ISSUE 5 FEAT DR. SANJAY GUPTA

MEDICINALLY SPEAKING

CNN Chief Medical Correspondent Dr. Sanjay Gupta weighs in on the possible benefits ts of exploring medicinal marijuana research and why he changed his stance regarding the support of its medicinal possibilities.

Words by: Michael Landers

Snaps by: CNN

The medicinal marijuana community has long held a united, yet stifled voice among the mainstream medical community. Long before the acronym “MMJ” became a staple within the lexicon of marijuana subculture and a hashtag in the realm of social media, supporters of cannabis in the medical sense echoed the homeopathic virtues of the plant for decades. Everything from glaucoma to anxiety and other neurological, psychological, and physical afflictions were credited to have been remedied or to have had their effects lessened from regular marijuana use, and those results should seemingly have been enough to yield a genuine, remedial analysis from the medical community at large. Instead, the plant has primarily been viewed as an illicit drug and its supporters saw as “users” looking to find any reason to justify legalizing the plant for its more widely known psychoactive and stimulant nature. Given its Schedule 1 classification by the federal government and subsequent federal illegality, marijuana has remained largely overlooked in the medicinal sense, and its proponents reluctant to risk professional credibility in pursuing studies regarding the medicinal value of the plant. The fact that the plant contains nearly 480 different compounds didn’t exactly entice those interested in dissecting its medicinal possibilities either, and that stilled voice among MMJ enthusiasts has largely remained so without mainstream support – until now. Leading the most supportive charge of late within the mainstream media is CNN Chief Medical Correspondent Dr. Sanjay Gupta–a former opponent of cannabis research in the medical field.

A world renowned and practicing neurosurgeon, Dr. Gupta currently serves as a member of the staff and faculty at the Emory University School of Medicine, and he’s also the associate chief of neurosurgery at Grady Memorial Hospital in Atlanta. He is a New York Times Best Selling author three times over, and his awards and accolades span everything from the first ever Health Communications Achievement Award from the American Medical Association to three Emmys – all earned as CNN’s chief medical correspondent. His work with the network includes post 9/11 live reporting, overseas conflict live reporting, and Peabody Award-winning coverage earned by the network during the wake of Hurricane Katrina. One of Forbes Magazine’s 10 most influential celebrities, Dr. Gupta has also been a White House Advisor to Hillary Clinton and was even offered the position of U.S. Surgeon General by the Obama Administration – a position he declined to continue to focus on his family and neurological research and reporting. Gupta’s on-air personality has led to appearances on Larry King Live, The Daily Show with Jon Stewart, Real Time with Bill Maher, The Oprah Winfrey Show, and special interest reports for the CBS Evening News. Though his media presence has increased tenfold since he joined CNN in 2001, Dr. Sanjay Gupta remains far removed from today’s climate of talking head hyperbole, focusing instead on legitimate health care breakthroughs, reform, and research. One such area of research that has piqued the good doctor’s interest is that of the medicinal potential of cannabis. Though he once penned an anti-legalization Time Magazine op-ed piece in 2009 entitled, “Why I would Vote No on Pot,” Dr. Gupta famously changed his stance in 2013, opting instead to be a voice of support for the study of marijuana in the medical sense. After offering a public apology for his previous opposition to the subject, Gupta immediately began looking into and supporting MMJ research, which spawned his two-hour 2015 CNN documentary “WEED.” The documentary received the Alfred I. duPont-Columbia Award and served as the springboard for two more installments to the series, all of which encompass a variety of MMJ success stories and research statistics. So, why the change of heart? What was it that Dr. Gupta saw within the research that made him change his mind? We held a conversation with Dr. Gupta to find out these answers and learn more about what was uncovered during his latest benchmark documentary for CNN, “WEED 3.” Rejoice MMJ supporters; it looks as though in the case of Dr. Sanjay Gupta, you may finally have a friend in high places.

