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SANJAY GUPTA MD
Marijuana as Medicine; Old Drugs, New Cures
Aired October 6, 2012 - 16:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Hello and thanks for joining us this week. I'm in northern California.
I'm going to tell you, there is something already in your medicine cabinet that millions of Americans might find could be a cure for cancer. We'll explain that.
Also, I'm going to introduce you to a boy who was viciously bullied over his speech disability. Well, now, he's found a way to make his stutter disappear.
Plus, how to eat less, eat healthier, and still feel satisfied.
But we begin with marijuana. It's on the ballot next month in six states. And in three of those states, the question is this: should doctors be allowed to prescribe marijuana for medicinal use?
Here in California, the country's first medical marijuana law took effect about 16 years ago. But I will tell you, being out here, the concept is still controversial, and it's confusing to many people.
Here to talk about is Dr. Julie Holland. She's an assistant professor of psychiatry at the NYU's School of Medicine. She's also author of "The Pot Book: A Complete Guide top Cannabis."
Dr. Holland, thanks for joining us on the program.
DR. JULIE HOOLAND, NYU SCHOOL OF MEDICINE: It's my pleasure, Dr. Gupta.
GUPTA: You know, I -- it's interesting, being out here in California, people talk about this all the time. There are many states where this is already allowed, medicinal marijuana use. What do doctors really typically most likely prescribe the marijuana for? Are there certain conditions? And how do people know what those conditions are?
HOLLAND: Well, you know, the main indications for using the medicinal cannabis is to reduce nausea and to stimulate the appetite. It's also can be used for chronic pain. That's particularly good for neuropathic pains, the sort of pins and needles that the opiates aren't very good at treating.
It's also a good muscle relaxer, and it's an anti-inflammatory, and a free radical scavenger and it also helps quite a bit with autoimmune disorder, sort of regulating the immune system. So it can be used for a whole host of medical indications and psychiatric indications as well.
GUPTA: You know, it's interesting, and I think the tag line sort of when you think about marijuana use, especially here in California, is that doctors may not always be the most scrupulous when it comes to prescribing it. They prescribe it for all sorts of different things.
What is your impression? I mean, it's gotten a bad rap in that sense. Is there a good record-keeping? How diligent do you think many of these doctors are?
HOLLAND: Well, I think, you know, there's a spectrum like anything else. I think that there are many doctors who take their responsibilities very seriously. And I think that there are probably a good handful of unscrupulous physicians who know it's an easy way to make money.
GUPTA: As a medication, if you think about the medicinal marijuana, does it seem to make a difference how people would actually take this medication? Will they smoke it?
GUPTA: Or use it as a vaporizer? What's the difference?
HOLLAND: It does make a difference. First of all, I think if you have any sort of, you know, free disposition to long problems. If you've got diminished pulmonary function, then you would want to either use a vaporizer or eat the cannabis or eat the cannabis instead of smoking it.
You know, the issue with eating it is that you actually create a new drug. THC, which everybody knows is the component in marijuana that makes you feel altered, but is also the medicine. When you eat it, your liver breaks down the component into a different component called 11-Hydroxy-THC and that can feel a little bit more disorienting or psychedelic.
So, typically when you eat pot, it gives you a little bit more altered than when you smoke it. And also, it lasts much longer when you eat it. So if you want to titrate your dose, you're better off smoking or vaporizing, than eating it.
But, you know, the other thing that's happening a lot now, Sanjay, which is interesting, is that people are juicing the whole plant. And what's good about that juicing the whole plant is you don't get high. You get all the medicinal effects from the plant but don't become altered.
And because it's illegal and so expensive, you really can't juice the whole plant in many other states in the country. But if this were a medicine, you would have that option.
So there are many ways of getting the medicinal benefits of the plant, without being altered. And I think that needs to be explored. GUPTA: There was a recent study -- final question, a recent study that talked about marijuana use in young people, and saying if you use it as a young person, it is more likely to have a longer-term impact, in terms of memory degradation and things like that. Didn't see it so much with adults.
GUPTA: But, Dr. Holland, what worries you about all of this? Are there certain concerns?
