All language subtitles for NOVA.S48E13.The.Cannabis.Question.1080p.x265-ZMNT_track3_[eng]

♪ ♪

NARRATOR:
Cannabis.

A multi-billion dollar
industry is moving

from the illicit market
into our daily lives,

creating a stark divide.

KASSANDRA FREDERIQUE:
In a country where people are
talking about its medical use,

someone gets arrested for
cannabis every 58 seconds.

♪ ♪

NARRATOR:
A plant demonized
to arrest millions

now marketed as a medicine.

EVELYN NUSSENBAUM:
My son had a devastating
form of epilepsy,

and a cannabis
compound gave him a life.

NARRATOR:
How does the vast array
of chemicals in cannabis

engage a mysterious
system in our bodies?

YASMIN HURD:
The cannabinoid receptor

is the most abundant
receptor in the brain.

MATTHEW HILL:
How a single
system can influence

so many biological
processes is surprising.

♪ ♪

NARRATOR:
Will regular... even daily... use

cure us or hurt us?

PAUL DEBASSIO:
If someone were to tell
me that I was dependent

on marijuana, I would have
said no way, absolutely not.

NARRATOR:
Smoked, dabbed, vaped,

and eaten, today's
cannabis is hyper-potent,

and far from understood.

ZIVA COOPER:
These products are coming online

much faster than we
can actually research them.

NARRATOR:
As federal law blocks science,

an unintended public
health experiment is underway.

CHINAZO CUNNINGHAM:
Really the questions
are for what conditions

is it beneficial and for
what conditions is it harmful?

It's not black and white
and it's complicated.

NARRATOR:
What's the right dose?

Who should use cannabis?

Who shouldn't?

STACI GRUBER:
It's a highly contentious
subject,

but it's not about your personal
thoughts or feelings.

What does the data tell us?

What does the science tell us?
Truth through science.

We should know the answers.

NARRATOR:
"The Cannabis Question,"

right now on "NOVA."

♪ ♪

♪ ♪

♪ ♪

NARRATOR:
More than 80 years
after America ended

one type of prohibition,
it's ending another.

The majority of people
now live in a state

where cannabis is legal.

As a multi-billion-dollar
industry rises,

our country is at a crossroads.

♪ ♪

HILL:
Cannabis is genuinely
one of the most

fascinating discussion
topics I've ever seen

because of how emotionally
polarizing it is amongst people.

And it's very strange
because the entire field

of cannabis science
is very poorly developed.

There's not been a lot
of research and there's a lot

of things that
we don't understand.

And yet, what we have
in society is groups

of people that
very fervently believe

it is this panacea that can cure
any disease that exists,

or it's the devil's grass,

and it's going to cause
the downfall of society,

not recognizing that
the reality of cannabis

is somewhere in the middle.

♪ ♪

(birds chirping)

♪ ♪

NARRATOR:
Americans everywhere
are turning to cannabis,

seeking relief from
a wide range of ailments,

including veterans,
like Sean Worsley,

who uses cannabis to treat his

post-traumatic stress disorder
caused by combat in Iraq.

SEAN WORSLEY:
Our sole purpose was to

clear the routes for supply
convoys that came through,

looking for roadside bombs
that were on the route.

(explosion)

I was on a mission
and we rode over

a hole that was
in the center of the road

and unfortunately it was an IED
that went off.

(explosion)

(overlapping shouting)

Knocking me unconscious,
and when I woke up,

medic was in my face,
asking me was I okay,

could I hear him.

(shouting)

♪ ♪

NARRATOR:
After his tour, Sean struggled
with a traumatic brain injury

and disturbing symptoms
caused by PTSD.

WORSLEY:
For me it's paranoia, insomnia,

seeing things that
aren't necessarily there...

"shadow people,"
as they call them...

night terrors, dreams,

but these nightmares
were very realistic.

(gunshot fires)

If I was shot in the dream,
I would wake up grabbing

my chest because
I felt the pain.

NARRATOR:
Sean's medications for PTSD
had troubling side effects,

so he got a medical
cannabis card.

