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Sanjay Gupta MD

Inside the World of Addiction; Could a Pill Replace Rehab?; One Woman's Weight Loss Footsteps; Tips for Parents: When to Wait It Out or Go to the Emergency Room

Aired April 18, 2009 - 07:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

DR. SANJAY GUPTA, CNN HOST: Good morning. Welcome to HOUSE CALL, the show that helps you live longer and stronger. Thanks so much for watching. I'm Dr. Sanjay Gupta.

Imagine craving something so badly that you give up your family, your job, and your health. This morning, we'll delve in inside the world of addiction. What works, what doesn't, and are we all potentially addicts?

Then, could a pill replace rehab? Some are saying yes. It's fascinating stuff.

And a simple decision leads to amazing results. How you can follow one woman's weight loss footsteps.

For many recovering addicts, though, relapse can be a constant threat. I found out firsthand. As part of my upcoming special, "Addiction: Life on the Edge," I talked candidly with the author of the popular book, "Tweak." His name is Nic Sheff.

Now, when we first met Nic nearly a year ago, he was in the middle of a book tour. And he was talking about recovery, he was describing. But as we found out and Nic demonstrated it for us, addiction is a powerful disease.

(BEGIN VIDEOTAPE)

GUPTA: Nic Sheff loved drugs, crack, cocaine, ecstasy, heroin and his favorite -- crystal methamphetamine.

NIC SHEFF, RECOVERING ADDICT: When I did crystal meth for the first time, it was like -- yes, it was like the answer to my problems. It was like I felt strong and confident.

GUPTA: After five rehabs, Nic finally kicked his addiction and wrote a popular book called "Tweak." It's about the toll drugs took on his life.

SHEFF: I cooked up a bunch of heroin and go to pick out a bottle of white wine from the refrigerator.

GUPTA: His recovery looked like a success. And everyone, including Nic, thought he had beaten his disease. Then he dropped off the radar. (on camera): We have heard that he relapsed. Finally, we tracked him down at this sober living home in Santa Monica, California.

Hi, Nic.

SHEFF: Hello.

GUPTA (voice-over): In August, he admitted to taking prescription drugs and smoking pot.

(on camera): I was surprised to find you here.

SHEFF: Absolutely. Man, I think I was doing -- well, I was doing really well, you know, externally. It's just so crazy how I went from zero to 60, you know, in a day and a half or something.

GUPTA (voice-over): The peril of relapse is common among addicts.

Dr. Kevin Clark is medical director at the addiction treatment center, Hazelden.

DR. KEVIN CLARK, MEDICAL DIRECTOR, HAZELDEN: Relapse is certainly sometimes a part of the disease process. Our figures are about 53 percent to 56 percent of patients remain abstinence for a year.

GUPTA: Nic, who has been diagnosed as bipolar, said a split with his girlfriend and an episode of manic behavior precipitated his return to drugs. He relapsed again in October, taking Vicodin pills. Now, he said he's been sober since the beginning of December.

And speaking so publicly about his addiction and relapses, Nic hoped to continue his healing.

SHEFF: Internally, you know, the gift I've given myself of being able to be honest is -- maybe saved my life.

GUPTA: He's optimistic about the journey of recovery that still lies ahead.

(END VIDEOTAPE)

GUPTA: You know, Nic's relapse always surprised us. But as we learned a revolving door of recovery in relapse is not unusual. So, what does the evidence say is the best way to get sober? That's the question.

And to answer of that question, you have to know the cause of the problem. Is it a lack of will power or is addiction more brain disease? It is still a very hot debate.

I sat down with Dr. Bankole Johnson. He's the chairman of the Department of Psychiatric Medicine at the University of Virginia. I wanted to learn more about the science. (BEGIN VIDEOTAPE)

GUPTA: Is addiction a disease?

DR. BANKOLE JOHNSON, UNIVERSITY OF VIRGINIA: Addiction is a brain disease. Alcoholism, cocaine dependence -- all of them are brain diseases.

But let's talk about alcoholism. About 60 percent of alcoholism is biologically genetic. About 40 percent is environmental. If I was to put that in lay terms, addiction to alcohol is as biological as having diabetes or having high blood pressure. And therefore, no one, if you'd asked them in the street and said -- is high pressure an important medical disease? They'd say, "Of course, it is." If you said, if diabetes, they'll also say, "Of course, it is."

But strange enough, sometimes, if you say -- is addiction a disease? Some will say, "Well, perhaps, perhaps not."

GUPTA: Is there an addictive personality, though? When you say that there are people who are addicts, there are people who just enjoy the drink every now and then -- how do you extinguish the two?

