’t or won’t.  If every time you bought a bag of weed you tacked on another $5 to be sent to NORML, marijuana would be legal by now.  If you just choked up a little like I did, take tomorrow’s Starbucks money and send it to us.  I don’t want to go to another friend’s funeral.

Join Beverly Hills NORML today at http://norml90210.org/become-a-member.php

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Hemp Headlines

1. Hawaii woman dies after being kicked off liver transplant list for marijuana use
2. Bill would restore financial aid for students convicted of marijuana possession only
3. Stress, dieting, may lead to positive marijuana test results
4. Student shot by police over miniscule amount of marijuana sentenced

This Month in NORML with Executive Director Allen St. Pierre

• Update on Obama “Yes We Cannabis” Poster
• NORML’s presence at Seattle Hempfest

Daily Toker Tunes by Marijuana Music Awards . com

• Message Monday – ‘Policeman (Always Come and Take My Weed)’ by The Killin’ Time Band

Cannabis Conversations

• Casper Leitch from Time 4 Hemp on his new live radio show, Time 4 Hemp Radio

We just received this letter at NORML.  I’ll reserve my “American Disease Care and Health Insurance Bureaucracy Subsidation” rant for another time on my personal blog, but I will say that my wife used to be a claims manager at Blue Cross Blue Shield and the following story, while infuriating and tragic, is far from the worst health care nightmare this company has created for one of its paying customers:

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

I was born with reflux disease and required my first kidney transplant in May 1978 at the age of 2 1/2. My older brother gave me one of his kidneys and the transplant was a success.

Now, 31 years later the transplanted kidney is failing. I currently only have 17% of my kidney function.

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).

I spoke to one of my doctors and they suggested that I contact NORML. It is my understanding most of your lawyers listed on your website are for criminal defense but I was hoping that you may have a lawyer familiar with medical insurance claims in the Atlanta area. Any assistance you can give with the matter will be greatly appreciated.

If you can help Walter in any way, send me an email at stash@norml.org with the subject Help for Walter.  We have put out the word to our Georgia-area NORML Legal Committee members and I’ll keep you updated on any progress.

Meanwhile, transplant patients like Walter are being discriminated against for no medically valid reason.  We reported on the study showing cannabis use has no impact on survival of liver transplant patients like Tim Garon, who, with two weeks to live, was told by hospital administrators he needed to be 60-days clean from the cannabis medicine he used to treat his pain and nausea before they’d even consider him for a life-saving transplant — this after he was next on the list for a transplant, but like Walter, made the mistake of being honest with his doctor. While the study was on liver transplants, there is no medically logical reason to assume cannabis use would be harmful for kidney transplant patients, either.

NORML Legal Committee attorney Douglas Hiatt in Seattle is now defending a man who, like Walter, is being denied a kidney transplant because of marijuana use, but unlike Walter, this guy lives in a state that has legally recognized his right to use medical marijuana! For many of these transplant patients, their bodies are so weakened they can’t handle powerful pharmaceuticals and the ones they can handle give so many terrible side effects.  Especially for the liver patients, their bodies can’t process the toxins of these drugs.

Marijuana is not renatoxic or hepatoxic – it doesn’t harm the kidneys or liver.  It treats the side-effects of the pre- and post-transplant anti-rejection drugs and treats the pain and nausea caused by the failing organ itself.  This needless cruelty must stop!

Medical marijuana and organ transplants don’t mix – Los Angeles Times

SEATTLE — This month, Timothy Garon, 56, a Seattle musician, died after being turned down for a liver transplant. He was rejected partly because he had used medical marijuana.

Now, a second critically ill patient in Washington state says he has been denied a spot in two organ transplant programs because he uses doctor-prescribed marijuana.

Jonathon Simchen, 33, of Fife, a town south of Seattle, is a diabetic whose kidneys and pancreas have failed.

He said he was removed from the transplant program at Virginia Mason Hospital in Seattle because he admitted using medical marijuana. Later, he said, University of Washington Medical Center transplant officials refused to accept him because of the medical marijuana issue.

The lawyer who represented Garon has taken on Simchen’s case.

Douglas Hiatt argues that his clients are the victims of a loosely defined transplant policy, one not based on science.

