Should medical marijuana use influence whether Oregon patients are on transplant list?
SALEM, Ore. (AP) — Oregon lawmakers may tighten restrictions on the state's organ transplant centers to ensure they don't discriminate against patients based on marijuana use.
House Bill 2687, sponsored by Rep. Rob Nosse, D-Portland, would stop medical providers from recommending that transplant candidates be removed from the organ waiting list managed by the nonprofit United Network for Organ Sharing because they tested positive for pot, the Statesman Journal reported .
In Oregon, more than 850 transplant candidates are on the wait list for organs, according to the organ network. About 340 transplants were performed in Oregon last year.
For some, symptoms before surgery are severe enough they turn to medical marijuana for relief.
Responding to Nosse's bill, the state's major transplant centers disputed turning patients away based on marijuana use.
"No transplant candidates are turned away from the OHSU Transplant Program because they use marijuana," said Tamara Hargens-Bradley, a spokeswoman for the Portland research hospital.
However, "a patient who meets the criteria for substance abuse disorder, and does not follow through with recommendations set forth by our selection committee, could be turned down for a transplant," she said.
Piseth Pich, a community relations official with Portland-based Legacy Health, said, "Patients being considered for transplant are assessed using a number of different factors that may include positive drug tests for marijuana as we do with other factors such as alcohol or chronic opioid use within the context of a patient's overall risk-benefit ratio for transplant."
"That being said, it's difficult to identify a specific number of patients who may be considered less for a transplant based on one factor alone," Pich said.
Patients in need of organ donations can wait years to receive one that's a good match for them, if they receive one at all. Once a transplant is completed, there's a chance the recipient's body could reject the foreign organ.
Representatives from OHSU and Legacy Health have voiced concerns with Nosse's bill, pointing to the high demand for organs up against the lower number of transplants, as well as issues related to smoking pot.
Dr. William Bennett, medical director at Legacy Transplant Services, said in a letter to lawmakers the bill "attempts to legislate unsafe standards of care for transplant medicine."
"The consequences of marijuana in kidney transplant recipients are well-known and the adverse effects of marijuana have been well characterized in recent publications," Bennett said in the letter.
Smoking marijuana carries is as risky as smoking tobacco for cardiovascular health, he wrote. An OHSU handbook for post-transplant care also states that using pot "can cause lung and brain fungal infections."
In the letter, Bennett contended Legacy does not remove patients from a transplant waiting list just because they are a registered medical marijuana card holder, but patients are required to avoid using marijuana because of the risks.
"Transplant centers should reserve the right to consider positive drug tests, as we do with other factors such as alcohol or chronic opioid use, within the context of the patients overall risk-benefit ratio for transplant," he wrote.
Meanwhile, Dr. Renee Edwards, chief medical officer at OHSU, said in a letter that the medical provider does not consider "marijuana use specifically" to be what's called a "contraindication" for transplants.
"Current substance use disorders, however, are considered transplant contraindicators, as such conditions can negatively impact organ function and inhibit a patient's ability to comply with strict medical regimens required to maintain the efficacy of a transplant," Edwards wrote.
Scarcity is another problem: Across the United States, some 114,000 patients need a transplant, with only about 36,500 organ transplants performed last year.
"Transplant healthcare providers like OHSU are obligated to select transplant candidates in an equitable manner while also being good stewards of a scarce resource and precious gift," Edwards wrote.
Testifying before the House Committee On Health Care last month, Nosse introduced Robin Socherman of West Linn. She wants to become a kidney donor for her husband but can't, because he uses marijuana.
Socherman said her husband, Jake, suffers from a condition known as polycystic kidney disease. "This is an inherited disease, which is ultimately fatal," she said.
Her husband's kidney function had declined so badly that he was referred for a transplant, she said. "That is when we learned about the prohibition on those seeking transplant to use their medical cannabis."
Jake Socherman had gotten a medical marijuana card about six years ago to alleviate lower back pain, she said.
"We now realize this pain is caused by his kidneys, which are each about three times the size of a normal kidney," she said. "This puts pressure on his back and his other organs."
Using cannabis helps with symptoms of his disease, including pain, nausea and trouble sleeping, Robin Socherman said.
"The transplant center was clear that while my husband would not be allowed to use his medical cannabis, he was free to use opiates," she said. "This seems irrational, considering the current opiate crises in our state and nation."
For a time, Jake Socherman stopped using medical marijuana to become an acceptable transplant candidate. But as pain, nausea and sleep deprivation became unbearable, he turned back to the substance. He then tested positive for cannabis.
"While my husband had been told that he was the perfect candidate for transplant, he was kicked out of the program," she said. "The medical doctor shamed us and treated my husband like a street junkie, telling us how disappointed he was that my husband was a drug user. I couldn't believe it."
In an interview, Robin Socherman said her husband is a director for a national agricultural supply company who has been working in his field since he received a degree more than 25 years ago. He manages a multi-million-dollar business and travels extensively for work, she said.
"He is not an addict," she said.
Nosse told the Statesman Journal he took up the issue because he felt bad for the couple.
"Why should all these doctors interfere in their relationship and deny her the chance to donate a kidney and improve his life?" he said in a text message. "Medical marijuana is legal."
Information from: Statesman Journal, http://www.statesmanjournal.com