The Problem With Denying Organ Transplants to Drug Users

October 6th 2016

The New York Times ran a story on Thursday that struck some Twitter users as insensitive to drug users.

The report described the rise in fatal drug overdoses as "a silver lining for transplant patients" who are receiving more organs from deceased users as the U.S. continues to grapple with an opioid epidemic.

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The language of the headline seemed to be the main source of criticism, with some arguing that it dismissed the lives of drug users.

But as the Drug Policy Alliance's Bill Piper wrote, the story also serves as a reminder of the fact that many people who use illegal drugs — including medical marijuana patients in legal states — are denied organ transplants, which he called "ironic" in light of the report's findings.

"[Few] things show the disregard for the lives of people who use illegal drugs more than the ban preventing them from getting transplants," Piper wrote. "[People] who use *illegal* drugs are usually barred from receiving organ transplants; so ironic [that] if they die, their organs are given to others."

Here's what the report found.

The rate of fatal drug overdoses in America has steadily risen over the past 15 years, according to the Centers for Disease Control and Prevention. Overdoses now account for more deaths annually than car accidents, and drug users have become "the fastest-growing category of donor" for transplant patients. "They rank fourth, behind donors who died of strokes, blunt injuries, and cardiovascular problems," the Times reported.

"So far this year, 69 people in New England who died from an overdose have donated their organs, according to the New England Organ Bank. They account for 27 percent of all donations in the region, up sharply from 2010, when eight donors, or 4 percent, were drug users. ... Nationwide, more than 790 deceased drug users have donated organs this year, accounting for about 12 percent of all donations. That is more than double the 340 drug users who donated in 2010, or about 4 percent of the total."

So drug users who die from overdoses are helping transplant centers meet the high demand for organs, but critics point out that many of those centers also turn down drug users when they're in need.

Arthur Caplan, who heads the division of medical ethics at NYU's Langone Medical Center, told ATTN: that he sees the irony but also notes that transplant center policies are starting to shift when it comes to accepting drug users as transplant recipients.

"Over the years, there's been a lot of discrimination against alcoholism, against people who use drugs, but that has gotten more liberal in recent years," Caplan said. In part, that's because stigmas against drug users are being broken down, and it's also because centers are getting better at executing successful transplants, which has enabled them to accept a wider range of recipients.

"The other reality is, if you're a heavy drug abuser, the ability of you to survive a transplant is probably very, very poor," Caplan added. There are certainly risk factors associated with drug users that transplant centers ought to take into consideration, but for moderate users — especially of less harmful substances such as marijuana — it stands to reason that these individuals should be eligible to receive organs, too.

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