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The Current Transcript for March 13, 2018

Host: Anna Maria Tremonti

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

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Those deaths of Canadian soldiers those inflicted by the Taliban at a time when American taxpayer money was supporting ISI. How was it that the NATO system accommodated that betrayal?

ANNA MARIA TREMONTI: After 9/11 and throughout more than a decade of warfare in Afghanistan the U.S. was performing some dangerous geopolitical gymnastics with an ally that it knew was playing a deadly double game. Deep within Pakistan's spy agency, the ISI, was another secretive agency, Directorate S, whose attempt to extend Pakistani influence saw it arming, supplying and trying to legitimize the Taliban. It was against that backdrop that the U.S., Canada and other NATO allies arrived to fight a war against Al Qaeda's Taliban hosts. General Steve Paul has documented the consequences as layers of spy craft among allies and enemies turn to warfare. Steve Coll joins me in an hour. Also today you can exercise like it's the 80s.

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This is my brand new aerobic workout tape Sweatin' to the Oldies. And if you don't like having fun, hahahaha... Well, you best not come in here. Woo.

AMT: Or you can avoid the bad music, the sweaty armpits and the gym fees then simply swallow an exercise pill. As researchers close in on a drug with the potential to reprogram genes and recalibrate muscle in a way that mimics exercise, the optimist sees potential for those with conditions that limit their mobility. The pessimists see a windfall for athletic cheats. We'll tell you more in half an hour. But we're starting with the tiniest of those affected by the opioid crisis.

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[Sound: Crying baby]

AMT: And the first still keep infants exposed to opioids in utero closer to their mothers in the immediate days after their birth. A practice doctors say it can be life changing in the best of ways for both. I am Anna Maria Tremonti. This is The Current.

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Separating newborn babies from mothers with addiction does more harm than good, says doctor

Guests: Rebecca Dowds, Dr. Ron Abrahams

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[Sound: Newborn crying]

AMT: The cries of a newborn baby but with the distress in its cry that should not be there. The baby's mother is dependent on opioids. The child is born suffering from neonatal abstinence syndrome. As Canada's opioid crisis worsens there are more and more babies born this way, some eighteen hundred a year. That's a 27 percent increase from five years ago. Now hospitals are taking a different approach in dealing with them. Normally they've been whisked off immediately after birth to neonatal intensive care units where they can be monitored and treated for withdrawal symptoms. But new medical research and advice from pediatricians is changing that. Increasingly hospitals are adopting rooming in policies that let the baby stay with their moms. Something advocates say has better outcomes for all involved. Rebecca Dowds is a mother who participated in the rooming in program at Kingston General Hospital. She joins us from Kingston, Ontario. Hello.

REBECCA DOWDS: Hello.

AMT: How did opioids become part of your life?

REBECCA DOWDS: A suffered from back pain and sciatica and I was looking for a way to manage the day to day pain just to get through things like work and day to day life.

AMT: And what were you taking?

REBECCA DOWDS: I was taking Percocet which is a 5 mg oxycodone with [unintelligible].

AMT: And by the time you were pregnant how much were you taking?

REBECCA DOWDS: Approximately seven pills a day.

AMT: And how long have you been doing that?

REBECCA DOWDS: It was almost two and a half years.

AMT: So you were addicted to them at this point.

REBECCA DOWDS: Yes definitely dependent.

AMT: When you found out you were pregnant what was your response to that news?

REBECCA DOWDS: I was excited but very nervous, having knowledge about what narcotics could potentially do to a child while pregnant.

AMT: And so what happened? Did you try to get off the opioid you were pregnant?

REBECCA DOWDS: When I first found out I went to the pain specialist I was seeing who had been raiding the prescriptions and told him of the pregnancy and that I wanted to start lowering my dose as soon and quickly as possible. In the middle of doing that I ended up moving from Newmarket to Kingston and so I didn't have a family doctor or OBGYN when I moved here at first.

AMT: So you didn't have any medical assistance in trying to lower the dose.

REBECCA DOWDS: Not for a few months.

AMT: What happened?

REBECCA DOWDS: I ended up going in with some chest and back pain that were unusual and found out I need my gallbladder removed at 20 weeks pregnant. So when I had completed the surgery there was a surgical resident that went to school with someone who became a family practitioner and set me up with him for a family doctor, as well as the OBGYN floor. They have several doctors there and that is how I started seeing a doctor regularly and discussed lowering doses with the OB. They tend to recommend being finished, lowering and stopping medication by about half way through the pregnancy, 20 weeks, and I already surpassed that point.

AMT: And so how was your daughter when she was born?

REBECCA DOWDS: Thankfully very well. She had one minor symptom which was sneezing. By the time we left the rooming in program which was about these, she went from sneezing a couple times an hour to once every couple days.

AMT: So let me a little bit more about the rooming in program. What happened? What was that like?

REBECCA DOWDS: So after the initial 12- 24 hour recuperation period since I had an epidural I was there a little bit longer under my own name. I was discharged and my daughter was put in to the paediatric floor which gave us a room to myself and I was able to stay in that room with here. I had access to nurses and doctors any time I needed or have had a question. They regularly came in and tacked up on her. For the first couple days it was between every 48 hours to reassess her withdrawal symptoms which in my case thankfully got lower. It was like having a big family instead of just myself and her to help at any time you needed help with anything. And they took amazing care, didn't judge which was great. That's always one of the biggest fears in a situation like this. They helped me connect with my programming. There was program better beginning that until recently, I was still seeing every two weeks as well as a problem in Kingston called Drive which is specifically for mothers dependent on narcotics.

AMT: So in other words it continued for you even now after in terms of the help you hang around you. But let's go back to the very beginning you said you didn't feel judged. That's really important, huh?

REBECCA DOWDS: Uh ha. There is sometimes a tone in people's voice or a luck they have when they're talking to you, just that feeling you get from somebody even if they don't directly see something to you. And all the people that were working with me were just amazing compassionate people that didn't appear to have a single judgement for my seeking help with the problem.

AMT: In the past or in other hospitals she might have been separated from me red at birth and put in a neo natal intensive care. What would that have meant for you?

REBECCA DOWDS: It would have meant a lot of long days and trips going back and forth from the hospital. I have a friend who went through that situation just last year because Toronto hadn't implemented this particular program. And it was very painful to watch the stress both her and baby went through not being able to be together all the time.

AMT: How's your daughter today?

REBECCA DOWDS: An incredibly lively happy little girl who will talk your ears off.

AMT: How old is she?

REBECCA DOWDS: She's two and a half now.