JOHNSON: There is a personality for addiction. And, in fact, this has been researched very, very carefully. There is no one addictive type. So, I'm hoping that in the next 10 to 15 years, because a lot of research has been on genetics, we'll be able to identify individuals who are likely to become addictive and perhaps start intervention or prevention treatment earlier on.

GUPTA: Is that going to be the next step frontier? Are we thinking about actually using operations to treat addictions?

JOHNSON: I think that that's not too farfetched. I think, one of the important things that we have learned from animal studies, for example, is that we can stimulate different parts of the brain to produce addiction, and we can stimulate other parts of the brain to dampen down the addiction. So, it is possible that at some point in the future, there will be treatments that use different types of brain stimulation to basically modulate brain activity. And that can be a treatment for the future.

GUPTA: Are we all potential addicts?

JOHNSON: We don't think so. We think that some people are more vulnerable than others. And the people who are more vulnerable than others are deemed the topic of the research, very actively pursuit by the National Institute of Health over the last decade. We don't have an alcohol gene yet, but we do know that there are certain types of genetic polymorphisms that may protect an individual from developing alcoholism.

(END VIDEOTAPE)

GUPTA: And for more on the latest research about the causes and treatments of addiction, tune in tonight, 8:00 p.m. Eastern, for my special "Addiction: Life on the Edge."

But first, could something as simple as a pill be a cure for alcoholics? It does have an impressive success rate, about 80 percent.

Then, knowing whether it's time to take your child to the emergency room or maybe just wait it out. We'll get some tips to make the decision easier.

But first, could where you live be stressing you out? We've got some new research, and they are naming states.

Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: We are back with HOUSE CALL.

Energy drinks are everywhere. But the question is: How do they really work? New research shows they may trigger a reaction in the brain.

Yes, keep up with this. In a recent study, athletes were given drinks continuing either sugar, a carbohydrate or nothing at all. Now, participants were asked to rinse their mouth with the drinks while exercising and then scientists check their endurance. Those given a sugar and carb drinks outperformed the other athletes by 2 percent to 3 percent. And when MRI scans were taken of their brains, researchers found both drinks triggered specific areas of the brain associated with reward or pleasure.

Now, scientists believe the ingredients in energy drinks may help the body, but they also trick the brain, creating an over all stronger physical endurance of athletes.

And being stressed out may have something to do with where you live. A fascinating stuff. A new study researching nationwide mental distress shows people living in some areas of the country are more at risk. Scientists found that people who live in Hawaii have lower levels of mental distress than, say, those who live in the Appalachian region. The stress levels varied according to an individual state's jobless numbers, income level and number of disabled.

And the Centers for Disease Control says the figures are important because they give the government a better idea where mental health programs are much needed.

HOUSE CALL is back in 60 seconds.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

FELICIA ANDERSON, RECOVERING ADDICT: The crack was my norm (ph). The crack was my friend. The crack was my job. The crack was my children. You know, it was my life. And so, no matter how bad I wanted to stop, I couldn't stop.

(END VIDEO CLIP)

GUPTA: That was Felicia Anderson, an addict for 17 years before she finally triumphed over her disease. Today, she is clean and she's the director of a community service program working with developmentally disabled adults.

You know, we hear addicts tell us over and over again how difficult it is to quit. Some try again and again and again, too many times to remember. Rehabs, A.A., even cold turkey, but what if there was another way -- something as simple as a pill?

(BEGIN VIDEOTAPE)

GUPTA (voice-over): This is the last place you would expect to find a recovering alcoholic.

WALTER KENT, RECOVERING ALCOHOLIC: One of my old favorite watering holes.

GUPTA: But this is where Walter Kent hangs out. A bar calls Goober's.

Walter is a giant of a man, but for most of his life, he couldn't find the strength to put down the bottle.

KENT: I was the type of person that the only time I drank was when I was alone or with somebody. You know, other than that, there was never a problem.

GUPTA: He tried rehab and A.A. Nothing worked.

KENT: Nothing seemed to get rid of that urge. I couldn't get rid of the craving.

GUPTA: But then in 2000, he tried again, an experimental program at Brown University. This time, he got counseling once a week and a daily pill. A medicine called Naltrexone. And this time, it worked.

KENT: When you can lose the total urge, the total craving for alcohol, you can beat it. There's no doubt in my mind because I'm living proof -- the proof that this can happen.

GUPTA: Several recent studies show alcoholics do better when they get medicine as part of treatment, especially newer drugs like Naltrexone or Topiramate. They are not addictive and side effects like a dry mouth are minor. But not everyone is sold. Most leading rehab centers use medication only rarely if at all.

SUSAN FORD BALES, CHAIRMAN, BETTY FORD CENTER: We do not use them at the Betty Ford Center.

