In embracing medical cannabis, CNN’s Dr. Sanjay Gupta cultivates another ethical quagmire

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Mary Chris Jaklevic is a reporter-editor at HealthNewsReview.org. She tweets as @mcjaklevic.

In a promo for his upcoming report on the role of marijuana in alleviating the opioid crisis, CNN chief medical correspondent Sanjay Gupta, MD, beckons viewers: “Join us as we investigate a search for answers and meet potential pioneers and outspoken critics. Whether you struggle with opioids or know one of the millions who do, decide for yourself.”

Decide for yourself?

He seems to suggest that legalizing medical marijuana is an issue on which reasonable people may disagree.

But Gupta has already made up his mind (for a second time) about medical marijuana, and he wants the world — and particularly U.S. Attorney General Jeff Sessions — to know about it.

On Tuesday Gupta published an open letter calling on Sessions to support legalized medical marijuana, asserting that it could save the lives of up to 10,000 people a year who are addicted to opioids.

The letter was announced on CNN’s web site right under that promo for his upcoming documentary, “Weed 4: Pot vs. Pills”:

We’ve written many times about Gupta’s showboating, where he injects himself into stories in ways that undermine journalistic objectivity and raise significant ethical concerns. It happened when Gupta reported on his own delivery of medical care to Haitian earthquake victims, as well as when he subjected himself to a coronary artery calcium scan as part of a “mission to never have a heart attack.”

We’ve also seen him cast aside journalistic independence to be considered for the post of surgeon general under the Obama administration.

Gupta often portrays himself as simultaneously a journalist, a doctor, and an advocate. Sometimes those roles conflict, and this is one of those times.

Data uncertainties aren’t mentioned

At the heart of Gupta’s four-page public plea to Sessions was this sweeping claim: “If we had to start from scratch and design a medicine to help lead us out of the opioid epidemic, it would likely look very much like cannabis.”

But he didn’t acknowledge the extensive limitations of the data behind that assertion, as the public should expect a journalist and a medical doctor to do.

Take research by the Rand Drug Policy Research Center showing declines in opioid overdose deaths in states with legalized marijuana, about which he wrote: “Though it is too early to draw a cause-effect relationship, these data suggest that medicinal marijuana could save up to 10,000 lives every year.”

The very significant uncertainties about whether marijuana is actually responsible for those declines went unexplored.

Further, Gupta didn’t say it’s unclear whether that association can be sustained. Rosalie Liccardo Pacula, co-director of the research center,  has pointed out that the link between legal marijuana and fewer opioid deaths has declined as states have tightened medical dispensary regulations and as the opioid crisis has shifted from prescription opioids to heroin and fentanyl.

“This is a sign that medical marijuana, by itself, will not be the solution to the nation’s opioid crisis today,” she said in a news release.

Extrapolating from cancer data

Gupta wrote that cannabis is “proven to offer relief” from symptoms of opioid withdrawal such as rapid heart rate, nausea and vomiting, excessive sweating, anorexia and anxiety.

Where’s the proof? He cited “longstanding evidence that cannabis helps chemotherapy-induced symptoms in cancer patients, and those symptoms are very similar to opioid withdrawal,” linking to a paper by a doctor funded by four cannabis companies.

But do conclusions that apply to chemotherapy hold for treatment of opioid withdrawal?

Sean Hennessy, PharmD, PhD, a professor of epidemiology at the University of Pennsylvania who served on a panel of medical experts that produced a sweeping 2017 National Academies of Sciences, Engineering, and Medicine report on cannabis health effects and also has consulted with GW Pharmaceuticals, a biotech company focusing on prescription cannabinoid medicines, told HealthNewsReview.org in an email he’s unaware of any data from controlled trials on whether cannabis helps people quit opioid use.

“As far as I know, it’s not been rigorously studied,” Hennessy said. “Dr. Gupta seems to be aware of case reports. In this way, some statements in his letter may overstate the documented benefits of cannabis.”

Reliance on anecdotes

Gupta wrote, “All over the country, I have met patients who have weaned themselves off of opioids using cannabis.” He relates the story of an attorney who suffered opioid withdrawal symptoms and found pain relief with marijuana “with hardly any side effects.”

