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Sanjay Gupta MD

Chronic Alcoholics Given Free Reign to Drink; Breast Cancer Basics; The Sweet Life

Aired October 29, 2011 - 07:30   ET

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

DR. SANJAY GUPTA, HOST: Happy Halloween, everybody. Welcome to the program. I'm Dr. Sanjay Gupta.

The candy of our childhoods. Why do we still crave it every year at Halloween? Have you been dipping in already?

We also have serious business to get to -- you've seen the pink ribbons all over this month. We want to clear up misconceptions about breast cancer.

But, first, I want to tell you about a number -- this one, $1.90. That's the cost per drink of excessive drinking in the country. It adds up to about $223.5 billion burden to the U.S. government and individuals, about $746 per person.

Just about three quarters of those costs of excessive drinking were due to lost workplace productivity, 11 percent of it from health care expenses, 9 percent from law enforcement and other criminal justice costs, 6 percent for motor vehicle or crash costs for impaired driving.

Excessive drinking was defined as binge or heavy drinking or any drinking by pregnant or underage youth.

Look, alcoholism is not an easy thing to deal with, either by yourself or even alongside someone you love.

But this brings me to another story I want to tell you about, a home for alcoholics that lets them drink and is funded by you, by me, the taxpayers. No matter what you think, it's an interesting concept for sure, and these types of places are starting to pop up more and more frequently around the country.

Our own Chris Welch spent the better part of a month working on the story at one of these so-called "wet houses."

He joins me now from Minneapolis to talk about it. Chris, thanks again for being back on the show.

Let me ask you to start -- how did you get interested in this?

CHRIS WELCH, CNN CORRESPONDENT: Well, this was a story that sort of popped up on a local newspaper a while back. And, you know, we thought -- me and a couple of producers and some of our managers saw it and thought, this could really make an interesting story to really dig deeper into. So we thought why not devote some time and really, you know, spend time at this place, this so-called "wet house," see what life is like there for the residents, for the staff. Is it a place of death and despair or is it a place of hope?

That's what we set to try and find out.

(BEGIN VIDEOTAPE)

NICK LOTT (ph), RESIDENT, ST. ANTHONY RESIDENCE: This is where I keep my clothing and stuff.

WELCH (voice-over): It looks a lot like a college dormitory.

LOTT: This is the cafeteria here.

WELCH: But its residents are not students.

BILL HOCKENBERGER, MANAGER, ST. ANTHONY RESIDENCE: This is a program that's designed for chronic alcoholic men.

WELCH: This is not your typical halfway house.

HOCKENBERGER: The difference is there is alcohol in the mix. And these are all men that have been through treatment, numerous attempts. These are men that have lost their jobs due to alcohol, lost their housing due to alcohol, lost their relationships, lost their family, and have really reached their rock bottom.

WELCH: Program manager Bill Hockenberger refers to it as a harm reduction model -- providing a shelter for alcoholics. They don't serve any alcohol, but residents are free to buy their own and then indulge here on the patio.

RAY SPOOR, RESIDENT, ST. ANTHONY RESIDENCE: This is a wet house. This is a place for people to drink and some of us choose not to drink and we don't a lot of the times.

WELCH: Stories of success of sobering up and making a new life are the exception rather than the rule, but that's OK with Hockenberger. This place exists to give these men a home -- a place to make their own decisions in what for many of them will be the last period of their lives.

HOCKENBERGER: Sad as it is, I'm grateful to say that you have the choice to die in a bed instead of on the street.

LOTT: This is my room, my humble abode.

WELCH (on camera): You keep your room pretty clean?

LOTT: I'm just grateful to have a room to keep clean, you know?

WELCH (voice-over): After vodka ruined his career as a restaurant kitchen manager, Nick Lott (ph) found himself sleeping under a bridge. But for the last five years, he's found a place to rest his head, on the standard issue twin bed in a modest 12-by-12 concrete room.

LOTT: It's clean, comfortable, safe. I'd be in a bad position without a place like this. You know, I would be running around panhandling and annoying people and maybe stealing or something.