University of Washington officials, citing privacy laws, declined to discuss specifics of individual cases, but issued a statement acknowledging that they took marijuana use into consideration.

“Although medical marijuana may be an issue in rare cases, it is never the sole determinant in arriving at medical decisions about candidates for organ transplants,” the statement said.

A spokeswoman for Virginia Mason Hospital said smoking of any kind could “lead to patient-safety and transplant-effectiveness issues” and was precluded. She said the hospital’s transplant committee would also weigh a patient’s use of medical marijuana in pill form.

At the University of Washington, the transplant committee said it reviewed “behavioral concerns such as a history of substance abuse or dependency. If such a history exists, then the committee looks at the period of abstinence the candidate has demonstrated to date,” as well as the patient’s efforts to maintain abstinence and potential to abuse again.

Asked why the committee considered marijuana use under a doctor’s supervision “a history of substance abuse,” a hospital spokesman cited the federal law categorizing marijuana as an illegal drug.

Peggy Stewart, a clinical social worker with the liver transplant program at UCLA Medical Center, said bias existed in the medical community against marijuana because of the federal law.

Some transplant committee members see it as an illegal substance and as grounds for automatic rejection.

She said many other addictive prescriptions, particularly pain medications, did not automatically disqualify patients from transplant lists because they were not illegal substances under federal law.

It’s bad because it’s illegal because it’s bad because it’s illegal because it’s bad because it’s illegal…

It is simply beyond my ability to process the outrage of this ignorant cowardice!  Medical professionals will knowingly divert the frailest patients from the safe non-toxic herb and onto the dangerous addictive pharmaceuticals, and then hide behind the government’s skirts?  Ooh, it’s against federal law?  Your state doesn’t think so, members of your profession are recommending it, and your oath is to first do no harm!

Furthermore, that one official says they’d even “weigh” use of medical marijuana in pill form.  That’s called Marinol, and it isn’t against federal law.

As for the “patient safety and transplant-effectiveness” issues, you don’t have any evidence to back that up.  Vaporization or edibles eliminate the problems with smoking.  Post transplant there is no “addictiveness” in the serious physical sense of the word to jeopardize transplant-effectiveness.

This is nothing more than institutionalized discrimination against a disliked minority, only this isn’t about the color of their skin but rather the color of their medicine.

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It’s Friday, May 2nd and it’s 4:20 somewhere in the world! I’m your host, “Radical” Russ Belville and this is your NORML Daily Audio Stash.

Tomorrow is the Global Marijuana March, taking place in over 200 cities worldwide. Check out GlobalMarijuanaMarch.org for more details on the march in your area. Take to the streets and demand respect. We are not criminals, we are cannabis consumers. We are no more criminals for smoking pot in private than citizens who take a drink in private. We can end adult marijuana prohibition, but the world needs to see us standing up for our rights! It starts with you – take the time to get involved.

Friday is Cannabis Community day on the Stash, and coming up after the news, we’re speaking with our regular guest Steve Bloom, the webmaster at CelebStoner.com. Steve’s got the details for New York City’s Marijuana March, along with a New York native’s look at how the Big Apple became the marijuana arrest capital of the world. We also break down the role of weed in the NFL draft and great box-office weekends for Harold & Kumar and CelebStoner Amy Poehler’s movie, Baby Mama.

Next, Cannabis Karri brings back Freedom People with a perfect song for a protest weekend, “New (R)evolution”. Let’s all start a new revolution and get hemp re-legalized in this country.

Then we wrap things up with Tim Smith, a criminal defense attorney in Cincinnati, Ohio. Tim’s here to tell us about the Marijuana March event this weekend in Cincy and the threats by law enforcement to shut them down by threatening the venue owner’s liquor license.

Finally, don’t forget that every Saturday we’re now posting the NORML Weekend Music Stash, where you can get all of the last ten songs from our daily musical breaks in one podcast, suitable for your weekend party pleasure. If you have a band that would like to be featured on our podcast, please send us an email at stash ‘at’ norml.org.

So sit back and relax with your favorite strain and enjoy your NORML Daily Audio Stash…

Finally today, a personal note. This year’s Global Marijuana March marks the third year of my involvement with NORML through my local chapter, Oregon NORML.