But while anecdotes may be valuable for providing clues on the direction research should take, they don’t amount to evidence of a benefit.

“I have a whole bag of anecdotes that say the opposite of what he’s saying,” said Colorado Springs pain doctor Ken Finn, MD, who serves on the medical advisory board of Parents Opposed to Pot. “That does not make good science.”

Holding out a hypothesis as a proven benefit

Gupta acknowledged demonstrated effectiveness of medication-assisted treatment for opioid addiction, but related one researcher’s concern that it might “cause ongoing disruption to the glutamatergic system, never allowing the brain to fully heal.”

He wrote that “compounds found in cannabis can heal the diseased addict’s brain, helping them break the cycle of addiction.” The basis for that statement appeared to be an idea under study that cannabidiol, a compound in marijuana, might be able to curb opioid cravings.

But Gupta treated that concept as settled science — not as a tentative hypothesis that required testing in rigorous studies:

This new science sheds lights on stories like the one I heard from Doug Campbell of Yarmouth, Maine. He told me he had been in and out of drug rehab 32 times over 25 years, with no success. But soon after starting cannabis, he no longer has “craving, desire and has not thought about (opioids) at all, period.”
For the past 40 years, we have been told that cannabis turns the brain into a fried egg, and now there is scientific evidence that it can do just the opposite, as it did for Campbell. It can heal the brain when nothing else does.

‘I didn’t look hard enough’

This isn’t the first time Gupta — a neurosurgeon — has offered up his views on marijuana policy.

In 2009, he published an op/ed in Time magazine saying he opposed the legalization of marijuana. He acknowledged some evidence of medical benefit, then wrote that he was “unimpressed with the (then) proposed legislation, which would legalize marijuana irrespective of any medical condition.”

Back then he wrote about “numerous deleterious health consequences” including possible addiction, affects on short-term memory, impaired cognitive ability, depression or anxiety, lung damage, and impaired driving.

None of those potential ill effects were addressed in this week’s letter, or when Gupta reversed his stance in 2013, days before the CNN ran the first of his series of reports on marijuana. Gupta said what he learned in the process of reporting changed his mind:

I apologize because I didn’t look hard enough, until now. I didn’t look far enough. I didn’t review papers from smaller labs in other countries doing some remarkable research, and I was too dismissive of the loud chorus of legitimate patients whose symptoms improved on cannabis.

That could be. But now, Gupta has committed a different sin by selectively ignoring facts that don’t support his advocacy perspective.

In both cases, he failed to point out the void of reliable data on marijuana’s benefits and harms that stymies decision-making.

In both cases, the public loses.

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Comments (7)

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Susan McElyea

April 27, 2018 at 2:40 pm

Hi. I have been following the pharmaceutical companies somewhat, based on information that they are responsible for not divulging the truth about the duration of opioid effectiveness on pain. In short, my family has been affected from this and the best way I know how to describe it to someone who doesn’t understand…by the time you think this is knocking on the front door to your home…it has already came into your home…through the backdoor, affecting your family and home. I wish I could get more answers. I reached out to Governor Bentley’s office (Alabama) back in 2016 asking for help/guidance. But more needs to be done. My opinion at this moment, it is not the doctors or the pharmacies but the manufacture of the medicine who were not truthful about the formula. More needs to be done to ask the manufactures to pay for the remedies to help and aid patients. States are currently going after the manufacturers, however no one seems to want to represent the actual people affected. Financially draining on the family to get medical help. Almost lost my home of 25 years+ just to pay for doctor(s) to help family member. I don’t want to sound angry because I am not, but I am passionate about finding help for those who need it. I appreciate your time if you have read my response. I was trying to contact Dr. Gupta but wasn’t able to find an email address for him or his staff. That is when I cam across your article. Regarding the marijuana/cannabis as a remedy, I personally do not have an opinion about it. But I am open to something that will take the pain/strain from me and my family. I will say that after exhausting my last penny, my family member has been working full time, living independently and successful. I ask others do not judge. I saw people in my community from lawyers, bankers, teachers, all economic classes (no one is immune is what I had to realize and to be humble and not embarrassed) at this certain clinic when I would take my family member. Thank you for your time. Susan

