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Cancer Patient Denied Liver Transplant After Using Medical Marijuana

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Photo by Jpfmack via the LAist Featured Photos pool on Flickr

Doctors at Cedars-Sinai Medical Center removed a cancer patient from the liver transplant list in February for using medical marijuana and failing to show up for a drug test. Last week the 63-year-old patient, Norman Smith, asked the medical center to reconsider reinstating him.

Smith has been fighting inoperable liver cancer for two years and is in need of a new liver. He scored a spot on the transplant list last year but was removed after the drug test incident. Toke of the Town said Smith did test positive for medical marijuana. Cedars-Sinai transplant policy states that patients are still eligible for a transplant if they initially test positive for marijuana, but they must sign a statement promising not to use the drug. If they fail a random drug test or, like Smith, are a no-show for a test, they are bumped from the list. In order to be placed back on the list, Smith was ordered to abstain from using medical marijuana for six months, submit to random drug tests and undergo counseling.

Smith, who is currently undergoing chemotherapy and radiation, told L.A. Now, "It's frustrating. I have inoperable cancer. If I don't get a transplant, the candle's lit and it's a short fuse." His cancer recently returned after being in remission.

Joe Elford, an attorney with the medical marijuana advocacy group Americans for Safe Access, represents Smith and says that any delay in the transplant could be the "difference between life and death." Smith and Elford are considering a lawsuit against the hospital.

L.A. Now says that, according to the United Network for Organ Sharing, there is no standard policy on transplants and the use of medical marijuana. Due to the high demand for liver transplants nationwide, medical centers must prioritize. Over 16,000 people are on the national wait list for liver transplants. The average wait is approximately 300 days.

Dr. Goran Klintmalm, chief of the Baylor Regional Transplant Institute and an expert in liver transplantation, said, "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?"

One of the main concerns with granting a medical marijuana user a transplant is whether or not the patient will follow the complicated medication regimen post-transplant. Dr. Jeffrey Crippin, former president of the American Society of Transplantation and medical director at Washington University in St. Louis, claims, "If you are drunk or high or stoned, you are not going to take your medicine."

Cedars-Sinai spokeswoman Sally Stewart told L.A. Now that medical marijuana users can be exposed to a species of mold that can cause fatal disease among patients with weak immune systems. Patients are also susceptible to a fatal lung infection post-transplant. Stewart added that the center does not "make a moral or ethical judgment about people who are smoking medical marijuana" and that their "concern is strictly for the health and safety of our patients."

Dr. Steven A. Miles, Smith's oncologist, said, "Without a transplant, it is basically 100% fatal. It's just a matter of time."

Americans for Safe Access Chief Counsel Joe Elford wrote in a letter to Cedars-Sinai, "Cedars-Sinai would not be breaking any laws, federal or otherwise, by granting Norman Smith a liver transplant, and it's certainly the ethical thing to do."

Smith said he started using medical marijuana while suffering "extreme pain" and "physical anguish" after an unrelated back surgery. Miles approved of his patient's medical marijuana use to manage his pain plus the effects of chemotherapy and refilled Smith's medical marijuana prescription. Smith stopped using the drug in August and is hopeful for a liver transplant.

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Comments [rss]

  • grandeur1

    making marijuana legal makes it easier for the cartels to legally and illegally grow it here in the US.   The problem with that is the harsh chemicals they use are starting to seep into our water supply, killing animals, some of which include our food supply cows, and the crops that get the run off from these streams.  We simply don't have the manpower right now to police this issue. Since this is happening in california, and we supply most of the rest of the country... this is a very large issue.  



    I say we start with trying to make products out of marijuana/hemp (Paper!!) and police it less to bring the price down.  Any other suggestions are appreciated, this is just off the top of my head. 

  • westlafadeaway

    It must be off the top of your head otherwise you'd know that legalization would put the cartels out of that business. (they'd shift to other drugs)

    This isn't cocaine or heroin that needs a lab to process.  Picture grow kits at Home Depot and that's more the direction it would go.

    There is a lot of money to be made in a legal culture of marijuana and corporations aren't going to sit idle and let the cartels snatch it up if they can legally participate.

  • I can't quite understand what your saying, so if I got it wrong do get me on the right track.

    If I interpret correctly.......

    Regarding Cartels. Making cannabis legal would do the same thing to the gangsters that it did when prohibition ended. It would quite quickly push them aside as those growers who are regulated and taxed control the real market. (yesterday a guy got busted with 30k of unstamped cigarettes,,, even that still happens to a degree..)

    Other people.. a good many would grow a plant or two at home.. many would realize they don't have the patience.

    As for chemicals being sprayed on cannabis/hemp.. That is another great reason for regulation.. most competent growers need no such harsh chemicals and the upward trend is to grow organically. As it is with the stuff coming over the border, we have no clue what is on it.. in the 70's our government sprayed it with paraquat figuring no american kids would smoke it if they knew it was poisoned.. the practice stopped shortly after a few famous congressmen's kids got sick.

