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SANJAY GUPTA MD
Latest On Medical Marijuana; Beating Cholesterol; Protection From Big Hits?
Aired November 16, 2013 - 16:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, CNN HOST: Hey there. I'm in London on assignment. And there's a pharmaceutical company here that is trying to turn secretly grown marijuana, weed, into a serious medicine. I'm going to tell you about medical marijuana here in the United Kingdom.
Also, new guidelines are out on drugs to lower your cholesterol. You have to listen to this. A lot more people will be prescribed these medications, up to 70 million people. But for many, there's a better alternative. I'll tell you what it is.
And a device like this -- can it really tell if you just got hit hard enough to have a concussion?
But first, as you may know, I travel the world in search of new, sometimes alternative therapies to treat people. The answer is not always pharmaceutical medicines. And as I found this year, marijuana can sometimes help when nothing else does.
But legally it is so difficult to obtain in many places around the world, including right here in the U.K. But you're about to meet Jamie, who has done something not previously thought possible, and could offer a glimpse of the future of medical marijuana.
UNIDENTIFIED MALE: What number 20, or 26?
GUPTA (voice-over): In just a few moments, 33-year-old Jamie Watling will get the medicine he says he desperately needs. The medicine his doctor prescribed. We weren't allowed to record him inside this pharmacy. But there, you can see him waiting.
JAMIE WATLING, MEDICAL MARIJUANA PATIENT: In my country, no, they won't dispense it.
GUPTA: This is no ordinary visit to the pharmacy because Jamie had to fly from his home in the U.K. to here in the Netherlands. And this is no ordinary medicine. It is Bedrocan, known as medical marijuana, illegal in the U.K.
(on camera): Are you more functional? Are you able to do things that you otherwise could not to do?
WATLING: Yes, (INAUDIBLE). GUPTA (voice-over): As soon as Jamie gets his medication, within minutes, he's in the closest coffee shop.
WATLING: I need to borrow a grinder and order a cup of coffee.
GUPTA: So he can light up.
UNIDENTIFIED FEMALE: Thank you very much.
GUPTA: And find some relief.
WATLING: We're covered all the (INAUDIBLE).
UNIDENTIFIED MALE: This is like Christmas. You can't wait for it to get here. Once it's here, you don't want it to go.
GUPTA (on camera): What happened?
WATLING: I was attacked in a subway when I was 13 and got my back fractured in three places. Then, a work accident, and I opened up all three fractures again when I was 18.
GUPTA: So you were originally beat up?
WATLING: Beat up, yes.
GUPTA: And three spinal fractures?
WATLING: Three spinal fractures. I was told it was a miracle I wasn't disabled from that.
GUPTA (voice-over): He saw doctor after doctor and took a staggering number of medicines.
WATLING: Stronger and stronger. Baclofen.
GUPTA: Baclofen for spasticity.
GUPTA: Gabapentin, that's for nerve pain.
(voice-over): But none of it really for him. And the young man was pretty certain he had reached the end of the line.
WATLING: It was my only option. Apart of being alive, it was my only chance of a piece of happiness.
GUPTA (on camera): That's really how bad things were? I mean, were you actually thinking about ending your life?
WATLING: Yes, yes.
GUPTA: Until his doctor prescribed medical marijuana. Only problem, it is illegal in the U.K., though many doctors have started recommending it. Dr. Eli Silber is a neurologist at London Bridge Hospital.
(on camera): Would you say medical marijuana has been accepted in the medical community here?
DR. ELI SILBER, NEUROLOGIST, LONDON BRIDGE HOSPITAL: I think that if you use it for appropriate patients, who are not responding to conventional therapies, then cannabinoids that have been properly developed at proper doses for proper patients I think is entirely reasonable and most of my colleagues would believe that this is an entirely acceptable way of treating patients.
GUPTA (voice-over): But here again in the U.K., the law hasn't caught up with the attitudes of those doctors, forcing Jamie's journey.
(on camera): So you were nervous the first time?
WATLING: Yes, completely.
GUPTA (voice-over): He declared his medical marijuana to the customs agent and was allowed to bring it back here.
(on camera): So, this is it, this is your medicine now?
(voice-over): To his home.
Jamie hopes none of this is forever, and would love to be off all of his meds one day, including medical marijuana.
