Up First from NPR - Biden's Border Action, Elections in India, Ecstasy and PTSD

Episode Date: June 4, 2024

The Biden administration is expected to issue an executive order that could restrict crossings at the U.S. southern border. Indian Prime Minister Narendra Modi is likely to win a third term. A panel of FDA experts examines whether MDMA, found in the party drug ecstasy, could treat post-traumatic stress disorder.Want more comprehensive analysis of the most important news of the day, plus a little fun? Subscribe to the Up First newsletter.Today's episode of Up First was edited by Alfredo Carbajal, John Helton, Jane Greenhalgh, Ally Schweitzer and Alice Woelfle. It was produced by Ziad Buchh, Ben Abrams and Milton Guevara. Our technical director is Zac Coleman, with engineering support from Arthur Laurent.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

The U.S. southern border is a top issue for voters and a potential liability for President Biden. Today, Biden is expected to issue an order that could limit the flow of people across the border. Could this also limit the political fallout for him? I'm Ian Martinez with Michelle Martin, and this is Up First from NPR News. Results are streaming in from the world's biggest election. India is still counting the more than 640 million votes cast in an election that's gone on for more than six weeks and appears Prime Minister Modi has won another five years in power. And people suffering from post-traumatic stress disorder don't have many treatment options to turn to. Today, the FDA will review whether an illegal party drug could provide relief.

If not MDMA, there really is nothing else out there in the pipeline. Stay with us. We've got the news you need to start your day. Now, Our Change will honor 100 years of the Royal Canadian Air Force and their dedicated service to communities at home and abroad. From the skies to our change, this $2 commemorative circulation coin marks their storied past and promising future. Find the limited edition Royal Canadian Air Force $2 coin today. The large number of asylum seekers at the southern border has become a political headache for President Biden in this election year. A few months ago, a bipartisan group of senators worked with the White House to negotiate a

compromise that would have addressed this issue, but Republicans walked away from the deal. So today, President Biden is expected to announce actions he will take through executive order, and he has invited several mayors of border cities to join him at the White House. NPR immigration correspondent Sergio Martinez Beltran is joining us this morning to tell us more about this. Good morning, Sergio. Good morning. Do we have any details yet? Has the White House said anything publicly? So we don't know much about it yet. But we do know, Michel, that ever since the Senate failed

to pass a measure, the White House has said it would consider taking executive action. And the Biden administration has been piecemealing restrictions for the last few weeks. For example, he recently announced a new rule intended to speed up the removal of some migrants who are not eligible for asylum. And what Biden is expected to announce today would also limit asylum claims. The expectation is that Biden will invoke and rely on, and bear with me here because it's going to sound clunky, Section 212F of the Immigration and Nationality Act. I talked to Lily immigration and visitors, non-immigrant visitors, from coming into the United States when he thinks, or she thinks,

that they're detrimental to the interests of the United States. In the past, this section has been used on the grounds of national security. The provision would also allow the president to suspend entries once the number of unauthorized crossings reaches a certain daily threshold. And this could be the most impactful border management policy to come out of this administration so far, but it's widely expected that it will face court challenges. I got it. Okay, so can you tell us how the southern border looks in terms of unauthorized crossings at the moment? I mean, it's way different than how it looked last year.

Back then, we saw a record number of unauthorized crossings, and many of these migrants were seeking asylum. But those numbers have plummeted this year. And the reason for that, according to immigration policy analysts, is Mexico. Mexico has been cracking down on illegal migration at the urging of the U.S. But at the same time, we know that border communities have been challenged by this influx of migrants going back, what is it, sort of some years now. You've been talking to mayors of these cities. What are they saying? Well, I reached out to a bunch of border mayors, and some of them have been invited to today's announcement at the White House. El Paso Mayor Oscar Leiser will be there.

He told me in a statement that his city is a welcoming place, but that no community can continue the resources expended on this humanitarian crisis. So he says he's looking forward to hearing from Biden. We know that the mayors of San Diego, California and Yuma, Arizona were also invited. And then, Michelle, there are some mayors who say they were not invited, like the mayor of Eagle Pass, Texas, a community that saw some of the highest number of unauthorized migrants last year. Mayor Rolando Salinas told me he wishes this policy rollout had been done back in December when his city saw about 2,000 to 3,000 migrants per day. He says, quote, we won't forget those days. Sergio Martinez Beltran is NPR immigration correspondent. Sergio, thank you.

You're welcome. After six marathon weeks of voting across India, where nearly one billion people were eligible to vote, to cast a ballot or press buttons on an electronic voting machine. Counting is now underway to tally the results. And initial results suggest that the Prime Minister Narendra Modi of the BJP party will become Prime Minister for the third time. On the line with us now to tell us more is NPR's Diya Khadid. She's in the capital, New Delhi. Hello, Diya. Hi, Michelle.