WELCH: He doesn't drink every day, but when he does --

LOTT: If we have money in the morning, you go and get drunk, and drunk by the middle of the day, you come up here, you knock out for a couple hours and then depending on what's going up, you wake up again, and you go out and drink again.

You are almost afraid to quit drinking, you know, because sometimes it just seems like that's all there is.

WELCH: In addition to a place to call home, Nick also gets $89 a month from the state. And the day that money comes, he's up early to use it. A few toiletries, new phone card, his tobacco -- and after what seems like an eternity, the clock strikes 9:00 a.m. The liquor store is open.

LOTT: Good morning.

UNIDENTIFIED FEMALE: How are you?

LOTT: Pretty good. How are you doing?

And I know that, you know, it's from (INAUDIBLE) the taxpayers and all that, it's the way it is.

WELCH: It may not come as a shock, the place has critics. Bill Hockenberger knows this.

HOCKENBERGER: I don't feel this enabling at all. This is a harm reduction model that if anything these guys are cutting back on the amount of alcohol that they are drinking coming in the door. And if we put it out there in a way and let them make the decisions, and they feel a lot better about themselves.

WELCH: Nick Lott would love nothing more than to make a decision and sober up once and for all -- to see his family again without feeling embarrassed.

LOTT: There are things I would like to do, but that's basically out of the question.

WELCH (on camera): Do you feel like it's a possibility that you could spend the rest of your time here?

LOTT: Well, that just depends on how much time I have left, if you know what I mean. People die here all the time.

(END VIDEOTAPE)

WELCH: We have a sad update to Nick Lott's story, he died a short time after we finished shooting this story. You know, at a place like St. Anthony, though, death is not uncommon. But even staff at the residence say, you know, Nick was in fairly good health relatively speaking -- Sanjay.

GUPTA: Yes. I mean, he alluded to it almost prophetic. It does seem like the end of the road for many people, this place, this wet house.

Do you have any idea -- it's tough to ask this, but how much money are we spending on this?

WELCH: Well, there are -- let's see, there's 60 residents in the house. And they cost $50 each to house each night. So you total that all up, it's about a million dollars each year.

Now, they're quick to point out, if these people are out on the streets, they are going to emergency rooms. They're going to hospitals. They're going to detox. One trip to detox alone cost $200 a night. In fact, one of the guys I met at the house had been to detox over 400 times. Those costs can add up as well.

So, you're going to have to look both sides of that.

GUPTA: Again, we look at addiction, we look at all sorts of different things in society to which we're addicted, and different solutions. This is one of them. A controversial one for sure, Chris.

Again, you know, I know you spent over a month there. So, appreciate you're reporting on this. Thank you.

WELCH: Thanks.

GUPTA: And excessive alcohol can lead to all sorts of things, including the increased risk of mouth, throat and liver cancer, for women, specifically, though, the biggest concern is breast cancer. We've got lots of questions on this, we've got lots of answers as well -- right after the break.

(COMMERCIAL BREAK)

GUPTA: You know, you've seen the pink ribbons, the runs, the walks. But just how much do you know about breast cancer? It's a good time to talk about it. October is National Breast Cancer Awareness Month.

And here to discuss the most common cancer for women is Dr. Valerie Montgomery Rice, dean of Morehouse School of Medicine.

Thanks for joining us.

DR. VALERIE MONTGOMERY-RICE, MOREHOUSE SCHOOL OF MEDICINE: Thank you for having me.

GUPTA: It's really good to have you here in studio.

This is a time to talk about breast cancer, although we could talk about it all the time. And, you know --

RICE: Yes.

GUPTA: My mom had breast cancer. So, this is something I think a lot as a son. First of all, when you think about family history, it's one of the first questions doctors like you always ask. How significant is family history?

MONTGOMERY-RICE: It's significant in the fact that if a woman has a positive family history, we tend to think of first degree, whether the mother or sister has breast cancer or was diagnosed. We want to ask them, was she diagnosed before she was age 50? That gives us a little bit more about the risk. But then that means that as the woman, you have about two times the risk of being diagnosed with breast cancer.