WATLING: I want to be fixed. I don't want to keep medicating. I want my life back. I want to be able to work and go out partying with the rest of the world. I want to be able to drive a car. I want to walk down the road and get a pint of milk.
GUPTA (on camera): This helps with the pain, but this doesn't fix the underlying problems.
WATLING: Doesn't fix the underlying problems, but it helps a hell of a lot with the pain.
GUPTA (voice-over): Extreme measures. But I've seen versions of the story again and again, on both sides of the Atlantic, as laws don't seem to keep up with doctor's growing interest in this plant.
GUPTA: Now, back in the United States, Obamacare is shaking up the system. It's been a bumpy start, but this week, we got the first cold facts about how many people have signed up for this new insurance through the Healthcare.gov Web site. For the month of October, it was way less than expected, fewer than 27,000 people made it through the federal Web site to get enrolled.
I do remember that many states have their own Web sites. And in California alone, more people enrolled than on the federal Healthcare.gov Web site. You can see how your own state is doing at CNN.com/healthcare.
And also remember, look, if you have insurance through your job, through Medicare, Medicaid, you're already set up. If not, you do have to sign up, but you have until March 31st to avoid that fine.
Next up, we have some new guidelines that might make it seem like everyone is going to be taking statins to lower their cholesterol. The question is, should you?
GUPTA: A mantra you've probably heard on this show or from your own doctor, know your numbers. We've always been told this. That with heart health, knowing your cholesterol number is key. That is until now.
GUPTA: So, what are these numbers that we're talking about? Well, first of all, what doctors typically have been aiming for is to get the total cholesterol below 200. Good cholesterol, HDL, above 60. And LDL, lousy, bad cholesterol, below 100.
That's often times when doctors would think about a statin for their patients. But under these new guidelines, things changed dramatically. So, really, they're looking at various risk factors now. So, someone has diabetes, regardless of everything, anything else, type 1 or type 2, they'll be recommended to take a statin medication.
If they have any history of heart disease, get a statin medication. If their bad cholesterol is congenitally high, above 190, obviously they're going to be recommended a statin medication.
And then this -- if your 10-year risk of developing hearth disease is over 7 1/2 percent, you'll be recommended a statin medication. That's the calculation, by the way, you compare with your doctor, or through online calculators as well.
But the point is this -- if you do the math, you could double the number of people taking statin medications over the next couple of years. It's about 35 million people taking it now. It could go up to 70 million people.
White it may reduce the risk of heart attacks and strokes, the question a lot of people are asking -- is it going to make us live longer, as well? And this may surprise you, but the answer to that question is not still clear.
GUPTA: It's a lot to digest. I wanted to bring in Dr. Steven Nissen.
Let me ask a couple of questions. I'm not a cardiologist, but I'm a doctor who always likes to ask a lot of question before prescribing medications. Is there a little bit of white flag waving going on? I mean, are you concerned? We know how to prevent a lot of heart disease, and you better than anybody. When something like this comes out, what is the message do you think for people who frankly like most people should be doing the basics better? DR. STEVE NISSEN, CHAIR OF CARDIOLOGY, CLEVELAND CLINIC: Well, first of all, no drug is a substitute for a healthy lifestyle. Let's be very clear about that. That the first line of defense against heart disease is lifestyle. That means keeping your body weight down at normal levels to avoid diabetes particularly. That means exercising regularly, and that means eating a healthy diet, which most of us now believe is a Mediterranean diet, which interestingly enough is not a low-fat diet, it's a diet that's fairly rich in fats, but good fats.
So exercise, diet, those are the mainstays of prevention. The problem is, in America, we have gotten so far out of the ideal lifestyle that millions, tens of millions of Americans have levels of cholesterol that are very unhealthy. We'd like to do this all with a healthy lifestyle, but healthy lifestyle has not worked out very well for the majority of Americans. They either don't do it or they don't do it well enough to get their cholesterol levels under control.
GUPTA: Patients come to you, Dr. Nissen, and they say, here's the question I want to know the answer to before take thing this med, am I going to live longer? What do you tell them?