HOLLAND: Yes, there are definitely concerns. You know one thing is that, you know, kids in their late teens, early 20s, their brains are really vulnerable and susceptible to psychiatric illness. It's a particularly delicate time in brain formation.
So, you know, I mean, one good thing about regulating cannabis is that you would actually potentially have fewer potential children using it. I mean, right now, you ask any kid, it's pretty easy for them to get pot. Dealers don't card. But, if things are regulated, you know, the hope is that there would actually be fewer children using.
I mean, you can look at other countries like the Netherlands. Actually, they got better much better statistics on, you know, teen drug use than we do.
GUPTA: Right, right. Well, Dr. Holland, I hope to have you back. We want to look at some of these studies as well, and hopefully have a longer discussion at some point.
Dr. Julie Holland, thanks so much for joining us.
HOLLAND: Thanks for having me.
GUPTA: And coming up, a potential cancer cure for pennies a day. It's a medicine that many Americans are already taking. We'll explain.
GUPTA: Continuing our series on cancer care now. The cost of some of these medicines that we have been talking about can be prohibitive, but I recently spent time at the largest cancer center, MD Anderson in Houston. And I found that patients there are often being treated with medication you could literally buy with a change in your pocket. It's an old drug that they hope will be a new kind of cure.
GUPTA (voice-over): Jan Chapman volunteers at this pet shelter. She helps pets find loving homes.
Now if you look at her, you'd never know she has endometrial cancer. And when it came back two years ago, prognosis was terrible. They told her she had a one in 10 she'd live five years.
And that's when she started treatment at MD Anderson. She got an experimental combination of two medications.
JAN CHAPMAN, CANCER PATIENT: I initially had a lot of ablation (ph) shrinking, and now I kind of stabilize where nothing much is happening.
GUPTA: In this case, nothing happening was good news. So, what did it? Maybe the experimental medicine. But based on the larger study she was part of, the difference maker was a drug Jan took initially just to control side effects.
DR. KAREN LU, MD ANDERSON CANCER CENTER: It's the most commonly used diabetes drug in the country.
GUPTA: Dr. Karen Lu is part of Jan's oncology team and she's talking about metformin. Millions of people use this medication to control diabetes. And when doctors started looking closely at all those patients, they saw something striking.
LU: When they looked at these large groups of diabetics, they saw that those individuals who were taking metformin had a lower risk of cancers, certain types of cancers, and also a lower mortality associated with those cancers.
GUPTA (on camera): It's fascinating.
LU: It is fascinating.
GUPTA (voice-over): Dr. Lu says tumors feed on insulin, and metformin seems to work in part by lowering those insulin levels, and in part by directly attacking cancer cells.
So now, she is launching clinical trials to see if this could really be an effective treatment.
LU: The question is, do we use it in patients for -- once they have measurable disease, and you know, use it at that point. Should we use it when people are in remission? We don't really know.
GUPTA: What we do know is this, based on 20 years of data is that side effects are minor and they are rare. And while cancer drugs can cost tens of thousands of dollars, metformin is barely 10 cents a day.
(on camera): By one estimate, a big drug company will spend about $4 billion to develop a new medicine. Now, part of that is paying for failures. You see, even if the medication is promising enough to be tested on humans, the vast majority of those still will not work.
But that staggering huge costs and all those false starts have led many to take a new sort of approach, using old medication to try and find new cures.
(voice-over): In fact, we did find another example, right here at MD Anderson, drug that was used for organ transplants.
Dr. James Yao did research that turned Everolimus into a novel treatment for pancreatic tumors, that's like 40,000 people a year. DR. JAMES YAO, MD ANDERSON CANCER CENTER: This is the first drug to be approved in 29 years, or nearly three decades.
GUPTA: The National Institutes of Health sees the potential, offering $20 million in grants to see if existing medications of all kinds might have other uses, like fighting cancers.
YAO: I think there's going to be even more important discoveries in years to come.
GUPTA: It's impossible to say for sure what saved Jan Chapman, but she's still taking metformin, and her cancer is still under control.
CHAPMAN: It has really made a difference in my life and, of course, the life of my family, too.
GUPTA: Now, of course, the research is still early. But so far, metformin shows at least some promise against breast cancer and pancreatic cancer, too. It's interesting to note that you are more likely to get all these cancers of your obese. Less obesity, less risk of diabetes, less risk of cancer as well.
