Jauhar is a cardiologist at Northwell Health. Avila is the medical director of the cardiac transplantation and mechanical circulatory support programs at North Shore University Hospital at Northwell Health.
In 2023, Kentucky became the most recent state to pass a law prohibiting the denial of organ transplantation to patients solely because of their marijuana use. The legislation is scheduled to go into effect Jan. 1, 2025. Over the past 11 years, similar measures have been enacted in 21 other states.
Though these laws overstep into medical decision-making, they are part of a rising trend. As cannabis use becomes increasingly prevalent in American society — in 2023, 61 million Americans smoked, vaped, or otherwise consumed marijuana — state governments are taking the lead in upholding the rights of cannabis users, including the rights to medical treatments to which they have historically been denied, such as organ transplantation.
At the same time, organ transplant societies, which set guidelines on transplant care, have passed on setting standardized directives on cannabis use, allowing individual programs to make their own rules. Some programs have taken a hardline approach, adopting zero-tolerance policies on marijuana. Other programs have been more permissive, taking a sort of “don’t ask, don’t tell” stance. Still others have settled in the middle, allowing transplant listing for cannabis users after six months of abstinence — even in states that have passed statutes prohibiting such limitations. There is no consensus on this issue in the transplant community.
The variability in approach has led to disparities. Cannabis users with adequate resources, for example, can translocate to communities where programs allow transplant listing despite substance use. Such “program shopping” rewards wealthy patients with even more access to life-saving organ transplants than they already have.
We need a standardized approach to transplant eligibility in the substantial and growing cannabis-using population. Donor organs are a national commodity. That means national guidelines, not miscellaneous (and often ambiguous) institutional policies, are essential to ensuring organs are fairly distributed without improperly denying treatment to those most in need.
H/T: www.statnews.com
