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Sanjay Gupta MD

How Synthetic Drugs Are Killing Kids; Awake During Brain Surgery

Aired December 07, 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: On the program today, you're going to see an incredible brain operation while the patient is awake. But why she's having this operation is more incredible.

Plus, Mike Rowe is going to stop by later in the show.

But first, there's this new threat to our teenagers, a new type of drug that you may have never heard of, but are being marketed to your kids as harmless. And the truth is, as you might guess, is that they are anything but harmless.

Senior investigative correspondent Drew Griffin is here with a really important story to tell.

DREW GRIFFIN, CNN INVESTIGATION CORRESPONDENT: And it's a story, Sanjay, that the parents of two dead teenagers really want to be told because they themselves have no idea what happened to their children. These new drugs are called synthetics, chemically produced designer drugs. Listen, they are designed to evade the law, sold online, easy to get and before anyone knew what they were dealing with these drugs tore through a Midwestern city ruining dozens of lives.

(BEGIN VIDEOTAPE)

DRIFFIN (voice-over): In the week of June 10th, 2012, law enforcement in Grand Forks were dealing with an outbreak of violent overdoses. Mystery drug on the streets had already killed two teenagers.

TIMOTHY PURDON, U.S. ATTORNEY DISTRICT OF NORHT DAKOTA: We have multiple overdoses, two young men that lost their lives. What is more serious than that?

GRIFFIN: Tim Purdon is the U.S. attorney for North Dakota.

PURDON: That was unprecedented. You know, I had -- I've been U.S. attorney now -- going on four years, this is the only time we've reached out to a school system, to the university and said, hey, there's a danger on the streets right now that people need to be aware about.

GRIFFIN: As the emergency warnings were being issued, investigators were desperately trying to find out just what this drug was, and more importantly, where it came from. CHRIS MYERS, FIRST ASSISTANT U.S. ATTORNEY, DISTRICT OF NORTH DAKOTA: It took lab analysis to determine the true nature of these substances. When we learned what they were, 2C-I-NBOMe, 2C-C-NBOMe, that was new to us.

GRIFFIN: 2C-I-NBOMe and 2C-C-NBOMe are synthetic designer drugs, chemicals designed to imitate the high of the banned drug LSD. These drugs are so potent a dose the size of a few grains of salt is enough to get high.

North Dakota's top federal drug prosecutor had never heard of them and neither had Christian Bjerk's parents.

DEBRA BJERK, CHRISTIAN BJERK'S MOTHER: I had to go to the Internet to look up information on it. I didn't understand the whole synthetic drug, I didn't know what it was, didn't know how dangerous they were.

KEITH BJERK, CHRISTIAN BJERK'S FATHER: The message we got after we went on air is that somebody had said it was OK for these drugs to be on the street and they had been tweaked, but that's all we knew.

UNIDENTIFIED MALE: Synthetic LSD has been blamed for at least --

GRIFFIN: Parents across the county are now learning the simple truth about synthetic designer drugs.

UNIDENTIFIED FEMALE: Investigators say he overdosed on a synthetic marijuana --

UNIDENTIFIED FEMALE: Otherwise known as K2.

GRIFFIN: With deaths and overdoses reported almost daily.

UNIDENTIFIED MALE: Poisons a 15-year-old girl.

UNIDENTIFIED FEMALE: Sixteen-year-old --

UNIDENTIFIED FEMALE: Life abruptly ended at just 18 years old.

JOHN SCHERBENSKE, DRUG ENFORCEMENT ADMINISTRATION: These dugs are being marketed and sold as legal alternatives to marijuana, cocaine, methamphetamine, LSD, and heroin.

GRIFFIN: In the last four years, more than 300 synthetic designer drugs with names like Spice, N-bomb and bath salts have flooded into the United States. Even the popular club drug Molly which is marketed as a pure form of the drug Ecstasy is being replaced by a variety of synthetic compounds. According to DEA scientists, the highs may be the same, but the molecular structure is modified just enough to evade the law.

(END VIDEOTAPE)

GUPTA: You know, and Drew Griffin joins us now, you look at these drugs and it's interesting the kids in that picture, it totally changes your perception of the whole drug industry. I think people hear people taking illicit drugs and it conjures up an image in their mind of who people are doing this, engaging in this sort of behavior. These kids had these drugs marketed to them you said.

What does that mean? They're living in this neighborhood. They obviously have good parents. How does one market a drug to kids like that?

