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SANJAY GUPTA MD
FDA: Many Online Pharmacies Selling Fake Medicine; Doctors Who Can't Practice Medicine; The Brainbow Connection
Aired June 30, 2013 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Welcome to SGMD.
Lots to get to today -- including this: doctors who are working construction and flipping burgers in the United States instead of practicing medicine. I'll tell you why more of them could soon be seeing patients.
And, an amazing way to study the brain. I love this. You can literally see new connections being made.
But, first, a crackdown on pharmacy Web sites selling popular medicines that are not what you think they are. This week, the Food and Drug Administration shut down 1,600 Web sites it says were selling illegal, unapproved or counterfeit drugs.
The problem isn't new, but as I found out in my investigation, it's only getting bigger.
GUPTA (voice-over): Behind too many Web sites, says the FDA, is this. Counterfeit medications made in Ecuador, Peru, Paraguay, Colombia, China, often in back alley shops, under filthy conditions. Now, to get these fakes into your medicine cabinet, counterfeiters have to first get them across the border. Here in Los Angeles, we have one of the largest international mail facilities in the country.
(on camera): You say the problem is getting worse.
GORODON CHU, FDA SUPERVISORY CONSUMER SAFETY OFFICER: The problem is getting worse. It's on the rise.
GUPTA (voice-over): Here, U.S. Customs and Border Protection agents are separating out products to be screened, with a device called the CD3 (ph). It can identify counterfeit drugs on the spot.
(on camera): Are you able to screen everything that comes through?
MARCUS FAIRCONNETUE, FDA CONSUMER SAFETY OFFICER: We try to screen as much as we can. But before we would have to send it to the lab and then that could take weeks. So, what we're able to do here, we're able to do it in a few minutes.
GUPTA (voice-over): The National Association of Boards and Pharmacy or NABP says that most fakes come through online sales and that 97 percent of online sites don't comply with state and federal laws.
CARMEN CATIZONE, NATIONAL ASSOCIATION OF BOARD OF PHARMACY: They're offering prescription drugs without a prescription. They're selling unapproved FDA drugs. Drugs that the FDA has not found safe for applications or use in the United States or drugs that are not even allowed in the U.S. market.
GUPTA: Often the draw is cheaper prices and claims that the drugs are coming from Canadian pharmacies, which most Americans consider safe.
CATIZONE: The drugs that they are shipping to consumers, they believe are coming from Canada and have been approved by Health Canada are really drugs that are coming from places that you would never believe and never suspect.
GUPTA: In the fight to stop fakes, the FDA gets help from pharmaceutical giants like Pfizer. They know counterfeits can help the bottom line.
John Clark, Pfizer chief security officer, says his people found counterfeit versions of 60 different Pfizer drugs last year. That's up from 20 in 2008.
JOHN CLARK, CHIEF SECURITY OFFICER, PFIZER: Brick dust, wallboard, flour, things of that nature, the better counterfeiters might put in 10, 20 even 30 percent of the active pharmaceutical ingredient that's supposed to be in the medicine.
GUPTA: The Pfizer lab in Connecticut tests thousands of Pfizer products and packaging a year. It's found fake cancer medicine, fake vaccines, fake heart, fake cholesterol drugs, even fake ChapStick.
CLARK: They'll start with the packaging. Do a number of tests to sort of see authentic versus a counterfeit, or versus the questionable one. And if the packaging doesn't demonstrate that, it's counterfeit then they actually go to the medicine itself.
GUPTA: This is an audio clip that Pfizer gathered as part of an uncover investigation.
UNIDENTIFIED MALE: We can still make 50,000 pills a month.
UNIDENTIFIED MALE: Wow.
UNIDENTIFIED MALE: And that's by hand.
GUPTA: The company shares the information with law enforcement, which then conducts the actual raids and makes arrest.
Those counterfeiters were caught but plenty are not.
GUPTA: And joining me now from FDA headquarters, Dr. Margaret Hamburg, the FDA commissioner. Do you know of actual harm to someone taking one of these counterfeit medications?
DR. MARGARET HAMBURG, FDA COMMISSIONER: Oh, absolutely. These products can have none of the active ingredient that people need. They can have too much or too little. They can have toxic ingredients. They can prevent patients from getting the actual medications that they badly need to treat their disease.
Moreover, with certain kinds of conditions and their treatment, sub standard drugs, counterfeit drugs, can actually put us all at risk by enhancing the problem of drug resistance. This is true with a disease like malaria and its treatment.
HAMBURG: So, these are issues that affect people every single day.
GUPTA: Yes. I mean, even if they're not getting harmful ingredients, simply by getting inert or inactive ingredients, that could be problematic but they think they are treating their blood pressure and they're really not for example.
GUPTA: And this week, you announced crackdown for 1,600 Web sites for illegally selling counterfeit drugs, 1,600 Web sites.
GUPTA: What do you -- when I investigated this before, it seemed like they would have a Web site and be taken down, they would just come up with another one. How do you make sure these sketchy sites don't just pop up again with a different name?
HAMBURG: Well, it's a huge problem. And you're absolutely right. You close one down and it can pop up somewhere else. We need, you know, relentless attention from an enforcement perspective.
We also need to enhance public awareness. And that's part of what we're trying to accomplish. And why I'm glad you're doing this story because consumers need to know that sadly, the majority of Web sites that they're going to encounter when they search the Web, looking for an online pharmacy, are most likely rogue. They are not selling FDA approved products and they are operating illegally and potentially purchasing from these sites put people at risk.
GUPTA: Yes. And you've mentioned this before, but if you find a site that does not ask for prescription, is selling a product that they say is not FDA approved, those should be big red flags. I think 97 percent, I'm hearing --
GUPTA: -- ninety-seven percent of these Web sites could have some sort of fraudulence in that way. When you talk about Web sites, that's one particular thing, but people use those sites because it's expensive. These medications are pricey. I know my own family had done that.
Is there something they can look for on a site that is credible, instead of saying 97 percent are bad, we know these ones are good?
HAMBURG: Right. Well, that's so important. There are some things that consumers can look for. Number one, the Web site should ask for a valid prescription. And if they don't, beware.
The pharmacy, the Web site pharmacy should be located in the United States. They should have a license pharmacist available for communication. And they should be licensed in the state where the Web site is registered by the state board of pharmacy.
You're not assured of a safe product and a legally operating Web site pharmacy.
GUPTA: Dr. Hamburg, thanks so much for joining us. Appreciate it.
You know, every day, it seems we're talking about a gene that does this or that. But it was less than a lifetime ago that scientists first figured out the basic code for which our genes are written. DNA and its famous double helix shape was actually first described by Francis Crick and James Watson, you may know that. It's hard to think of a more discovery than this.
Now, as we celebrate its 60th anniversary, here is James Watson as he talks about his life's work.
(BEGIN VIDEO CLIP)
JAMES WATSON, 1962 NOBEL PRIZE IN PHYSIOLOGY/MEDICINE: I was inspired to go into science because I wanted to understand the world about me better. I wanted to know how birds did migrate. You know, I learned that when I was something like 8 years old, it seemed a big puzzle.
DNA was just becoming solvable. Crick and I both thought it was solvable. He was the first person I met I could talk to. I met people, but they didn't share my conviction only DNA was important.
There are no monks copying things inside cells. So, somehow the cell had way of copying its information.
We knew it has a structure. The information suggested there was a helix that they first around.
I think early on, I wanted to do something important with my life. I still wanted to think about science and really nothing else, being driven by the desire to find the truth. That's my legacy, the truth. Sometimes you don't find it and it's complicated. But you'll always have that as you start with the truth, it's helpful.
(END VIDEO CLIP)
GUPTA: James Watson there. Just in his mid-20s when he did some of that amazing research.
And up next on SGMD, immigrant doctors forced to work construction and odd jobs even as we have a shortage of physicians in this country. I'm going to show you one possible solution.
Stay with us.
GUPTA: The Congress and the country are in the middle of a hot debate over immigration. Now, wherever you stand on this issue, it does have a direct connection to another problem. And that's our doctor shortage in the United States.
It turns out there are thousands of medically trained immigrant doctors living in America but not practicing medicine.
DR. PATRICK DOWLING, UCLA: We've always wondered, given there's so many international medical graduates working in America, where are the people in Latin America? And we've stumbled upon them working in menial jobs.
This is a woman that works at McDonald's in Colorado.
