Is It Time to Allow Organ Donations from Drug Overdose Deaths?

131,000 people in the United States are waiting for an organ donation right now, according to the Organ Procurement and Transplantation Network (OPTN). Many of them have to wait at least 3 years for a transplant. 22 of them die waiting. Every. Single. Day.

There should be a way to keep that from happening. According to The New York Times, there is – if we open up donations from drug overdose deaths.

For decades, the CDC has restricted organ and tissue donations from drug overdose donors due to fear of transmitted disease. Those donors are considered high risk – along with anyone who’s been incarcerated (over 2.4 million people in the US, according to the World Prison Brief), prostitutes (at least 1 million people in the US, according to Business Insider), and gay men, as The Times explains:“For many years, patients with H.I.V. and hepatitis C were not even considered potential donors and their organs were thrown out.” With only 1 in 3,000 people dying in a way that allows their organs to be transplanted, according to Organ Donor.gov, the restriction against drug donors limits an already tiny pool. And the need continues to grow:

Credit: OPTN

Despite increasingly sophisticated medical screening processes and updates from The U.S. Department of Health and Human Services (HHS), that attitude is still upheld by many physicians. As Dr. Robert Veatch of Georgetown University told The Times, “‘Putting a virus into a person is repulsive to many clinicians.’”

Yet drug users tend to be healthier than most other donors, according to The Times. “Drug users tend to be younger and healthier than other donors,” Dr. David Klassen, chief medical officer for the United Network for Organ Sharing, told them. “The risk of actual infection transmission with current screening strategies is numerically very, very small.” 249 people contracted a disease from their transplant in the last 9 years, according to OPTN. 71 of them died. Compared to the total number of transplant recipients in that time (171,388), that’s a 0.01% risk.

Additionally, the potential risk of receiving an infections disease from an organ donor is far smaller than the guaranteed discomfort of life while waiting for the transplant, as Veatch explained to The Times: “We know now that the mortality rate of being on the waiting list for several years is higher than that of getting an organ with an infection that is treatable.”  

He’s not kidding. 65% of patients waiting for an organ transplant are over the age of 50:

Credit: OPTN

That means patients often have health issues in addition to the transplant, and can become very ill while waiting. Compare that reality to the fact that hepatitis C can be treated, even cured, and HIV can be managed, and a transplant from a drug donor looks like a pretty good idea. Especially since that transplant can improve a patient’s quality of life for 10 years or more.

Drug users are also the most plentiful source of donors we have right now, as The Times explains: “Transplants were initially associated with deaths from car accidents, which is why organ donors are noted on driver’s licenses. But overdoses (47,000 in 2014) have surpassed car crashes (32,000 in 2014) as the leading cause of accidental death in the United States… Drug users are now the fastest-growing category of donor.”

Also, scientifically speaking, there is absolutely nothing wrong with receiving an organ donation from a drug user. As The Times points out “dying of an overdose, which usually occurs when oxygen cannot reach the brain, does not affect kidney function or other organs. The drugs and blood are flushed from the organs when they are removed from the body.”

While there are still legitimate concerns about potential infection, the need far outweighs the risk. The best potential longterm option for transplant patients might be replacement organs 3D-printed from their own cells. But that technology has only just begun to emerge, and still needs lots of testing before it becomes a viable option. Until then, relaxing restrictions from drug overdose deaths seems like our best solution.

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