Karen Randall

April 30, 2018 at 9:08 am

There has been widespread and readily available marijuana through out the state of Colorado for the last 4 years. Despite this, Colorado’s opioid deaths have increased, with 2016 setting a record number of deaths due to opioids (yes, prescription opioids decreased, but deaths due to heroin and fentanyl increased). Dr. Gupta is misleading the public by only talking about 1/2 of the study. As a medical professional, he should know better. He did not speak of the harms that we in Colorado are seeing: increased youth usage, increased DUIs, hyperemesis, overdoses, increased crime, etc. Funny that in Dr. Gupta’s shameless commercial advocating for the use of marijuana, he forgot to mention the harms. And wait, he did not talk about the exposure to infants and babies in utero. There is strong evidence that maternal use in pregnancy affects the fetus. There is evidence that the fetus will lose IQ points.
Finally, while encouraging everyone to use marijuana, he forgot to mention that THC is addictive. There is not enough centers for treatment for opioids and now we need mental health facilities to treat marijuana addictions. The number one addiction treatment diagnosis for youths in Colorado is marijuana dependancy.
Bottom line – user beware. Be willing to accept the plethora of adverse events when using marijuana. The high concentration THC being sold now is NOT the pot of the 1970s.

Aubree Adams

April 30, 2018 at 10:02 am

Dr. Gupta and CNN have lost all credibility. Their report tonight was political and totally anecdotal, but I don’t think the average person would understand that so here are some key points they left out.
Pills are made so you don’t have to smoke drugs, they demonized pills, and promoted smoking. Smoking puts tar and toxins in your lungs. He must have forgotren to mention that.
They reported opioids increase suicide risk but did not share that cannabis increases suicide risk by 7 fold and he didn’t educate the audience that cannabis is the #1 drug to produce mental illness. (Lancet psychiatry 2014.)
They had images of weed being smoked over and over. They even showed one of the football players smoking weed while he was exercising. (Do they have to constantly smoke weed?)
It’s not safe lifting heavy weights with a marijuana cigarette in your mouth. They are normalizing use and showing clean-cut people who use it that are rich. They didn’t show you a mentally ill person on the street. They also didn’t show you a Marijuana rage, but they showed an opioid rage.
Withdrawal from marijuana can look like psychotic breaks; they did not share that. They did not tell you THC effects the reward system of the brain just like any other drug thus rendering it powerless just like any other addiction.
Cannabis gums up the receptor sites too and can potentially damage them.
Walking around stoned all the time is not a solution. They didn’ t show how marijuana impairs driving skills and puts you at a high risk for injuries. Someone who is stoned should not be picking up children.
They stated marijuana is an exit drug to get off opioids and they did not report any risk of a returning to use opioids. I know parents whose children did return to opioids and now have died.
They showed drug bias. Poly use of many drugs is common with addiction.
They did not report most opioids overdose deaths have multiple drugs in their system, including marijuana.Marijuana is often a companion drug.
Federal funds have been released for studies, but they needed to demonize Jeff Sessions to politicize this issue and stay true to the left wing agenda.
They actually stated federal money is not being used when it is and many studies have happened and are still happening. (25,000 studies at the University of Mississippi, and all the excellent data from Europe.)
Also after they stated federal funds were not being released to study cannabis then they announced the 1st medical grade CBD oil that will probably be approved in a few months. They didn’t tell you how that was pushed through fast so these families can have safe CBD oil .
They didn’t show the people who didn’t benefit from cannabis, they just tried to demonized Jeff Sessions. Obviously Jeff Sessions has observed the negative impacts of marijuana.
They don’t tell you most of these opioid addicted people have been abusing drugs since their youth and many of them probably were using marijuana before becoming addicted to opioids.
They lied stating it is not a gateway drug. They called thousands of us parents liars and denied all the studies that prove marijuana can be a potential gateway/ pathway drug. They didn’t tell you Marijuana primes the brain for an opioid addiction.
Zero fatalities is a lie. Levi Pongi, Daniel Juarez, momsstrong.org
Patrick Kennedy did an excellent job and set Dr. Gupta straight. He called him out on his BS!!
This was a political report/agenda, not a true science report. It was all Anecdotal!!!
In conclusion, an FDA approved the drug is much better than coming from the marijuana industry. The marijuana industry is poisoning many people with heavy metals, pesticides and fungus.
The NFL denied the use of Mike’s marijuana because using cannabis is like playing Russian Roulette with his brain. You don’t know if one hit off a joint may cause a psychotic break.
This was a political report/agenda, not a true science report, it was all Anecdotal!!! At least they have Dr. Volkow state the truth. I have high respect for her!!!