    Controlled organic grows.. this is what you would see more of if it were legal.. much like wine grapes in napa valley. Other than that it is just like any other crop, except more friendly and eco friendly as well.. google the benefits of a hemp crop to the soil if you ever get bored.

  • ashka777

    The whole problem here is that cannabis is illegal and nothing else as is always the case with cannabis.  Proven to be an amazing medicine many times over for really serious diseases and pain by desperate individuals forced to try alternative methods when modern medicine fails them and the only side effect is that it is illegal.  Big Pharma will not let go of their power(money) easily.

  • exbaytriate

    inhaling particulate matter and exhaling less particulate matter is not good for anyone, regardless of the "healing of the nation" properties of the smoke and should be taken under consideration by anyone who uses weed as a "medication." 

    any positive effects of the ganga will be tempered by the damage inflicted by the inhalation of the burnt, carcinogenic carbon of the plant material. 

    the delivery of the "medication" should also be taken into consideration by the medical professionals. the concerns of lung damage or infection and mold poisoning are valid only if the weed is smoked, not ingested.

    after all, if one can remember to take the painkillers like the oxycodones and valiums, what's the difference from remembering to take a weed pill? 

    (what we are missing from the story, though, is that the medical community frowns on giving liver transplants to "users" of any kind as the majority of liver transplants are performed on alcoholics who have cirrosis and junkies who have necrotic liver damage from hep C.)

  • malcolmkyle

    Please do at least a minimum of research before posting on this important subject:

    1) Tobacco is cancer causing largely because it delivers specific carcinogens such as NNK and NNAL that are not present in cannabis. Not all "tar" is created equal, and tobacco has some of the most carcinogenic types of tar known to science, whereas cannabis does not.

    2) Cannabis (marijuana) use is associated with a DECREASE in several types of cancer... potentially even providing a protective effect against tobacco and alcohol related cancer development.

    Donald Tashkin, a UCLA researcher whose work is funded by NIDA, did a case-control study comparing 1,200 patients with lung, head and neck cancers to a matched group with no cancer. Even the heaviest marijuana smokers had no increased risk of cancer, and had somewhat lower cancer risk than non-smokers (tobacco smokers had a 20-fold increased lung cancer risk). Tashkin D. Marijuana Use and Lung Cancer: Results of a Case-Control Study. American Thoracic Society International Conference. May 23, 2006.

    Researchers at the Kaiser-Permanente HMO, funded by NIDA, followed 65,000 patients for nearly a decade, comparing cancer rates among non-smokers, tobacco smokers, and marijuana smokers. Tobacco smokers had massively higher rates of lung cancer and other cancers. Marijuana smokers who didn't also use tobacco had no increase in risk of tobacco-related cancers or of cancer risk overall. In fact their rates of lung and most other cancers were slightly lower than non-smokers, though the difference did not reach statistical significance. Sidney, S. et al. Marijuana Use and Cancer Incidence (California, United States). Cancer Causes and Control. Vol. 8. Sept. 1997, p. 722-728.

    In a 1994 study the government tried to suppress, federal researchers gave mice and rats massive doses of THC, looking for cancers or other signs of toxicity. The rodents given THC lived longer and had fewer cancers, "in a dose-dependent manner" (i.e. the more THC they got, the fewer tumors). NTP Technical Report On The Toxicology And Carcinogenesis Studies Of 1-Trans- Delta-9-Tetrahydrocannabinol, CAS No. 1972-08-3, In F344/N Rats And B6C3F Mice, Gavage Studies. See also, "Medical Marijuana: Unpublished Federal Study Found THC-Treated Rats Lived Longer, Had Less Cancer," AIDS Treatment News no. 263, Jan. 17, 1997

  • exbaytriate

    cut and paste that shit all you want, it doesn't refute what i had posted. 

    "tar" is a subset of "particulate matter." please do "a least a minimum of research" on the english language before you get all snotty. 

    i'm not talking about tabacco nor weed but the (particulate matter in) the smoke. 

    has everyones critical reading comprehension gone to shit these days? or is it just all that weed y'all smokin?

  • westlafadeaway

    Hey man what's with lumping "everyone" into that category - besides i think you're both taking extreme points of view - i got cut and paste guy claiming to know everything on one hand and another who says ANY positive effect from smoking is tempered by the inhaled particles. 

    Tell that to someone who's got AIDS or who's in chemo and can't eat without cutting through the nausea with a joint...I think the ability to eat is far greater than the nuisance of a cough for those guys and doesn't completely temper the positive effect.  The concern of lung damage isn't always a major issue.

  • exbaytriate

    i agree that lung damage isn't always an issue with the patient and there are more than two sides to this issue.

    with that said, i also understand the doctors concerns for the patient and the patients needs for themselves.

    the topic at hand is liver damage and the fact that most people who have liver damage and need liver transplants are substance abusers. where does medical marijuana fit in this picture (clearly a substance considered to be abused)? i'm not sure that can be answered in the message boards. 

  • Welcome to the internets.

  • exbaytriate

    HEY! that's MY line!