How are the numbers looking so far? Well, so far, a tally by India's Election Commission indicates that Modi's party, it's called the BJP, has won the largest number of seats in parliament. It hasn't won a clear majority, but with its allies, it looks like it will be able to form a coalition government. On the flip side, India's opposition alliance has done better than exit polls expected, but it hasn't won enough seats to form government, according to the count so far. So essentially, it's a victory for the BJP and a victory for the prime minister, yet again. Yes, but you know, I'm on the ground in the capital, New Delhi, and if you were here just judging by the mood outside each of the campaign headquarters, you would say that Modi's BJP had

lost and the opposition won. And that's because at the outset of these elections, Modi promised that his party would win a super majority. The exit polls predicted Modi's party would nearly hit those numbers. And so outside the BJP headquarters, we saw a man seemingly pray to a Modi-like God, beseeching him to come back to power. And so, unless there's a dramatic change as counting continues, yes, Modi will return to power. He will be the only Prime Minister after the founder of modern India, Jawaharlal Nehru, to win three times. But he'll rule as a part of a coalition, not as this seemingly unstoppable juggernaut led by a man who recently suggested to a journalist that he was chosen by

God. So, Dia, what does this mean for India going forward? Well, Michelle, I think it will be harder for Modi and his party to continue their vast recasting of India as a country that elevates its Hindu majority above other citizens. Harder but not impossible. It also appears to have signalled to the opposition, which is led by the Congress party, that power is within reach. That party is led by Rahul Gandhi, the great grandson of India's first prime minister. It used to dominate Indian politics, but it's waned in recent years. And under Rahul's leadership, the party shrank and shrank. But in these elections, the party looks like it won double the seats that it did in the previous ones

so now Rahul can show voters that he and the Congress party can fight back. There'll be a more muscular opposition and critics say that will also likely shake Indian institutions which critics say were increasingly partial to Modi and his party in recent years like the mainstream media, YouTube news outlets, influencers, law enforcement agencies, and even India's election commission itself. That is NPR's Diya Hadid in New Delhi. Diya, thank you so much. Thank you, Michelle. MDMA is what we're going to talk about now. That's a party drug.

It's usually associated with all-night raves. But one company is seeking FDA approval to use it as a mainstream treatment in mental health care. Yeah, today a panel of experts to the Food and Drug Administration will review the evidence behind using MDMA to treat post-traumatic stress disorder, what they say could affect whether the agency approves the treatment. NPR's Will Stone is with us now to tell us more about this. Good morning. Good morning. So this treatment is called MDMA-assisted therapy. How does it work? Well, it basically combines a form of talk therapy with the psychedelic drug MDMA. So a patient with PTSD gets a dose

and then works through their trauma with two therapists. The clinical trial involved several of these dosing sessions. FDA staff have said based on that data, participants appear to experience, quote, rapid, clinically meaningful, durable improvement in their PTSD symptoms. I asked Dr. Mason Marks about the chances of approval for MDMA. He studies psychedelics at Harvard and Florida State University. At first glance, the data looks promising. There are also legitimate questions, but just looking at the totality of the circumstances, I suspect it will be approved.

In fact, the drug company that's funded this research called Lycos Therapeutics has raised more than $100 million ahead of possible FDA approval. So Dr. Marks referred to legitimate questions. What are those questions? That's right. This is not a done deal because there are questions about whether the findings from the trials are solid. And one big concern is that most people in the trials could tell whether they received MDMA or a placebo. Ideally, in clinical trials, people can't tell. Obviously, that's hard to do with psychedelics, but ultimately, when this does happen, it can lead to bias, and that skews the results. There are other concerns about the methods and long-term data, but what's caught

attention more recently are inflammatory allegations about the trials. Okay, so what are those? Essentially, there are claims that some therapists and investigators may have pushed patients to report good results and overlooked adverse events. That was emphasized in a recent report from the Institute for Clinical and Economic Review. This is an independent group that did a deep dive into the data and said there were substantial concerns about the validity of the results. Some of that is based on what trial participants have said. Sarah McNamee was in one of the trials. Take a listen to part of her public testimony read by a friend. Three months after I was given my first dose of MDMA, I was for a time one of the staunchest

advocates for MDMA therapy. The problem is that I was also suicidal and clinically decompensating in drastic and unprecedented ways. And what she means by that is basically she was having worsening symptoms. And McNamee says her therapist played up the idea that she was helping make history. And she says others in the trials have also shared with her negative experiences that did not get fully captured in the published findings. As it turns out, there was a petition calling for this FDA public meeting in part because of these kinds of concerns. So what could this mean for possible approval of the treatment? The drug maker Lycos has pushed back on these allegations and said they stand by their results. Therapists in the trials have also said this outside report was based on hearsay and misrepresentations.

And there are certainly many who do feel MDMA should be approved, including groups representing military veterans. Here's former Army Ranger Jesse Gould with the nonprofit called Heroic Hearts Project. If not MDMA, there really is nothing else out there in the pipeline. So yes, there may be flaws in the study, but what is the risk reward of potentially saving millions of lives? So this panel of advisors will have to weigh all of this because the FDA wants to make a decision by early August. That is NPR's Will Stone. Will, thank you. Thank you. And that's Up First for Tuesday, June 4th. I'm Michelle Martin. And I'm Amy Martinez. Listen to Consider This from NPR.

The Pentagon is trying to cut health care costs by outsourcing service members' care to the private sector. What could that mean for the future of battlefield medicine? Find out on Consider This. Today's episode of Up First was edited by Alfredo Carbajal, John Helton, Jane Greenhall, Allie Schweitzer, and Alice Wolfley. It was produced by Ziad Budge, Ben Abrams, and Milton Guevara. Our technical director is Zach Coleman, and we get engineering support from Arthur Laurent. Join us again tomorrow. you