In some hospitals, smoking weed could make you ineligible for an organ transplant — even if the alternative means you’d most likely die.
A majority of medical centers in the United States will not consider a patient for a transplant if they abuse, or even just use, any drug, including alcohol, cocaine, heroin, and cannabis.
In some cases, the reason is legal: Marijuana is prohibited under federal law, no matter whether the patient has medical permission to use within their home state. There’s also a part physiological, part psychological reason behind this policy: According to Art Caplan, head of the Division of Bioethics at New York University Langone Medical Center, there’s a psychological fear among transplant teams that “if you smoke a lot of marijuana, you won’t be able to be compliant with the post-transplant regimen.” Whether there’s any strong evidence to support that fear, it’s nonetheless a concern within the medical community.
Physiologically, cannabis could complicate things for people who need liver transplants, says Caplan. “It causes problems for people who already have fatty livers,” he says. “If you need a liver transplant, it may accelerate your need if your liver is already starting to go, and it can damage the new liver.” If the liver comes from an elder donor, which isn’t uncommon, Caplan says there’s some evidence that cannabis can weaken the new liver’s functionality.
On the flip side however, cannabis has been shown to be beneficial for certain liver disorders, such as cirrhosis, or late stage liver scarring.
In most other scenarios, whether a patient needs a liver transplant, a lung transplant, or something else, the hospitals decide on a case-by-case basis to grant the transplant — if they don’t already have a policy barring organ donations to anyone who’s used cannabis, such as the University of Utah Hospital.
“We do not have a specific policy regarding cannabis, but generally speaking, we do not transplant organs in patients with active alcohol, tobacco, or illicit drug use or dependencies until these issues are addressed, as these substances are contraindicated for a transplant,” a spokesperson at the University of Utah Hospital tells Buzzfeed. In the state of Utah, not even medical marijuana is allowed, except for a very small number of patients who suffer from seizures.
But even in California, where both adult use and medical marijuana are widely used, Stanford Health Care at Stanford University can deny a transplant to anyone who might have used even medical marijuana.
Federal law doesn’t dictate whether cannabis users should be denied organ transplants. And the United Network for Organ Sharing doesn’t have a policy on it either.
However, as states loosen their adult use and medical marijuana laws, health care policy makers may need to recognize a growing disparity between hospital policy and state policy. If not, a number of patients in need could be denied vital organs — all over smoking a joint.