Medical Marijuana Jeopardizes Liver Transplant
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Medical Marijuana Jeopardizes Liver Transplant
Posted by CN Staff on November 26, 2011 at 10:39:10 PT
By Anna Gorman, Los Angeles Times
Source: Los Angeles Times
Los Angeles -- Norman Smith, who has been fighting cancer for two years, needs a new liver. He was placed on the transplant list at Cedars-Sinai Medical Center last year but doctors removed him in February because he was using medical marijuana and failed to show up for a drug test.To get back on the list, Smith, 63, has to spend six months avoiding medical marijuana, submitting to random drug tests and undergoing counseling. Meanwhile, he is still undergoing chemotherapy and radiation for the cancer, which recently returned after being in remission.
Smith asked Cedars-Sinai last week to reconsider and reinstate him now."It's frustrating," he said from his home in Playa del Rey. "I have inoperable cancer. If I don't get a transplant, the candle's lit and it's a short fuse."Any delay could mean the "difference between life and death," said Joe Elford, an attorney with the medical marijuana advocacy group Americans for Safe Access, which is representing Smith and considering a lawsuit against the hospital.There is no standard policy on transplants and the use of medical marijuana or other drugs, according to the United Network for Organ Sharing, which manages organ transplantation for the U.S. Instead, transplant centers make their own decisions on which patients are the best candidates for new organs.More than 16,000 people are in line for livers nationwide and the average wait is about 300 days, according to the network."We have to do a prioritization, like you literally do on a battlefield — who can die and who can survive, because we don't have enough livers," said Dr. Goran Klintmalm, chief of the Baylor Regional Transplant Institute and an expert in liver transplantation. "As long as we have patients who die on the list waiting for organs … is it right to give [to] patients who have a history of drug use? You can discuss until the cows come home if it is social marijuana or medical marijuana."Transplant doctors said one of the main concerns is compliance with a complicated regimen of post-transplant medications."If you are drunk or high or stoned, you are not going to take your medicine," said Dr. Jeffrey Crippin, former president of the American Society of Transplantation and medical director at Washington University in St. Louis.Cedars-Sinai spokeswoman Sally Stewart said federal law prevented her from talking about Smith's case. But she said marijuana users can be exposed to a species of mold that can cause fatal disease among patients with compromised immune systems. They also run a risk of a fatal lung infection after transplantation, she said."We do not make a moral or ethical judgment about people who are smoking medical marijuana," she said. "Our concern is strictly for the health and safety of our patients."At Cedars-Sinai, if patients who need a transplant initially test positive for marijuana, they can still be listed but must sign a statement agreeing not to use the drug. Then, if they fail a random drug test or don't show up for one, they are bumped from the list. "There have to be guidelines in order to give people the best chance at surviving a transplant," Stewart said.UCLA Transplantation Services has an even stricter policy, requiring six months of sobriety before a patient can be listed. Dr. Douglas Farmer, a transplant surgeon and surgery professor at UCLA, said that drug and alcohol use is a "huge issue" and that patients on medical marijuana have also come to UCLA seeking transplants.Farmer said, however, that many patients with medical marijuana prescriptions are not "legitimate" and transplant surgeons can't risk wasting a precious organ on someone who is going to continue abusing alcohol or drugs. "There are a significant number of people who come in for liver transplants who have a substance abuse history," he said.Smith's oncologist, Dr. Steven A. Miles, refilled the prescription for medical marijuana to manage his patient's pain. Miles, who is in private practice and an attending physician at Cedars, said that missing the drug test didn't bode well for his patient's post-transplant compliance.Nevertheless, Miles said his patient will die without a new liver. "Without a transplant, it is basically 100% fatal," he said. "It's just a matter of time."Smith, a former precious metal trader, acknowledged that he didn't follow the rules. He said he used medical marijuana after having unrelated back surgery and weaning himself from the prescription pain pills. "I was in extreme pain and physical anguish," he said.In April, he wrote a letter to the head of the liver transplant program at Cedars, Steven Colquhoun, asking to be relisted. In his response, Colquhoun wrote, "More than other organ programs, liver transplant centers must consider issues of substance abuse seriously since it does often play a role in the evolution of diseases that may require transplantation, and may adversely impact a new organ after transplant."Smith, a recovered alcoholic, said he used marijuana recreationally in the past before getting a prescription for medical marijuana. He also has cirrhosis of the liver and previously had Hepatitis C. Smith said he stopped using marijuana in August and is attending Alcoholics Anonymous meetings to satisfy his counseling requirement.Smith is hopeful that he will get a transplant in time and that his fight will raise awareness for others with medical marijuana prescriptions. "That's why I am going through this challenge, at the very least to make it easier for the next guy," he said.Source: Los Angeles Times (CA)Author: Anna Gorman, Los Angeles TimesPublished: November 26, 2011Copyright: 2011 Los Angeles TimesContact: letters latimes.comWebsite: Medical Marijuana Archives 
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Comment #21 posted by FoM on November 30, 2011 at 05:25:16 PT
It's really good to see you. I am happy for you. We have a very close friend who had a liver transplant because of HepC years ago and he was at the VA Hospital recently for a liver check up and they told him his liver is working great and to keep doing what he is doing so he does. It must be close to 10 years since the transplant. He had a stroke and that makes it hard for him but his liver is fine.
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Comment #20 posted by Oleg the Tumor on November 30, 2011 at 03:26:38 PT:
Congradulations, survivor!
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Comment #19 posted by Hope on November 29, 2011 at 22:47:17 PT
That's amazing and wonderful. Congratulations on your wonderful success. Staying alive... against some huge odds.
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Comment #18 posted by juztbudz on November 29, 2011 at 22:34:36 PT
Cannabis use during treatment and transplant...
Had it not been for cannabis use during my treatment for HEPC I would not have gotten as far in the RX as I did. Unfortunately, I was unable, due to the toxicity of the treatment plan, to complete the treatment, but cannabis got me as far as I could go. I let my doctors know that I was supplementing my treatments with cannabis, was put on the transplant list and eventually got a new liver. Of the 13 folks who transplanted at the same period, I am the only one left alive after 12 years and I attribute that to continued use of cannabis...j.b.
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Comment #17 posted by The GCW on November 28, 2011 at 19:28:44 PT
Look who does and who doesn't
A cannabis prohibitionists causes increased crime, murder rates, increased hard drug addiction rates, contempt for government, hemp prohibition, shredded constitutional rights, harms peoples future etc. etc.And they can get a liver transplant but a cancer patient using cannabis to get through chemo, can not?
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Comment #16 posted by FoM on November 28, 2011 at 16:23:48 PT
Discovery Channel: This Thursday: Weed Wars
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Comment #15 posted by The GCW on November 28, 2011 at 15:48:26 PT
is a lizard.Ending cannabis prohibition is one of the most important issues of our time.
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Comment #14 posted by Oleg the Tumor on November 28, 2011 at 15:21:50 PT:
Newt Gingrich? Excuse me, let me get my waders on,
Because the BS is going to get deep this winter!This guy comes off sounding like an out of touch control freak because he has been advising out of touch control freaks for so long that he doesn't know how to do or be anything else.
The setting for today's news story about Mr. Gingrich is at a bookstore in an upscale neighborhood.
This is meaningful in a number of ways. 
First we have the skillful dovetailing together of the publishing industry, (which would like to see Newts book in the stores for not just any Christmas rush, but the last one before the next presidential election) and the GOP'S political PR machine gearing up for their own "Night of the Long Knives" in New Hampshire.Rich people are getting scared. 
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Comment #13 posted by Hope on November 28, 2011 at 15:07:32 PT
Thankfully... and hopefully,
I don't think the Newt has a chance at all. He is so unlikable. 
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Comment #12 posted by FoM on November 28, 2011 at 15:01:09 PT
I agree with you about Newt Gingrich.I don't blame Barney Frank for wanting out at this point in his life. 
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Comment #11 posted by Hope on November 28, 2011 at 14:45:45 PT
Newt Gingrich is despicable.
Barney Frank is retiring.