AMT: And how are you doing?

REBECCA DOWDS: Great. Just started back to work, so we are working out schedules a little bit with dad but he's handling it pretty well, pretty much at a point of a normal life.

AMT: Well Rebecca thank you for sharing your story with us.

REBECCA DOWDS: Of course I am hoping this will become a widespread program everywhere. It was the best experience I ever had in a hospital.

AMT: Okay well thanks again.

REBECCA DOWDS: Thank you very much.

AMT: Bye bye.

REBECCA DOWDS: Bye.

AMT: Rebecca Dowds. She's a mom from Kingston, Ontario. My next guest pioneered the practice of roaming and keeping newborns exposed to opioids in utero with their mothers. Dr. Ron Abrahams is the medical director of Perinatal Addictions at B.C. Women's Hospital in Vancouver. He is also the co-founder of the Fir Square Combined Unit, Canada's first room in program; also ABC women's he joins us from our studio in Vancouver. Hello.

DR. RON ABRAHAMS: Good morning Anna Maria.

AMT: As you were listening to Rebecca tell her story what were you thinking about?

DR. RON ABRAHAMS: Well I was thinking that it really describes how important it is to keep the babies with the mothers. When I started as a young GP I had patients who were living on the street and the response to patients who were pregnant and exposing themselves and their babies to drugs - both prescribed and illicit - was to whisk the baby away as you said into the special care nursery. And the babies- Whenever you put a baby in an abnormal environment it's going to exhibit abnormal behavior and that was interpreted by the medical system in those days as the baby withdrawing when it was actually withdrawing from the mother.

AMT: We heard a clip of a baby in withdrawal off the top. What was that baby experiencing?

DR. RON ABRAHAMS: That baby was experiencing the same thing any baby experiences when wandered away from its mother. When we started Fi Square the first thing that was happening was you know the babies would be crying I'd work on the ward and the baby would be crying and then the nurses would say 'oh you know the baby is crying we have to watch for withdrawal'. And I said 'but where's the mother? Let's put the baby in the mother's arms' because 90 percent of the time the baby will settle in the mother's arms. Because that baby knows its mother from nine months in utero. It knows the mother's voice, it know the mother's smell when it comes out. And that bond is the most important thing to establish the baby on a lifelong journey of being able to be socially connected to people and to mother.

AMT: Again we clarified that babies are not born addicted. Are they?

DR. RON ABRAHAMS: Know they are born exposed and the classic teaching words that the babies were addicted. But addiction is defined as seeking out the drug. These babies don't seek out the drug they are just experiencing some withdrawal from the drug that they were exposed to. So with that in mind people said 'oh well if you're going to room in these babies with the mothers, how longer are the babies going to have to stay with their mothers because they're going to be addicted for the rest of their lives?' Well in actual fact if you look at adults who are withdrawing from any drug, but particularly illicit drugs and particularly heroin or opiates, that's only about a two week process where they're physically withdrawing. In fact it's only about three or four days. So what we're finding is that if we get the babies through the first three or four days or the first week of life, they're over the withdrawal and all this- There used to be talk about but the late withdrawal in these babies at six months later, one year later, two years later in their life, if they were upset or just having what a lot of babies have - normal behaviour - that was considered a delayed withdrawal. When in actual fact anybody who's had a baby will tell you that around six weeks of life there's a thing called purple crying which is a normal newborn behaviour where babies tend not to settle around six weeks. It's a lot of... It has colic etc. but these babies because they're labelled it was called late withdrawal.

AMT: What are some of the symptoms of withdrawal in newborns?

DR. RON ABRAHAMS: Well true withdrawal is a baby who fails to gain weight, who has an inability to feed, who has diarrhoea. And that's the key is we looked at these babies objectively. It was interesting to hear Rebecca talk about sneezing. The old scoring system used to look at the baby subjectively. So if the baby or sneezed or didn't settle with crying that was considered to be withdrawal. But in actual fact those are subjective symptoms and dependent on which nurses on the shift, which paediatricians on the shift. So I said we're going to look for the objective measure to measure whether these babies and that objective measure is whether they have the ability to gain weight or actually not gain weight. And most babies will lose weight in the first few days of their life. So we don't jump on these babies until they have reached a point where they're losing up to 10 percent of their weight. Even then if they're losing 10 percent or more then we ask questions about is the mums breastfeeding adequate, is her milk adequate. And a lot of our mothers here in Vancouver are living on the streets. So their malnourished from the beginning. So they may not have the ability to produce enough milk to breastfeed. So that's why we start formula and that's when we see a turnaround in the baby starting to gain weight.

AMT: How many hospitals are there switching to the rooming in method?

DR. RON ABRAHAMS: Well it's interesting. When we started nobody wanted to do it and then we started doing teaching and doing outreach to communities across Canada. Kingston is a good example, one of the doctors who saw what we were doing actually came to Vancouver, spent a week with us went back to Kingston and instituted it. Now my understanding is it's about 50 hospitals across Canada. It is a standard of care and now we have to see it instituted in every hospital. I've been working in the United States with the special care nurseries down there over the last several years. And the interesting thing about the States is Americans when you talk about evidence based data they will listen. But when you say to them that it's cost effective, boom, they've instituted it. They'll institute it. And that's the important key here for Canadian politicians and administrators. This is a cost effective program.

AMT: How so?

DR. RON ABRAHAMS: Well in Victoria they started multidisciplinary antenatal clinic similar to what we have here in Vancouver which is called Sheway. And they've shown that for every dollar spent upfront you save four dollars. I said to them we are going to need the 20 year study because I guarantee you that if we can avoid putting kids into foster care and the mothers back on the street, over 20 years we would probably save 20 dollars for every dollar spent up front.

AMT: In the rooming in programs are all mothers with newborns who have been exposed to opioids able to have the baby sit in a room with them?

DR. RON ABRAHAMS: every mother who delivers in our hospital, who is exposed to drugs, the baby goes right on to their chest at birth. The only reason it won't go on the chest is because it's medically unstable.

AMT: And so are there any guidelines or it's everybody?

DR. RON ABRAHAMS: I know and I know it's hard for you to really grasp it but when you treat these mothers just like we treat every other mother who delivers in this country.

AMT: No I'm not questioning that but are all babies who have been exposed to opioids, are they able to be with their mothers right away or are there cases where they do have to be going to other kinds of care? Or is that is that not related to the opioids if that's the case?