GUPTA (voice-over): UCLA's Dr. Patrick Dowling and Dr. Michelle Bholat are on the hunt for Latino immigrant doctors.
DOWLING: She was in a University of Family Medicine.
Potentially as a solution to America's primary care doctor shortage. Dowling says there's a few thousands Latino immigrant doctors living in southern California alone, but they aren't practicing medicine anymore. Instead of treating patients, many spend years cleaning houses, working on construction sites and in fast food chains.
DOWLING: Often, they work for 10 years and come here. And they're not licensed, and then they see the process. So, they have to get a job to support themselves.
GUPTA: Jose Chavez was a doctor in El Salvador with more than eight years of training when he moved to the United States in 2005.
DR. JOSE CHAVEZ, RIVERSIDE COUNTY REGIONAL MEDICAL CENTER: I'm going to call this patient to let them know we're going to refill her medication. Is that OK?
UNIDENTIFIED MALE: Of course.
GUPTA: But prior to last year, he wasn't working in this U.S. hospital or any hospital. Instead --
CHAVEZ: I will do anything you ask me to as long as it's legal and you pay me for it. I was helping, you know, cleaning houses, painting, doing flooring.
GUPTA: For years, he juggled odd jobs during the day with studying for the U.S. medical boards at night.
CHAVEZ: It requires that you study at least 10 hours a day. Imagine you're working eight to 10 hours a day, and try to study eight to ten hours at night. It's really impossible.
UNIDENTIFIED MALE: All residents are required is to submit a personal statement.
CHAVEZ: It's a costly, time-consuming process that most Latino immigrants aren't prepared for.
UNIDENTIFIED MALE: One of the things I want to help you avoid is to help you --
GUPTA: UCLA's IMG program helps fast track these doctors to practice medicine again.
UNIDENTIFIED FEMALE: Hi, everybody. How are you doing today?
GUPTA: It provides a stipend as well as medical board prep classes and mentoring by UCLA physicians.
CHAVEZ: When I get accepted I was able to stop construction and focus on my exam. That gave me the opportunity to take the test six months after joining the UCLA program.
GUPTA: They've helped 66 Latino immigrant doctors including Chavez pass the U.S. medical boards and then get placed in residency boards in southern California. There is a desperate need there. In Riverside County, there's just one M.D. for every 9,000 people.
But, now, Dr. Chavez gets to be one of their physicians.
GUPTA: Now, if you're wondering, this UCLA program is completely funded by private donations. And here is another number to think about as well. You know, with Obamacare, an estimated 25 million to 30 million new people are going to have health coverage next year, and they're going to be looking for doctors. The shortage is important. It's probably going to get worse before it gets better.
Imagine being confined to a wheelchair your whole life and then someone gives you a chance to get out. Now, you have a sense what Ryan Chalmers felt when he left the security of his wheelchair for the depths of the ocean.
GUPTA (voice-over): Ryan Chalmers was born with spina bifida. That's an incomplete closure of his he spinal column. As he grew up, he excelled at wheelchair sports. But then he decided to try something new, scuba diving.
RYAN CHALMERS, PARALYMPIAN: When I went diving for the first time, it really opened my eyes to that whole idea that, you know, I'm exactly like the able bodied people down under the water.
GUPTA: Now 24, Ryan just returned from the push across America, pushing his wheelchair 3,000 miles across the United States to raise money for Stay Focused. It's a charity that helps disabled people learn to scuba dive.
GUPTA: So, 3,000 miles, 71 days. I'm curious and people are watching that video, I mean, what do you even think about? What's going through your mind as you're doing this?
CHALMERS: You know, it changes throughout each day, what you're going through if you're going through the mountains of Colorado or you're going through, you know, just the flat lands of Kansas. But, you know, a lot of it comes back to thinking about why I started to journey in the first place and the people I got to meet along the way, because that's what this is all about, you know, awareness. And being able to meet people is what made it all worth it.
And so, it was really just thinking about, you know, all the people we impacted.
GUPTA: You have raised about $500,000 roughly for Stay Focused. Is that right?
CHALMERS: So, what happens next?
GUPTA: You know, actually, over the next couple of weeks, I'm going to go with the Stay Focused program. And we're just really trying to make it sustainable, make an organization, you know, Roger Muller, who's the founder of the organization, this is the 10-year anniversary.
