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SANJAY GUPTA MD
Controversial Drugs Get Another Look; Sick Kids Flooding ER's
Aired September 13, 2014 - 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: All right, Randi, thank you so much.
We are live from L.A., and I'll tell you I'm here because of the CNN Fit Nation Team. We got a big triathlon this weekend. I'm going to tell you a lot more about that in just a little bit. But these past few months have been a remarkable experience for all of us.
But, first, I want to talk about something else I think is very important. You've heard me talk a lot about medical marijuana over the past few years -- the potential benefits of it and also the obstacles to doing more research. Well, as we investigated this, we found that there's another group of outlawed drugs out there that are also generating new interest among a growing number of doctors.
Some of these drugs include things like MDMA also known as ecstasy, also LSD. Take a look.
UNIDENTIFIED MALE: Find any difference between one half of your body than the other half?
UNIDENTIFIED MALE: Well, I have sort of a wavering tendency.
GUPTA (voice-over): Almost from the day of its discovery, psychiatrists have been fascinated by the properties of LSD and similar drugs, often called psychedelics. It means mind manifesting.
UNIDENTIFIED MALE: Here's a group of normal soldiers responding correctly to a series of routine drill commands. After receiving a small dose of LSD, they're confused and undisciplined.
GUPTA: Some so-called research didn't deserve the name. It was totally irresponsible. Like the U.S. military's efforts in the 1950s. They tested LSD as a potential weapon. But the interests in these drugs didn't stay in the lab. And they trickled on to the black market and were soon outlawed. The pattern repeated itself with MDMA in the 1980s which had picked up the nickname ecstasy.
Therapists tried it with patients. Millions tried it on their own. And in 1985, it was banned under federal law.
UNIDENTIFIED MALE: MDMA, like MDA, would cause permanent or long-term brain damage in users. GUPTA: But over the last decade, a small band of researchers wrangled
permission to try again. This time giving MDMA during therapy sessions with patients who were suffering post-traumatic stress.
UNIDENTIFIED FEMALE: I can't believe I have this in my head. I can't believe it's in me.
DR. MICHAEL MITHOEFER, TESTING MDMA AS TREATMENT FOR PTSD PATIENTS: It's not people just had an experience and felt great about the world and they were cured, but a lot of the time, it was revisiting the trauma that was painful, difficult experience but the MDMA seemed to make it possible for them to do it effectively.
GUPTA: Dr. Mithoefer has treated nearly 50 patients in his studies and he's currently working with veterans as well. We're going to talk about that.
The medical world is taking note of this. Now, there's a growing body of research on psychedelic drugs and not just MDMA. There's a fascinating story behind this and a lot of it can be traced back to a small group I would say unlikely characters, one of them is here with me now.
Rick Doblin, he runs the multidisciplinary association for psychedelic research. Also here is Tom Shroder who lays it all out in this great book. It's called "Acid Test."
Welcome to both of you for joining us. Thank you.
UNIDENTIFIED MALE: Thank you, Sanjay.
GUPTA: You know, it's interesting. And I read the book. It's terrific. We'll talk about that.
MDMA with post-traumatic stress, like we just saw, what do you think is happening there? Do you have an idea what the mechanism or how you would describe what's happening in the brain?
RICK DOBLIN, MULTIDISCIPLINARY ASSOCIATION FOR PSYCHEDELIC STUDIES: Yes, MDMA reduces actively in the amygdala where fear is processed and it increases activity in the frontal cortex where people put things in association, in context. So, people are able to look at traumatic memories, the fear is reduced, and then they're able to separate out it was happening then and not now. And then they don't have to be triggered so much when they have the memories.
GUPTA: So, if they're going through counseling, for example, it could make that counseling more effective, they're not as paralyzed if you will by the memories that are being brought up?
DOBLIN: Yes, we're saying that MDMA itself is not the medicine, it's MDMA assisted psychotherapy.
GUPTA: There is other research, right? I mean, as much as we're talking about this, historical research, including some of it done in the army as we saw there in the clip we just watched, some of it's crazy to watch, some of that footage, it just looks nuts. But did we learn something from that we're now applying?
TOM SHRODER, AUTHOR, "ACID TEST": Oh, absolutely. From the time that Albert Hoffman discovered LSD and started sending it around to labs around the world, it became the most studied psychoactive drugs in history. And it was considered to be extraordinarily promising.