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Comment #10 posted by FoM on November 28, 2011 at 13:42:10 PT
Newt Gingrich: MMJ Must Be Stopped
Newt Gingrich: Medical Marijuana Is a Convenience That Must Be StoppedNovember 28, 2011It’s rare to hear Republican politicians espouse medical marijuana. If they support it at all, they stick to the “states rights” rhetoric their voters know so well. See, for example, Ron Paul.But Newt Gingrich thinks marijuana, medical or otherwise, is so dastardly that federalism should be tossed out the window and Mary Jane should be banished from coast to coast. URL:
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Comment #9 posted by FoM on November 28, 2011 at 13:19:23 PT
The War on Weed: 'Vanguard' Trailer
In "The War on Weed," Christof Putzel travels coast to coast to investigate the bizarre range of marijuana laws and enforcement in America. In California, legalized medical marijuana has led to something of a free for all and the Feds are cracking down. In Colorado, medical marijuana is protected by the state constitution and millionaire entrepreneurs have set up shop. In New York City, African-American men are arrested by the tens of thousands for low-level pot possession.Tune in Monday, November 28 at 9/8c for the premiere of "The War on Weed.""Vanguard" is Current TV's no-limits documentary series whose award-winning correspondents put themselves in extraordinary situations to immerse viewers in global issues that have a large social significance. Unlike sound-bite driven reporting, the show's correspondents, Adam Yamaguchi, Christof Putzel and Mariana van Zeller, serve as trusted guides who take viewers on in-depth real life adventures in pursuit of some of the world's most important stories.For more, go to:
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Comment #8 posted by HempWorld on November 28, 2011 at 10:06:12 PT
Norman Smith
You are a victim of the appalling system that condemns you for using cannabis to combat the effects of chemo and radiation.Doctors are not recognizing medicinal cannabis use and they are punishing users regardless of the reason, even if it is medicinal.I recommend Norman Smith to use Rick Simpson's 'Hemp Oil' and beat the cancer without help or interference of the medical establishment:
Cure Cancer Yourself!
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Comment #7 posted by afterburner on November 28, 2011 at 09:39:27 PT
Dr. Goran Klintmalm
You know what you are doing is wrong, and yet you do it anyway. You are a medical criminal. "First do no harm!" Remember your Hippocratic Oath? Discussion about cows is not cute in this context. Medical marijuana is legal in California and you are located in California. Reconsider your stance, or stand as a death merchant, not a healer!
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Comment #6 posted by ekim on November 28, 2011 at 07:48:03 PT
patent on cannabis
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Comment #5 posted by The GCW on November 27, 2011 at 22:58:55 PT
Cancer is hard enough w/o prohibitionists.
Cannabis prohibition is bad ju ju.The list of reasons to end the discredited farce is growing faster than the plant itself.-0-And again this conversation is based on cannabis the "DRUG" not cannabis the PLANT."""is it right to give [to] patients who have a history of drug use? You can discuss until the cows come home if it is social marijuana or medical marijuana."""-0-Further, cancer patients not only take many drugs, they take some drugs to counter side effects from drugs.  So "drugs" are not even the problem.Government subsidized discrimination. -For using a God-given plant (see the 1st page of the Bible).
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Comment #4 posted by ekim on November 27, 2011 at 18:20:45 PT
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Comment #3 posted by disvet13 on November 27, 2011 at 09:57:18 PT:
social or medical?
it should have never been criminalized to begin with. the lawyers and the doctors are still playing the pea shell game, following their own agenda's, and abusing their powers over you and your money(taxes). They'll keep on playing adversarial process bureaucracy as long as you can't vote for complete legalization. this great medical argument and how to control it is still about control. The control group says the liver cancer patient can die, while they get to play adversarial process bureaucracy and spend his life and your money. where is our freedom, while they know what's best for us. I vote for the liver cancer patient to use medical marijuana and get the transplant he needs to live. I vote for complete legalization so the lawyers and politicians and all the big corporations can die.