GRIFFIN: You put it in a little wrapper, you put it in a little cellophane wrapper, you put a nice shining label on it, you call it something called Bubblegum or Spice and you put a cartoon figure on it, and the kid gets a wrapper and it's all sealed up like it comes from a company, Sanjay, they believe it's safe. They can get it over the Internet. It comes in the mail. That's how it's being marketed.

GUPTA: They know it's hallucinogenic. They know it's a drug but they believe it's safe. It's not going to kill them.

GRIFFIN: That's exactly right. They shouldn't believe that because right on every single one of these packages it says not for human consumption. That's the little catch-off phrase that these manufacturers use to try to evade the law as well.

GUPTA: And protect themselves.

GRIFFIN: Exactly.

GUPTA: The dealer, who is this person? We see the picture of the kid.

GRIFFIN: This is what is most scary about this entire story. The dealer was a drug entrepreneur. He was a middle-aged man with a family, a swing set in the backyard, suburban home, and from his Internet computer set up a boutique drug industry. He even registered with the state of Texas and paid his taxes.

He thought he was legitimate. Ordering in bulk these chemicals that are mostly made in China, now, they're mostly made in China. They come over. He divvies them up and he sells them. He was selling them to all 50 states.

I shudder to say this for the DEA's sake, anybody could do this, Sanjay. That is how scary this is.

GUPTA: I hope a lot of people see this and watch this and are reminded of it. You shouldn't do drugs.

GRIFFIN: Yes, that's the message really.

GUPTA: That's the message. But, obviously, what's in this stuff what are you about to put in your body, do you really know? And the answer is often, you don't.

Thank you, as always. I really appreciate it.

GUPTA: You're going to want to stick around for this next story. It's about a brain operation performed while the patient was still awake. We're gong to take you straight to the operating room and explain what happened here. I'll preface it by saying the results are nothing short of remarkable.

(COMMERCIAL BREAK)

GUPTA: Since deep brain stimulation was first approved for tremors in 1997, more than 100,000 patients have had them implanted. The success of deep brain stimulation or DBS in helping patients return to normal lives has been pretty overwhelming. But it hasn't been the case with Tourette's syndrome, until now.

(BEGIN VIDDEOTAPE)

(SINGING)

AMBER COMFORT: I love to sing. Singing is what gets me through a lot of hard days.

On the computer, when I'm driving, when I write poetry, basically anything with a sense of focus.

You'll see me completely at ease when I'm doing those things because I'm in my comfort zone and I'm not really caring about anything else. I don't have to worry about my ticks. I do just that, I worry about my ticks.

GUPTA (voice-over): Amber Comfort is 25 years old. She suffers from Tourette's syndrome. It's a neurological disorder that usually starts at a young age.

COMFORT: I don't remember any parts of ever being tick free. So I was 5 when the symptoms started happening, 6 when I was diagnosed and not a day that's gone by that I don't remember moving or making noise and I didn't help it. It's been lovely. Sitting in class second grade teachers would put me outside the hallway because I would be ticking so loud I was a distraction, so teachers would walk by me back and forth and say you better stop that before you get in my class next year. Things that were just completely obscene that you would never expect the world to be, but I had to deal with it on a daily basis.

DR. MICHAEL OKUN, NEUROLOGIST, UNIVERSITY OF FLORIDA HEALTH: OK. Deep breath.

GUPTA: After years of unsuccessful therapies and only limited results from her medications, Amber was referred to Dr. Okun at the University Florida Center for Movement Disorders.

OKUN: Turn around again for me. Okay. What we are planning on doing in your case is putting a lead down into Grand Central Station on each side, but also there's going to be a lead on the top of your brain sitting on the surface of your brain.

GUPTA: Dr. Okun and Dr. Foote have chosen Amber for an experimental DBS surgery. They will implant a new grid-like device on top of her brain in addition to the standard leads which go deep inside the brain. By combining both, they hope to gather information from Amber's brain that will not only lessen her ticks, but maybe someday stop them.

OKUN: So, the difference in Tourette is the movement disorder isn't there all the time, you know, when you get a tick, it comes on. And the patients that have ticks they get this buildup, they call it a premonitory urge, that's what the scientists call it, and they feel like they need to move and until they move, they don't feel better and so they get a sense of relief.

COMFORT: Between the two black, OK?