DR. RON ABRAHAMS: Well its related to is the social and medical instability of the mother at the time of birth. We have a lot of mothers who are living on the street who were malnourished, who may have an ongoing infection. The babies when they come out are a reflection of the mother. So if the mother if the mother is medically unstable - and I am not talking about the drug per se, I am talking about medical stability - then the babies tend to be unstable and sometimes we have to admit them to the intermediate nursery just for observation over 24-48 hours until they settle.

AMT: But the instability isn't caused by the opioids, is what you are telling me, it's caused by the circumstances around their living arrangements and how they have to live.

DR. RON ABRAHAMS: Exactly.

AMT: We spoke to Dr. Thierry Lacaze who set up the new neonatal program at the University of Calgary. He was telling the Globe and Mail that he has actually said that he agrees with this program but he's also said that while it sounds simple, not all hospitals are equipped to keep mothers and newborns together, the space or the nurses or the actual experience. How do you see that?

DR. RON ABRAHAMS: Well that's always the argument and we now have evidence to show that it's cost effective to institute rooming in and it's also medically imperative, and it is socially imperative. And it is imperative because we have to prepare the next generation of these women and their babies to institute- I call it a sustainable healthy community. And when we talk about the Indigenous community this is the chance for us to reconcile the Indigenous community. You know generations before the residential school system. Now it's the foster care system. It is a lot of Indigenous kids in foster care. They end up on the street and we were just perpetuating their residential care system. It's more a medical issue but it's the same thing and we have to really break this cycle and we have to carry on with moving towards a sustainable healthy community.

AMT: So you're connecting the dots between if somebody separates the mother and the child right away, that way, then they're more apt to want to take the child away as well.

DR. RON ABRAHAMS: Oh oh absolutely. And I use the expression; what we're doing is we're hard wiring these babies to be socially competent human beings. But the most important thing is are we rewiring the mothers to be socially competent and be socially competent [unintelligible] mothers.

AMT: And that's what you find happen isn't it?

DR. RON ABRAHAMS: Oh yes. I mean that's what keeps us going. These women are so resilient. They have such inner strength. That's why I do it. You know I've always said that the people say 'Ron how can you how can you work with this population'. Well I'll tell you; they're easy. They just weren't - like Rebecca was saying - they want a non-judgemental attitude. The real problem is the system. That's the biggest battle we have is changing the system and changing the attitude and prejudice of the system.

AMT: Ron Abrahams good to hear you on this. Thank you.

DR. RON ABRAHAMS: Thank you.

AMT: Dr. Ron Abrahams is the medical director of Perinatal Addictions at B.C. Women's Hospital in Vancouver. He's also the co-founder of the Fir Square Combined Unit which is Canada's first room in program. He joined us from our Vancouver studio. Let us know what you think of what he's had to say and what our earlier guest Rebecca Dowds had to say about this. You can tweet us. We are @TheCurrentCBC. Find us on Facebook. Go to our Web site cbc.ca/thecurrent. And stay with us. The news is next. Then, why hit the gym when you can pop an exercise pill. I am going to speak with the scientist developing just such a thing, right after the news. I am Anna Maria Tremonti. This is The Current.

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A pill that replicates a cardio workout — would you take it?

Guests: Ronald Evans, Vybarr Cregan-Reid

AMT: Hello I'm Anna Maria Tremonti and you're listening to The Current.

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AMT: Still to come: It's a war Canada I lived with for more than a decade. It's a war in which Canada actively fought for years. But behind the scenes in the fight against the Taliban in Afghanistan there was another force at play. Journalist Steve Coll joins me in our next half hour to talk about the shadow role played by a shadow organization; the Directorate S, Pakistan's intelligence service. But first take two of these and hit the showers.

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VOICE 1: Body Break. With Al Johnson and Joanne Mcleod.

VOICE 2: Whether at home or in the gym exercising should be an enjoyable experience. However selecting a fitness club can be intimidating and confusing

VOICE 3: But once you determine what your needs are and what you can realistically commit to the next step was to find a club that's right for you.

AMT: That's a Body Break segment that's probably about 30 years old. The message hasn't really changed however. If you want to take care of your body exercise is key. You've got to hit the gym or find some other way to sweat, because there are no shortcuts. There are no magic pills you can take to give you all the life enhancing benefits of exercise. Well that may be changing. Scientists have been developing just such a pill and it does sound like a magic pill. The idea is that it makes Abidi think it has just exercised. And the possibility of such a pill has captured a lot of interest from people whose physical abilities make regular exercise difficult, to fitness buffs, ethicists and couch potatoes. Ronald Evans is a biologist at the Salk Institute for Biological Studies. He is the director at Gene Expression Laboratory in La Jolla, California. He is working on this pill and he joins me from La Jolla. California. Hello.

RONALD EVANS: Hi.

AMT: How does this drug mimic exercising?

RONALD EVANS: Well when you exercise you burn energy to improve your muscle performance, physical exercise. And when you do that you reprogram- Actually the genetics of your muscle goes from sort of a quiescent or inactive state to an active state. And in that process the activity we use is adaptation. We sort of hacked into that genetic program that gets activated, found the molecular code and then developed a drug that allows us to actually sort of game the system through a back door type of method. And we find that we do that the muscle activity in the genes reprogram at our command basically. As a result you start bringing more energy in increasing fitness but not by actual mechanical exercise but taking this particular drug.

AMT: So the mechanical exercise reprograms the muscle. So you’re reprogramming through that by going right to the genetics, essentially

RONALD EVANS: Correct.

AMT: Okay. In the process does that produce the endorphins of exercising - you know - the high.

RONALD EVANS: That is a great question and we can't fully answer that particular part of it because we're doing this in mice. So we can't really ask the mice so much to tell us what's happening. But we do know that there are athletes that have tried to use it, have been using this and also the Russians have actually had a big program using it. And so we don't so much about the high, although some of the people that have used this say they really like using it. But they are sort of an illegal way to use it, for healthy people. We're looking for people who were sedentary or have illnesses that prevent them from being able to exercise. There is two groups; one is people who really need it, the other are people who want to enhance performance but they're healthy or athletes who just want to have an edge on the competition.

AMT: And let me just clarify so this is an evolution of a drug called 5 1 6 that was banned by the World Anti-Doping Agency.

RONALD EVANS: That is correct. Yes.

AMT: So there are people actually using a variation of this now.

RONALD EVANS: Well they're using 5 1 6. They're using the banned drug. If you go online you can actually find the banned drug.

AMT: So where did the idea come from for this?

