The Doctor Is In

[dropcap class=”kp-dropcap”]N[/dropcap]amed one of the 10 most influential celebrities by Forbes in 2011, CNN Chief Medical Correspondent Dr. Sanjay Gupta didn’t just report on the Iraq War, he performed neurosurgery on wounded Marines while reporting on the Iraq War. The Emmy Award-winning host of Sanjay Gupta, M.D. appears regularly on 60 Minutes and Good Morning America and is such a massive star that he single-handedly caused a sea change in cannabis history in 2013, when he publicly reversed course and declared his support for medical cannabis.

Science drove Gupta’s conversion, he said, as it has driven his entire life. The first-generation Indian American was born in Michigan in 1969 to two engineers, and obtained a Bachelor’s Degree in Science from the University of Michigan, followed by a Doctorate in Medicine from the University of Michigan Medical School in 1993. In 1997, the trauma neurosurgeon became a White House Fellow and special advisor to First Lady Hilary Clinton. In 2001, Gupta joined CNN and has reported from hurricane-ravaged New Orleans, war-torn Iraq, and earthquake-devastated Haiti.

In 2013, his CNN show brought him to Colorado to where he met a child named Charlotte Figi who had almost died from chronic, incurable seizures before Figi’s parents tried medical cannabis, with near-miraculous effects. Gupta’s bombshell, hour-long documentary Weed debuted in August. Here was an assistant professor of neurosurgery at Emory School of Medicine, and an associate chief of neurosurgery at Grady Memorial Hospital in Atlanta, Georgia saying that he and other Americans had been “terribly and systematically” misled about cannabis. It was a risky career move that made him the tallest lightning rod for the issue, but instead of backing down, Dr. Gupta has doubled down.

In early March, Dr. Gupta released follow-up documentary Weed 2: Cannabis Madness, detailing the plight of medical cannabis refugees moving to Colorado and Washington to seek treatments unavailable in prohibition states. In the following interview with CULTURE, Dr. Gupta explains why medical cannabis should be available in every pharmacy in America, and how he had been misled.

What are you hoping to accomplish with Cannabis Madness?

I think there’s some very interesting science here that people are clamoring for. They want to understand this substance better—what it is, what it does to the body, and these types of things. So I want to certainly use this as an opportunity to teach through some stories of what’s happening on the ground here in the U.S.

One of the things that’s happening is the dichotomy between federal law and the states and the resulting refugee situations in places like Colorado where I am now. We want to tell some of those stories as well.

Why the title Cannabis Madness? What were you hoping to evoke?

It was a riff on Reefer Madness from 1936, which I think everyone agrees now … was a propaganda film filled with a lot of falsehoods and hyperbole.

Cannabis Madness is supposed to be a modern day look at medical marijuana and at the real science of it. I hope it’s a much more factual look at this issue.

Eight months ago you came out and said we’d been “terribly and systematically” misled. How did medical school at the time you were in it confront cannabinoid science?

I think when you talk about something being “systematic” it really means at all levels there was misleading going on.

When you look at scientific discovery, people coming up with hypotheses for a particular scientific problem, you’d expect there to be a broad array of questions being asked around the topic.

What I came to realize, ultimately, was that the vast majority of studies that were funded in the U.S. were designed to look for harm. The idea that the National Institute on Drug Abuse had such a role in approving these marijuana studies and approving the ability to get funding and marijuana—it painted this sort of picture. That was part of the systematic misleading, but it goes deeper than that.

In 1972, when this was classified as schedule 1 substance, denoting it as being among the most dangerous substances, it’s usually because you have scientific evidence to show that. In this case, there wasn’t scientific evidence to show that. There was a paucity of scientific evidence, at least according to people who made the recommendation for it to be a schedule 1 substance.

That’s really unusual to think that way. Usually you do things because of evidence, not because of the lack of evidence.

And then I think part of it is the overall stigma and demonizing of this substance.

After the first documentary aired, I had a lot of healthcare folks and doctors and healthcare leaders of organized medicine who called me and did not want to be named, but they said, ‘Look, of course you’re right on this stuff. We’ve known this. It was on the Pharmacopeia in the U.S. up until the early ‘40s.’ They just don’t want to talk about it.

So that’s part of the systemic misleading as well.

Are you taking heat for these positions?

There’s heat. But in some ways it hasn’t been as lonely a position as I expected it to be. I get these calls from people voicing support behind closed doors. But the thing that people have not argued with are the facts that we present, and I think that’s really important.

What do your parents think of your cannabis reporting?

They have been fascinated with it . . . This hasn’t been a big moral dilemma or something that we did a lot of hand-wringing over it.