And so, I'm just trying to help. You know, it's changed my life. The organization has changed my life ever since I was a part of it in 2005. I just want to be able to make a difference and go forward.
GUPTA: Are you aiming for Rio in 2016?
CHALMERS: That's the plan. I went to London for Paralympic Games 2012. And then, that's the goal for the next three years is to focus on Rio and see, well, I can do that.
GUPTA: We're going to keep an eye on you. We hope we'll see you in Rio as well.
GUPTA: All right. Thanks so much for joining us.
CHALMERS: Up next, an incredible new look at the wiring of the brain. We'll take a look at that.
GUPTA: Welcome back to SGMD.
You know, earlier this year, President Obama announced he would commit $100 million to create a detailed map of the human brain. Well, I recently got a chance to visit the neuroimaging lab at UCLA to see an early phase of this work. I can tell you, if nothing else, it looks amazing.
GUPTA: How much progress have we made in neuroimaging say over the last 10 years?
DR. ARTHUR TOGA, UCLA NEUROIMAGING LAB: I think it's been amazing because the technology to acquire detailed images of structure and function has been unprecedented. We can look at very small regions as small as a millimeter or even smaller, in a living human individual and we can relate not only what we see in terms of its anatomy, the person's anatomy, but how it works.
GUPTA: The function.
TOGA: The function. How those cells are interacting with other regions in the brain to allow that person to behave.
GUPTA: This is pretty spectacular. What are we looking at?
TOGA: You're looking at tracks. You're looking at the fibers themselves that connect different regions. And it allows us to see what region is connected to where and how much of a connection is there.
GUPTA: Talk about function like movement and sensation, people understand that. What about things that are a little more nebulous -- self-awareness, happiness, pain and reward, is this going to help better identify those areas?
TOGA: I hope so. Obviously one has to start with a cruder map initially. It's like making a map of the earth. We create a coordinate system. We find where the continents are.
But now, we can, with our GPS systems, we can find specific roads. We can even look at the amount of traffic on those roads. That's a very good analogy because it holds on when we're studying the human brain as well.
We first have to create these big maps that show us the overall picture of how the brain is wired. But then we go down and look at the final detail.
GUPTA: What does this mean for the average person?
TOGA: I think it's important for us to undertake a challenge like this because we suffer from a number of neurological disorders. The population is getting older. It's an increased percentage of people that have Alzheimer's disease, for example. This kind of science lays the foundation for us to look for targeted therapies and really is instructive in terms of improving the health and well-being of everyone.
GUPTA: Of course, the physical structure is just one part of the understanding of the brain. It's daunting for sure but it could someday change the way we understand ourselves, maybe in the way that we practice medicine in a very real way.
And next, before you head to the beach this summer, what you need to know before you take a dip.
GUPTA: Our Fit Nation team is a little more than two months away now from racing in the Nautica Malibu triathlon. And they're all looking pretty good.
In fact, 6-pack Rae Timme, she's a Colorado prison warden, she's also the oldest member of our group, since she started training, she's lost more than 17 pounds. She's now running up to six miles a time and she's even come to love those long bike rides.
(BEGIN VIDEO CLIP)
RAE TIMME, FIT NATION PARTICIPANT: I was motivated to do this because I wanted to feel better and I was willing to do the work. I cannot begin to tell you how good I feel, how much energy I have.
(END VIDEO CLIP)
GUPTA: Congrats, Rae. I'm going to see you at the finish line. I'm confident of that.
And time now for "Chasing Life".
It's officially summer and I know a lot you have are headed to the beach. But before you step into the water you may want to look at the National Resource Defense Council's annual list of the country's cleanest and dirtiest beaches.
Now, some of the top beaches in the country include Gulf Shores Beach in Alabama, Newport Beach in California, and Dewey Beach in Delaware. But you want might to think twice if you're headed to Avalon Beach in California, or Beachwood Beach in New Jersey. Both have been listed among the dirtiest beaches in America for the past five years.
That's going to wrap things up for SGMD today. But stay connected with me at CNN.com/Sanjay. Let's get the conversation going as well on Twitter @DrSanjayGupta.
Time now though for a check of your top stories making news right now.