Sanjay Gupta

March 11, 2014

I am Dr. Sanjay Gupta, neurosurgeon and Chief Medical Correspondent at CNN. I'm doubling down on the legalization of medical marijuana. AMA

Hey there Redditors -- Sanjay here! I’m a practicing neurosurgeon… CNN’s chief medical correspondent… a husband, dad to 3 beautiful daughters… and according to some of my twitter followers, they jokingly dubbed me the “Wolf of WEED Street” (more on that later!). I’m in Colorado today reporting LIVE on CNN from a marijuana dispensary and grow facility. In between my live shots, I’m going to be answering your questions. To confirm, I’m Dr_SanjayGupta on Reddit and @DrSanjayGupta on Twitter.

Proof

Stepping away to do a quick liveshot from CNN from the dispensary I’m at in Colorado. Be back in a few to answer a few final questions!

Redditors! I really enjoyed this conversation today. Thank you for sharing your stories, for asking thoughtful questions and for your role in helping break down the stigma surround medical marijuana. It’s important to focus on the science. And the science is now clearer than ever. Let’s continue this conversation tonight! I’ll be tweeting LIVE (@drsanjaygupta) this evening during the debut of my follow-up Weed documentary -- ‘Weed 2: Cannabis Madness’ debuts tonight at 10p ET on CNN. Thank you again, Reddit. This AMA was the highlight of my day here in Colorado. Have me back again sometime?



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Thank you for this. We have done a fair amount of reporting on this topic. Some of the research from Michael Mithoefer has been particularly compelling, if you havent seen it. Will continue to report on this.


Hello Dr.Gupta,

I would just like to thank you for being in " The last heart attack", In high school I took an unconventional nutrition class. After watching the documentary I had to write a report and was given so much insight.

Find what you are passionate about, without letting anyone else define it for you. If you run to that, you are likely to be happy and to have tremendous success.


Are you getting any pushback from CNN executives/higher ups about this?

No! There has been no push-back about this and we have stuck to very sound science in our reporting.


They're right behind you aren't they?

ha! nope. all by myself here in edwards, colorado


Thanks for replying!

This might get buried but I just thought to ask, as a neurosurgeon would you recommend medical marijuana to traumatic brain injury patients?

So glad you asked about this. I think we will get to the point where this is a viable treatment option. You should look at the data around patent 6630507. It is a patent held by our own department of health and human services for this very reason.


Can you post a picture of the grow room you were just in on CNN?

Here it is


Hello Dr. Gupta! I don't have a question but I just wanted to say that I admire you a lot and I'm stoked to see you at University at Buffalo in a few weeks! Thank you!

Come say hi!


Given all your activities and travels, how much time are you able to spend as a surgeon at Emory? (side note: your "boss" there, Dr. Daniel Barrow, saved my life by clipping an unruptured aneurysm in 2010, and made it feel no worse than a really harsh haircut)

I love neurosurgery, and still operate every week. It is a big part of my life, and my first true love! Dan Barrow is terrific, and a great boss.


How many surgeries do you perform in a week on average?

Anywhere between 5 and 10


Wow. Thanks for the reply. One more question, did you ever think about going into other surgery specialties like general surgery or orthopedic?

I seriously thought about transplant surgery. I loved the operations and the immunology that was involved.


Do you see the southern states making any progress on marijuana legalization in the next five years?

If they pay attention to the science I think there will be considerable progress in the next five years.


Do you see the southern states making any progress on marijuana legalization in the next five years?

It is already happening now, in states like Georgia and Florida


GA is on track to legalize medicinal use, though not of the actual plant matter. It's the most restrictive medicinal use law on the books in the USA, but it passed the GA House with something like a 171-4 vote count.

They actually used science to determine the restrictions and targets -- e.g., it's restricted solely to cancer patients who have tried chemo unsuccessfully, seizure patients who are responsive to the cannabinoids, and one other patient group I can't remember offhand. It's also only cannabidiol (I think I spelled that right). All of that was based on the science that proved that those were what they considered legitimate uses of the product.