NISSEN: There are data that show in certain populations, statins seem to prolong life, but not in everybody. The most compelling evidence is that they prevent heart attack and probably stroke, as well. What you don't see so clearly is in what we call primary prevention. That is people that don't yet have heart disease, is there compelling evidence that statin drugs prolong life in those people? The answer is it's not quite as compelling. It's less compelling in women than in men.
If you look at the totality of the data, most of us believe that there is a mortality benefit, but it is a more modest benefit than on the benefit of preventing heart attacks and strokes, which ultimately do lead to death, but it takes time for that effect to occur.
GUPTA: But you are balancing it in this case, Dr. Nissen, as you know, with some potentially serious side effects. Muscle pain, weakness, increased risk for liver disease, in some case type 2 diabetes. So, if you can't give a compelling evidence in people who don't have severe heart disease that's going to lengthen their life, how do you balance it with those side effects?
NISSEN: I think the guideline writers did their own analysis, and they came to the conclusions that more people should be treated.
Now, I want to be clear about something, statins, the drugs that we use for treating cholesterol are safe. They do have adverse effects, but the serious adverse effects are uncommon. Those include muscle injury that can actually be serious and even life threatening. That's extremely rare on statins. What's not so rare are muscle aches and pains and sometimes muscle weakness. We can often treat that by switching to a lower dose of the statin or changing to a different statin.
GUPTA: You described this as a tectonic shift. I mean, think about it, we're going to put these guidelines on our Web site so people can find them there. But you're predicting 35 million new prescriptions for statins, a lot of people suspicious about what this means for pharmaceutical companies. Are they really driving this train?
NISSEN: Well, that's a great question. And, you know, if you went back 10 years, you might be able to make that argument. But there's a wonderful aspect of the use of statins now. All but one of them are now generically available. You can go to the pharmacy in a big box store and you can get a three-month supply of Simvastatin, also known as Zocor for $10. Ten for a three-month supply. There are no pharmaceutical companies that are going to get rich with these guidelines, because these drugs are now very inexpensive, generically available.
So, this is really about public health. Not about company profits and that takes the worry out of this for a lot of people, including myself. This is not promotional. This is about public health.
GUPTA: I really appreciate it. And I always enjoy speaking to you.
And how about you and I making a pledge that -- well, it's not as exciting as talking about 35 million new prescriptions. You and I will both continue to beat the drum on prevention, because it's so important and people need to know that as you pointed out.
Appreciate you being on the show today. Thank you.
NISSEN: My pleasure.
GUPTA: Coming up, sensors that are supposed to tell if a hit to the head is hard enough to cause an injury. We're going to put them to the test.
GUPTA: Football can be a dangerous game. We talk about it quite a bit on this program. A high school player died in Arizona this week from a head injury.
You know, many parents and players and coaches, they're looking for more protection. One approach to try and prevent these injuries involves helmet sensors.
Now, the companies that market them say they can tell if a blow to the head is too hard and requires a closer look. But now that these sensors have been around for a while, the question is how well do they work? We decided to find out.
ERIK SWEENEY, 13-YEAR-OLD: The quarterback ran and I tackled him. We just both hit the ground.
GUPTA (voice-over): Thirteen-year-old Eric Sweeney is describing a concussion he suffered a few weeks ago.
E. SWEENEY: It didn't hurt or anything, it just felt fuzzy on the back of my head.
GUPTA: On his team's sideline, no one saw the play. And despite that fuzzy feeling, Erik was rearing to go.
SEAN SWEENEY, ERIK SWEENEY'S FATHER: He came out after that play, but he was ready to go back in.
GUPTA: But he was stopped short by this. It's a sensor worn under the helmet. It is supposed to flash yellow after a moderate impact to the head, and red after a severe one. When Erik came off the field, his light was flashing yellow.
S. SWEENEY: He sat out one play and began to get dizzy, then the headache. Then it became evident something was not right.
UNIDENTIFIED MALE: Fortunately, the impact indicator flashed red and he was removed from the game.
GUPTA: Concussion helmet sensors, they're beginning to pop up on all sorts of playing fields.
UNIDENTIFIED MALE: So, once you try that on --
GUPTA: They're marketed as being able to measure whether a hit is too hard. And as in Erik Sweeney's case, an extra set of eyes on the field. But how well do they really work? That is what scientists at this lab are trying to find out.
