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Sanjay Gupta MD

Where Do You Draw the Line?; Prescription for Pot; Are School Start Times Hurting Children?

Aired August 31, 2014 - 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: Got a lot to get to this half hour, including a fascinating look at pain pills. If you've ever taken one, what did it do to your brain and your body?

Plus, something I thought about a lot recently now that I'm a dad of three school-age children, how early should school start? How early in the morning can kids even learn? We got a wake-up call about wake- up calls.

But, first, the images on the internet, you may have come across some of the more gruesome ones yourself, such as the horrific beheading in Iraq by ISIS. ISIS is a media savvy terrorist organization -- make no mistake -- the likes of which we really haven't seen before not even with al Qaeda.

To talk about it, I want to bring in CNN senior media correspondent Brian Stelter. He's joining us from New York.

Thanks for being on the program, Brian.

BRIAN STELTER, CNN SENIOR MEDIA CORRESPONDENT: Thank you.

GUPTA: It's a modern terrorist group I guess for lack of a better description. They are all over social media. They're trying to intimidate people. They're trying to recruit people and they are trying to appeal to, you know, a subset of millennials. They pose some real challenges.

I'm curious -- I mean, are there policies by companies like Twitter and YouTube when it comes to these kinds of things, including the disturbing material?

STELTER: There are policies that are evolving as we speak. You know, a decade ago, it was al Qaeda creating online magazines which was for them innovative at the time.

Now, it is a group like ISIS using Twitter or Facebook or other tools that we all also use every day in order to spread their messages and that is innovative for them at this time. Twitter and YouTube are having to figure out how to handle this because these kinds of Web sites almost always err on the side of free speech and free expression.

GUPTA: Right.

STELTER: On the other hand, I had a public relations person reach out to me this week concerned about a family that he is helping. He represents a family of one of these people who are -- have been detained either in Iraq or Syria. One of the Americans that's being held hostage and he needed help reaching Twitter to try to get tweets taken down that he said were directly endangering his client and that family. So, I was able to connect him to Twitter to try to help with that.

That's just one small example of this situation where Twitter and YouTube and other sites like it -- like them play a role I don't think they probably expected to when they were invented, do you know what I mean?

GUPTA: They are sort of, you know, the free speech, you know, that's what they do the social media and they empower the users. On the other hand, some of this is disturbing stuff. We know that YouTube yanked the beheading video of American journalist James Foley. Twitter has suspended accounts, uphold photos, they sent out forceful tweets saying they were going to do this.

But I'm curious -- what is -- do people get around in a room? How many people are making the call? Is it the CEO of Twitter saying unacceptable, let's just stop it? I mean, do you have any more insight into that?

STELTER: Well, it's the CEO of Twitter in this case, who came out and made his announcement saying that he -- Twitter was going to take action in the case of James Foley and take those images down.

But it is lower level staffers, some of the same staffers who also deal with cases of child abuse or child pornography that appear on these sites, who also have to make these calls, and they do err on the side of free expression but it is tricky when there's such outrage about images that show up on these sites.

I think we have to keep in mind, Sanjay, that these messages are only as effective as we let them be. Fear is only as effective as we let it be, and that's so important in these cases of terrorist messages. We don't have to choose to be afraid. We don't have to choose to buy into the hysteria.

GUPTA: Yes, Brian, it's a brand-new world. I'm going to turn 45 this year. Sometimes I feel like I'm on the more downward slope a bit.

STELTER: I don't envy being one of these executives at Twitter or YouTube who has to decide how to handle this stuff.

GUPTA: Yes. Thanks for helping us out, Brian. Really appreciate it.

STELTER: Thanks.

GUPTA: I tell you again, as I said, as a father of three young girls, the news this past week, it brought up a lot of questions in our own family and my good friend Wendy Walsh, she is also a mom, a psychologist, a human behavior expert and I'm sure deals with some of these same questions as well, personally and professionally.

Thanks for joining us, Wendy. Really appreciate it.

WENDY WALSH, PSYCHOLOGIST: Always happy to be here.

GUPTA: You just got an idea how big social media companies are trying to address some of these problems and it seems a little bit ad hoc for the time being, it's a brave new world as they say. But I want to talk about us parents.

What is the obligation to protect? It's going to be different in every household, I know, but what are your thoughts on that?

WALSH: Well, I think the obligation is enormous, but the task is daunting. The problem is, as soon as you put this little box in the hands of a child, they have access to virtually any piece of video or information in the world. It's very difficult to put parental controls on iPhones specifically.

