Drug Overdose Deaths Drive Increase in Organ Donations

Laurie Clemens described her son, Brandon Morris, as an outgoing, all-American boy who loved to play football and go fishing.

“He was always there for me,” Clemens said, “a typical mama’s boy.”

On a spring day in 2015, Morris died after a heroin overdose caused him to stop breathing. Clemens said she was crushed to find her son brain dead in a hospital bed.

“I never expected Brandon would stick a needle in his arm,” Clemens said. “We don’t want this to happen to anyone else’s family. The heartache is just unbearable.”

At the hospital, Clemens was surprised to find out her son could be considered for organ donation, even though he was an intravenous drug user and died from an overdose. Doctors were able to match Morris’ liver to a 57-year-old grandfather named George Henderson.

Within a year of Morris’ death, Clemens met the man saved by her son’s donated organ. After losing her son, Clemens said she has found a bit of hope in her friendship with Henderson, who was previously a stranger but has since become “family.”

In recent years, so many people have died as a result of the nation’s opioid epidemic that it has caused the number of organ donations from fatal overdose victims to skyrocket — an unexpected consequence that highlights the nation’s agonizing opioid crisis.

In 1994, only 29 donors in the U.S. had died of drug overdoses. Last year, that number climbed to 848, according to the United Network for Organ Sharing (UNOS), the nonprofit organization that manages the nation’s organ transplant system.

The rise in numbers is not due solely to the increase in opioid overdoses. Medical advances have also allowed more organs from drug intoxicated donors — which were often unusable for transplantation years ago — to save the lives of some people facing long waiting lists.

In the midst of an epidemic that remains stigmatized as a moral, or even criminal issue, rather than as a health crisis, some families have found hope after their losses through organ donations.

Dr. David Klassen, the chief medical officer for UNOS, said he has witnessed the opioid epidemic unfold through the mounting number of deceased organ donors who passed away as a result of drug overdoses.

Around five years ago, Klassen said that the number of organ donors had stagnated, and UNOS studies predicted that the number of organ donors would remain “relatively flat” going forward.

“Somewhat unexpectedly, it has increased very substantially, starting around 2013, 2014, and especially last year, 2015,” Klassen said, “Some of the biggest increases in donations has been from people who have died of drug overdoses.”

From 1994, when UNOS record-keeping began, until 2015, the number of organ donors has increased by 112 percent. Meanwhile, in that same time, the percentage of donors who died of a drug overdose has increased by 2,924 percent, according to UNOS.

“It is not something that the transplant system is happy about. Society in general is not pleased with this,” Klassen said. “But from one perspective, you can see some good come out of a bad situation.”

Charles Alexander, the CEO of the Living Legacy Foundation of Maryland, which helps facilitate transplants in the state of Maryland, an area hit especially hard by the opioid epidemic, told ABC News that in 2010, 6 percent of its donors died of a fatal overdose. This year, it is on track to be as high as 25 percent.

“I think we have stigmatized what a drug overdose or a drug user looks like. Many of these people lead normal lives but have a recreational drug habit,” Alexander said.

Clemens added that when her son died of an overdose, “everybody was in shock, a lot of our friends, because they never could even think about Brandon doing that.”

Clemens said Brandon was always very active and had held a job since he turned 15.

“In high school, he had a few knee injuries and that’s when doctors prescribed him pain pills. He would skip physical therapy to get back in the game,” Clemens added, noting how he started taking opioids.

Clemens said she found out in late 2014 that her son switched from pharmaceuticals to IV drugs.

Dr. Kimberly Johnson, the director of substance abuse treatment at the Substance Abuse and Mental Health Services Administration, said that in terms of overall use, the opioid epidemic is “similar to other epidemics.”

The Substance Abuse and Mental Health Services Administration is a federal agency that tries to reduce the impact of substance abuse and mental illness on America’s communities.

“In terms of fatalities, it’s higher, it’s much higher,” Johnson added.

Dr. Jay Fishman, the chief of transplant infectious diseases at Massachusetts General Hospital, added that in the recent opioid epidemic, “the individuals who are dying are young and are first- or second-time users.”

For donor families, the choice to donate can be fraught as they struggle with both the grief of losing a loved one and concern that IV drug use means increased chance of spreading infected organs to another family’s loved one. Hilda Halstead grappled with the decision earlier this year when her daughter Nadya Zitek was found unresponsive after an opioid overdose.