RONALD EVANS: The arc of the discovery is 20 years when we first discover the genetic regulator back in 1995 that controls this program, when you exercise. As I mentioned this is a mechanical way of turning genes on. And when you try and that genetic activity slowly you adapt. With each day that you exercise you change your genetic activity until you're actually in what you call fitness. When we were studying the genetics of [unintelligible] - that is what my lab does, they set genetic programs and how they achieved. And so we figured out what controls it. And then we asked if we just turn on that controller by itself without the exercise what happens. And all those genes start changing, made changes about the same rate as when exercise. So each day that we give the drug the mice get a little bit better. And after a month of the drug they are as good, if not better, than a mouse that was training every single day. So we dissected this and it mimics, as far as we can tell, nearly every property of the actual training itself and so that's what got it to move the program into developing a better drug and more modern drug or people actually until we can use it to treat disease.

AMT: So you actually saw the couch potato mouse actually be coming strong.

RONALD EVANS: Well. So what we're looking at is running endurance. There are different kinds of exercising. It's really important to keep in mind is that the word exercise doesn't actually say - really everyone thinks of something else; it could be Pilates, it could be spin, it could be weight lifting, it could be running. One's endurance one's power, some are about speed, some are about balance. There are different kinds of exercise. In particular were mimicking what might be called Endurance exercise and I like that because endurance exercise is associated with many of the benefits that we consider healthy for people who do exercise. And we know that exercise is a benefit to reduce risk for many types of diseases: heart disease, diabetes, actually psychologic diseases like depression. It lowers the risk of cancer. So this is the kind of exercise that I am very excited about because it has the potential to impact in lots of different kinds of diseases.

AMT: And so what phase of development is it now?

RONALD EVANS: Requisition. The new drug its development has been completed and safety studies have been done in animals. It's been formulated and it's been put into a pill form and it is now in what's called phase 1 trial.

AMT: And you have to get licensed by the Food and Drug Administration in The States I guess, huh?

RONALD EVANS: Yes. With the food and drug administration is linked in to each step that you go. They check on every single aspect of it. So it's a detail process. The good thing is that all of those details have been checked off and were now in people. So were actually un-parted most of where you have to go through. In phase one is safety in humans, volunteers. Then we move to the actual clinical trials with working with patients.

AMT: You talked about maybe using it for people with disabilities; other people have a hard time exercising. We spoke to Perry Kootenyahoo to ask what he thinks of the idea. He's a peer reach out co-ordinator with spinal Cord Injury Alberta. He is what he calls an incomplete quadriplegic which means he has some older function in his arms and hands, not a full range of motion. Listen to what he had to say.

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The lack of activity in a physical sense definitely affects my- sometimes my mood because if you're feeling you know weak low you obviously going to have some mental side of it. I find that with a lack of physical activity a lot of weight issues do come up a lot. I personally try to watch sometimes what I eat, just because of the fact that I know that I'm not going to be able to lose that weight easily. So I definitely find that the weight gain issues with a disability is something that stays on the radar. If I had the opportunity to take a pill that would replace exercise I would definitely be for it, without sounding too lazy about it. It kind of brings a smirk to my face because I knew who wouldn't want to get that kind of aid, especially being in a wheelchair. I mean that would be great. My only concern would be the medical standpoint if this is something that can go without any medical complications, again I am on for it.

AMT: Okay so that's Perry Kootenyahoo of Spinal Cord Injury Alberta. Ronald Evans. What about potential medical complications or side effects.

RONALD EVANS: It's a great question. So far the complications are likely in side effects, as far as I view it's likely to come from the drug itself having off target properties. If it's untargeted to the way in which we develop it, we find very few side effects. Right now we don't know of any real side effects that we see that would be some they would stop the development of the program. And the reason for that is I believe is better with the drug - and we think this is a good one - in the more it mimics real exercise you they ask what is the downside of getting exercise. It's very little. Most of the downside of exercise is people who run their whole life they get injuries and their knees breakdown or their cartridge breaks down. But in this type of exercise, with the pill, if we get that benefit there is no real downside to consistent exercise. And so I like that part of it and we don't see the downside yet. It is not that there can't be any downside but this far we are not seeing them. So you do have to be careful. That's why we don't have the safety studies right now. And then it needs to be evaluated in the people with disease. But so far it's looking pretty good.

AMT: But you're saying that it doesn't mimic exercise. It would make you stronger so that when you do exercise you have greater strength.

RONALD EVANS: Well so that's a good question. This is more mimicking or relating to endurance exercise, the type of exercise that you get from either being class or running or jogging, a type of exercise and so it's not so much weight lifting.

AMT: Right but what I'm asking is if you took that would you be a better runner? You would not stop running you'd be a better runner.

RONALD EVANS: Well. Yes. That is another question is does it help healthy people become better runners, and the answer is at least in mice it does. So for mice to train on this, they tend to improve the rate at which they get better. And so we are very interested in that part as well because it has certainly implications for other types of use. It is just related to for example disease and so we would like to think about the whole enchilada here.

AMT: Okay. Well we have to leave it there. Thank you for your explanations today.

RONALD EVANS: Okay you're very welcome. Thank you.

AMT: That is Ronald Evans he's is a biologist at the Salk Institute for Biological Studies. He is the director of the Gene Expression Laboratory in La Jolla, California. Well there could be wide appeal for such an exercise. Well in fact many bodybuilders are already using a version of it. You heard my last guest say that. So the early compound is GW501516 simply called 5 1 6. It has been banned by the World Anti-Doping Agency. It is available on the black market. Search through YouTube and you will find scores of videos from people who have tried out.

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VOICE 1: What's up guys. Zladac here Like you from Always on Nutrition and today we are going to talk about a magical little chemical called GW501516. I definitely noticed an increase in energy. I've definitely noticed the increase in vascularity, and I even got new veins that I didn't have prior to taking it especially at tops of my forms.

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VOICE 2: Day five of this. The cardio on it is amazing. Just being able to cardio were at a higher level makes you feel so so much better guys, like, honestly I think the [unintelligible] is absolutely amazing.

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VOICE 3: Basically this is just the back burner and it's not actually for human consumption. So it's one of these research chemicals that you're not supposed to actually use that millions of people are using. You know one of these gray areas supplements. So don't actually take it. Whatever. It is really amazing this stuff is actually legit awesome, it is freakishly good stuff.

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AMT: Okay that was non-scientific. We are just going to underscore that 'not actually for human consumption' was the quote. 'Freakishly good stuff'. My next guest has been waiting to weigh in on the potential pitfalls of the exercise pill Vybarr Cregan-Reid teaches English at the University of Kent. He's the author of Footnotes: How Running Makes us Human. Vybarr Cregan-Reid joins us from London, England. Hello.