Are they overlooking many other potential uses of cannabis? Sure. Do I still think it's a damn good start? I do.

So not everyone in the south is as unscientific as you think we are, for being in the bible belt, I'm pretty impressed that it looks like GA will have a med law on the books approved in 2014. Just waiting on that senate...

You make a very good point. There is good evidence that the whole plant is better than single compound drugs. Take a look at this blog I wrote: http://www.cnn.com/2014/03/11/health/gupta-marijuana-entourage/index.html?hpt=he_c1 - But I agree that this is a good start.


Dr Gupta - do you think the future of cannabis as a medicine is as a pharmaceutical drug or as a supplement/food? Thanks so much.

I think it will likely be a combination of both but we'll need safeguards to make sure it is consistently safe, effective, and reliable.


Dr. Gupta, what is the best thing someone can do in a state where cannabis is currently illegal to make it legal?

Make sure to talk to your representative and arm yourself with the science. Hopefully our documentary airing tonight on CNN (10p et) will help you with that.


Ever considered an "in-depth" investigation into weed with one Anthony Bourdain?

No - But that's a great idea. I'll give Anthony a call after this session.


session

Interesting choice of words given the topic at hand. :)

really? why?


Have you smoked weed? You can say it was for science.

I have tried it before.


How was your experience?

It made me a little anxious!


If you don't mind me asking, what was the context of this? Were you just a teenager experimenting, or was there a more serious motive behind this?

Nope, just tried it. Nothing more serious about it than that.


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I don’t… but I do remember Mr. Armstrong who was my math teacher!


Hello! Fellow NHS graduate here, and I wanted to let you know that I love all your work! What was the craziest memory you had while living in Novi? Also, did people smoke marijuana as much as they do now while you attended NHS? Thank you for your time!

When I lived in Novi, it was a pretty sleepy small town. The craziest memory I have is when the horses escaped from the farm at 8 mile road and meadowbrook. I don't remember seeing much marijuana around when I lived there. So how much IS there now?


Who or what companies are leading the charge in helping Med Mar patients?

I followed the work of the Stanley Brothers, they were one of the first to develop a high CBD marijuana. I also traveled to England to visit GW Pharmaceuticals; they are working with whole plant extracts.


Hi Dr. Gupta, I don't have a question, just wanted to thank you for all you are doing.

appreciate that!


Dr. Gupta,

Firstly, thank you for taking the time to participate in the AMA. I wanted to inquire as to what your thoughts are on marijuana for recreational use.

Given your preliminary research, aside from the apparent short term psychological alterations that occur in the brain, what do you feel could be the long term negative aspects AND positive aspects of consistent recreational use of marijuana? Often times, the positive aspects of recreational use are overlooked and I would be curious to hear your thoughts on what they could be (for example, a glass of red wine each day has been determined to have a positive effect on your long-term heart health).

Thank you for your time, reporting and research!

I think that in the developing brain - which neuroscience says is below the age of 25 - I have concerns about consistent marijuana use. Beyond that, there has not been much science to show long-term negative side effects for marijuana use. We do have CB receptors throughout our body and we know that our body makes cannabinoids. So we are learning more and more about the potential positive benefits of cannabis.


The only reason I don't fully support legalization is something my father once said to me. "People don't always drink to get drunk, but people smoke weed to get high." I know there are various levels of high, but even your basic high is I think stronger than what one drink will do.

Edit: Yes, I knew that in a thread about the positive benefits of weed on reddit, that this comment would be universally hated. But seriuosly ask yourself if you've ever consumed just enough weed to take you to a [1] or less.

If you think of cannabis as a medication that can help people, especially when nothing else has worked -- you might change your mind. I know that not everyone is using cannabis to get high.