STEFAN DUMA, BIOMEDICAL ENGINEER: Everything is green, nothing triggered and that's what we would expect.
GUPTA: A low level impact, and all the products tested have green lights glowing. But when the helmet drops from higher up --
DUMA: Sixty inches, five feet, this is probably going to be over 100 G's. Big hit. Three, two, one.
That is surprising. So nothing went off there.
That's well into the range of concussion. You have definitely wanted an alert at 110 G's.
You see the six different accelerometers in there.
GUPTA: Stefan Duma, a biomedical engineer who leads the testing at Virginia Tech, decides to drop from six feet.
DUMA: I would be concerned if this does not trigger one of those. Three, two, one.
GUPTA: That impact, 130 G's, is like running full speed into a brick hall. One device did trigger. The other did not.
DUMA: That's ready.
GUPTA: Then a higher drop, one product flashes green, the other red.
DUMA: So this really kind of underscores we need to do testing and understand what we're measuring when they trigger, when they don't, so parents can have a better understanding of what they're getting back.
GUPTA: A frequent disclaimer on these products, they do not diagnose concussions, but concussion experts say the devices themselves still need more testing.
Erik Sweeney's light flashing may have been a fluke, or maybe his sensor worked. Either way, the Sweeneys are happy that he had it.
After his doctor diagnosed him with a mild concussion, he sat out for three weeks. He got back on the field just in time to make the state championships.
E. SWEENEY: Without it, I might have gone back in. You would think you're dizzy and stuff, you might stay out, you might not. The light definitely helps determine whether you should or not.
GUPTA: Now, Reebok, which makes that sensor, says the time of test we just saw is not the best way to gauge impact, because the head in that test isn't moving. They say they don't know of any real world case where a hit that caused a diagnosed concussion did not turned the light red or yellow.
Educate, not medicate. I say it all the time. And while 36 million more Americans may start on statins, there are other ways to help control your cholesterol without ever having to fill a prescription. I've been looking into it, and I'll tell you how, right after the break.
GUPTA: We talked earlier about how the new cholesterol guidelines will essentially double the number of people on statins to more than 70 million Americans. It's mind-numbing. I want to listen to this. This is important. I want to remind you that diet and exercise can be as powerful as just about any medicine, sometimes more so, and knowledge.
The first thing to know, what is cholesterol?
GUPTA (voice-over): It's hard to go to the grocery store without seeing a mention of it. "Can help lower cholesterol." "Supports healthy cholesterol levels."
In fact, diet is a major source of cholesterol. But it's not the only source. Your liver produces about 1,000 milligrams of cholesterol each day. Cholesterol binds the proteins to travel through the blood stream, creating high density lipoprotein or HDL. That's the good stuff. And low density lipoprotein or LDL, known as the lousy stuff. Think of HDL as the cleanup crew, picking up the LDL in the blood vessels and taking them back to the liver to be processed.
But sometimes, there's too much LDL.
MARISA MOORE, DIETITIAN: Wen you eat more of the bad fats, it causes your liver to produce more bad cholesterol.
GUPTA: But foods higher in fiber like oatmeal, they help reduce those levels of LDL in your body. So keep your cholesterol in check by eating smart.
GUPTA: As you chase life, don't forget about exercise. But you don't have to become a marathon runner, just a brisk walk can do it. Remember this, 30 minutes a day, five days a week. And even get the same benefit if you split it up into ten minute intervals.
How intense? Well, here's a good test for you. It's OK if you can still talk while you're exercising. But if you can sing, you're not pushing it hard enough. So get out there.
The latest research says if Americans would just exercise this much, we could cut the number of heart attacks and strokes by a third, educate, not medicate.
Now, before I hand off the show, I do want to give you a reminder of what's going on in the Philippines. So many areas are still reeling from that typhoon that hit over a week ago. The destruction in some places near complete.
Aid is going to be needed now, but also in the weeks and months to come, often times when international attention has started focusing somewhere else.
If you're looking for a way to help, you can find all sorts of information on our Web site, just go to CNN.com/Impact.
That's going to wrap things up for SGMD. But stay connected with me at CNN.com/Sanjay. Let's keep the conversation going on Twitter @DrSanjayGupta.
Time now, though, to get you back into the "CNN NEWSROOM" with Don Lemon.