(Honolulu Advertiser) Big Island resident Kimberly Reyes, who was diagnosed with Hepatitis in March 2008, had been told in July that she had less than 30 days to live. Her family claimed the Waimea resident had followed doctor’s orders, but her insurance carrier, Hawaii Medical Service Association, denied her coverage for a liver transplant she needed to survive because three toxicology tests showed trace amounts of cannabis in her system.

Kimberly Reyes died July 27 at Hilo Hospital, 16 months after being diagnosed. In the months after her diagnosis, she suffered cirrhosis of the liver, chronic Hepatitis infection, end-stage kidney disease and hepatorenal syndrome, which is caused by low blood flow to the kidneys due to liver deterioration.

Kimberly Reyes was twice denied her application for transplant by HMSA for “technical reasons,” such as missing required Alcoholics Anonymous meetings because she was too weak for doctor appointments, claimed [her mother]. However, on July 17, Reyes received HMSA’s approval for a liver transplant.

That approval signaled that the Reyes family and HMSA had apparently resolved compliance issues, [Reyes' attorney Ted] Herhold said.

Three days later HMSA denied the transplant approval after it received toxicology tests that showed cannabis in her system, Herhold said.

He claimed her marijuana use was “an indiscretion.”

She did not, according to her attorney and family, have a prescription for medical marijuana use.

Kuhns and Robin both claimed Kimberly Reyes had stopped smoking marijuana “years ago,” but took a few hits off a marijuana cigarette that day to relieve feelings of nausea, disorientation and pain.

How many transplant-eligible patients must die for their marijuana use before this needless cruelty is stopped?  The reason Kimberley Reyes needed to attend those Alcoholics Anonymous meetings is because alcohol is hepatoxic (liver-killing) and we don’t want to give precious organ transplants to people who are just going to keep drinking and kill the new liver.  But cannabis use has no impact on the survival rates for liver transplant, because cannabis is not hepatoxic!  The drugs the hospital might have given Reyes for nausea, disorientation, and pain would have been far more dangerous to her liver than the joint she smoked.

This is nothing more than a death sentence for sick and dying people on the basis of morality alone.

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Last week, a bill was introduced in the state General Assembly to allow patients registered with the state to possess, grow and use the drug for medicinal purposes.

Patients would be protected from being refused employment, volunteer positions, organ transplants and child custody rights.

What the bill wouldn’t do, however, is legalize marijuana for just anyone.

Most patients would have to be suffering from debilitating, chronic or even terminal illnesses that marijuana is scientifically proven to help, and their doctors must recommend it as a necessary treatment option.

via – The Fayetteville Observer “Medical Marijuana Fight to legalize moves forward“

[As more states push for medical marijuana, they take the template of the law from other states and revise and improve the statutes.  The protections for employment stem from cases in Oregon and California where patients have been fired for failing workplace urine screens.  The protections for transplant patients follow the sad cases in Washington State and Oregon of deserving organ transplant candidates using medical marijuana who are kicked off the transplant list for being "drug abusers". -- "R"R]

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Longtime Stash listeners will remember the tragic story of Tim Garon, a Pacific Northwest man who was kicked off a liver transplant list because of his legal use of medical cannabis.  Many, if not most transplant programs will refuse a patient with inactive cannabis metabolites based on gross prejudice against cannabis users and lack of understanding about medical cannabis.

So I am excited about this new study to be published out of the University of Michigan entitled, “Marijuana Use in Potential Liver Transplant Candidates.”  These researchers began the study hypothesizing “that patients with chronic liver disease who were marijuana users will have inferior survival.”  From 1999-2007 they studied 1,489 liver transplant patients, 155 of whom were cannabis users, identified by a drug screening.  The result?

Upon multivariate analysis, MELD score, hepatitis C and transplantation were significantly associated with survival, while marijuana use was not.We conclude that 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.

In other words, the only reason to deny a marijuana user an organ transplant is if our doctors want to play police officer.  Marijuana use does not impact survival rates for transplants one bit, so the only reason to deny transplants is because patients are breaking a federal or state law, or just a federal law in thirteen states now.

