MARINOL DEATH SENTENCE

Oregon Man Denied Liver Transplant Because of Prescription -- He's Not
the Only One

Oregon resident Dave Myers brought a lot back from his stint in
service in Vietnam. Myers served in the US Navy inspecting boat
traffic off the Vietnamese coast and he brought back memories, good
and bad, of course, and some lasting friendships, but also Hepatitis
C, probably caught inspecting some dark and waterlogged junk in the
South China Sea.

Now suffering from terminal liver failure due to the disease, Myers
sought a transplant from Oregon Health Services University (OHSU) in
Portland, one of 16 major liver transplant centers in the country. But
he was rejected by program head Dr. John Ham
(http://www.ohsu.edu/transplant/bios/ham.html)
because he is taking Marinol, a synthetic cannabis compound and legal
prescription medicine. Worse for Myers, Ham accused Myers of being a
marijuana smoker, something Myers vehemently denies having done for at
least 15 years, when he was first diagnosed.

The removal of Myers from the list of those awaiting liver transplants
is a virtual death sentence. "With liver failure, you die -- it's as
simple as that," said Dr. Jay Cavanaugh, head of the American Alliance
for Medical Cannabis (http://www.letfreedomgrow.com) and himself a
Hepatitis C sufferer. "And a good number die while they're waiting for
the transplant," he told DRCNet.

Myers is one of about 18,000 people waiting for livers, most of them
Hep C sufferers, according to the Scientific Registry of Transplant
Recipients (http://www.ustransplant.org), which tracks all organ
transplants in the US. According to the registry, some 5,000 liver
transplants are done each year, but some 2,000 patients die while on
the waiting list.

Because a large proportion of Hep C patients got the disease through
intravenous drug use and because significant numbers of other liver
transplant candidates developed problems due to alcohol abuse,
transplant centers have developed strict protocols barring transplant
eligibility for those people who continue to abuse drugs. While
protocols vary from center to center, the OHSU protocol specifies "no
smoking, no drinking, no illicit drugs."

Marinol, a synthetic cannabinoid, is not an illicit drug. It is a
Schedule II drug available for prescription in the United States. It
is commonly used to increase appetite and as an analgesic, the use for
which it was prescribed to Myers by his attending physician.

OHSU deflected numerous DRCNet attempts to interview Dr. Ham or get
anyone to talk about the Myers case or OHSU's liver transplant
protocols, but Myers told DRCNet -- and he has the tape recording to
back it up -- that Ham told him that Marinol would suppress the immune
system, thus making post-transplant infections more likely.

"This has me pulling my hair out," said Cavanaugh, himself a Hepatitis
C sufferer. "One thing transplant people worry about is infection," he
explained. "That was the rationale used to deny Myers, that the use of
cannabis would suppress the immune system and make him prone to
infection, but there is no validity to that whatsoever. Cannabis is
not a general immunosuppressant and those doctors must know that. And
it's ludicrous anyway because once you get a transplant you get
whacked with the heaviest anti-rejection drugs around, and what do
they do? They suppress the immune system."

But according to Myers and the recording of his meeting with Dr. Ham,
the Marinol issue was most likely a smokescreen for Dr. Ham's real
concern: that Myers was smoking marijuana. "I haven't smoked marijuana
for 15 years or so, and I told Dr. Ham that I would willingly submit
to a polygraph and/or a lung biopsy to prove that I am not smoking
marijuana," Myers told DRCNet. "He said that was unnecessary because
he knew I was smoking marijuana. So now I have a doctor who is also a
psychic, I guess."

If Dr. Ham's extrasensory abilities leave room for doubt, so does
OHSU's position on marijuana use as a reason to keep people off the
transplant waiting list. According to Transweb (http://www.transweb.org),
an online resource center for transplant patients, occasional
marijuana use does not automatically preclude people from obtaining
liver transplants. "It depends," wrote Dr. Jeff Punch, a University of
Michigan transplant surgeon in response to a query. "First it depends
on the policy of the individual transplant center. Second it depends
on the individual patient: what organ they need, why they need it, and
other factors. For example: Most lung transplant centers will not
transplant patients that smoke anything, even occasionally. Another
example is patients who need a liver transplant because of alcohol
abuse. In patients with a history of alcoholism, studies have shown
that one marker that indicates a particular patient is more likely to
return to alcoholism is continued use of any psychoactive drugs. Most
transplant centers will not transplant patients with active substance
abuse of any kind if the reason for the transplant relates to
substance abuse."