For perspective, what does neuroscience say about the effect of consistent alcohol, or even caffeine use on the developing brain? Thanks in advance.

Good point. I wouldn't recommend alcohol use for the developing brain either!


What is your favorite food or dish?

Ice cream! (my guilty pleasure)


Hello Dr. Gupta. I greatly respect you, and your unwavering skepticism.

I have had some personal experience with the medicinal benefits of cannabis, and I truly believe that plants do hold the key to solving a great deal of medical problems.

For my questions:

What are the neuroplastic properties of cannabinoids?

What do you think is the most interesting property of cannabis?

We know that there are receptors for cannabinoids throughout the central nervous system. CBD is one of the more interesting compounds of the nearly 500 that make up marijuana. I find it fascinating that it can quiet excessive electric activity in the brain, as in the case of seizures.


Dr. Gupta

Thank you for participating in the AMA. Does your recent change of heart considering medical marijuana have any impact on your standing for recreational use?

I have been focused on medical marijuana because I believe it can stand on its own merits.


Dr. Gupta, how do you feel that being Surgeon General would have affected your career long-term?

I am great fan of public service and have worked in the White House previously. I was surprised to learn that as Surgeon General, I would have not been able to practice surgery. I love that part of my life and would have missed taking care of patients in the operating room.


My father is a doctor who majored in public health, and your programs on cannabis, from a medical standpoint, have absolutely shifted his views in a big way.

My uncle, his brother-in-law, recently passed away from liver cancer- and cannabis oil helped him immensely, in addition to traditional treatment, in stimulating his appetite and increasing his quality of life.

This isn't a question, I just wanted to thank you for advocating for people like my uncle. My father, now, endorses cannabis-augmented therapy to patients in a similar situation to my uncle, something that I could not in a million years imagine happening even a decade ago.

Thank you for your note. So sorry to hear about your uncle. I am glad your father is considering the science on this issue. He could help a lot of people in the process.


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No. Are you?


Dr. Gupta, what is something cool about the human body that has stuck out to you in your neurosurgery practice?

I am fascinated by the areas of the brain that control speech -- left temporal lobe. You can develop conditions where you can speak and write without difficulty, but cannot understand speech or read. In fact, there are people who can write something down, but then are unable to read what they just wrote.


Weed is NOT a substance that is addictive. To be part of habit yes. but can you confirm this to all that inquire?

Studies have shown that about 9% of people develop an addition to marijuana. It's likely more psychological than physical. Simply put: if the use of marijuana is interfering with other aspects of your life and you can't control that, you may be developing a psychological addiction. For context -- the addiction rate for alcohol is 15% - heroine 25% - cocaine 20% and tobacco comes in the highest at 30%. With those substances, the addiction is more physical.


Hi Sanjay! What are your thoughts towards using high percentage CBD strains to help people with Anxiety? I’ve read numerous reports proving that CBD is an Anxiolytic and heard firsthand experiences from people. Do you think that using CBD in combination with therapy could be effective and less dangerous than other drugs such as Prozac or Xanax? Thanks for everything you do.

I so think so. We have a better understanding of how CBD works in the brain, and the receptors where it binds. There are many prescription drugs that have a much higher risk than cannabis, but are prescribed often. Narcotics, in particular. We consume 80% of the world's pain meds in the United States.


Peanut butter or Nutella?

I don't have much of a sweet tooth, so peanut butter for me -- although I've really started to develop a taste for Nutella after a recent trip to France.


Does smoking hurt your memory or is this myth?

It seems to affect everybody in the short-term. But it has more of a long-term impact in people who use it while their brain is still developing (roughly anyone under the age of 25).


Dr. Gupta,

My ENT doctor in Colorado is also named Dr. Sanjay Gupta, but definitely somebody different. Are there a lot of you out there? And have you ever talked to each other?