GUPTA: There's a lot of testing as far as genetic testing goes now. BRCA 1 and BRCA 2, breast cancer 1 gene and breast cancer 2 gene. How significant is it?

I mean, first of all, who should get tested for this? And then what do you do with that information?

MONTGOMERY-RICE: So the women that should get tested are women who have a history of breast cancer in their family, particularly if their mother had breast cancer at a young age, 20 to 30. They have a father who had breast cancer, prostate cancer, ovarian cancer.

When you see the cancer running in the family, you think that there may be one of these mutations of these genes that you are describing. When a woman gets tested, though, we know that if she's positive, they have a mutation. She has about a five time greater chance of being diagnosed with breast cancer over her lifetime.

GUPTA: So you start to look at these things in aggregate. First of all, there are more women going to be diagnosed with breast cancer who have no family history, right?

MONTGOMERY-RICE: Right, 85 percent or so.

GUPTA: Eighty-five percent. So that means, you know, you shouldn't take great solace and that you don't have family history thinking I don't need to get the screening test or to be examined. And as far as the breast cancer gene goes, it's not necessarily for everybody, but you got to know how to you it. If you're going to get the test, you're going to have to have to know how to use the information.

MONTGOMERY-RICE: The genetic counseling that goes with that is important. If I tell you have a positive mutation, and I have to tell you, you have five times likely chance of getting breast cancer than someone who doesn't, OK? Then I have to tell you what you're going to do with that information.

GUPTA: That's right.

MONTGOMERY-RICE: And most women make decisions based on what their doctors say. So the counseling is very important. And we want to counsel women that still the best thing we know to do is surveillance, doing yourself breast examinations, having your annual mammogram. If you were younger than 40 and you had this test and it was positive, what I would then do, of course, I would do MRI. I may do ultrasound. I may do some other things that are in a clinical trial or something where I'm getting more information for the woman, but, again, surveillance because we know that early detection makes the biggest difference.

GUPTA: Your typical patient, let's say has no family history, let's just say is in their late 30s and is coming to you for counseling. At what age do you recommend someone like that start mammograms? Because there's been controversy over that as you know recently as well.

MONTGOMERY-RICE: So, no risk factors, like most women, other than they are a woman and they have breasts.

GUPTA: That's right.

MONTGOMERY-RICE: And I tell women -- you're going to start yourself breast examination, start in your 20s, just so they get comfortable with the procedure, doing their own self-breast examination, because most women will find a mass on their own instead of the doctor finding it.

So, then, what I'm going to do with this woman, I'm going to advise her at age 40, I want you to get your base line mammogram. Every two years after that, I want you to get a mammogram. And then every month, you're doing yourself breast examination, you're seeing me once a year, I'm examining your breast.

And after age 50, we're going to start doing a mammogram every year.

GUPTA: You should know as well that my mom is doing great. She's the beneficiary of a lot of the things you're talking about. You know, a lot of people talk about this, Giuliana Rancic, recently, you know, a host on entertainment channel E!, spoke very candidly about this. Take a listen.

(BEGIN VIDEO CLIP)

GIULIANA RANCI, CELEBRITY: Through my attempt to get pregnant for the third time through IVF, we sadly found out that I have early stages of breast cancer. And it's been a shock.

(END VIDEO CLIP)

GUPTA: She's only 36 years old. Her doctor suggested she have a mammogram, and that's when they found this. I mean, so what do you make of stories like that? Because, obviously, it's not to say that the advice we give or anybody gives is wrong, but what about that? What do we take away?

MONTGOMERY-RICE: Well, the good thing for her is that she did have the mammogram and she has early diagnosed breast cancer. And so, she should do pretty well, I hope. The challenge we have, though, is that we know that women under the age of 40 have what we call more dense breasts. And so, we do standard mammogram, we have a higher chance of having a false positive. So, we have to weigh that risk versus benefit. False positive means that I think I see something, I'm going to do an additional test that actually may cause you harm.