CLARK: With the health care professional staff here at Hazelden, our experience tells us that having that network of support and recovery makes the difference. GUPTA (on camera): More so than medication?

CLARK: More so than just medication, absolutely.

GUPTA (voice-over): The medical director at Hazelden and Betty Ford each told us therapy is much more important. And they both said that years of success of treating alcoholics backs that up.

The head of the federal agency that oversees research on drinking says only one alcoholic in 10 even hears about medication.

DR. MARK WILLENBRING, NAT'L INSTITUTE OF ALCOHOL ABUSE AND ALCOHOLISM: Most people are not ever told about the medications that are available for treating alcohol dependence. I think that's a crime.

(LAUGHTER)

GUPTA: Some say once an alcoholic always an alcoholic.

But sitting in Goober's with Walter Kent, I have to say, it changed my view of what that means.

(END VIDEOTAPE)

GUPTA: And Walter's story is just one. You're going to see in my special tonight, we're also following a writer, a teenager and a mother -- as they all struggle to stay sober for one year. Don't miss my special. It's called, "Addiction: Life on the Edge," at 8:00 p.m. Eastern.

It's middle of the night and your child is sick from a high fever to a stomachache. Deciding whether to wait it out or rush to the emergency room, sometimes, is not an easy choice -- even for doctors. In this week's "Empowered Patient," Elizabeth Cohen has some tips every parent should hear.

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: Sanjay, all parents have asked themselves from time to time, "Do I need to take my child to the emergency room or can I handle this illness or injury on my own?" So we put the word out to parents, tell us about a time when you weren't quite sure, you couldn't quite decide what to do, but you decided to go to the E.R.

Well, we have stories from four mothers whose instincts told them -- I need to take my child to the emergency room. They say their children are alive today because they did. They said the injury or the illness didn't necessarily look so terrible, but it turns out that it was something that needed urgent attention.

Now, in addition to using your maternal or paternal instincts about your child, there are some guidelines about what requires urgent care. For example, all child -- all children get tummy aches. That's not unusual. If your child's stomach is swollen in addition to hurting, and if it is tender to the touch, those are signs that your child might need urgent care. And you should call your doctor or just go to the emergency room.

Also, if your newborn, that is a child 3 months or younger, has a temperature of 100.4 or higher, don't take care of that on your own. Your child needs immediate medical attention. It might be something serious.

And here's another situation. Some small burns can be handled at home, however, if a burn is larger than your child's palm, if it's deep or if it's discolored or if it's caused by a chemical, then your child needs urgent medical attention.

So, Sanjay, those are just some of the situations where you shouldn't handle them at home. Your child needs to go to the emergency room -- Sanjay?

GUPTA: All right, Elizabeth, thanks. And be sure to read the rest of Elizabeth's tips on how to tell when your child might need some emergency attention. Visit the Web site: CNN.com/EmpoweredPatient.

Now, Alzheimer's is a disease with no cure, you know that if you watch the show. But what if you could do something very simple to start preventing it? And we are not talking about any medication. Find out how. We got that in Ask the Doctor -- coming up.

And are you feeling a little irritable, a bit of a headache? It could be that cup of Joe or to be more precise, the lack of it. We got some tips for cutting back without paying.

Stay with HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

You know, coffee, tea and cola -- they all contain varying amounts of caffeine. But what happens if you skip your daily dose? Are you suffering?

Judy Fortin has a science of caffeine withdrawal.

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN MEDICAL CORRESPONDENT (voice-over): Americans love their caffeine fix, but skip that regular cup of Joe or glass of cola and experts warn you might feel symptoms of caffeine withdrawal.

SKEET SPILLANE, COFFEE DRINKER: Pretty severe headaches, and according to my wife, pretty significant irritability.

SUSAN TODD, COFFEE DRINKER: Lousy all over. It's not that anything hurts, I just feel funny.

FORTIN: Neuropharmacologist Michael Kuhar calls caffeine a drug that acts as a mild stimulant. It blocks receptors in the brain that can dilate blood vessels causing headaches and other symptoms. Kuhar says it's possible to become dependent on caffeine after just a week or two. He says, "Don't be surprised if you feel bad when you try to give it up."

MICHAEL KUHAR, YERKES PRIMATE RESEARCH CENTER: The withdrawal syndrome can start from 12 to 20 hours after your last cup of coffee, and peak at about two days. And it can last as long as a week.

FORTIN: Kuhar recommends weaning yourself off caffeine slowly, and reducing consumption by a half to a whole cup a day.

KUHAR: Now, that doesn't mean that that's going to be easy at every step, but it should be easier than going cold turkey.

FORTIN: Judy Fortin, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right, Judy, thanks.