Ken Finn

April 30, 2018 at 10:34 am

Colorado had a record number of opioid overdose deaths in 2017 despite a medical marijuana program since 2001. Colorado is now experiencing an increase in deaths associated with methamphetamine and cocaine since legalization of marijuana. This has become a significant public health and safety issue, particularly as it relates to youth use and driving fatalities, to name a few.

Bill Hutchinson

April 30, 2018 at 1:37 pm

Gee, I’m no fan of Dr. Gupta, but it’s the 4 comments below, that I find most disturbing. What a load of ridiculous nonsense, intermixed with *SOME* legitimate info. Let’s remember, folks, that cannabis was part of the U.S. Pharmacopeia until well into the 20th Century. So we’re really RE-legalizing cannabis. Cannabis is the strongest “drug” known to man. It can make people psychotic, who have never even used it! Yes, but I’m only being partially facetious. I’m sorry, but “one hit off a joint” can NOT “cause a psychotic break”, as was alleged below. The 1930’s movie “Reefer Madness” was blatant hysteria and false propaganda, and sadly, we still see the same sorts of pseudoscientific nonsense today. Too bad the “gateway” crowd can’t acknowledge that cannabis is ALSO a GATE-Keeper drug. Most people who go on to use “harder drugs”, would have done so with or without cannabis. Cannabis is no panacea, but neither is it as bad as the “Reefer Madness” crowd believes, either. Most of the so-called “problems” we’re seeing with (re)-legalized cannabis are in fact social problems cause by ignorance fear, anger, and prejudice. And while we’re arguing over cannabis, global drug dealers, and worse anti-American forces, are flooding fentanyl and carfentanyl onto our streets. It’s chemical warfare against a civilian population, and that’s far beyond a simple medical issue….
(c)2018, Tom Clancy, Jr., *NON-fiction

Lori Robinson

April 30, 2018 at 8:22 pm

It’s really time for some honest discussion about why CNN is once again promoting only the virtues of weed ( think ratings) by allowing their celeb reporter Dr Sanjay Gupta another round of so-called “weed documentaries” (would love to know how much Gupta is paid by the pot lobbying groups). Anytime a reporter calls me I ask a couple of important questions 1) are you or anyone in your immediate family invested in the pot industry 2) please share what being an ETHICAL journalist means. It seems in the 21st century too many people obtain their informed opinion, not based on the science, but rather on social media sites. Dr Gupta claims he’s been misguided about the benefits of pot for several years. Now he’s touting the virtues of marijuana to curb the opioid epidemic. Interestingly, former Speaker of the House, John Boehner, also had a change in opinion about marijuana virtues as he now sits on the board of a big cannabis company.
Let’s ask the public to open their eyes and be very clear:
“Medical” marijuana until isolated cannabinoids go through the vigors to pass FDA approval where such compounds can legitimately qualify with the title of being “medical” the pot products sold in dispensaries creates high risks for healthy people — especially young people — who make up the majority of Americans.
The article below is long, but exceptionally thorough from the American College of Pediatricians which covers the true THC harms from the unborn child to the young adult:
https://www.acpeds.org/marijuana-use-detrimental-to-youth.
While no one argues the value of finding solutions to the opioid crisis, why should we create added problems because Dr Gupta wants to ignore the myriad of adverse effects from pot.

Karen Randall

April 30, 2018 at 8:52 pm

Really to Bill Hutchinson: we did not just re-legalize marijuana. We legalized high concentration THC. This is different than the marijuana of the olden days. Can you imagine if they had been able to manufacture THC concentrate back then? Wonder where we would be now. Much of the harms we are currently seeing are secondary to the high concentration of THC and the fact that people are smoking more. It is not uncommon for a patient to tell me that they smoke over a gram of THC/day (compared to 1-3 mg of THC from the 1960’s). This is where the issues and problems are coming from.