So, that's why we do mammograms starting at age 40, doing them every two years. After age 50, we know doing them every year we decrease our chances of having a false positive. That is I see something and there's something there that needs to be treated.

GUPTA: You know, you're terrific.

MONTGOMERY-RICE: Thank you.

GUPTA: You really -- I mean, this is a complicated matter for a lot of people. And it's serious, yet you made it really understandable. So, thanks for being here.

MONTGOMERY-RICE: Thank you for having me.

GUPTA: Will you come back?

MONTGOMERY-RICE: I will definitely come back.

GUPTA: All right. Dr. Rice, really terrific.

This morning's "Human Factor" is about a young woman's journey from overweight teen to beauty queen. Brie boys changed her body and her lifestyle through healthier eating habits, more exercise and finally believing in herself.

Take a look.

(BEGIN VIDEOTAPE)

BREE BOYCE, MISS SOUTH CAROLINA, 2011: I actually used to sit where you're sitting. I'm the same person that I was in high school, although my exterior may have looked a little different.

GUPTA (voice-over): For Bree Boyce, becoming a beauty queen was beyond her wildest dreams.

BREE BOYCE: I was just so unhappy with the way I looked, but, yet, I still continued to eat unhealthy and lack of physical activity.

GUPTA: And at 17 years old, Boyce weighed 234 pounds.

BOYCE: I would come home from school, sit on the couch for hours and watch TV and snack all day long.

GUPTA: It was nagging pain in her knees that led her to go see her doctor and what he said led her to change her life.

BOYCE: He said, you know, this weight has to come off. At that moment I knew that he's right. And it's up to me and only me to change it.

GUPTA: She didn't try a quick fix to losing weight.

BOYCE: I completely threw out all the junk food. I joined the gym. I educated myself. I went to a nutritionist. I did all the right steps.

GUPTA: Three years later, Boyce had transformed her body from pudgy duckling to beauty queen. In July, she was crowned Miss South Carolina, even winning an early round of the bathing suit competition.

UNIDENTIFIED FEMALE: Are you really excited?

UNIDENTIFIED FEMALE: I'm a big fan.

GUPTA: Every beauty queen has a platform. Hers, as you might guess, is eating healthy and fighting obesity -- and it's a mission she happily promotes whether it's doing Zumba with kids at health fairs or speaking at her hometown city council meeting.

BOYCE: I'm going to bring the crown back to Florence.

GUPTA: Or talking to students at her former high school.

BOYCE: I challenge you all to make a change today and to make a change to be a happy, a healthy and confident individual and whatever it is in life that you want to set out to accomplish.

GUPTA: And she practices what she preaches -- still making her health her top priority.

BOYCE: Yes, I block out, you know what am I going to eat and how I'm going to eat that day.

GUPTA: Boyce still wants to achieve more. She has her sights on winning the Miss America title 2012 in January and she's not afraid of this next challenge.

BOYCE: And anything in life that you want to do it takes hard work and determination and most of all perseverance.

(END VIDEOTAPE)

GUPTA: Bree Boyce looks terrific -- what a transformation. Maybe a lesson for a lot of people.

Last but not least this morning, I want candy and I know you do, too. We'll explain. Stay with us.

(COMMERCIAL BREAK)

GUPTA: Happy Halloween, everybody.

You know, when it comes to Halloween, candy buyers crave the sweet taste of nostalgia. That's what we're learning. From wax lips, Smarties, candy cigarettes, yep, they still make candy cigarettes, to chocolates standards like Snickers, Hershey's, Reese's, the classics are still king of that trick-or-treat pail.

Joining me now from New York is Kat Kinsman. She's managing editor of CNN Eatocracy, a very popular blog, and quite possibly looking at her, the most Halloweeniest person here at CNN as well.

Thanks for joining us, Kat.

KAT KINSMAN, CNN EATOCRACY: Glad to be here.