OKUN: And so in the tick brain there's a relationship between what we call the motor behaviors or the movement and the limbic behavior, OK? And that's the actual systems in the brain that are encoding values for emotion.

GUPTA: That sensation, the urge to tick, is what Amber suffers from every day.

COMFORT: It's like I'm having 15,000 mosquito bites that you can't itch. You can't itch it. And they come out and you have no control and you cannot take them away.

DR. KELLY FOOTE, NEUROLOGIST, UNIVERSITY OF FLORIDA HEALTH: One of the most scientifically exciting things about deep brain stimulation is that it offers the really uncommon opportunity to record the electrical activity from a living human being's brain.

GUPTA: It's the cutting edge of what is known as neural network modulation. Through their extensive work with Parkinson's and other movement disorders, the doctors are honing in on a particular area, deep in the brain, known as the basal ganglia. It's an area that can control both movement and emotion. I've been invited to observe Amber's groundbreaking surgery.

I'll be joining a team of doctors flying in from around the world for this unique chance to listen to the bran and to learn from it.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: You can do it. I'm just going to size it up first and see how it fits.

UNIDENTIFIED FEMALE: Try to relax.

UNIDENTIFIED MALE: Ouch, ouch, ouch.

GUPTA: The day of Amber's brain surgery has finally arrived. After a lifetime of living with the debilitating effects of Tourette's syndrome she and her family are hoping today's operation can finally provide some relief.

UNIDENTIFIED MALE: There she is, the guest of honor. UNIDENTIFIED MALE: So, hopefully we should put a pillow --

GUPTA (on camera): Do you understand everything that's being done today?

COMFORT: Yes.

GUPTA: OK. How you feeling about it?

COMFORT: As good as I can be.

GUPTA: OK. You get to stay awake through the whole thing.

COMFORT: Yes. I heard.

UNIDENTIFIED MALE: Let me just watch the internal capsule and watch the boundaries of the structures that we can see. That is what we think looks like a pretty safe trajectory to get there.

GUPTA (voice-over): Dr. Okun and Dr. Foote expect the operation to last 12 hours.

UNIDENTIFIED MALE: (INAUDIBLE) is negative 12.

UNIDENTIFIED MALE: Negative 12.

GUPTA: Before any incision is made, the entire surgery is mapped out virtually.

UNIDENTIFIED MALE: What I'm about to do is not painful at all. It's not a painful procedure. It's just really loud.

All right. Here we go.

GUPTA: To begin, four holes are drilled into her skull.

UNIDENTIFIED MALE: One down.

So, you're now a member of an elite club. Very few people can say they've had a hole drilled in their skull while they're awake.

GUPTA: Dr. Foote and his team have performed more than 1,000 deep brain stimulation procedures, but the additional contacts they are placing on top of Amber's brain are new, and still being tested.

UNIDENTIFIED MALE: So, we said left cortical first, right?

UNIDENTIFIED MALE: We want to split the contacts so that we have got some over the pre-motor region, so we can sense the ticks before they happen when they get premonitory urges but also over the motor region.

GUPTA (on camera): What is so interesting here is when you think about Tourette's, you're thinking about something that is almost half motor, motor movements, and almost half emotion. So when you take a look at what they're trying to do, they're actually going right in the middle. You got motor on one side, emotion on the other. And look at that line that goes right down the middle of both.

(voice-over): To make sure they found the right location, this sometime late the leads on Amber's motor cortex.

COMFORT: How you doing?

GUPTA: That involuntary switch that's a good sign.

COMFORT: Is this going to change?

GUPTA: Next, the deep brain electrodes are lowered into place to capture neuronal activity.

OKUN: OK, let's get the lights down. What we're listening to now is three channels so it's like an orchestra so it's an ensemble.

GUPTA: Okun gradually drives the electrodes deeper and deeper listening as the cells talk to him.

OKUN: All three channels are up, guys, got a burster (ph) coming out of the posterior channel.

GUPTA: They are telling him the best place to implant the remaining leads.

OKUN: Then when you hear that crisp sound, that means you're really close to --

GUPTA: Uh-huh.

OKUN: -- to the neurons there. It's total, you know, blow your mind kind of stuff because you just sort of -- we really have no idea until we get in there and we really start to look at the data.

OK, so let's go ahead and have you tick just freely. Don't suppress your ticks. Let them come, OK?

GUPTA (on camera): You can see when she's having her ticks. You are seeing activity deeper in her brain not just in the more superficial areas. Take a look over here.