 

You recently changed your stance into looking into the possible benefits ts of medicinal marijuana. What was the tipping point for you?
I had been reporting on this issue for a long time and the tipping point really has to do with the fact that I approach these things as a scientist and a doctor. I looked at the existing literature on this topic and in the past, I was not particularly impressed with the medical literature. I think what I realized was that so much of the literature was sort of preordained, meaning that the studies that were being funded were studies that had a particular hypothesis – they were looking for harm when it comes to medicinal marijuana, and not looking for benefits ts. In fact, according to our research, only about 5-6% of studies over a fourteen-year period had been designed to look for benefits, while over 90% of them were looking for harm. My point is that I was seeing a distorted picture, and when I started to travel outside the country and look at their labs and talk to their scientists, that’s when the clearer picture for me started to emerge, and that’s when I realized that my mind was changing.

 

Given the negative stigmas attached to marijuana in terms of being seen as an illicit drug, do you think that the latest cannabidiol or CBD research has a chance to sway not only the public opinion but maybe the political opinion in terms of supporting further research on medicinal marijuana?

I think we are seeing that. I’ll confirm the numbers, but I think we are seeing more studies now being done by mainstream scientists and big academic centers within the last twelve months than we had seen within the last twelve years – in terms of looking for benefits. In that sense, we are already seeing an impact from CBD and all of the medicinal marijuana research. As an aside, the CBD-only legislation, even though I think it’s a step toward better understanding medicinal marijuana, may be a little shortsighted along the lines of what is called “the entourage effect.” What that refers to is the fact that the plant as a whole works in concert with all of these other chemicals; the cannabinoids, the various vehicles, messengers, and other proteins which all play a role in varying degrees. We don’t know what the rules are for all of that, but the idea of extracting only one small part–it’s unclear how effective that’s ultimately going to be. I think it’s still possible to create a non-psychoactive oil as in the case of Charlotte Figi, who suffers from Dravet Syndrome, and other kids with grand mal seizures, but this likely would be sourced from a whole plant extract as opposed to a CBD-only extract or even a CBD-synthesized drug. There have been rumors that CBD can act as an anti-inflammatory agent for those who chose to use the vaporizer method of ingestion, commonly known as “vaping.”
Do you think CBD could be proven to ease inflammation in the lungs within a vapor form as opposed to any other form?
I think that when you start to look at it from a harm standpoint, you get different data from the different forms of ingesting cannabis. We haven’t seen an increase in cancerous carcinogenic activity but I don’t know how much we’ve seen in the anti-inflammatory activity, specifically in bronchial patients – I just don’t know. That data could exist. What I think is interesting with the CBD aspects is when you look at the various locations of where the receptors are in the body, for either the CBD or the anandamide, which is circulating our own cannabinoid that we make in our bodies; when they bind to these receptors, CBD does appear to have an anti-inflammatory effect. How that translates exactly, I think is going to be very interesting to see. I think there’s been some evidence to show the impact on inflammatory bowel disease, Crohn’s Disease, and ulcerative colitis, and having these symptoms improve with cannabis.

 

Could you have those same anti-inflammatory effects in neurodegenerative diseases?

There’s a group of researchers at the Byrd Alzheimer’s Clinic in Florida that are looking at not just CBD, but also whole plant extracts, including THC in terms of an anti-inflammatory effect on the development of Alzheimer’s disease. It’s quite fascinating. There’s a flax being developed; they’re quite bullish on it now. It’s still early, it’s still laboratory studies but there are people who are using marijuana to try and improve some of the symptoms of Alzheimer’s–not even just memory, but also the mood swings, the agitation, the insomnia problems, and everything else.

 

You have been of the opinion that rescheduling marijuana federally would be a huge help to the MMJ communities. Why?
The anti-inflammatory effect is probably one of the big effects of cannabis in terms of how it works, in different areas, even including pain–although with pain, it may also be a direct impact on the pain receptors–we just don’t know for sure. But I think that is part of the reason that there should be some legislation that would lead to rescheduling, which would really lead to opening up the avenues for more research, given the current federally illegal status of the plant.
Your “WEED” documentary series for CNN takes a big look at the possibility that MMJ can effectively treat patients with PTSD. What has research shown?

