A medical marijuana prescription could render many Americans ineligible for an organ transplant.
Nearly 115,000 people’s lives hang in the balance as they wait for a transplant in the US. About 20 people die a day waiting for an organ.
Despite the fact that medical marijuana is now legal in 30 states and Washington, DC, there are no federal guidelines about cannabis use and organ eligibility, Herb reports.
Even state laws are ambiguous, and hospitals largely make their own individual rules.
This means that while one doctor could prescribe a patient marijuana to treat the pain or nausea he experiences while waiting for a new organ, in, say, Maine another might just as soon tell them that treatment disqualified him from the transplant list.
Even in states where medical marijuana might be prescribed to treat their symptoms, hospitals have the authority to deny transplant patients life-saving organs for cannabis use
In the US, the law and regulations are still very much playing catch up to the blazing spread of both medical and recreational marijuana legalization.
On the transplant side, every program establishes its own eligibility criteria.
While one transplant may cap candidate age at 80, another may accept patients of any age. These programs can also choose to tell their patients that they must lose weight or make other health improvements to their lives.
Marijuana-use criteria are no less consistent – and far more medically and legally complicated.
Some hospitals exclude patients who inhale marijuana based on evidence that it could lead to a lung and sinus infection that could prove deadly after a transplant.
Marijuana plants sometimes get contaminated with a fungus called Aspergillus, which can lead to a severe infection for anyone and could easily prove deadly for a transplant patient whose immune system has to be suppressed to prevent organ rejection.
Similarly, inhaling smoke of any kind – including from marijuana – has been shown in some studies to constrict blood vessels, raising risks of heart disease and circulatory system issues.
Interestingly, the same is true for cigarette smoke. While Maine Medical Center prohibits transplant patients from smoking or vaping marijuana, smoking tobacco products is merely ‘discouraged.’
Edible and tincture forms of cannabis are not thought to pose such risks, as they do not involve smoke inhalation and the oils are extractions from the plants, and the stomach is a hostile environment to Aspergillus.
Still, even in states like Massachusetts – where marijuana is legal for both medical and recreational use – Massachusetts General Hospital requires that its transplant patients be cannabis-free for six months to a year, according to Herb’s reporting.
In fact, at least one small study of 50 people linked cannabidiol (CBD) to lower rates of graft-vs-host disease, which causes a transplant patient’s immune system to reject an organ as a foreign invading body.
Moreover, a wealth of research supports the effectiveness of marijuana in treating pain and nausea, and many patients prefer the natural analgesic to addictive opioid medications (which, with a prescription, some hospitals allow transplant patients to continue using).
Without a clear medical basis for this rule, some argue that excluding patients who use prescribed cannabis edibles from transplants amounts to discrimination.
So far, 12 states and the District of Columbia have enacted laws that bar hospitals from disqualifying patients from transplant lists due only to their (legal) marijuana-use, according to Herb.
Ultimately, however, hospitals may still have fairly broad discretion to deny transplants marijuana users – if not solely on that basis.
For the more than 114,000 patients waiting for organs, there are only some 7,000 organ donors.
Unsurprisingly, it is the prerogative of the review committees that decide who will and will not get an organ within each program to choose patients whose lifestyles are healthy and give them the best shot at survival post-transplant.
But, as Herb reports, there is currently no database cataloging the transplant programs that allow marijuana use, so patients with these prescriptions may be wholly unaware that the substance they use to treat their symptoms may keep them from their cure.