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Pot eased suffering, may have cost his life

Sam Sabzehzar 2011-11-14 2 comments
Legal medical marijuana use bars transplant

By Seattle P-I  |  Published on

Tim Garon lay in his hospital bed as his girlfriend, Leisa Bueno, leaned over to give him a kiss while they waited to hear if he would be put on a transplant list to receive a new liver. One week after he was refused a transplant for the third time, Garon died. (Photo: / Associated Press / SL)

The death of a musician who was three times denied a liver transplant highlights a new ethical concern: When dying patients need a transplant, should it be held against them if they’ve used marijuana with a doctor’s¬†blessing?

Timothy Garon, 56, was the lead singer for Nearly Dan, a Steely Dan cover-band.

His lawyer, Douglas Hiatt, said that although no one told him why Garon was turned down for a transplant, he suspects it was because he used marijuana with medical approval, as allowed under state law, to ease the symptoms of advanced hepatitis C.

Garon died a week after a University of Washington Medical Center committee had for the second time denied him a spot on the liver transplant list.

Harborview Medical Center previously turned him down. No reasons were given for the denials, Hiatt said.

Harborview said he would be considered if he avoided pot for six months, and the UW Medical Center offered to reconsider if he enrolled in a 60-day drug treatment program, but doctors said his liver disease was too advanced for him to last that long, Hiatt said.

The university hospital committee agreed to reconsider anyway, then denied him again.

“When a doctor authorizes medical marijuana, it’s like a prescription,” Hiatt said. “Telling a dying guy in his shape to wait 60 days is insulting and sickening in my¬†opinion.”

“Everyone agrees that marijuana is the least habit-forming of all the recreational drugs, including alcohol and unlike a lot of prescription medications, it’s nontoxic to the¬†liver.” ~ Dale Gieringer

Medical officials around the country have been wrestling with the issue.

“Most transplant centers struggle with issues of how to deal with people who are known to use marijuana, whether or not it’s with a doctor’s prescription,” said Dr.¬†Robert Sade, director of the¬†Institute of Human Values¬†in Health Care at the¬†Medical University of South Carolina. “Marijuana, unlike alcohol, has no direct effect on the liver.”

In a statement, officials from the University of Washington Medical Center said while they couldn’t speak specifically about Garon’s case, medical marijuana is never the sole determinant when making decisions about candidates for organ transplants, and whether a patient is¬†listed.

“UW Medical Center follows an extensive evaluation process to determine whether organ transplant candidates should be listed. Patients with a reasonable chance of survival and a good outcome, given a variety of factors, are listed,” according to the¬†statement.

“Currently, in a given year, there are approximately 98,000 patients waiting for organs in the U.S. and only 6,000 donors available,” the statement continued. “Because of this scarcity of organs, the listing process is often rigorous. Those patients who have done — and continue to do — everything they need to ensure a healthy lifestyle pre- and post-transplant will have the best chance of a good¬†outcome.”

In addition to health care issues, the¬†UW committee¬†“looks at a number of other issues, including behavioral concerns such as a history of substance abuse or dependency.If such a history exists, then the Committee looks at the period of abstinence the candidate has demonstrated to date, efforts made to maintain this abstinence, and the potential to abuse again. The Committee also factors in the patient’s long-term history of social stability and ongoing medical compliance, as these are the best predictors to maintain graft survival following transplant,” according to the¬†statement.

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.

Dr.¬†Brad Roter, the Seattle physician who authorized Garon’s pot use for nausea, abdominal pain and to stimulate his appetite, said he did not know it could be a factor if Garon were to need a transplant. That’s typically the case, according to¬†Peggy Stewart, a clinical social worker on the liver transplant team at UCLA who has researched the¬†issue.

“There needs to be some kind of national eligibility criteria so that everyone will know what the rules are,” Stewart said. The patients “are trusting their physician to do the right thing. The physician prescribes marijuana, they take the marijuana, and they are shocked that this is now the end¬†result.”

Many doctors agree that using marijuana — smoking it, especially — is out of the question post-transplant. The drugs patients take to help their bodies accept a new organ increase the risk of aspergillosis, a frequently fatal infection caused by a common mold found in marijuana and¬†tobacco.

But there’s little information on whether using marijuana is a problem before the transplant, said Dr.¬†Emily Blumberg, an infectious disease specialist who works with transplant patients at the¬†University of Pennsylvania Hospital.

Further complicating matters, Blumberg said, is that some insurers require proof of abstinence, such as drug tests, before they’ll agree to pay for¬†transplants.

Dale Gieringer, state coordinator for the California chapter of NORML, the National Organization for the Reform of Marijuana Laws, scoffed at that notion.

“Everyone agrees that marijuana is the least habit-forming of all the recreational drugs, including alcohol,” Gieringer said. “And unlike a lot of prescription medications, it’s nontoxic to the¬†liver.”


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  1. msaint

    The alliance of the AMA and the Fed are the primary reasons for such stern attacks on cannibus users. If cannibus alleviates such profitable medical conditions i.e., migrains, respitory ailments, sleeps disorders, cancer etc, it can be refered to as a panacea. This would result in billions of dollars lost to the medical professions. On the other hand, the Fed are primarily lawyers. Naturally, their primary interest is money to be made from arrests. Therefore, they write legislation insuring lower level criminal lawyers make huge profits, of which much of it is donated to political campaigns. Courts make millions of tax free money, and everyone goes home richer and happier, except for the poor defendent. Therefore, the Fed will at any cost, do what ever they decide it takes to keep the flow of currency autonomous. With law enforcement, as with everything else, money is always the common denominator.

  2. o b gold

    Tim Garon was a friend of mine. He was a talented singer/songwriter. I was shocked at his death and his denial of treatment due to his cannabis use. Then, I read an article in the L A Times that put things in a different perspective. Transplant applicants, and there are more applicants than donors, must be sober before, during and after their medical procedures to avoid complications due to their suppressed immune systems. They must also be extremely compliant to the recovery regimes of pharmaceuticals and supplements. The article broadened my understanding of this life-death conundrum and helped me understand the medical decisions that went against certain patients. Of course, if you have lots of money like David Crosby, for example, you might get a new liver no matter how alcohol soaked and cannabis laden your old organ was.