Halstead, a hospital administrator, assumed that because her daughter was an IV drug user, organ donation would be off the table. But the doctors reassured her it was a possibility, though Zitek’s organs would be labeled “high-risk” for recipients.

“If something happened [to the recipient] … I don’t think I could stand it,” Halstead told ABC News. “You have this moral, ethical responsibility not to cause harm to other people even though you think you’re doing it for a good reason.”

The U.S. Centers for Disease Control and Prevention classifies an organ transplant from an IV drug user as “high risk” because statistically it holds a higher risk for HIV and hepatitis B or C infections.

Klassen added, “There is the assumption that for people that are involved in drug use, the quality of the organ might be substandard. But in fact, the organs really are generally in fact of better quality in comparison to the general donor population.”

“That probably has to do with the fact that donors like that are younger and maybe don’t have the other health problems that result in death,” compared to the general donor pool, Klassen added.

Recipients must specifically consent to receive a donation from a “high risk” donor, according to Klassen.

In part, risks surrounding these diseases have diminished thanks to new tests that look for genetic signs of a virus. These tests mean that the “window” period for these illnesses, when a person is infected but the disease is not yet detectable, have diminished greatly. HIV can now be detected in five to nine days after infection thanks to nucleic acid testing that identifies virus genetic material, as opposed to 22 days previously with antibody testing. Similarly, hepatitis C can now be detected in three to seven days as opposed to 66 days.

“Even though it is called ‘high risk,’ the risk, if you look at it, is actually extremely low. The risk is increased in comparison to other donors, but if you look at it, it is actually a fraction of a percent,” Klassen said.

The CDC’s “high risk” label might give some families pause, and they may choose not to accept an organ from a drug OD victim, Klassen added, especially if they are waiting for a kidney or another organ that they can survive without, at least for a while. Those who are waiting for a heart or a liver may not have as much of a choice.

Data from the New England Organ Bank show that in 2011, about 8 percent of their hearts transplanted were from donors who died due to “drug intoxication.” In 2016, so far, nearly 30 percent of their hearts transplanted were from donors who died from “drug intoxication.”

Laurie Clemens said she chose to donate her son’s organs because she knew the pain of losing her own son, and hoped that no other family would have to go through the same thing.

Clemens recalls the first time she met George Henderson and his wife, less than a year after her son’s liver was transplanted into Henderson’s body.

“I brought a picture of Brandon. I wasn’t going to show it to them unless they asked, and they did ask, and they stared at his pictures for the longest time, and then George looked up at me and said, ‘I’ve got a strong liver,’” Clemens said. “He constantly calls me and checks in on me. He is a good man.”

Henderson, 57, told ABC News, “When I met Brandon’s family in 2015, I felt so much joy. The first thing that I could think of was how much it meant for the family to give me life when they had lost Brandon.”

Henderson said prior to receiving the gift of a new liver, he was “living day-to-day,” and his wife Rosalind added, “This was his second transplant. The first one didn’t take.”

Henderson had cancer in his liver, and 30 years ago he suffered from an addiction of his own, alcoholism, he said.

Rosalind Henderson said they knew how Brandon died, but they still decided to take a “high risk” organ. “George was not going to make it. We didn’t have a choice. George was very ill,” she said.

George Henderson told ABC News that if he could’ve met Brandon, he would have tried to save him.

“I would tell him about my life when I was an alcoholic, approximately 30 years ago,” Henderson said. “I would talk to him about the reasons that I drank and how I stopped in 1987. I would talk to him about how he could stop his own addiction.”

Rosalind Henderson added that she and George have six grandchildren, and that previously, George could never travel to see them because he was so sick.

“I tell [Brandon’s] mom all the time how much I appreciate her and pray for her. That is an understatement,” Rosalind Henderson said. “She gave life, at a time when she really didn’t have to.”

Clemens said she thinks Brandon would be happy to know that he saved someone’s life.

“Even though his life ended in a tragedy, he helped someone live on,” Clemens said of her son. “I feel Brandon is a hero.”

Clemens said she and her family have since spent a lot of time advocating for increased awareness of the opioid epidemic, and of organ donations.

She said she has developed a close bond with the Hendersons, and through that friendship, “I feel Brandon around me all the time.”