The Portland Tribune reports: “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.”
Klahr has a medical marijuana card, but he hasn’t smoked since 2004, because Oregon Health & Science University liver transplant center won’t provide organs for people with cannabis metabolites 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 prescribed for pain and nausea are often hepatotoxic – 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 safer to diseased ones than pharmaceuticals. The acetaminophen we get in Tylenol is more damaging to the liver than cannabis.
Mike Seely, OHSU’s director of transplant and procurement services, says in the Tribune article, “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.”
In 2009, the Veteran’s Administration changed its policy to no longer void “pain contracts” with veterans in states where they have a valid doctor’s recommendation to use cannabis medicinally. The VA had been forcing veterans to sign contracts for their opioid prescription painkillers (like Oxycontin) that required urine screening. If the VA found cannabis metabolites, the veteran lost his painkillers. It forced veterans to give up the cannabis that relieved the PTSD (and reduced their painkiller dosages) if they wanted to have any painkillers at all.
The 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.
Seely also told the Tribune, “in addition, transplant doctors are afraid of a fungal infection occurring in patients who smoke marijuana.”
This is the “Aspergillus argument”. Aspergillus is a mold that can occur when someone cures harvested cannabis improperly. It can also be found just about everywhere; in your carpet, your air vents, and your lawn. How much of a real risk is it?
Aspergillus caused 261 deaths in 2004. For comparison, you’re more likely to die from “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 that cannabis users 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 risks (which kill 5,000 a year) is with warnings about undercooked food on menus, 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 the risk of salmonella and e coli.
Later in the Tribune piece, John Niemitz, manager of transplant services for Legacy Health System, Oregon’s other transplant center, 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.
The fear that a medical marijuana patient post-transplant is going to be too stoned to remember to take his medications and show up for the appointments is absurd. The blood pressure medications and painkillers prescribed post-transplant will sap energy and fog the mind far more than cannabis will.
The Tribune reports that Niemitz also says 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,” Niemitz says.
Like when you hold a gun to someone’s head they suddenly find your request for their wallet pretty reasonable.
What is the science on medical marijuana and organ transplants? In 2009, a study in the American Journal of Transplant entitled “Marijuana use in potential liver transplant candidates” 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.”
The only possible reason Legacy and OHSU have to deny transplants to medical marijuana patients is simply institutional bias. Every day Jim Klahr has to do without medical marijuana is a day he’s been blackmailed to not use “the safest therapeutically active substance known to man”, which Oregon law says is to be “treated like other medicines”.