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Comment #2 posted by Oleg the Tumor on November 26, 2011 at 14:12:45 PT:
The Doctors Really Need to Speak Up…
…now that some of their own are turning a blind eye to the subjective reality of medicine – suffering – in favor of the objective ideology that includes research funding, so long as the doctor is willing to make certain presumptions – "as long as we have patients who die on the list waiting for organs… Is it right to give (to) patients who had a history of drug use? You can discuss until the cows come home whether it is social marijuana or medical marijuana."
Coming from a physician, this is an astonishing statement!
It smells an awful lot like a Fifth Amendment issue being decided by a guy with the wrong color robe on.
The last time I looked judges wore black and the doctors wore white. If the patient had claimed that his marijuana use was of the "medical marijuana" nature or for spiritual use, would that have changed the outcome of the discussion in the state of California? Did this poor guy just self incriminate himself to death? So much for the honesty doctors and patients have come to expect from the doctor/patient relationship. This guy should claim that he wasn't given his Miranda warnings, now that his transplant hinges upon whether the legal issue should be held over the medical one. Or is this whole thing at one massive HIPPA violation?Spokesman Sally Stuart's comment, "marijuana users can be exposed to a species of mold that can cause fatal disease among patients with compromised immune systems", should be taken as a personal insult by every God-fearing marijuana farmer everywhere. Her claim sounds vaguely like a scientific observation, but does this disease have a name? Mold? Excuse me, but my official Louis Black BS-meter just flew off the wall again, screaming "PLAUSIBLE DENIABILITY…". Mold is everywhere. Try again. But she goes on, "They also run a risk of a fatal lung infection after transplantation."
She is therefore claiming that cannabis users run the risk of fatal lung infection that non-cannabis users presumably do not face. Is this a fact or an opinion regarding the substance? It sounds like an opinion on a possible delivery system, smoking, to the exclusion of any other delivery method such as ingestion. So come on Sally, it's true, global warming is real – have a brownie!
But wait, there's more! She keeps her mouth open and has a "let them eat cake" moment:
"We do not make a moral or ethical judgments about people who are smoking medical marijuana", she said, "our concern is strictly for the health and the safety of our patients"
That is, the ones that stay out of legal trouble trying to cope with their own physical ailments with a proven non-toxic organic plant! This is yet another form of entrapment!
That doctors are obligated to make choices of life or death is an unavoidable reality. That they continue to choose to lump cannabis together with alcohol should enrage a respected physician somewhere.
Too many patients are running out of time.
Where are you Doc?
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Comment #1 posted by museman on November 26, 2011 at 11:17:35 PT
good question
"As long as we have patients who die on the list waiting for organs … is it right to give [to] patients who have a history of drug use?"How many 'drugs' has that 'Dr.' 'prescribed -to all of those patients waiting for a transplant? And how many of those prescriptions have resulted in side effects, permanent damage, and death? How many harmful side effects are actually -in reality- associated with cannabis? Just one; the government and it's thugs.Doctors are not healers, they are merchants, store fronts for the Big Pharma. Where the famous indicator of a physician used to be the stethoscope, its now the calculator, so they can deduct the most profitable drug they can prescribe. Doctors are not healers, they perpetuate their craft by treating symptoms instead of causes. They aren't really interested in 'cures' because then they would lose job security.Doctors are not healers, they are players in a rich-mans game, and many are just glorified mechanics with no concerns other than 'malpractice' suits, which reveal their over all ineptitude and lack of understanding of what a Healer is.A wise man once said; "Physician, heal thyself."It is sarcasm of biblical proportion.People have the healing power within, and without that there is no healing. Healing does not come from 'drugs' but from a natural resource within us all. Real doctors and healers know this. Thus the CREDIT for healing goes to the patient, not the quacks and pretenders, or the 'drugs.'People have got to stop paying attention to the so-called experts, because they have an agenda of selfish consumerism, and they will lie to keep their position on the game board in hopes they will rise just a little higher towards the 'top' (which incidentally is about to fall down).So, "Is it right?" How about "Is it right to deny anyone goodness and mercy, because of your friggin' material worship?" HELL NO!LEGALIZE FREEDOM
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