You know, had I think one study in the '50s called it of utmost value to psychotherapy. And thousands of people were treated this way and they were getting astounding, great results. And then the cultural thing happened in the '60s where it got out into the -- and became a drug of abuse.
And not only that, but there was something about the nature of the psychedelic experience that really scared Western rationalist culture, and there was a tremendous overreaction and a stigma attached to that drug, you know, Nixon famously called Tim Leery the most dangerous man in America. And that was ludicrous, of course.
GUPTA: I know, Rick, you've been doing this for a long time. Do you have worries? Do you have concerns, dangers that you think, you know, really -- some people can go both ways on this. Some people can underplay the danger, some people can overplay it. What are the dangers?
DOBLIN: Well, there's a different set of dangers when this is used in a clinical research setting than when people use these drugs in nonmedical, recreational settings. But in the clinical settings, the dangers are mostly psychological, they're not physiological, we are able to screen people who have heart problems. We're able to administer pure drugs with adequate fluids and people are resting.
So, we've not really found any physiological dangers from administering MDMA or LSD and other people have administered others in clinical settings. It's more psychological, managing the fact that people's unconscious emerges and particularly people who have been traumatized, they need a lot of support both during the experience and then afterwards.
We call everybody on the phone every day for a week just to check in with them. We have weekly nondrug psychotherapy between the MDMA sessions which occur three to five weeks apart. We track people two months and up to a year after their treatment. So, I think that from the FDA's risk analysis perspective that the benefits outweigh the risks.
GUPTA: Look, facts matter. And I thank you both for presenting those facts.
GUPTA: Thanks for being here. Keep on it.
DOBLIN: Thank you for helping us present them. GUPTA: Sure.
And up next, we got one of the biggest medical stories of the week. A virus, Enterovirus, it's spreading across the country. What is it exactly? And what can you do about it? We got that next.
GUPTA: By now, you've probably heard the buzz around the term Enterovirus. I want to take a moment today to explain this really well for you today. First of all, it sounds scary, and it can be.
Here's why. At first, it looks just like the common cold but it can turn far more serious and fast.
Here's CNN's senior medical correspondent Elizabeth Cohen.
MATTHEW YORK, SICK CHILD: I just couldn't breathe at all. No wheezing or anything, just couldn't breathe. I personally thought I was going to pass out or die or something.
ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT (voice-over): An unusual strain of Enterovirus called EVD68 has been hitting children hard.
JENNIFER CORNEJO, MOTHER OF SICK CHILD: He goes blue lips. He just passed out. Had his eyes roll back in his head and I had to call 911.
COHEN: At least half a dozen states have confirmed cases and more than a dozen have reached out to the Centers for Disease Control for help. An official at the CDC says these cases might just be the tip of the iceberg and children's hospitals have seen an alarming number of children coming in with serious respiratory illnesses.
DR. JASON RICHERSON, USA CHILDREN'S & WOMEN'S EVALUTION CENTER: Right before the Labor Day weekend we were seeing numbers in the 150 to 160 per day. These children became quite sick pretty quickly. Some of them within 12 to 24 hours, they were seeing symptoms and we're seeking treatments that -- the treatments weren't working at home.
COHEN: Children with asthma have been hit the hardest.
DR. BRUCE K. RUBIN, VIRGINIA COMMONWEALTH UNIVERSITY: If it's cold, treat it like a cold. Don't panic. If your child does have asthma, give them the therapy that they -- that they've been prescribed.
COHEN: This is Enterovirus season, late summer and early fall, but why has this type first identified in the 1960s, gotten so out of hand this year?
DR. WILLIAM SCHAFFNER, VANDERBILT UNIVERSITY MEDICAL CENTER: Why one virus or another crops up is inexplicable. It's a mystery to me.
(END VIDEOTAPE) GUPTA: Joining me to talk more about this is Dr. Mary Anne Jackson. She's division director of infectious diseases at Children's Mercy Hospital in Kansas City.
Welcome to the program, Doctor.
DR. MARYANN JACKSON, CHILDREN'S MERCY HOSPITAL: Thank you so much.
GUPTA: You there in Missouri, you were really the first ones to observe and track the virus, and so you are arguably more familiar with it than just about anybody else. I think the thing that grabs everybody's attention, Doctor, is it starts looking like the common cold and then it progresses rapidly. So how can parents, in this case, tell the difference?
JACKSON: So, our experience started about mid-August and what we found was a large number of children being admitted to our hospital to the point our average daily census would be 240, 250 this time of year, we were upwards of 300. We tracked this back to an unusual virus circulating. And what we found was these children who were unusually sick mainly had asthma and weren't responding very well to their asthma treatments.