VYBARR CREGAN-REID: Hello. Good morning.

AMT: What are you thinking about as you listen to this?

VYBARR CREGAN-REID: I am slightly alarmed. I am very concerned really that you know the idea that exercise is already - exercise is already a hack you know. Exercise is already something that we have to do because our lives are really out of joint with what our bodies are supposed to be doing, what our bodies need. So the reason that we exercise is because we're not doing manual or physical work anymore and we're becoming too sedentary. And now this pill seems like a hack for a hack and it just seems like a heck too far.

AMT: What about the idea that it could help people with mobility issues. They say they're looking at it for people with Parkinson's or ALS, people who aren't able to exercise.

VYBARR CREGAN-REID: I don’t think you'd find anybody that would come on a radio station and say that that's a bad idea. That just sounds wonderful and you know the chap you had earlier on. Yeah it just seems like a perfect drug for people that are not able to exercise but that seems to me to be a sort of minimal, clinical application for a drug that's been undergoing research for - Is 11 years now? It seems to me that this is a drug that's really ripe for misuse and abuse.

AMT: You just heard on that, the last clip we had, the guys using it.

VYBARR CREGAN-REID: Yes. I mean it would be very easy to be snarky about those. But I mean exercise is not really something that we need to have optimized. It's a really holistic things. So running is the most natural form of exercise. It's something that we've done as a species for about two point three million years. And you can't just take a pill or take one aspect of it and assume that all of the other things don't matter. So there are real issues I think with the idea of taking the pill not only will it be misused but there are questions like what’s going to happen to our bone density. If this is a pill that means that we can exercise a lot less and still get the same metabolic advantages from having done the exercise, our bones are bones aren't going to be changing as a result of taking this pill. So as hunter gatherers - When we moved from home hunter gathering to agriculture, about 10000 years ago, studies show that our bone density dropped by about 20 to 30 percent. And then a more recent study was done that looked at the bone density of agriculturalists from five to 10000 years ago and modern sedentary humans. And that shows a further drop of 20 to 30 percent. So what we really don't need is a pill that's going to encourage us to do even less and for our abundance to drop even further.

AMT: Can I just ask you at the same time we just heard our last guest say that some of the injuries associated with the light of running could be changed, as well.

VYBARR CREGAN-REID: Yes that would be good. I'm not sure that's quite what he said. He said that it optimized people's experience so that they didn't have to do so much.

AMT: True. He said the downside of exercise is often injuries.

VYBARR CREGAN-REID: Yes. And it's something I think that everyone that's exercised has experienced. I've certainly experienced it many times. But I don't know how many radio programs I have to go on and say running is not bad for your knees. There are scientific studies that are done annually. The last one was done a few weeks ago that show that actually the knee cartilage in runners is much healthier than in non-runners. So there is a lot of myths about running being bad for us. What's really bad for us I don't really believe in running injuries? I mean obviously I get running injuries but I don't really believe in them. I believe that I slowly pick up injuries when I'm doing things like I am doing now which is sitting in a chair. It’s sedentary in us that's bad for us and anything that discourages movement is fundamentally a bad idea. You know the very long classification as a species that we have, the first word is Animalia and basically that word means we move and it seems to me this is a pill that's going to encourage people that could move, to move less.

AMT: But you do agree there are any running injuries or there are running injuries?

VYBARR CREGAN-REID: Oh yes. I mean of course I do believe there are running injuries but I believe that most people that get injured - and it's a very high proportion of people that do get injured - are injured because of their sedentary lifestyle and then they suddenly take their body out doing something that's very very demanding and they pick up injuries.

AMT: Well I'm going to make you feel better. One of our producers went to a spin class to see what people there thought of an exercise pill, and they don't all agree. Listen to this say.

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INTEVIEWER: If I told you didn't have to exercise you just have to take a pill, would you still come here?

VOICE 1: I don't know if I would release those endorphins that you get from exercising and that's why I do it too, to clear my mind. It's an hour that I'm not on my phone. I disconnect. I do it for my body and I do it for my mind too.

VOICE 2: I work out and I do these classes because I actually like coming here. Sure you can have a pill for everything but I guess it will be like if you can't work out. Let's say if you have an injury, then maybe. Or if you - whatever circumstances stop you from working out and you have this pill that gives you that, great. But if people start taking it instead of working out, to look fit, that's just weird

AMT: Vybarr Cregan-Reid are you feeling better now? [Laughs].

VYBARR CREGAN-REID: I am. I am feeling like someone's on my side.

AMT: How have views of exercise changed over the centuries?

VYBARR CREGAN-REID: Well it's a really interesting thing because you don't exercise for 2.3 million years, as I said the history of our species it doesn't exist. It appears in ancient Greece and it appears with the rise of cities about you know about 3000 years ago. And the reason that you exercise appears is basically because of slavery. You have these aristocrats who have all of their needs provided for by slaves effectively and they realise that their bodies are withering on the vine. So the Greeks invent exercising. Again it sort of disappears from culture really until you get the sedentary revolution. The revolution in sedentary work at the beginning of the 20th century. It's bubbling away in the 19th as well but certainly in the 20th century. And then because our work becomes so much more sedentary. We now see exercise everywhere and we think it's a natural thing to do but I mean I think it's actually a barometer of how out of touch a culture is becoming with its time and place.

AMT: What are the benefits are there to exercising beyond the strictly physical?

VYBARR CREGAN-REID: Oh so so many you know we'd need an hour to go through them. But the endorphins - that one of the speakers mentioned from the spin class there - are important neurotransmitters that operate all around the body. They dilate are veins and make oxygen more freely available. They're wonderful things everyone that's had them from exercise really loves them. But there's also an endocannabinoid system in the brain that gives as what is commonly known as a runner's high but you can get it from any kind of sustained aerobics exercise.

AMT: We have to leave it there. We're out of time but it's interesting to hear your pushback. Thank you for your time.

VYBARR CREGAN-REID: You're welcome. Thank you very much.

AMT: That is Vybarr Cregan-Reid. HE teaches English at the University of Kent. He's the author of Footnotes: How Running Makes us Human. And he joined us from our studios in London, England. Well, if the exercise comes on the market, would you want to weigh in? Would you want to try it? Let us now with just think this. Reach us on Twitter @TheCurrentCBC, Find us on Facebook, e-mail us from our Web site cbc.ca/thecurrent and click on the Contact link. In our next half hour an in-depth look at the little understood secret unit in Pakistan's intelligence service and the role that played in supporting the Taliban. Journalist Steve Coll joins me right after the break. I mean Anna Maria Tremonti. This is The Current.