We’re a family of scientists . . . and the emotional part of this is the idea that politics have trumped science for so long. If you’re a scientist and you were brought up that way, that’s never something you want to hear.

Have people needlessly suffered and died over this war on cannabis?

Probably. We know that cannabis can be a medicine. I’ve seen this now myself. They’ve known this in other countries for a long time. We’ve probably known it here even though we haven’t been as public or as vocal about it. We know cannabis has been used as a medication openly in hospitals in Jerusalem because they believe it’s part of a treatment protocol that extends and improves lives.

What is most compelling is it seems to have worked in situations where nothing else has—these situations with children with intractable epilepsy, children on seven different medications, different generations of medications, and they’re not working. And then they try this oil that’s high in CBD, low in THC, but full plant extract oil and they get tremendous results.

It doesn’t work for everybody, just like any medication doesn’t work for everybody, but this idea that it could work when nothing else has—I think its’s safe to say that people have probably suffered when they didn’t need to because of this not being available to them.

Should forms of medical cannabis be in every pharmacy in the U.S.?

It should be treated like any other medicine . . . Ultimately, we want this to go through the same safeguards as any other medicine so people have a degree of confidence their product is safe and effective. And we haven’t been able to do that because you’re dealing with a substance that is listed as “schedule 1,” so it’s very hard to get testing and safeguards in place when it’s deemed as not having any medicinal benefits.

But ultimately, you got the first FDA-sanctioned trial starting in this country and we’ll get results back from that, that this is a medicine, they will show that it works and has been shown to work in other countries already—yeah, I guess it should be available to anyone who needs it.

You’ve been focused tightly on medical cannabis. What if I want to puff on a vapor bag instead of having a glass of wine after dinner? Has recreational use become part of your perspective yet?

My focus has been on medicinal marijuana. I’m happy to talk about recreational but the reason that I haven’t is because I think the moral equivalency argument has, in some ways, worsened the stigma around this. When you look at a medication like (anti-convulsant) Dilantin. OK, well Dilantin is better than alcohol for you, so therefore it’s good?

I really wanted this issue to stand on its own merits, because I think it certainly can and it should.

So, first things first, let’s get this drug re-scheduled and then have that discussion?

Yeah. As a doctor, as a neuroscientist, I think there is a certain degree of irresponsibility with not making this available to people who need it and that’s where I really want to focus.

Can cannabis cure cancer?

Some of the original research shows that people who were taking cannabis for their side effects from chemotherapy seemed to do better than those who did not. It’s a very fertile area of study I think.

Dr. Donald Abrams has certainly done some incredible work in Northern California. I don’t know what the status is right now but the word “cure” is a bit of a loaded word. I don’t know that we’re ready to say that.

Can cannabis cure epilepsy?

Again with the word “cure” I think it’s a little bit of a loaded word. I’ve seen these situations where you have children that have been having 300 seizures a week down to now two or three per month with the cannabis oil and one little girl is not taking any other medications. She’s not cured, per se.

She is a happy, healthy girl. Before, she was seizing all the time. Forget about going to school or having a way of life. I mean, her parents were constantly worried she would not survive. Now, when I meet her, she’s leading me around introducing me to her friends.

Is that a cure? I guess not. She’s still having some seizures. But, it’s just so dramatically better than what she was. It’s pretty darn close.

What excites you about cannabinoids for spine and brain trauma, your area of expertise? 

In the case of trauma and both blunt force and ischemic trauma, it’s pretty exciting. It’s a really tough thing to treat and accelerate the healing after head trauma or stroke and ischemic injury from stroke.

The U.S. holds a patent on using cannabinoids as a treatment for those types of injuries from blunt force or stroke. That’s exciting.

You recently endorsed whole plant cannabis medicine, arguing that THC, CBD and other cannabinoids work better synergistically than alone. But the so-called “entourage effect” flies in the face of the modern medical paradigm of ‘single-molecule, single-target’ drug development. Who is going to win here?

I’d like to think the entourage effect. Marijuana is what we’re discussing now, but the entourage effect can be applied to a lot of things. Whole foods, whole fruits and vegetables, we know, are better than fruits and vegetables in pill form. It’s not novel thinking. It’s pretty widely accepted in some places.

With some of the CBD-only legislation going on, I hope the science there helps inform the medical marijuana legislation going forward. I do think the whole plant extract is going to be a more effective treatment option. We saw this with Marinol already. It just doesn’t seem to have the effect, the same benefits for people . . . There’s going to be a lot of back and forth on that . . . Hopefully, people will come to a better understanding of the entourage effect and see it as the better option.