RYAN VANDREY:
Cannabis at a low dose

can help reduce anxiety,
relax someone.

And individuals who have
PTSD that newly initiate

cannabis use report
it being life-changing.

So, I can sleep for
the first time in two years,

and I can go to
the grocery store without

being so intense and on edge.

That's why individuals with PTSD

heavily gravitate
towards cannabis use.

NARRATOR:
For thousands of years,

humans have cultivated
cannabis for its fiber,

seeds, and medicinal properties.

Ancient Hindu texts
claim it was brought

by the god Shiva for
the pleasure of humanity.

♪ ♪

The plant contains
over 400 chemicals,

including cannabinoids,
which are most abundant

in the resin glands
of budding female plants.

♪ ♪

In the 1960s, Israeli
scientist Raphael Mechoulam

isolated THC,

the psychoactive cannabinoid
that makes users feel high.

♪ ♪

The discovery launched
a new chapter in neuroscience.

DANIELE PIOMELLI:
Cannabis opened a window

into the functioning
of our body,

completely unexpected window.

Because what was
discovered was that THC binds

to receptors in the brain

and outside the brain,
and when it does so,

when it binds
to these receptors,

the cells now
behave differently.

♪ ♪

NARRATOR:
Cannabinoid receptors,
named after cannabis,

are found on nearly
every organ in the body.

They bind with our own
cannabis-like molecules,

called endocannabinoids,

which regulate
functions like sleep,

cognition, memory, and mood.

♪ ♪

Unlike other brain chemicals,
they travel backwards,

across the synapse,
where they control the release

of most neurotransmitters.

♪ ♪

GRUBER:
One of the most amazing
things that happened

was the discovery of
the endocannabinoid system.

Every mammal has one.

And this is a system
of chemicals and receptors

throughout the brain and body.

And really the primary goal
of the endocannabinoid system

is homeostasis...
Keeping things in balance.

♪ ♪

NARRATOR:
At Mount Sinai Hospital,

neuroscientist Yasmin Hurd
remembers the first time

she looked for
cannabinoid receptors

in the human brain,

seen here in vivid red,

orange, and yellow colors.

The cannabinoid
receptor is the most abundant

receptor in the brain.

When we looked at where these
receptors were expressed,

they're expressed in
brain regions relevant

for motor coordination,

cognition, memory,

emotional regulation, reward.

All of these brain areas
are key to so many

normal behaviors, obviously,

but also psychiatric
disorders as well.

A key role of the
endocannabinoid system

is to manage stress.

In fact, the first
endocannabinoid found

in our body was given
a Sanskrit name,

anandamide, meaning "bliss."

HILL:
In response to stress,

our body mobilizes an
endocannabinoid signal.

And so, if something
aversive happens

to us and we suddenly see
a threat in front of us,

our body kind of goes into a
high alert mode and we shoot up.

Once we've been removed
from that threat, though,

our body needs to turn that
stress response back off.

And what we have learned is that
this burst of endocannabinoids

that occurs in response
to stress is really

critical for that
recovery phase.

NARRATOR:
Scientists suspect this signal
goes awry in people with PTSD,

and that's why THC,

which mimics our own
endocannabinoids, might help.

VANDREY:
And so, when you look
at individuals that have

PTSD and use cannabis,
in short-term trials,

you see very
beneficial outcomes.

But if all they
do is use cannabis

and they don't engage
in other behavior therapies

to help work
through their trauma,

they're not treating the
root cause of the disorder.

And it's important
to recognize that THC

at higher doses
increases anxiety.

CUNNINGHAM:
Cannabis is not a miracle,

nothing is a miracle.

And so really the questions
are for what conditions

is it beneficial and for what
conditions is it harmful,

and for whom is it beneficial
and for whom is it harmful?

So, it's shades of gray.

It's not black and white,
and it's complicated.

♪ ♪

NARRATOR:
In 1996, cannabis was legalized

in California for medical use.

But federally, it remains
a Schedule One drug,

like heroin,
making research difficult,

and leaving patients like
Elizabeth Pinkham on their own.