"There is no evidence that marijuana has any negative effect on the
liver," Dr. Cavanaugh said. "A 1970 study found that if you inject a
mouse with a massive dose of THC, there is some liver involvement, but
the human equivalent would be mainlining an ounce of cannabis. More
recent studies have found that cannabinoids and other compounds in
marijuana are actually hepato-protective. They reduce inflammation in
the liver associated with cirrhosis. Hell, cannabis benefits the
liver!" Dr. Cavanaugh said.

In Oregon, a state with an active medical marijuana program, OHSU
protocols against illicit drugs don't appear to have kept up with
state law. The result is that Dave Myers is not alone in being
rejected. "I am aware of about a dozen other people removed from the
liver transplant list at OHSU because of medical marijuana use," said
D. Paul Stanford, director of the Cannabis Hemp Foundation
(http://www.thc-foundation.org). "We run a medical marijuana clinic
here in Oregon, and we've got some 200 patients who have Hep C," he
told DRCNet. "Medical marijuana helps those patients by stimulating
their appetites, and it has some antibacterial properties," he said.
"Denying these people transplants because they use medicinal marijuana
is a death sentence. The Hemp Cannabis Foundation is preparing a
lawsuit against OHSU, including Dave Myers because the facts of his
case are the strongest, but also including registered Oregon medical
marijuana patients who have been bumped."

"Does the transplant team really believe I'm a non-deserving drug
addict for using medical cannabis?" asked Dr. Cavanaugh. "Isn't it
ironic that my Hep C doctors had no problem considering me when I was
being prescribed methadone, Clonopin, Ambien, Flexaril, Neurontin, and
more? Does anyone really believe I was better off and a better
transplant candidate when I was whacked on all those drugs?" he asked.

"To say that someone who uses physician approved cannabis is at risk
of substance abuse is just ridiculous," Cavanaugh continued. "The vast
majority of patients seeking liver transplants are Hep C patients, and
the majority -- but not all -- are former intravenous drug users.
There is some sense to the notion that if you are continuing a
self-destructive pattern of behavior, such as shooting speed or
smoking crack or drinking booze, you are not a worthy candidate
because you'll just ruin the new liver, but in the case of Dave Myers,
he is conforming to the center's desire that he not be using drugs
that could damage his liver and he is still being discriminated
against because of doctors' prejudice against medical marijuana, and
in this case, Marinol, a federally-approved Schedule II drug."

As for Myers, he alternates between depression and anger, he told
DRCNet. "I'd like to punch Jack Ham right in the face," said Myers.
"He sat right across from me, my wife, and our daughter, smirking at
us. I told him I wasn't his enemy, that I was willing to work with
him, but it didn't matter. My daughter was crying, and he just kept
going on about no THC," Myers said.

Without a liver transplant, he will be dead within two years, he
said.

"Hep C is seen as the junkies' disease," said Myers. "It has the same
sort of stigma that AIDS had, but it doesn't have those celebrity
spokespeople to raise awareness." Myers should know. He operates a web
site for veterans with Hep C (http://www.hepvets.org) and writes on
the issue for publications covering the disease. "There is a prejudice
like there was in the 1960s. Then, if you had long hair and a beard
you must be a pothead. Now, if you have Hep C, you must be a junkie.
I've been clean and sober for 15 years," said Myers, who recently
completed a stint with Promisekeepers, the conservative Christian
men's fellowship.

Myers must find another transplant center that will take him, if he is
to survive, he said. OHSU is the only one in the state.

Dr. Cavanaugh viewed the whole episode as outrageous. "That medical
professionals would inject prejudice into a life and death decision is
more than unethical. It's cruel, ignorant, and arrogant."