And pretty much just because of parental need it's a necessity for us now to have our kids sort of digitally wired for us so that we can reach them, so I think more than anything it's about teaching kids what is appropriate, what is not, what is acceptable, what is not, and how to self-regulate, and also to keep the lines of communication open so if their peer group is starting to get into areas that's more seedy areas of the internet that they will tell you so that you can circle in the other parents.

GUPTA: So, what do you do? First of all, do you do something proactively or protectively? Do you broach this issue with them before they bring it up with you?

WALSH: Well, I think the worst thing is kids being exposed to bad news and having no ability to fix things, you know, we feel that as adults, right? So, I think the important thing is for them to understand and I tell my girls this all the time, the only reason this really awful stuff is on the news is because they have to fill the airwaves and they have to fill a lot of channels and so the only -- the few rare times that something bad happens, it just gets, you know, bombarded onto the media. It's not that it's everywhere. Do you see it in your day everywhere?

But secondly, yes, there are people suffering and there's something we can do about it. Recently someone connected me with the Center for Effective Altruism, who actually does economic analysis of the best charities in the world that save children's lives and on their Web site givingwhatwecan.org, I took my two girls there the other day and they chose their favorite charities. One my little daughter learned about fistula and that disturbed her. So, just her allowance money, she saved some girls' lives and bought them some fistula surgery. I bought 10 mosquito nets at a cost of only $30 -- for $3 each so for $3 you can change a child's life.

My older daughter went for water and making some pure water.

So you actually can do proactive things with the Internet and save people's lives and that helps you deal with the other bad stuff that you're seeing.

GUPTA: That's such an important point. I mean, the idea that you feel empowered in some way, and I'll tell you, Wendy, even as a journalist, we obviously go to some tough places, but the idea that we're reminding ourselves that this will make a difference somehow, that it shines a big spotlight on an issue and therefore more people will be caring about it, more people will be compassionate about it, more people will be compelled to act in some way, I think it's a really important point and the thing about the fistula surgery, water purification, there's so many things that people can help with.

I appreciate you being on the program. Thank you.

WALSH: Thank you.

GUPTA: Up next: we are going to shift gears here a little bit. Marijuana as a treatment for pain, we've done a lot of reporting on it and there are a lot of unknowns still. But one surprising I think and very important benefit. We have it for you.

(COMMERCIAL BREAK)

GUPTA: Prescription painkillers are the leading caution of accidental death in this country. Did you know that? They're also starting this growing number of people on the road to taking heroin.

All week, CNN's been taking a closer look at this connection: pain pills and heroin. And first, I want to start off by showing you just how these drugs work on the brain and the body.

(BEGIN VIDEOTAPE)

GUPTA: Before we can explore your brain on opiates, we need to understand a few things. An opiate is a chemical derived from opium and is the key ingredient in heroin. Those narcotics in your medicine cabinet, codeine, oxycodone and hydrocodone they are opiate-like, but they are manmade and are commonly referred to as opioids.

So, how do these chemicals affect the brain? One big way is by exerting powerful pain relief to the rest of the body. Chemicals flood the system and latch on to millions of opiate receptors peppered throughout the body. Think of opiates and the receptors like puzzle pieces. When they bind together pain signals are dulled or they go away altogether.

If the brain already has opiate receptors, doesn't that mean it can naturally provide pain relief? That's right. Feel-good chemicals like endorphins are natural opiates that dull pain and also give you a rush. The problem with manmade opiates that mimic endorphins -- take too many and they can overwhelm the system, give you too much of a rush. That can lead to dependence or abuse.

Addiction becomes an even bigger problem because opiates also slow down breathing and heart rate. Mix them with other things that slow down your body and everything could grind to a halt. In fact, every 19 minutes someone dies of an accidental prescription drug overdose, most of the time it involves an opiate.

It's now more common than dying in a car crash. If you want to avoid that fate, don't take more than you are prescribed. Don't use other people's prescriptions. Never mix opiates with alcohol. And maybe try other ways of alleviating your pain, like over-the-counter pain relievers and good old fashioned exercise.

(END VIDEOTAPE)

GUPTA: Also, you know, there's this new report that came out I found pretty fascinating. It says that in states which passed medical marijuana laws, deaths from prescription drug overdose went down by 25 percent, 25 percent. There's an obvious connection here. A number of people who use marijuana do use it to cope with pain. And it seemed that a fair number of people are choosing it as an alternative to some of the pills you just saw there.

Legal issues aside, which medicine to use is a question for you and your doctor, obviously. Your health issues, your own personal concerns and pros and cons, they're all going to be a little bit different for everyone.

But I want to be clear on this: the potential for these deadly side effects is a lot less with marijuana than with opiate pain pills. We have not found a documented case of anyone dying from a marijuana overdose.