Actually, it is not surprising, considering how many of our police have been playing doctor over medical marijuana.  In Hawaii, the medical marijuana program is actually administered by law enforcement!

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Should Hepatitis C Patients Who Smoke Marijuana Be Eligible For Liver Transplants?
ScienceDaily (Oct. 22, 2008) — The pain is debilitating. The only option: smoking medical marijuana. That’s the reality for many hepatitis C patients whose road to health includes a liver transplant. Although Canadian transplant centres are more willing than those in the United States, not everyone says yes to liver patients who smoke marijuana, and a University of Alberta researcher says that decision-making process is unacceptable.

Karen Kroeker, along with three other students at various universities, sent out surveys to a number of transplant clinics across the United States and Canada. Results found that the difference between the two countries were obvious in some patient groups: around 60 per cent of Canadian centres would either do the surgery or consider it for a liver transplant patient who smoked marijuana, while 70 per cent of U.S. transplant programs said absolutely not. Kroeker also found that patients in both countries, who have no social support—meaning they have no family, friends or a social worker—aren’t likely to receive the organ they need.

The problem Kroeker has with these results: the lack of literature to support the surgeons’ decision. As a result of her findings, which will be published in the November issue of Liver International, Kroeker says physicians need to determine eligibility criteria for liver-transplant patients that pertains directly to the likelihood of a patient rejecting the organ and is based only on empirical medical evidence.

When a patient is being reviewed for eligibility, whether they smoke marijuana shouldn’t be a factor, she says. “If we have evidence to say the patients don’t do well, then I think that’s a reason to exclude people,” Kroeker said.

She cites alcohol use as an example. When transplants first began to be performed, those who drank alcohol weren’t eligible for a new liver. Kroeker’s study found, however, that surgeons conducted studies on the topic of abstinence and liver health and, as a result of that research, transplant rules changed. If the patient has been sober for six months, 94 per cent of the clinics in North America will now consider transplantation.

This was the tragic situation for Timothy Garon, a legal medical marijuana patient whose doctor recommended he use cannabis to treat his pain.  He was top of the list to receive a new liver to save his life, with only two weeks left to live, when the university hospital denied him a transplant because of his medical marijuana use.  ”Come back after 6 months sobriety,” they told him – a man with two weeks to live.  Tim Garon died because of ignorance and prejudice about marijuana and its users, plain and simple.

Transplant centers will bring up the idea that marijuana users are more apt to reject the organ or that using marijuana post-transplant may cause harm to the person with the compromised immune system.  They’ll claim that marijuana could have molds or fungi and the transplantee could easily die.  There is absolutely no medical evidence or research to back that claim, which is more ludicrous when you consider that the patient could use cannabis edibles, tinctures, or vaporization and avoid any harms from smoking.

No, what is happening here is the old guard AMA medical establishment can’t have “druggies” getting livers and kidneys and hearts.  They can’t be showing any legitimacy to cannabis via tolerance of herbal, non-prescribed, un-bar-coded, unadvertised remedies with no corporate backer who sends reps with samples to doctors’ offices and treats doctors to fun and informative island junkets.

The most maddening thing is that for many patients like Tim Garon, whose bodies are so weak and compromised, cannabis is the best-tolerated, most-effective medicine they can use.  They can eat, they keep weight on, and yes, they get a little high, and if you’re dying of liver failure, couldn’t you use a little something to brighten your day?  In a situation like that, the high IS medical!

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Willamette Week | “Organ Failure” | May 21st, 2008

Garon, a 56-year-old professional musician who had hepatitis C, died after a University of Washington Medical Center committee denied him a spot on a liver-transplant list. Part of their reason: Garon used medical marijuana—which is legal under Washington law.

Garon wouldn’t have fared any better in Oregon, where medical marijuana has been legal since 1999. Hospitals here refuse to perform transplants on patients who treat their severe pain, nausea and other symptoms under the Oregon Medical Marijuana Program.

The state’s largest transplant program, run jointly by Oregon Health & Science University and the Portland VA Medical Center, turns away patients who use marijuana. Legacy Health System also performs kidney transplants and refuses marijuana users.

Those are the only two transplant programs in the state, leaving Oregon’s medical marijuana patients completely out in the cold.