  • I haven't smoked cannabis since the late 60's... I do eat it though.. As does everyone I know that uses it for medical reasons.. but I only know a few.

  • Rob Roland

    Do yourself a favor and look up what a vaporizer is.

  • exbaytriate

    do yourself a favor and reread what i wrote. do you think plant material doesn't burn at 360 F? 

    actually, do yourself a greater favor and take a chemistry class.

  • Rob Roland

    Of course it burns, but it's not burning at the same temperature as rolling a joint and burning the paper and the like.

    Additionally, a good vaporizer has a filter in it.

    It's far from perfect but it's better than the alternative.

    BTW, I aced chemistry and reading comprehension. What's your excuse? Wait, don't answer that - I know. You're a jackass.

  • exbaytriate

    you won the internets with your scathing and intelligent comment!

  • Rob Roland

    You're not very good with sarcasm and condescension. Maybe you should find a new hobby.

  • westlafadeaway

    Edibles anyone?

  • exbaytriate

    100%!

  • I've had to deal with cancer twice and this is fucked up. BTW, when I was diagnosed the first time in 1990, my doctor asked if I smoked. I told him no cigarettes, but pot occasionally. He said something like "No I'm talking tobacco. If pot caused cancer, we'd all have it."

  • Pete

    "Dr. Jeffrey Crippin, former president of the American Society of Transplantation and medical director at Washington University in St. Louis, claims, "If you are drunk or high or stoned, you are not going to take your medicine."
    This shoddy doctor simply has no idea what the massive differences between being drunk and stoned are. Functional stoners are so prevalent in todays world, you'd think he'd offer a more informed opinion. 

  • You have to understand.. a great many doctors used cannabis in college.. and there were some of their peers who were jealous they were still getting better grades than they were and seeming to have more fun at it.. so it carrys over to their professional practice amongst each other now.. *ducks*.. *G*

  • Pete

    Medical marijuana is PRESCRIBED by doctors for patients with inoperable cancer, why would he have to "promise not to use the drug" even if he failed the test? 

    Seriously, replace marijuana with asprin here and this story is completely morally wrong and unamerican. Make all marijuana use 100% legal for everyone NOW.

  • With one caveat.. Asprin actually IS bad for your liver. Unlike cannabis, over a thousand people died from Asprin last year alone.

  • exbaytriate

    aspirin (acetylsalicylic acid) is bad for the lining of the stomach. the tylenols (acetaminophen) and advils (ibuprofen) are bad for the kidneys and liver (respectively). 

  • rsteeb

    Acetaminophen overdose is the most common cause of drug-induced liver disease.

  • I am also un clear as to this person has a legal card or not,,very good point Chas

  • Shane, most the other stories I have read say he was prescribed it by a doctor working out of Cedar... of course Doctors work in and out of hospitals and the man also has his own practise.. but it was in the Cedar facilities that he was given his recommendation by this doctor for the effects of the Chemo (a real liver killer) he was going through. 

  • LadyLloyd

    Shane and Chas, thanks for reading and commenting! I've added information about Smith's medical marijuana prescription to clarify that yes, he had a prescription from his oncologist.

  • malcolmkyle

    Thank you for adding that important information!

  • Hey, that's great.. you know, this never happens on these net boards.. You deserve a gold star.. ~!! Seriously.

  • Ok, re read.. no mention in this story that it was prescribed out of Cedar in the first place, which it was.. and is matter of record now. Google it. 

    These doctors would not bat an eyelash if they had him on the strongest most body wrecking narcotics in the world (daily morphine is no fun for the body or mind, trust me).. even acetaminaphin (tylenol) is worse for the liver than cannabis. My doctor and then surgeon were the ones who brought up eating cannabis as an alternative to the narcotic cocktails they had me on which were destroying the liver..at one point I was told to avoid tylenol if at all possible.. eaten cannabis has no effect on the liver, I do believe it saved my life and 30 year mariage.. daily morphine and other dangerous narcotics are no way to go through life.

    If they had him on any other liver destroying medication, they wouldn't think twice about it.. but because it is medical cannabis (that they prescribed him) some bigshot has decided to play God.

    I love the part where they say 'if he smokes pot he wont remember to take his follow up medications'... really guys? I feel like a rhodes scholar on cannabis compared to the morphine, vicodin, percsoset, percadan, demerol and other goodies I have been burdened with 'trying' at the advice of my doctor.

    My goodness this is insanity overflowing.. the man is going to die and all some jackass cares about is the 'power' he has to make life and death decisions arbitrarily.

    This is another ramification on our nations war on cannabis.. we arrest someone every 27 seconds, spent 80 million this year and almost a million in jail... not a second disruption in supply nor demand.. insanity.

  • This is beyond sad

  • Why oh why... (did I miss it? It's happened before) did they not mention in this story that the man was PRESCRIBED (referred) the cannabis from a Doctor at the very facility that now denies him because he is using cannabis.

    I really think that is an important part of the story.. 

    I'll go read it again and see if I just cruised by that part.

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