We want to invite everyone in the Portland / Vancouver area to enjoy the huge festivities we have planned. We have Pioneer Courthouse Square reserved in the heart of Downtown Portland for the entire day. Vendors and bands will begin at 10am.

Then we leave for the march at High Noon, led by Ma, our Cannabis Dragon – a forty-foot-long hemp-cloth dragon like you might see at a Chinese New Year, with a four-foot head made completely from cannabis stalks.

We return to the Square for more of the festival, with special guest speakers, including myself, educating the public about marijuana in-between band sets.

We’re kicking off our PR campaign for OCTA 2010, the Oregon Cannabis Tax Act, an initiative for 2010 that will legalize, tax, and regulate the sales of cannabis in Oregon through state-run liquor stores.

The outdoor festival ends at 5pm, but then we’re off to the Mt. Tabor Legacy Theater at SE 39th & Hawthorne at 8pm to enjoy the Marijuana March After Party, a concert featuring The Martyrs and Marquee, with special guest Chief Greenbud and our headliners, Las Vegas hemp-hop superstars, Los Marijuanos.

Then the after after party is at my place, I suppose, since the DJ, his girlfriend, a visiting Sacramento NORML board member, and two vendors are crashing there for the weekend. Ah, you know what? I have the greatest job in the world.

Medical marijuana user dies without transplant | KOMO-TV – Seattle, Washington | News
SEATTLE (AP) – A musician who was denied a liver transplant because he used marijuana with medical approval under Washington state law to ease the symptoms of advanced hepatitis C died Thursday.

The death of Timothy Garon, 56, at Bailey-Boushay House, an intensive care nursing center was confirmed to The Associated Press by his lawyer, Douglas Hiatt, and Alisha Mark, a spokeswoman for Virginia Mason Medical Center, which operates Bailey-Boushay.

Dr. Brad Roter, the physician who authorized Garon to smoke pot to alleviate for nausea and abdominal pain and to stimulate his appetite, said he did not know it would be such a hurdle if Garon were to need a transplant.

The case has highlighted a new ethical consideration for those allocating organs for transplant, especially in the dozen states that have medical marijuana laws: When dying patients need a transplant, should it be held against them if they’ve used pot with a doctor’s blessing?

Garon died a week after his doctor told him a University of Washington Medical Center committee had again denied him a spot on the liver transplant list because of his use of marijuana, although it was authorized under Washington state law.

“He said I’m going to die with such conviction,” Garon told an AP reporter at the time. “I’m not angry, I’m not mad, I’m just confused.”

Garon believes he contracted hepatitis C by sharing needles with “speed freaks” as a teenager. In recent years, he said, pot has been the only drug he’s used. In December, he was arrested for growing marijuana.

He had been in the hospice for two months and previously was rejected for a transplant at Swedish Medical Center for the same reason he later got from the university hospital.

Swedish said he would be considered if he avoided pot for six months and the university hospital offered to reconsider if he enrolled in a 60-day drug treatment program, but doctors said his liver disease was too advanced for him to last that long. The university hospital committee agreed to reconsider anyway, then denied him again.

The idea of keeping drug addicts off of transplant lists is not necessarily a bad idea.  There are precious few organs to go around, and one should not be given to a person who is just likely to destroy the new organ because of their addictions.  But this is clearly not the case with medical marijuana patients.

The grim irony here is that Garon could have used other drugs to treat his hepatitis symptoms, but those pharmaceuticals are toxic to the very liver he needed to be transplanted.  He used medical marijuana because of its lack of liver toxicity.  Perhaps it is what kept him alive as long as he was; perhaps the other drugs would have killed him more quickly.

Doctors in charge of the transplant division at UWMC were unsure that after the transplant, Garon wouldn’t resume using medical marijuana.  Most of their quotes revealed an astonishing lack of understanding about cannabis, with worries about Garon being unable to control a so-called addiction to cannabis, that, had he continued smoking cannabis, his immune system, suppressed for the transplant, would be unable to fight off any infections or molds he might pick up from smoking.

A man is dead today because of ignorance about medical marijuana, stereotypes against responsible cannabis users, and the cruel federal prohibition of the most helpful plant known to mankind.