GUPTA: You know, I have to say, first of all, because we're the medical unit -- I look at you, you have all that desk candy sitting there. And you're getting rid of all of our efforts here to try and keep people healthy at CNN.

Are you giving that candy away? What are you doing with all of it?

KINSMAN: It's ending up on your desk.

GUPTA: It's funny -- and I'll freely admit this here on TV -- but, you know, when my kids bring home the candy, I go through that -- I rifle through that bag because nostalgia is an incredibly powerful thing.

KINSMAN: It's incredibly emotional. Just when I was sitting outside in the hallway with this candy, several people walked by and said oh, my gosh, I haven't had that since I was a kid, gave them a Bi-O-Honey, give them Mary Jane. They just got a look on their face like they were reliving something of their past.

Like it is with any holiday, you just don't want to mess with that. It's an incredibly powerful emotional connection to it.

GUPTA: What was your favorite? Do you have a favorite that you still get that emotional connection with?

KINSMAN: You know, I love a good sour candy, a Smarty, a Sweet Tart, the giant ones. You know what I'm talking about.

GUPTA: That's interesting. I love the peppermint patties. We used to throw those in the freezer. I'll still eat those today. Even though they do taste sweeter to me.

KINSMAN: Because people have that nostalgic connection with it, a lot of the candy companies really loath to change their formulas. So, while they might have corn syrup in them and sugar, they're not high fructose corn syrup. People would know and people would spot that difference.

And while they can deal with other snack foods that are evolving and being a little more trendy, they can't do it to a lot of these classic candies. And if you look at the things in front of me, the bottle caps, the Now 'N Laters, the nickel nips. People would know and they would taste the difference.

GUPTA: Do you -- is there a worst candy, though? Not to be the sort of sugar kill here, but is there a worst -- like the thing that you see in your kids' pail, that's it there?

KINSMAN: Well, you know, OK. So I was always traumatized when you would go to somebody's house and they would have change or a religious tract. And the thing is, to this day, as a woman in her late 30s, I still remember exactly which houses those were. And I felt so bad for the kids who lived there and had to live that down.

GUPTA: And here's the funny thing because you and I are still so nostalgic, that I was asking worst in terms of nutritional damage. And you were answering in terms of not bringing in good loot. So, is there a worst in terms of --

KINSMAN: You know -- oh, nutrition goes out the window at this point. We did a story last year on Eatocracy where there was this trend toward slightly healthier snacks. Nobody was buying them at all.

I like to think of this as portion control because this is -- a wrapper is portion control.

GUPTA: Good point.

KINSMAN: It's up to, you how, many you eat. Keep a tally of the wrappers. And, by the way, you know what the single best-selling candy in the U.S. is? Out of all of this beautiful stash?

GUPTA: Yes.

KINSMAN: It would be the M&M.

GUPTA: Oh, yes, that makes sense. Are you a peanut or a plain?

KINSMAN: You know, they keep switching it up. I like the almond ones an awful lot. I haven't tried the coconut yet, and I'm afraid to because I'm afraid what that will do to me as a person.

GUPTA: Now, I have to ask as a doctor, are you getting enough air right now? Because you have this candy necklace around your neck. I mean, is that actually squeezing off your trachea?

KINSMAN: I'm going to eat my way out of this. And then finish it off with a little bit of this bling here.

GUPTA: There you go.

KINSMAN: Like I said, I told your producer that I bought doubles of these so these will be showing up in your office in the near future.

GUPTA: If I were with you, I'd give you a kiss on your hand to get a little piece of that candy.

Kat, thanks so much. Happy Halloween. Glad you're getting into the spirit. Appreciate it.

KINSMAN: Have a sweet holiday.

GUPTA: You, too. That's going to wrap things up here for SGMD this morning. Thanks so much for being with us.

Stay connected with me throughout the week on my Livestream CNN.com/Sanjay. Follow me on Twitter @SanjayGuptaCNN.

I'm going to see you right back here next week.

And time now to get you a check of your top stories in the CNN "NEWSROOM."