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Canadian soldiers died in Afghanistan because Pakistan was supporting the Taliban, says author

Guest: Steve Coll

AMT: Hello I'm Anna Maria Tremonti and you're listening to The Current.

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More than two weeks ago I gave Taliban leaders a series of clear and specific demands: Close terrorist training camps, hand over leaders of the Al Qaeda network and return all foreign nationals including American citizens unjustly detained in your country. None of these demands were met and now the Taliban will pay a price.

AMT: Weeks after the 9/11 attacks President George W. Bush on October 7th 2001 announcing the start of hostilities against the Taliban in Afghanistan. The war he started that day still continues. At the time U.S. intelligence services were sure that Osama Bin Laden - and other high ranking members of Al Qaeda - were hiding in Afghanistan with the support of the Taliban, 157 Canadians died fighting in that war, nearly twenty five hundred members of the U.S. military, along with CIA officers were also killed in the conflict. It was the Afghans who bled the most with the death toll estimated at 140,000 Afghan deaths. One of the murkiest players in this ongoing war is the Pakistani intelligence agency called the Inter-Services Intelligence or the ISI and its secretive S Directorate. Steve Coll has dug deep into Pakistan's role in Afghanistan. Along with being a Pulitzer Prize winning author, he is the dean of the Graduate School of Journalism at Columbia University. His new book is called Directorate S: The CIA and America's Secret Wars in Afghanistan and Pakistan. Steve Coll joins me from New York City. Hello.

STEVE COLL: Hi. Glad to be here.

AMT: We just heard President Bush give his reasons for attacking the Taliban in the wake of 9/11. How serious was the attempt to get the Taliban to turn over Osama bin Laden to the U.S.?

STEVE COLL: Not very serious. I mean there were efforts to talk to Mullah Mohammed Omar that were brokered through the ISI and there weren't really any Americans speaking directly to Mullah Omar at that time. There was also a CIA effort to talk to one of Omar's ministers about the possibility of getting out of the way of this war by handing over bin Laden and closing down these training camps. But you know what's so interesting about that clip to me is also that it foreshadows the ambivalence that the United States had throughout the war about fighting the Taliban directly. So after September 11th, even in the heat of that moment and seeking to retaliate or disrupt Al Qaeda, even the Bush administration did not declare initially 'we're going straight to war with the Taliban there were no Afghans on those planes'. It's not even clear Mullah Mohammed Omar knew about the 9/11 attacks. You could say the Taliban were morally or legally complicit because they'd provided sanctuary to Al Qaeda but the U.S. did not want to fight a war against the Taliban. They wanted to destroy Al Qaeda. And that kind of uncertainty about where the Taliban fit in Afghanistan, in the US and ultimately NATO goals in Afghanistan haunted the war right through the period for example when Canada was involved.

AMT: As the leader of the Taliban why didn't Mullah Omar just turned over the Al Qaeda leadership to the Americans?

STEVE COLL: There's great material about that where ministers and advisors to Mullah Omar have described their conversations with him. And they said basically 'Look boss, the Americans are going to go to war and we're not going to farewell. And maybe the emirate is worth preserving. And at the price of turning over Osama Bin Laden you know he's never really followed our directions. He is not one of us.' And Mullah Mohammed Omar essentially replied 'I cannot turn a fellow Muslim over to American justice. God would never forgive me and if we are to lose our government it's because it's God's will. It means that there's something about the way we've been conducting ourselves that has caused us to fall out of favor. We should go and reflect on what that is'. And so I think he really defied the majority of his own counsel and took pride in his decision to sacrifice everything for his beliefs.

AMT: You you have gone into great detail. You have unearthed great detail on those conversations. You even have the fact that in that conversation he was picking at his toes.

STEVE COLL: Well I had some correspondence from the ISI chief who flew in right before the war started to try to talk him into some kind of compromise because it was in ISI's interest in Pakistan's interest to keep the Taliban intact. And there's this great conversation that Mahmoud Ahmed described in a letter to me as I was finishing the book and I included it in there. And he said that he tried to persuade Mullah Mohammed Omar on the basis of religious faith which he shared. And he said 'Emir, if you were at prayer and you see a snake approaching you, is it acceptable to break off from your duty and take care of the snake and then go back to prayer?' And Mullah Mohammed Omar thought about it said 'Yes I think that is acceptable'. Then the ISI chief said 'the snake is coming, it's the United States. You really need to do something different'. And Mullah Mohammed Omar just deflected him and said 'I'll think about it', and then he really made the decision that he was just going to stand.

AMT: Tell me about Pakistan's Inter-Services Intelligence. What is its role in this state?

STEVE COLL: Well it's their principal domestic and foreign intelligence service. It's a creature of the army, the military. Inter Services meaning also including the Navy and the Air Force and it's been around since Pakistan has developed its own independent military. But it really grew during the 1980s as a partner of the CIA and Saudi Arabia who used ISI funded and provided weapons to ISI in order to support the Afghan mujahideen who were fighting against the Soviet occupation of Afghanistan during the 1980s. And that was when ISI really grew. It grew into kind of a state within the states swollen by this support from the CIA and the Saudis, billions, over the course of a decade as well as lots of armaments and sophisticated technology. And when the United States essentially left the Afghan conflict after the end of the Cold War, ISI now had discovered a methodology in supporting these Islamist militias that it extended to unbalance India - primarily in Kashmir but also in Afghanistan - in fact it use some of the training camps that the CIA helped fund during the 80s to train Kashmiri guerrillas who would then go attack India. So we knew very well what ISI was because we had help to build it up and we even knew what it's covert action arm Directorate S was about because we had worked with them during the 80s. But when we came thundering into Afghanistan in Fall 2001, we went back to the Pakistani leadership at that time Pervez Musharraf the military dictator and said you know 'you're either with us or against us' and Musharraf made ISI a partner of the CIA initially and ISI did help arrest some Arab Al Qaeda leaders as they fled into Pakistan. But ultimately ISI had its own agenda in Afghanistan and that was the Taliban and so they accommodated and ultimately I think supported the Taliban's revival, starting around 2005-2006.

AMT: And tell us more about the covert arm Directorate S?