And up next, this is video you need to see to believe. A 13-year-old boy has a severe stutter that he's had all his life. At long last, he's fighting his flaw.
(VIDEO CLIP PLAYS)
GUPTA: Bullied relentlessly, Lil Jakes is now finding refuge in rap.
GUPTA: Stuttering can be a disability that's so debilitating it forces a person to shut down, to withdraw, to keep to themselves.
Well, not so for one young man from Toronto. He's found a way to make his stutter disappear and to take center stage.
JAKE ZELDIN, 13-YEAR-OLD: Hey, you could watch a drone (ph), are you Jay-Z or Kanye, you could go and join my circle --
GUPTA (voice-over): Listening to Jake Zeldin rap, you'd have no idea that he suffers from a speech disorder that's so debilitating that this 13-year old used to keep to himself.
ROBYN ZELDIN, JAKE`S MOM: He started speaking at the age of two, and pretty much, I mean with single words that wasn't so bad, but then when he would get into sentences with the couple of words, two or three words, that's when it started to come out.
ZVI ZELDIN, JAKE`S DAD: Those who love Jake, knew he needs to get the words out, let him finish what he's speaking or saying. GUPTA: But many others tormented him. He was bullied, not only by his classmates, but by his teachers as well.
JAKE ZELDIN: One teacher was like, and I was just doing this voice in drama class, and I was like hi, and then like the teacher is like, I don't know what's more annoying, that voice or your stutter.
GUPTA: Jake's parents, Robyn and Zvi, invested a ton of time and money into therapy for their son, but nothing worked. Then, when he was 10 years old, a profound breakthrough at a summer camp.
JAKE ZELDIN: I was doing this rap battle and I was like -- hey, I'm kind of good.
GUPTA: Now, Jake is performing as Lil Jakes. Smooth as can be. The rhythm or cadence of rapping makes it easier for him to get the works out without stuttering.
One night last December, Jake got his big break.
JAKE ZELDIN: I got backstage at a concert, and rapped with Dre (ph).
GUPTA: Jake's brother Cole recorded the encounter and uploaded the video to YouTube. So far, 200,000 views and counting.
COLE ZELDIN, JAKE`S BROTHER: It's awesome. I get to go wherever he goes. Meet cool people.
GUPTA: And for all those who used to torment him, the haters, they now serve as motivation for Jake to perform for crowd of up to 20,000 people.
JAKE ZELDIN: My big dream is to have fun and to make music, and it's coming true right now.
GUPTA: From Jake to Lil Jakes. Stutterer turned rapper and a role model.
JAKE ZELDIN: Lil Jakes, on CNN, let me introduce.
GUPTA: Well, this is not the first time we've seen something like that, but it is still so remarkable to watch. You know, one reason Jake may not stutter when he raps is that music relies on the right side of the brain, while language relies on the left. Other trick that people used to stutter is sometimes using a stage voice, even a foreign accent, sometimes a whisper.
Whatever is going on inside Jake's head, it's pretty incredible to watch. And we certainly do wish him all the best.
Well, still ahead on SGMD, we're going to will help you put an end to what we call mindless eating. Some psychological tricks you can use on yourself to eat less, eat healthier, and most importantly, still feel satisfied.
GUPTA: We're kicking off a new series today called "Food for Life." You're going to see it every week here on SGMD. The most important thing is I'm going to tell you how the food that you're putting into your body affects your overall health.
I want to begin with the conversation I recently had with New York City Mayor Michael Bloomberg. Now, you will remember his supersize sugary drink ban we talked about right here last month. Well, as part of that conversation, you haven't heard this -- I asked him if he had a personal story about dealing with obesity in his own family.
(BEGIN VIDEO CLIP)
MAYOR MICHAEL BLOOMBERG (I), NEW YORK CITY: No, but I can tell you, and I think I speak for almost everybody, if it's in front of me, I eat it. I love Cheez-Its. If you put a bowl, two-pound box of Cheez- Its in front of me, I'd probably eat them all. That's going to be good for you. But if you eat anything in moderation, there's no harm, almost anything. And so, if you put a small bowl of Cheez-Its in front of me, that's fine.