When you hear the scientists who are leading the way with PTSD in particular, they explain that there are several things that come into play. The anterior cingulate cortex area of the brain seems to be affected by people who are using marijuana daily as a medicine. They see increased activity in the anterior cingulate cortex – that’s an area of the brain that is in large part associated with empathy, emotion; it’s sort of one of the switchboards of the brain. That area of the brain tends to be more efficient in the follow-up scans among those regular users of marijuana. With PTSD, you are dealing with heightened anxiety, perseveration of thought regarding a certain topic, thus the idea that increasing activity within the anterior cingulate cortex could have an impact on PTSD seems very plausible. MMJ has also been rumored to be especially effective in the case of military veterans suffering from PTSD.

 

Have you seen any evidence to support this?
What I will tell you is that we had the chance to see the dawn of this new study, really follow it along from the start, and meet some of the people who are the first participants in this study. It was pretty remarkable. First of all, the options that many of these people are left with are really not very good. That’s part of the reason why you have 22 veterans killing themselves every day – I mean that’s one per hour. Second of all, one of the guys that we profit led throughout was a very high functioning guy, with a seemingly good life, and things going relatively well for him, but he wanted to die – he wanted to be one of those 22 veterans who commit suicide daily because nothing was working for him. Now, he lives in a medicinal marijuana supported state, California, and he can be treated. He’s self-treating, and for him, it’s definitely working. He is living a very functional life again, his wife, who is a very conservative woman, said, “I’ve got my husband back. I don’t know what the studies will show exactly in terms of how well it works or what the side effects could be, but there’s no way we would give it up.” We had another woman who is a 34-year-old stay-at-home mom, who is not a veteran, but she still suffers from PTSD because she witnessed the murder of a very close friend of hers. This woman turned into a complete hermit, could not go outside, couldn’t function anymore, had classic telltale signs of PTSD and nothing was working. She decides that there’s enough talk about this, says “I’m ready to get my life back,” and she tries medicinal marijuana. For the first time in her life, she got on a plane in October of 2014 and flew down to spend time meeting with me in regards to the study. I mean she couldn’t even leave her house, couldn’t even get into a car, and she flew down to meet with us?! She is part of a study where they are looking at her brain to see what is happening in the brain, for good and for bad. What they find is that increased activity in the anterior cingulate cortex and really no evidence of damage to the brain. The idea that it could be helping and not hurting, and in fact, could be protecting and defending the brain–as opposed to assaulting the brain–is a very important concept. Especially because we tend to think of marijuana in the decades of stigma surrounding the “this is your brain on drugs” commercials and now we really get to see what your brain on marijuana looks like. This is science now; this is not anecdote, this is science and what we are seeing, early on, admittedly, is that it looks promising.

 

What would you say to the naysayers who still feel that marijuana is solely an illegal drug and should be treated as such?

In my reporting, in all these documentaries, I tried to stay away from the idea of moral equivalency. I stayed away from saying, “It’s not as bad as X, Y, and Z; It’s not as bad as alcohol.” I tried to stay away from that because I think it should be given the same merits as any other medicine. We don’t look at medicine and say, “It’s not as bad as X, Y, Z”; we take medicine because we think it’s going to help us in some way and it should have a certain amount of respect. The options that some people who have epilepsy, or PTSD have are often not very good, and I think the PTSD thing is so concrete because we are having more veterans killing themselves at home than have died on the battlefield. What we have been doing to treat them is not working. This idea that something else, a plant, could work and have a very low side effect profile and still return people to a functional life – if you say you don’t even want to explore that – it borders on being immoral. It’s not right. But I’ll get off my soapbox now.

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