Now, Daylight Saving Time doesn't end for another two months, but we're getting a head start here. Should our kids be getting an extra hour of sleep right now? I'll tell you why people say it's the case and who says it is the case.

But, first, we've got this week's "Human Factor".

(BEGIN VIDEOTAPE)

GUPTA (voice-over): As a child, Jason DaSilva loved making home movies. He was 18 when he made his first film, and 25 when he was diagnosed with primary progressive multiple sclerosis.

JASON DASILVA, FILMMAKER WITH MS: All of sudden I was walking slow up and down the subway steps. And I was kind of walking like I was drunk during the day.

GUPTA: MS is a disease where the body's immune system attacks the central nervous system, damaging for destroying nerve fibers. The independent filmmaker traveled the world, making nine films. And then DaSilva turned the camera on himself, documenting the ravages of his disease and the struggle people with disabilities have living in New York City.

DASILVA: We're not super human, you know. People with disabilities shouldn't be asked to do the impossible.

GUPTA: In the seven years it took to make the movie, "When I Walk," which aired on PBS, DaSilva went from walking, to using a walker, to a wheelchair and now a motorized scooter.

His vision has started to deteriorate. His hands curl, making it impossible to hold a camera.

Passionate about making the city easier to negotiate for people with disabilities, he and his wife created a map of all the places in the city that are wheelchair accessible.

DASILVA: Some of the things that I'm doing is actually making a difference. But that's what keeps me going is that's how I can stay positive.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: We're back with SGMD.

You know, with the start of the school year, transitioning kids to get up earlier is always a challenge for parents. It's a challenge for us.

But one group of doctors is saying just let them sleep.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): It's 5:22 a.m. And for many high school kids, it's time to get up for school.

The bus comes at 6:20. The first bell rings at 7:25.

A new report says that's too early. It says for middle school and high school students, school shouldn't start before 8:30.

DR. DAVID SCHULMAN, DIRECTOR, EMORY SLEEP LABORATORY: Melatonin which is a hormone that tells our body basically what time it is to go to sleep, it's created later in teenagers than it is in adults. As a result, typically teenagers cannot fall asleep at 10:00 or 11:00.

GUPTA: On average, experts say, teens need more sleep than younger school kids. They need nine hours of sleep every night. Only one out of ten teens actually sleeps that much according to a new study in "The Journal of Pediatrics." The rest are sleep deprived and the result, a decreased ability to think and concentrate, not to mention a heightened risk of obesity, depression, even a higher risk of being in a car accident.

(END VIDEOTAPE)

GUPTA: I am fascinated by this topic and, again, in part because a lot of us have kids and trying to decide what time they should be waking up.

To talk more about it is Ron Clark. He is founder of Ron Clark Academy. It's a prominent middle school that also serves as an educational training facility for tens of thousands of teachers from across the country.

Pleasure for being on the program.

RON CLARK, RON CLARK ACADEMY: Thanks so much for having me. I appreciate it.

GUPTA: So, you've heard this report. We'll talk about that in a second. But let me ask about the academy. What time do the kids start there?

CLARK: They start at 8:00 and some arrive as early as 7:15.

GUPTA: How is that first part of the day for them? How do they perform, how do they do?

CLARK: We love it actually. I'm not a morning person. The kids in the 8:00 classes tend to focus better and test scores are better. And teachers want the classes at 8:00 a.m., because kids tend to retain more information earlier in the morning.

GUPTA: What drives the decision, though, in terms of when to start? I'm sure part of it is obviously trying to gauge how the students are going to do, but there's a lot of other factors that weigh in?

CLARK: It's society. It's the parents, because they need to get to work they need to drop the kid off at 7:15 so they can get to work on time. It's to accommodate the society we live in.

GUPTA: So, the parents are getting to work. Also, I know school buses, for example, will recycle from one group of students to the next group of students so you have to start them at staggered times as well. Things like that make a difference.

When you hear this sort of study, you saw the piece there, what do you make of it? You've been at this for a long time. Does it play a role for you in terms of how you would start school? When you would start it?

CLARK: Yes, lack of sleep's really an important thing in society that we deal with all the time with our kids, but I think there are things parents can do such as having the clothes laid at night before the kid goes to bed and trying to minimize the time to get ready in the morning, make sure kids aren't in social media. We see these days that once they finish the home work, it becomes the Internet, it becomes texting and that gets your brain going. It's harder to fall asleep.

The doctor said, oh, kids can't fall asleep at 10:30 or 11:00 these days it's because their minds are wired with technology.

GUPTA: Yes, it's a good point. Melatonin is the hormone that he mentioned. That's the hormone of darkness I call it, it's the stuff that helps you sleep. But if you have bright light shining in your eyes, for example, from devices it can decrease the melatonin to your point. You know, again, as a father now of school age children, I hope there

are more educators like you out there because I want my kids to be exposed to that and get that energy regardless of the time that we're forcing them to wake up.