There is something called a soup test that public health advocates -- public health scientists use. They put a bowl of soup in front of you, you eat it, ask you if you want another one, chances are you say no. Next day, they put another bowl of soup in front of you, but this time they run tube under the desk, through the desk, into the bottom of the bottom. And they replace the soup, as fast as you eat it. And half an hour later, you will continue to be eating.
We all do the same thing, and all we're trying to do with the full sugar drinks is to have a smaller portion in front of you. You want to take another portion, you can. Nobody is banning you from doing that. You can buy -- as a matter of fact, you can buy two 16-ounce cups or four of 16-ounce cups any time you want and take them all back to your seat or your table.
But if the 16-ounce cup is there, you probably won't drink more than one of those. And that would make a big difference, because full sugar drinks really are different than other kinds of things.
(END VIDEO CLIP)
GUPTA: Who knew Mayor Michael Bloomberg liked Cheez-Its so much. What the mayor and I were talking about there is known as mindless eating. I'll ask you a question, how do you know when you're done eating? Most people will say when there is no more food on the plate.
One man I know is out to change that. His name is Brian Wansink and he's the author of this book called "Mindless Eating".
BRIAN WANSINK, AUTHOR, "MINDLESS EATING": Thanks for inviting me in your home today, and just doing a little bit of a kitchen makeover, look at what you're doing well, and what you could be done a little bit better.
Your use of plates is amazing. One of the big things that messes how much people eat ends up being on the size of a plate -- because how much is the right amount of the pasta served? Well, you end up figuring that out based on the size of the plates.
So, what we ended up finding is that if people use a 12-inch plate -- I mean, this is massive. It's closer to the size you see in most kitchens. If people end up using something like these, they end up serving about 22 percent more than they serve on a plate about this size.
You want to have your kitchen designed so that you pick up the healthier food to begin with. Let's take a look at what's going on in the kitchen that might be -- any bias -- what you pick up when you go for snacks and go for meals.
Got a lot of good stuff there, we got some cheese, fruits, liquid refreshments. But one of the things that we find is that you're three times as likely to take the very first food you see and than the fifth food you see. It may be a lot easier, a lot better if you had either the low fat cheese sticks right here where it's visible or if you cut up fruit for the kids.
Take a look at the pantry here, there are some good, healthy things here, but just rearrange them, so that you see them first instead of the oh, candy bars.
It's a lot easier to change our environment than to change our mind. Bring out a fruit bowl, kids like fruit, convenience leads to consumption. This is going to be cool. We even see people with their junk food in the cabinet. Take these child-proof things and put them. Not that they can't get into it. But what it is, is an additional barrier.
UNIDENTIFIED MALE: Right.
UNIDENTIFIED FEMALE: Makes you think about it.
WANSINK: And the solution to mindless eating is not for most of us, mindful eating. It is easier to change your environment than it is to change your mind. You guys are really on target. I love what you've done. It's a couple of degrees of course correction and --
UNIDENTIFIED MALE: Sure.
UNIDENTIFIED FEMALE: Right.
WANSINK: -- be right there (ph).
GUPTA: Now Brian's work with the Blevins (ph) family is part of something called the Blue Zones Project. A blue zone, if you haven't heard the term, is a place in the world where people live measurably longer, happier, and healthier lives. Who doesn't want that?
Time now for "Chasing Life".
Now, in addition to making over kitchens, Brian and his colleagues at Cornell set out to see if creative food marketing, that's the kind that's usually used to sell unhealthy foods to kids, could be used to encourage them to eat veggies instead. So at this elementary school in New York, they overhauled the school lunch menus, changing carrots for example to x-ray vision carrots, broccoli became tiny tasty tree tops, and there were power punch peas.
Now simply by changing the names, they found that as many twice as many kids eat their vegetables. It turns out something all you need is a good marketing plan. Something I think I'll try at my own home with my kids this weekend.
Well, that's going to wrap things up for SGMD. You can stay connected with me throughout the week at CNN.com/Sanjay. Keep that conversation going on Twitter as well @SanjayGuptaCNN.
Time now, though, to get you a check of your top stories on "THE CNN NEWSROOM."