So, that was our tip-off and that's where we started tracking this virus as it's gone through our community. And we're now nearly six weeks into it.
GUPTA: And, I mean, how do parents know, though? We know it progresses rapidly, but how do they know it's something more serious than the common cold, and when should they be seeking help?
JACKSON: So, it's interesting, there's two things parents should know. Number one Enterovirus 68 when everything is said and done probably is mainly going to be manifest as common cold symptoms. And not every common cold is due to EV68. Those children who are most severely affected, though, they got sick very quickly.
So, cough, runny nose and within 12 to 24 hours, rapid breathing and couldn't catch their breath. For children with asthma, they couldn't speak a full sentence. Most of these parents knew very, very quickly that their child needed help and they needed to get to the emergency room fast. So it really declares itself.
I tell parents the powers of observation that they use typically in looking at their child when they have cold symptoms and cold symptoms being very common in children, they will recognize this. It is not a secret virus. It declares itself very quickly, very rapidly. And this difficulty breathing is what sets the tone for parents to know they need to seek help, especially for children with asthma.
GUPTA: I think that's a really important point. And you use the term that it declares itself. And you sort of know, I think, is what you're saying, parents will recognize that this is different. We have been tracking this as well and late this week we got word that the virus has spread to the Northeast. You probably heard that, Doctor. Other parts of the country also starting to test positive. But you've said something that I think is important, in your region the numbers seem to be coming down. What do we read into that? Is this coming under some sort of control?
JACKSON: I think it absolutely is. But one thing that I think is very important, Dr. Gupta, is that, you know, this virus -- we -- August is our down season for viruses in terms of respiratory viruses, but we are getting into our season where we are in respiratory viral season, so in my area here, Enterovirus 68 is going down, common cold like rhinoviruses of a variety are coming here. And most viruses are very predictable.
So, Enterovirus which you know, there are a quite a number of viruses, fever, rash, not respiratory symptoms like this year. But as we go in our September, October is marked by rhinovirus and then we'll get into RSV season which is very predictable in November and then influenza season.
So, I think we'll go back to back to back in viruses this year and not have this lull, at least not in my community, that we would normally have very we get well into respiratory virus season and that's important because parents need to be prepared and it's a good opportunity to prepare for the respiratory viral season.
GUPTA: Yes. No, it's a really good point, and, again, getting back to that issue that parents really need to keep an eye on their kids during this viral season, if you will.
Dr. Mary Anne Jackson, thanks so much for joining us.
JACKSON: You're welcome. Thank you very much for having me.
President Obama says he's going to visit the CDC headquarters in Atlanta this week. He's going to get a briefing there on Ebola. One of the reasons this is happening is because the head of the world health organization said the number of new cases is still growing faster than our ability to control them.
(BEGIN VIDEO CLIP)
DR. MARGARET CHAN, DIRECTOR GENERAL, WORLD HEALTH ORGANIZATION: The Ebola outbreak that is ravaging parts of West Africa is the largest, most severe, and most complex in nearly four decade history of this disease.
(END VIDEO CLIP)
GUPTA: Let me give you a little bit of context here in what she's saying. Right now, there are more than 4,000 cases and the WHO predicts that Ebola will sicken 20,000 people before it's brought under control. But there was a new analysis and it was partly funded by the U.S. government that says even those numbers could be optimistic. Here's what they say, at the current rate of infection we could hit
20,000 by mid-October. Now, public health efforts start to help, the number of cases would only double to around 8,000 or so in the next month. But if conditions worsen, then they say the case count could top 50,000.
Look, we've been in West Africa covering this story. We've been covering this story right here in the United States. We're going to keep covering this story. Keep you informed and tell you what you need to do to stay safe.
But up next, the real reason we're out here in Los Angeles in the first place, I can hardly believe it, but race day is finally here.
GUPTA: Back in January, we picked six lucky CNN viewers to join with us on our 2014 Fit Nation Challenge. These were people who were all looking to hit the reset button, and we've been following their transformations. We've all been training pretty hard, but race weekend is finally here.
GUPTA: Well, this is where it all begins. You're looking at the world famous Zuma beach. This is where we start the swim part of the triathlon.
Look at those swells out there, three to five feet. The water is mid- 60s and where those folks are trying to surf out there, that's where we're going to be swimming.