Yes, there are a lot of "Sanjay Gupta's " out there and, we do a conference call every sunday night... ;-)


Sanjay, did you ever work in or around the Jackson County area in Michigan? My wife's Alzheimer's patient swears that she worked with you as a nurse, but we have slight trouble believing it.

She may be right! I use to live in Chelsea, Michigan and performed operations at the University of Michigan hospital, Chelsea Community Hospital and Foote Hospital in Jackson.


Dr. Gupta,

Why isn't the federal government taking cannabis off of Schedule I? Can you talk to your boy Barack and make that happen?

It's a great question, and was the focus of an op-ed i wrote back in August. (link: http://www.cnn.com/2013/08/08/health/gupta-changed-mind-marijuana/)

I don't think marijuana meets the criteria for schedule 1. That would mean it is among the most dangerous substances and has no medicinal benefit. Neither of those statements are factual.


Dr. Gupta, thank you for taking the time to do this AMA. As an individual interested in medicine who is also prescribed medical marijuana, how do you feel about other healthcare professionals who use marijuana medicinally? For example, is it acceptable for a surgeon to use marijuana at night time to help with his/her insomnia or chronic pain?

First of all right now marijuana is recommended not prescribed, as marijuana is still a schedule 1 substance. Having said that, it should be thought of as a legitimate medicine for patients that need it. As long as it doesn't interfere with someones ability to do their job safely, it can one day be an option.


What is the best method of ingestion in your opinion?

It is probably vaporizing. I think smoking creates a lot of byproducts that we don't know enough about. I think eating it leads to very uneven absorption. Vaporizing seems to activate the medicine without burning it. I also think oils absorbed in the mouth are effective, especially for kids.


Do you want your children to follow in the medical field just like you?

I would love it if they did! And still consider it to be one of the most noble professions.


Do you feel that mainstream media is partially to blame for perpetuating the stoner stereotype & hurting the progress of legalization? When in reality a lot of motivated creative healthy successful people use cannabis responsibly?

Yes but there is plenty of blame to go around. Because of the stigma, so many of those 'creative healthy sucessful people' are fearful to be open about this.


I'm just here to say a big thank you to saving my grandpa's life several years ago with a pituitary tumor removal. He talks about you very often and your brilliance. My family and I all thank you.

Thank you so much for this note. I will really treasure it, and I'm glad your grandpa is doing so well.


Dr. Gupta, does being a correspondent for CNN add pressure on yourself to make no mistakes? Or is it more about spreading information to you than added pressure?

I am not sure I would describe it as pressure. However, there are a lot of parallels between medicine and media though. In both, we do tons of homework and are constantly reading. In both, there is a real potential to help people. And, with both -- credibilty is critical.


What is the single most profound piece of quantifiable data (or perhaps a correlation) that:

Dr. G - thank you for doing this!

The studies about cannabis and epilepsy were very compelling. Also, the use of cannabis as a treatment for neuropathic pain and MS. I think people should know that cannabis is being used a legitimate medication in hospitals all over the world. In fact, a medication for MS that is cannabis based, is now approved in 25 countries around the world, but not the United States.


I want to say that you are truly inspirational. Besides neurosurgery, what are some of your other interests that you might like to do with your free time?

Well I am a reporter for CNN, and that keeps me pretty busy. I have three young daughters (who also keep me busy!). I am taking up triathlons, which means lots of long bike rides, swims, and runs on my time off.


If you could write the bill for legalization of marijuana, what special details would you include?

The bill I would write would be a federal bill, not a state bill. It would include many different strains of cannabis from a whole plant extract. I would want these medicines to be researched and tested to ensure they are safe and effective.


Can Europeans watch your documentary somewhere live as well?

Yes, the documentary will air in the U.S. and CNN International tonight at 10p EST and then again on CNN International tomorrow at 7 a.m. EST and 6 p.m. EST.


This interview was transcribed from an "ask me anything" question and answer session with Sanjay Gupta conducted on Reddit on 2014-03-11. The Reddit AMA can be found here.