(voice-over): With the new lead successfully implanted on top and inside Amber's brain, the doctors have essentially created a new network. It's an early version of what they hope will someday become a tick detector.

UNIDENTIFIED MALE: Recording from 16 different locations in her brain right now.

GUPTA (on camera): And this -- what you're describing really hasn't been done before.

UNIDENTIFIED MALE: Right. But we're also trying to figure out what causes this so in some ways she's -- she's sacrificing for kids in the future --

GUPTA: Right.

UNIDENTIFIED MALE: -- who have Tourette's.

(END VIDEOTAPE)

GUPTA: We did check in with Amber this week who was at the University of Florida for her second checkup now since the operation. The way she puts it, she says she has about 30 percent fewer vocal ticks and the doctors are continuing to take new recordings from the brain and also recalibrate her device.

Amber's dad said he hopes they set the device on happy. That's a good way of putting it.

Up next, an idea maybe so preposterous we need to explain it. Why Mike Rowe has launched a campaign called "safety third". What's going on here? We'll explain.

(COMMERCIAL BREAK)

GUPTA: You know, when I was up in New York the week of Mike Rowe's show premiere we got a chance to sit down for this really amazing chat. One of the things we talked about was this idea of "safety third". In some ways it's an idea that's so crazy you got to stop and think about it for a meant.

(BEGIN VIDEOTAPE)

MIKE ROWE, CNN HOST, "SOMEBODY'S GOTTA DO IT": No, I made up safety third in an attempt to start a conversation, tweak people a little bit, because the safety first way of thinking is perhaps the most well intended goal. But if you really think it through, it's got some flaws.

First of all, safety is never first. If it were, we'd all wrap ourselves in bubble pack and stay home and drive rubber cars at speeds approaching five miles an hour. OK?

We -- life is about managing risk. It's not about making safety the prime directive. It's about being safe as often as you can. But the safety first culture and with great respect, you know, a lot of the protocols you'll read in OSHA and a lot of other well-intended manuals that mandate very, very specific adhesion, these things over time create in my view a kind of complacency that's actually counterintuitive.

So, when you're forced to sit through a compulsory meeting and when you're forced to do go through lock-out, tag-out routines and when you're forced to do a lot of things under the guise that somebody else cares more about my safety than I do, then you abdicate a certain measure of responsibility. You become complacent and you get hurt.

First four years of "Dirty Jobs" no injuries on the crew. Last four years, all of us.

I mean -- GUPTA: Really?

ROWE: Nothing serious but, you know, broken fingers and toes and stitches and all kind of things went side ways. We just took our eye off the ball.

GUPTA: You think some of that was complacency?

ROWE: I think all of it was complacency.

GUPTA: We have certain expectations, right? So, you go to pharmacy. You pick up medications, you buy food at the grocery store and you drink water out of a drinking fountain. In this country, at least, you expect those things to be safe.

ROWE: Yes.

GUPTA: That's part of our way of life, the quality of life. Is that -- I mean, do we -- do we by abdicating responsibility, is that making us more risk takers? What's the -- what's the -- is that what happened with your crew? Did they take more risks as a result of this complacency?

ROWE: Yes, right. So, I'm certainly not an expert on this, but I read a paper years ago that I thought was really interesting that talked about homeostatic risk, right? Or they called it the -- it was a theory about risk equilibrium.

So, you have a tolerance for risk and you have a tolerance for risk and statistically speaking they're not the same. But as we begin to employ safety protocols, we will counter-intuitively begin to assume greater levels of risk. Therefore, you ride a motorcycle. You put on a helmet. You're going to drive a little faster.

You drive a cab and somebody puts in an automatic braking system and they did this study in Munich years ago, it was fascinating, they monitored the whole fleet of cabs, the drivers took more chances and cornered more sharply and got in more accidents. So, the most dangerous intersections in the world are the signs that tell you when to walk because they train you not to look for the car. You look for the little guy walking and when you see him walking, you go. A big blue bus takes you out.

It's a controversial theory but I think there's enough truth in it because I've seen it in my own life.

(END VIDEOTAPE)

GUPTA: That's some pretty good advice from a great guy who has a terrific show. Don't miss the season finale of "Somebody's Gotta Do It". It's Wednesday night, 9:00 Eastern, only here on CNN.

It's also going to wrap things up for SGMD today.

Time now, though, to get you back into the "CNN NEWSROOM" with Poppy Harlow.