Now, eight out of 10 people have them. I'm talking about cold sores. No one likes to talk about them and they seem to appear at the worst times, am I right? Up next: I'll answer your e-mail questions why cold sores pop up when they do.

(COMMERCIAL BREAK)

GUPTA: And we are back with HOUSE CALL.

Time for my favorite segment -- "Ask the Doctor," to figure out what's on your minds. Let's jump right in with a question from Kaley in Tucson, Arizona, who writes this: "My roommate has been getting cold sores since she was a little girl. I never had one until recently. Is it true that once you get a cold sore, you're going to get them for the rest of your life?"

Well, Kaley, the short answer is, yes. Once you have the herpes simplex virus one, also called "cold sore virus," it doesn't ever leave the body. HSV-I is what it's called. It sleeps in your nerve cells until something triggers it to wake up and it starts moving to the surface. And you see what you see.

Some people will go years without having an infection while other people will have frequent outbreaks. Now, the truth is, there's no serious side effects or effects overall from getting a cold sore or a fever blister unless your immune system is impaired somehow.

But there are a couple things to be aware of. First of all, it is highly contagious. They can live on towels. They can live on cups, razors -- so be careful. Two, is that stress, direct sun light, certain foods like soda, chocolate, citrus fruits, for example, can also trigger the virus to wake up, if you will.

And another question now from Joanne from Philadelphia who writes this: "I heard that exercise helps protect the brain against Alzheimer's. Does this exercise have to be vigorous?" Well, first of all, you heard right, Joanne. Experts do believe that right now, physical exercise is the most effective therapy to prevent Alzheimer's. In fact, there are several studies out there suggest exercising about 30 minutes a day most days of the week may inhibit those Alzheimer's-like changes in the brain. Scientists believe this is because aerobic exercise helps maintain good blood flow to the brain. It also encourages the formation of new brain cells.

Now, to the other part of your question: how hard to exercise? It should raise your heart rate, get that heart pumping. But it doesn't necessarily have to be vigorous. The key is staying consistent and getting in some aerobic exercise very regularly.

(BEGIN VIDEO CLIP)

ANGELA STOKES, LOST 160 POUNDS: It was like a kind of a light bulb moment, like this is what I've been waiting for.

(END VIDEO CLIP)

GUPTA: How a simple decision helped this woman drop 160 pounds -- 160 pounds. Amazing stuff and amazing results. How you can follow in her footsteps -- straight ahead.

(COMMERCIAL BREAK)

GUPTA: She calls it a light bulb moment in her life. Thirty years old and struggling with her health and her weight, see how one woman radically transformed her life and more importantly, how you can do the same.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Angela Stokes was never an overweight child, but as she grew, an under-active thyroid gland changed all of that.

ANGELA STOKES, LOST 160 POUNDS: I was like 300 pounds and very unwell, very miserable. I really tried to give this impression all the time that I felt fine about everything and everything was good, but inside, I was really in a lot of pain a lot of the time.

GUPTA: But one day, while working in a greenhouse in Iceland, of all places, Angela says she had an epiphany.

STOKES: It was like kind of light bulb moment, like this is what I've been waiting for to just, you know, reclaim my health.

GUPTA: That day, she started a raw food diet.

STOKES: The mainstay of it is nuts, seeds, vegetables and fruits in an unheated, unprocessed condition. I often get asked does that mean sushi? Questions like that. And for me, no, it doesn't mean sushi. I'm pretty much a raw vegan.

GUPTA: And after just two years, she had lost 160 pounds. Angela hasn't looked back once.

STOKES: I went cold turkey into being raw, or cold cucumber, as we sometimes say. To me, raw food is -- yes, it's a lifestyle, you know? It's an amazing lifestyle choice to make for ourselves.

GUPTA: So, what tips does Angela have if you want to try the lifestyle for yourself? First of all, start slow.

STOKES: I recommend that people start out being at least 50 percent raw and just take it from there.

GUPTA: She also recommends getting plenty of variety, starting off with foods you're familiar with and getting plenty of support.

STOKES: I think emotionally and socially, it can be very challenging for a lot of people to live this way. Connect with other people who are into the raw food movement. It's very great to get support.

My name is Angela Stokes, and I lost 160 pounds with the raw food lifestyle.

(END VIDEOTAPE)

GUPTA: Well, unfortunately, that's all the time we have for today. Good for you, Angela, by the way.

And tune into our special tonight, "Addiction: Life on the Edge." We're going to follow four addicts fighting to stay sober for a year. You know, these people could be your neighbors. We have followed a writer, a teenager, a mother, and a retiree -- all of it at 8:00 p.m. tonight.

And if you missed any part of today's show, be sure to check out my podcast: CNN.com/podcasting.

Remember, this is the place for the answers to all your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta.

More news on CNN starts right now.