STEVE COLL: Well its shadowy and it's a little bit like the CIA's what used to be called the Special Activities Division, paramilitary division. It seems organized primarily to provide support to RUF militias that are clients of Pakistan or are thought to be allied with Pakistan's interests. And so in the descriptions that I was able to acquire there is a lot of special forces types who are in that group, just as there are in the CIA paramilitary division, there are also civilians and serving military who are assigned to this work. Even generals who run the logistics operations for example. So it's a very compartmented group. I remember talking to an ISI officer who had a regular career in the military and was just saying 'so what's the difference when you get sent over to ISI?' He said 'the main thing is you have no idea what the people in the officers all around you are doing. You just have your own kind of tunnel and you stick in that tunnel'. And they become very professional at running compartmented operations to support internationally listed terrorists without getting caught red handed in a way that would cause the state of Pakistan to itself be listed as a terrorist sponsor for example. And they use the typical methodologies of intelligence services to avoid getting caught. These are like cut outs to keep the distance between you know the most visible parts of ISI and the actual clients. So they use retired officers and contractors to do some of this work.

AMT: So describe the relationship between Directorate S and the Taliban after the attack on Afghanistan.

STEVE COLL: Well it was it was uncomfortable because the Directorate S was fully aligned with the Taliban right up until 9/11, and it was forced to change sides because of American pressure in the the decision of Pervez Musharraf that he didn't want to be on the receiving end of the U.S. war. And the ISI officers in touch with the Taliban I think were quite reluctant to follow Musharraf's idea. There is a scene in the book where a famous old Directorate S Colonel he comes out of Afghanistan because they all have to withdraw as the bombing's approaching. And he visits the Taliban's ambassador in Islamabad the capital, and he's in tears and he's denouncing Musharraf for making this this move. Now, he can have that conversation with a Taliban leader one day and the next day he'll meet a CIA officer and say 'we're on your side we're ready to go to war with you'. So it was a very difficult relationship for the CIA to navigate because they never quite sure what was true and what was just PR. But the there's another scene where the ISI officers are giving weapons to Gul Agha Sherzai who was one of the anti-Taliban commanders who is about a ride into Afghanistan to knock the Taliban government down. And they're handing him these weapons, the ISI officers telling him 'you really shouldn't be doing this. I mean why are you fighting with the Americans? You're aligning yourself with the wrong side in this war'. So their hearts, I don't think ever changed about this. They had to accommodate American power but as soon as they saw American power leaving Afghanistan - as the Iraq war became a huge distraction for the Bush administration - they went back to the program that they had always run.

AMT: You describe such a labyrinth, huh? The U.S. intelligence, the CIA, the Defense Intelligence Agency knows Directorate S is helping the Taliban. How does everybody navigate this compared to what the American public was hearing?

STEVE COLL: Well I think there was a decision not to call out Pakistan in public during the Bush administration and even during some of the Obama administration because they were too important logistically for the main war effort. And a lot of the rationale for accommodating ISI as it clearly was providing sanctuary to the Taliban, and even as the Taliban started to violently destabilize Afghanistan, and even as the Taliban started to attack NATO forces, Canadian forces- I mean all those deaths you mentioned of Canadian soldiers at the top of your show, those were inflicted by the Taliban at a time when American taxpayer money was supporting ISI with hundreds of millions of dollars a year. So how was it that the NATO system accommodated that betrayal? And I think there are there are phases to the answer. First, they were slow to recognize what was going on. They just didn't get it for a while. Musharraf kept telling them you know 'I'm on your side. I'm on your side'. Then when they did really come to terms with the fact that this was happening the Pakistanis just denied denied denied. There is no [unintelligible]. The Taliban are all in Afghanistan, there's nobody here. And that deflection worked for a year or two. It was kind of confusing. Are you really lying to us or maybe we just are misunderstanding what our own evidence shows. Finally the scales drop. But by the time the United States was in a position to pressure ISI over its support for the Taliban, say 2007 or so, Pakistan itself was falling apart. I mean Pakistan was entering into the most unstable violent period in its history domestically because of the destabilisation that had been caused by the U.S. led war. All of these Al Qaeda guys fled into Pakistan in the fall of 2001 and then they eventually hooked up with local radical groups and undertook a war against the Pakistani state. So just at the moment you want to hold Pakistan to account, here's a country with 100 nuclear weapons enduring truck bombs and suicide bombings and the attacks are going against the army and even against ISI from time to time. And so it wasn't a time when it was plausible to put pressure on Pakistan. In fact the number one interest of NATO, besides Al Qaeda, was preventing Pakistan's nuclear weapons from falling into the wrong hands so this was not a time to sanction them or bully them. And so that's why they allowed this to continue. Even at the expense of the lives of Afghans primarily but also NATO soldiers.

AMT: You have a quote from Canadian Brigadier General David Fraser who at the time was our top commander in Afghanistan saying that fighting the Taliban must like digging a hole in the ocean. What did he mean by that?

STEVE COLL: Well it was a resonant phrase and it was part of what he and British commanders discovered when they rotated into southern Afghanistan in 2005 and 2006. They had been sold on this mission by the Bush administration as essentially peacekeeping or peace enforcement at worst operation. The South didn't look to be the site of a major industrial strength insurgency. They agreed to take this on you know under multiple forms of pressure within NATO, some of it having to do with the fiasco in Iraq. This was an alternative to Iraq, for Canada I think. And anyway they got there and they discovered that the Taliban had been waiting for them and that the Taliban were now at the beginning stages of what would become an all-out insurgency. They were embedded in very difficult terrain around Kandahar where were Canada's true destroyer. And these green zones to the west of the city irrigated by the Arghandab River I mean the worst infantry fighting terrain that you could imagine worse than Normandy. And you know Fraser gets there and he's arriving with a policy that you know defense and diplomacy and development, with a strong emphasis on development, and he finds that in fact he has to fight a counterinsurgency war. And you know the Canadian task force I think rotated every six months and different units came in to fight it between then and say 2009 or so. And I went back, not a lot of this is in the book, but from my research I read every memoir than any Canadian officer or soldier published that I could find and was really a rich account of the Canadian experience between the journalism and the memoirs. And you know I was impressed that this was- I remember going up to Ottawa during this period to talk about Afghanistan and to be reminded that these were the first combat casualties Canada had to absorb since Korea. And I thought the military really rose to the occasion. The Americans would sometimes sniff at the fact that they'd turn this war over to tornado which was their decision of their folly in Iraq. But I thought Canada acquitted itself very well. And they did switch to fighting a counter-insurgency war in this impossible terrain. They even brought in Leopard tanks at one point to kind of roll over these IED infested agricultural areas, crazy to see like World War Two battle tanks out there but it was it was a kind of you know fighting on the moon.

AMT: I want to ask you about the relationship between Osama Bin Laden and Pakistani intelligence. When bin Laden was killed in Abbottabad, Pakistan, a lot of Americans said that was proof that Pakistani intelligence was hiding him. What do you think of that analysis?