To cope with her
cancer treatments,

Elizabeth has
turned to cannabis.

ELIZABETH PINKHAM:
When you go through
chemotherapy,

there are side effects that can
be... like nauseousness.

You may have loss of appetite,

you may have
difficulty sleeping.

So I was looking
for something that wasn't

another big, heavy-duty
pharmaceutical.

NARRATOR:
On display, one can find

cannabis-infused teas,

sodas, candies, bath salts,

psychoactive body washes,

and flower, with THC,

that can ease
nausea when smoked.

PINKHAM:
The effects are
pretty immediate.

I've definitely gotten my
appetite back a little bit more.

It also helps with neuropathy,

which is like the numbness
in your fingers and your toes.

This is super medicinal.

You see how, like,
dark and dense that is?
Mm-hmm.

That's indicating more
of the indica family.

Good for the body,
good for pain.

STEVE D'ANGELO:
My staff needs to do the best

that they can to try
and guide people

to the products that are going
to serve them the best.

But my staff,
they're not trained doctors,

and really we should
have cannabis medicine

being taught in every
single medical school

across the United States.

And that's not happening
now because of federal law.

It's really a voter-approved
quote-unquote "medicine,"

so people say, "Oh, there's
medical cannabis

that's approved."

It has not been,
it has not gone through

FDA rigorous research process.

And that's what's
critical for medicine.

PINKHAM:
I think it would be
great if there was

a bit more science behind this.

But I think in the meantime you
have to do what works for you,

and you have to figure
this out as you go.

♪ ♪

NARRATOR:
But it's challenging.

Scientists aren't sure
whether cannabis sativa,

indica, and ruderalis
are distinct species.

Most cultivars grown
today are hybrids.

They have distinct
chemicals called terpenes,

which create flavors and smells.

And in addition to THC,

the plant contains over
100 other cannabinoids.

One, called CBD,
is flooding the market.

COOPER:
One in seven adults

in the United States
are using CBD.

You see CBD everywhere,
you see it in the pet stores,

you see it at
Bed Bath and Beyond,

at Whole Foods.

And so there's a
multi-billion-dollar industry

that's built on this plant

and there are all
these different hypotheses

of what these different
chemicals can do to help us.

But these products are
coming online much faster

than we can
actually research them.

♪ ♪

NARRATOR:
Despite CBD's
availability today,

it took a group of determined
parents to bring it to market.

One quest began in
Palo Alto, California,

where Stanford neuroscientist
Catherine Jacobson

set out to treat her
son Ben's epilepsy.

♪ ♪

CATHERINE JACOBSON:
Watching your child
have a seizure is

really, really scary.

It's awful, right?

It's awful because you know
that brain damage is happening.

The kids get scared,
they get confused.

And with uncontrolled epilepsy,

we all live with this fear
that they're going to die.

(gasping)

NARRATOR:
About a third
of epilepsy patients

don't respond to medications.

Catherine knew the longer
Ben's seizures continued,

the less likely
they'd be controlled.

Could you have just
given him medicine?

MAN:
Mm-hmm.

NARRATOR:
And she was not alone.

In Berkeley, California,
her friends Fred Vogelstein

and Evelyn Nussenbaum
also felt powerless

to control their
son Sam's epilepsy.

♪ ♪

FRED VOGELSTEIN:
I mean the thing about seizures
that most people don't realize

is that they're dozens
of different kinds.

So, the kind of seizures
that most people know about

are the grand mal seizures

where you just lie on the ground
and, like, start flopping.

The other seizure that
a lot of people know about

are staring spells.

Sam had a version
of those seizures

because he would go unconscious
for, like, 15 seconds.

NUSSENBAUM:
When anyone has a seizure,

you could compare it
to an electrical storm,

or an overtaxed electrical grid.

We all have
electricity in our brains.

And when someone has a seizure,

the electricity
becomes irregular.

FRED VOGELSTEIN:
Every single drug we tried
didn't control the seizures,

and some of them had
pretty nasty side effects.

NUSSENBAUM:
One time he had
hallucinations and thought

he had holes in his skin

and there were bugs
crawling out of them.