It’s impossible to say anyone died just because they didn’t get a transplant. But at least 30 Oregonians who use medical weed have died in the past 10 years after hospitals denied them new organs, says Paul Stanford, head of the THC Foundation, a chain of medical-marijuana clinics based in Portland.

“It’s a death sentence,” says Madeline Martinez, head of the Oregon branch of the National Organization for the Reform of Marijuana Laws. “Most of the people have already expired because they didn’t have the transplant.”

Those affected include Jim Klahr, a 56-year-old professional musician from Brookings. He suffers from cirrhosis and hepatitis C, and quit taking medical marijuana in 2004 to qualify for a new liver.

Meanwhile, he lives with crippling nausea that used to vanish with a single puff of smoke. “I’ve capitulated because basically I don’t have much of a choice,” says Klahr, who sits on the 11-member state Advisory Committee on Medical Marijuana.

OHSU doctors also bar marijuana users because of medical concerns, including a higher risk of infection and pulmonary problems. Users of other illegal drugs, drinkers and even tobacco smokers are also barred from getting transplants, but anyone can join once they pass a drug test and meet other requirements.

Dr. William Bennett, head of kidney transplants at Legacy, says those are the same reasons his program bars marijuana users. He and Seely also say patients on mind-altering drugs are less likely to stick with their treatment in the long run, leading to a higher rate of transplant failure.

It amazes me when I read quotes from medical professionals that are so ignorant about cannabis.  Take that line “Users of other illegal drugs, drinkers and even tobacco smokers are also barred from getting transplants”.  Because those medical marijuana patients are just more “illegal drug users”?  They’re just people looking to get high recreationally, like smokers and drinkers?

“Anyone can join once they pass a drug test?”  What other legal, doctor-recommended medicines will you be testing for?  Lipitor?  Xanax?  OxyContin?  Percocet?  Viagra?  No, you’ll be testing for coke, meth, heroin, and of course, marijuana.

“Patients on mind-altering drugs are less likely to stick with their treatment?”  What, you don’t think OxyContin is mind-altering?  Have you ever listened to Rush Limbaugh?

“Risk of infection and pulmonary problems?”  Once again, cannabis can be grown organically and taken orally or in vapor form – no infections or lung problems to speak of!

They can wrap it in as many excuses as they want, but these transplant programs simply want to discriminate against cannabis users because they have a moral issue with cannabis.

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Medical marijuana patients face transplant hurdles | Chron.com – Houston Chronicle
SEATTLE — Timothy Garon’s face and arms are hauntingly skeletal, but the fluid building up in his abdomen makes the 56-year-old musician look eight months pregnant.

His liver, ravaged by hepatitis C, is failing. Without a new one, his doctors tell him, he will be dead in days.

But Garon’s been refused a spot on the transplant list, largely because he has used marijuana, even though it was legally approved for medical reasons.

With the scarcity of donated organs, transplant committees like the one at the University of Washington Medical Center use tough standards, including whether the candidate has other serious health problems or is likely to drink or do drugs.

And with cases like Garon’s, they also have to consider — as a dozen states now have medical marijuana laws — if using cannabis with a doctor’s blessing should be held against a dying patient in need of a transplant.

The Virginia-based United Network for Organ Sharing, which oversees the nation’s transplant system, leaves it to individual hospitals to develop criteria for transplant candidates.

At some, people who use “illicit substances” — including medical marijuana, even in states that allow it — are automatically rejected. At others, such as the UCLA Medical Center, patients are given a chance to reapply if they stay clean for six months. Marijuana is illegal under federal law.

This continued discrimination against medical users of marijuana has got to stop.  It’s beyond irony that someone in need of a liver transplant is punished for using the medicine that doesn’t harm the liver; it’s cruel.

Some hospitals told Garon he could be eligible if he would only complete a 60-day rehab or six months of abstinence.  Two-to-six months without treatment with marijuana means 60 to 180 days of using other drugs that are fatally toxic to the man’s liver.  So it’s really a crapshoot: use marijuana to feel better and face certain death from liver failure or don’t use marijuana and feel awful and take drugs that accelerate certain death from liver failure.

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