I want to go for it. It's about half a mile down the beach to the beginning of transition.
Now, when you finally finish the swim part of this race, there's a very important part that comes next and it's called transition. Look over here. All those racks over there are going to be filled with bikes. You got to find yours. Switch from your swim gear to your bike gear as quickly as possible and then there you see it, the bike start. That begins your 18-mile ride down the Pacific Coast Highway.
So, the bike part of the race may be over. But you are not. There's still the run. It's the last part of the race and it's four miles right down Zuma Beach -- it's not a bad run, but keep in mind you've already done a swim and a bike.
I can tell you, I've seen many sweet sights in my life, but there is no sweeter sight than that one right there. It is the sight of victory. And finally your triathlon is over.
GUPTA: I've gotten to know all six of my teammates, and, you know, they're really an incredible bunch.
I do want to take just one moment, though, and single out the struggle of one man that I'm now proud to call a friend.
GUPTA (voice-over): Eighteen months ago, Jamil Nathoo was in his prime, young, healthy and training for a triathlon, but race day came and went.
JAMIL NATHOO, CANCER PATIENT & MALIBU TRIATHLON PARTICIPANT: I was diagnosed with stage-three testicular cancer that spread into my abdomen and chest.
GUPTA: His triathlon dreams had to be put on hold as he battled cancer with chemotherapy and surgery. It took a toll on his body. But he was determined to get healthy again.
NATHOO: I owe it to myself and to other cancer patients and survivors to let them know that you can be fit again. You can be healthy again.
GUPTA: Nathoo started training and he joined the CNN Fit Nation triathlon team. Over the past seven months, he's rebuilt his strength in the water, on the bike, on the run. He even held a cycling fundraiser in New York raising money for the Sloan-Kettering Cancer Center.
And now he's cancer free, ready for his next triathlon this weekend with the "Fit Nation" team.
NATHOO: I feel good. I feel strong. I feel like I'm ready for next week. It's exciting to feel like me again.
GUPTA: And he has a renewed determination to his cause.
NATHOO: I took an oath early on saying if I can get through this, even if I can get through the ordeal, the journey will never be over for me.
GUPTA: Bright and early here in Los Angeles, Malibu, really, just a few hours from now, we're going to be racing going for that finish line.
And you can log op to CNN.com/FitNation this week, to see just how all of our applicants got here and how everyone did in the race as well. Congratulations.
Still to come here on SGMD: remarkable pictures of our nervous system. This is going to fascinate you -- nerve impulses lighting up in real time.
GUPTA: There is a new technology out there that helps us study our nervous system. It uses genes from a humble microscopic organism and it could have major implications for diseases like Alzheimer's. Monday night, Harvard chemist Adam Cohen is being recognized with a
Blavatnik Award. It is a particularly prestigious honor for innovative scientists.
(BEGIN VIDEO CLIP)
ADAM COHEN, HARVARD CHEMIST: As you know, one of the greatest unsolved challenges in medicine has been to find drugs for diseases of the nervous system. So, for ALS, Parkinson's, Alzheimer's, epilepsy, Schizophrenia, autism, there's really very little we can do.
I'm Adam Cohen. I'm a professor of chemistry and physics department at Harvard, and a founder of Q-State Biosciences.
I've been working on tools to make neurons light up when they fire. By studying the firing patterns of neurons from healthy people and the firing patterns of neurons from sick people, we can compare the patterns. And then we can test drugs on the cells and see if we can find compounds that can make the firing patterns of the sick neurons behave more like the healthy ones.
Basically, every cell in our body is pretty much genetically identical and scientists have figured out how to take skin cells to convert them into, for instance, neurons in a dish. In a wild this creature uses a protein to convert sunlight into electricity which it uses to power its metabolism. We found a way to run this protein in reverse, to convert electricity into an optical signal.
Then, we tape the gene, we introduce the genetic material into a virus, and we infect the neurons with this virus, so then the neuron starts to produce the protein and as we culture the neuron, the neuron becomes fluorescent. And so, we stimulate the neurons and we look at how they respond and we might put on a candidate drug and we see how that affects the firing pattern.
The ability for the first time to study human neurons in a dish, with these optical tools, really gives us a hook into how neurons are behaving and what goes wrong in disease processes.
GUPTA: Isn't that stuff so cool? I think it is.
Well, that's going to wrap things up for SGMD today. Let me hear from you on Twitter @DrSanjayGupta.
And also keep it here for a check of the top stories making news right now.