I'm in favor of the European method. Rather than opt-in, it's opt-out.
Organs from donors who died from overdose are "discarded" more than from other donors. That might not be the right choice. This study essentially shows that organs that come from donors who died of drug overdose do just as well as those that come from individuals who died from trauma. [Summary here.](https://www.methodsman.com/blog/overdose-transplant
Isn't intravenous drug use the primary cause for this "rule"? The higher-than-average possibility that habitual needle users may have communicable diseases?
There's an artificial kidney about 18-24 months away from full FDA approval, might help take some pressure off liver donations as well.
Would having drug abusers being obligated to opt into organ donation a way forward. Refuse full treatment until they opt in. In my country we're considering the 'opt out' where citizens organs are donated unless they specify not too.