STEVE COLL: When you look at his letters when he is in Abbottabad - for the four-five years before he was killed maybe longer than that, six years - the ones that have been captured and translated and declassified you know he's writing to his sons and his wives who he wants to have come visit him or live with him - and he's very worried about their security and his you know stay away from the Pakistani police. And so if there was support for him it would have been 'Don't call us we'll call you' type but the Pakistanis would have been quite anxious about getting caught supporting him. So they may have gotten him into that house where he was unplug from the Internet and they were burning the trash in the yard and so forth. And they may have said 'that's it. They were done with you. And good luck'. So there there's no evidence that he had a liaison officer visiting him or that sort of thing. And you know even if you think the worst of the Pakistanis, they weren't wouldn't be stupid enough to expose themselves that way because there is nothing in it for them.

AMT: One of the things that's clear from your book is that Directorate S has been supporting extremist organizations that have targeted India. For Canada the bombing of Air India in 1985 which killed hundreds of Canadians is still very raw. What do we know about Directorate S support for the Sikh separatist movement?

STEVE COLL: There was some definitely during that period. I've never unpacked that the way I have Kashmiri subject with the Afghan subject but there was definitely a contact between those radical groups who had gone across to Pakistani Punjab for for support. And of course that border it's all one place and there's a lot of ways that you radical groups could have acquired support there. But there is definitely a kind of set of political and subterranean contacts. But whether that has any evidence trail leading to that bombing I don't know. The one thing that is absolutely the clearest about where actual ISI officers have blood on their hands in terrorism against India is the Mumbai attack. I mean they did get caught. Basically the evidence trail is unmistakable and it's and it leads directly to ISI. And of course it wasn't just Indians who died in those raids; it was also some Americans and others.

AMT: Remind us how many people died in Mumbai attacks.

STEVE COLL: Oh gosh well over 100. I think a 160 or something like that.

AMT: In January President Trump announced the U.S. would with horde's two billion dollars of security aid from Pakistan to punish it for supporting terrorists. In light of the role the ISI and Directorate S had played in financing, training, supplying the Taliban and other extremist organizations does he have a point?

STEVE COLL: Definitely. I mean the Obama administration was also furious about ISI but didn't feel in that period of the Afghan war when all of the logistics ran through Pakistan to support NATO operations there and the troop levels were so high, they didn't think they could get away with alienating Pakistan and having their supply routes cut off. Also I think the Trump administration has the advantage of a more stable Pakistan that it can pressure without worrying about the whole place collapsing. Because you know after that long dark period that we were talking about before, now Pakistan has regained a measure of domestic security. The Army has really pushed a lot of the problem of terrorism back into Afghanistan and they're talking about building a wall on the border to try to keep it out. So anyway, I think it's understandable as to why an American administration would withhold aid to a government that hasn't done anywhere near as much as it could to prevent Taliban guerrillas from attacking Afghans and native forces.

AMT: Their President of Afghanistan has called for peace talks with the Taliban. The Taliban has rejected that. How would Pakistan intelligence look at that proposal?

STEVE COLL: Pakistan intelligence is interested in peace talks. I think they want influence in Afghanistan. They want to contain India's influence in Afghanistan. They want stability. They don't want Afghanistan to collapse back into civil war because that will only push more violence into Pakistan as it has twice, three times before in recent history. And so yes you can build a wall but you're not going to keep Afghanistan's problems out of Pakistan. A better way to manage Afghanistan's instability is to end it by negotiating political alternatives to war. ISI wants a seat at the table. One of the complexities in the negotiations and the book describes a two and a half years of secret talks the Obama administration had with a Taliban political representative. And the Taliban told the Americans then - and I think it's their position today - 'we don't want to talk to Karzai or Ghani because they are just quislings of the United States puppets. We were talking to you. You're the real power. We want you out. So let's talk about it'. And at the same time they would say 'we don't want the Pakistanis representing us. They're not our agents. They're not our lawyers. We're Afghans. Yes we live there. We have to put up with them but we don't follow their directions' and ISI wanted to have as much influence over these negotiations as it could obtain. So they would often point to a group of the Taliban called the Haqqanis which are particularly close to ISI. And so [unintelligible] talk to the Hasqqanis and when the Americans would talk to the Haqqais the ISI would be in the room. And so it's complicated but to be realistic if you really want to reduce the violence in Afghanistan it's not going to happen on the battlefield and there is no military victory available in any foreseeable future. And if you're going to have a settlement that isn't spoiled by either side then Pakistan is going to have to be part of that process.

AMT: Steve cause so much of this war has been reduced to so many quick headlines, if even that it's really really important to look at what you've done here to give us the many back stories. Thank you for your work.

STEVE COLL: Thank you for having me on. Really appreciate it.

AMT: Steve Coll. He is the dean of the Graduate School of Journalism at Columbia University. His new book is called Directorate S: The CIA and America's Secret Wars in Afghanistan and Pakistan. Steve Coll joins me from New York City. That's our program for today. Stay with Radio 1 for Q. Tom Powers joined by Nigerian American writer Tommy Adeyemi to talk about her debut young adult novel Children of Blood and Bone. We began today talking about NAS babies; babies born with neonatal abstinence syndrome because of the dependence of their mothers on opioids. More hospitals are keeping these babies in room with their mothers after birth. For years hospitals have also been inviting volunteer cuddlers to spend time with such newborns to give them some of the calming cuddling they need. Bob Woodruff is a retired professor in the United States. He spoke with CNN a few years ago about why he volunteers as a cuddler for babies with NAS. Will leave you with that. I'm Anna Maria Tremonti. Thanks for listening to The Current.

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BOB WOODRUFF: It is tremendously rewarding to take a stress baby and work with that baby till that baby is feeling better, is either sleeping. Sometimes I play with them and it is a lot of fun

[Sound: Baby moaning]

BOB WOODRUFF: [To baby] Oh. Sweaty, you are okay.

BOB WOODRUFF: When I come into the room they are usually stressed, crying or upset for one reason or another. And so I help them when I calm them down like this one. This now is now quiet and feeling safe. I am trying with this baby that to get him to sleep because I know he hasn't slept all day long.

INTERVIEWER: Do you get emotionally attached to these babies?

BOB WOODRUFF: I do love them. Yes. It's very hard not to get attached to these babies.

[Sound: Baby Moans]

BOB WOODRUFF: [To baby] It's okay. There. Good girl.

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Tuesday March 13, 2018 Full Episode Transcript

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