CLARK: Exactly.

GUPTA: Thanks a lot.

CLARK: Thank you, sir.

GUPTA: Come back anytime.

CLARK: Yes, sir.

GUPTA: All right. And I've got one more story for you today. This one is for my fellow travelers out there.

Call it a unique travel accessory -- the knee defender caused an in- flight fight so severe that it resulted in the plane being diverted. A true story. You got to see it to believe it.

(COMMERCIAL BREAK)

GUPTA: We've all been there. Crammed into this hot sometimes smell I had overcrowded flight. Take it from me. Look, I often feel like I'm in the air more often than I'm in my own bed.

But there is this new gadget. You may have heard about this. "Conde Nast Traveler" called it as devious and as it is ingenious.

Here's Jeanne Moos to explain.

(BEGIN VIDEOTAPE)

JEANNE MOOS, CNN CORRESPONDENT (voice-over): A new air war has broken out, in the air space over your knees.

UNIDENTIFIED MALE: The knee defender is a device that keeps people from reclining their airline seat into your knees.

MOOS: You put what amounts to two hunks of plastic on the legs of your tray table to stop the seat in front of you from going back.

(on camera): Do you get your knees crunched?

UNIDENTIFIED MALE: Sometimes. And I grin and bear it.

MOOS (voice-over): But no one was grinning on the United flight from Newark to Denver that had to be diverted to Chicago after a fight broke out. A 48-year-old male passenger deployed the knee defender to stop the seat of the female passenger in front of him.

(on camera): When she couldn't recline, she flagged down a flight attendant who told the guy to remove the gadget. He refused and the female passenger threw water in his face. (voice-over): They were both kicked off the plane. Oh, sure, when it

happens to others, it's funny.

But as this reviewer of the knee defender joked --

UNIDENTIFIED MALE: The captain has turned off the seat belt sign. Please feel free to move to the cabin and punch in the head the guy with the knee defender in seat 14B.

MOOS: The device was invented by 6'3" Ira Goldman.

IRA GOLDMAN: I was tired of being bumped in the knees by reclining seats.

MOOS: This was one of the early versions.

GOLDMAN: The seat won't recline.

MOOS: Now, it looks like this and sells for $21.95. In the words of Conde Nast Traveler, "As devious as it is ingenious."

And everyone we talked to agreed.

UNIDENTIFIED FEMALE: I think they're kind of evil.

UNIDENTIFIED FEMALE: That sounds terrible.

MOOS (on camera): Why is it terrible?

UNIDENTIFIED FEMALE: To make someone else uncomfortable. Everyone's crowded together.

UNIDENTIFIED FEMALE: It causes confliction, problems. People pay for their seats and they want to push it backward or forward. That's their God-given right.

MOOS (voice-over): The knee defender comes with a courtesy card for you to hand to the passenger in front of you. "I have provided with you with this card because I have long legs and if you recline your seat, you will bang into my knees."

The FAA doesn't prohibit the knee defender, though airlines can and United does.

(on camera): But, hey, the story about the fight on the plane seemed to be great for the knee defender's business.

(voice-over): The Web site crashed due to unexpectedly heavy demand.

But whether you consider it a knee defender or a knee to the flying public's groin, can't we all just remember what Louis C.K. says about the wonder of flying?

LOUIS C.K., COMEDIAN: You're sitting in a chair in the sky.

MOOS: Jeanne Moos, CNN, New York. (END VIDEOTAPE)

GUPTA: Now, I should -- I should note right here on the device itself, it says, be courteous to people. Do not hog space as well. And always listen to the flight crew. Right there on the device.

But, look, you know, more seriously, being forced to sit in cramped quarters for a long stretch of time especially if you are tall or if you are overweight can cause joint pain and stiffness, we know that, but in rare cases also potentially can cause a life threatening blood clot called a deep vein thrombosis, the clot forms in the leg and then can lodge potentially going up into your lungs.

Now, one study found the risk goes up by about 18 percent for every two hours of sitting. Still rare, but it can happen.

Quick trick that I use, these are my socks, by the way, I do the show sometimes without shoes on but I will sit in my seat and I will lift up my legs and you want to basically rotate around the ankles here. The goal is to try to keep the blood flowing in your feet and obviously into your calves as well where those clots can sometimes form.

Get up a lot as well, walk around the plane and make some new friends while you're at it. If you see me up there, which you likely could, say hi.

That's going to wrap things up for SGMD today. Time now, though, to get you back in the "CNN NEWSROOM" with Brianna Keilar.