I thought we were going to have
to take him to the psych ward.

VOGELSTEIN:
And then there were
all the medicines

that made him a zombie.

NARRATOR:
Then, they stumbled
across research suggesting

cannabis might quell seizures.

JACOBSON:
I knew nothing about cannabis,

but I did some research
and I found out that obviously

there are many different
chemicals in cannabis,

the two most
prominent are CBD and THC.

We know that THC
makes people high.

CBD doesn't do that.

And so, my preference was
of course to try CBD first.

NARRATOR:
CBD doesn't bind to
cannabinoid receptors directly,

but it's presence seems
to reduce the impact of THC.

♪ ♪

It also increases
levels of anandamide,

our bliss molecule,

and interacts with
receptors like serotonin,

which affect our mood.

Yet in 2011, it was hard to find
extracts high in CBD.

JACOBSON:
And so we would get these vials

and sometimes they
would work a little bit

and then the next
vial wouldn't work.

So, after probably six
to eight months of doing this

and seeing no benefit to Ben,

I just said, look,
I'm going to make my own.

(machine whirring)

NUSSENBAUM:
When Sam first took

Catherine Jacobson's CBD
tincture, it was clear as day,

his seizures were
going down immediately.

Unfortunately,
Catherine only had

enough for five days.

And so we had this
incredible five-day stretch.

And then we ran out.

♪ ♪

NARRATOR:
CBD also helped
Catherine's son, Ben.

But her next batch of
tinctures were too weak to use.

Drug companies
get a lot of abuse

for their marketing tactics.

But the one thing that
they do really, really well,

is they make every
pill exactly the same.

It's sanitized,
it's quality controlled.

And I wanted that for my son.

♪ ♪

NARRATOR:
Then, they heard about
an English company called

GW Pharmaceuticals,

with greenhouses
full of cannabis, and labs

that could make
chemically pure drugs.

♪ ♪

Since CBD was
illegal in the U.S.,

Sam's family flew
to London for treatment

while Ben's family waited.

(plane engines roar)

After four days
of taking GW's CBD,

Sam's seizures dropped
from 68 to six per day.

♪ ♪

On the eighth day of
treatment, he only had three.

NUSSENBAUM:
It worked and it worked fast.

But the other thing about
him improving was that

I saw this child
that I hadn't seen since

he was four years old
and started having seizures,

except now he was 11

and he was clever and funny

and wanted to ride
a zip line over London.

♪ ♪

NARRATOR:
Sam is now seizure-free.

His story led
to clinical trials,

and in 2018, FDA approval

of the first CBD drug,
called Epidiolex.

In certain types of epilepsy,

it can reduce
seizures by some 40%.

Sam is now in college.

♪ ♪

But since seizures
cause brain damage...

Is that a seizure?

NARRATOR:
for Ben, help came too late.

Okay, okay, hey.

I have no idea whether Epidiolex

given at six months
would have changed

the course of his disease.

I feel like it has
reduced the severity

of the most severe kinds
of seizures he has,

so I feel like it helps.

But Epidiolex
is not a miracle drug.

It's a tool in the toolbox,

just like every other
anti-seizure drug.

You try it, if it
doesn't work, you stop it.

If it works, then, you know,
it changes your life.

♪ ♪

One of the things
that's like super important

about a drug like Epidiolex

is that for the first time,
you've got a drug

that's derived from cannabis
that is completely legitimate

for mainstream
medicine to study.

And we're only beginning
to see where that can lead.

♪ ♪

Scores of clinical trials
are now underway,

including at U.C.
San Diego's Center

for Medicinal Cannabis Research.

Look at each dot
until it explodes.

NARRATOR:
14-year-old Braylon
has severe autism.

RESEARCHER:
Okay, look with your eyes,
look right here.

NARRATOR:
His parents are
hoping CBD might help.

Good job.

DORIS TRAUNER:
Braylon is a very sweet boy

who has a great personality.

He gets extremely
anxious if he doesn't know

what's going to happen.

And if something happens
that he didn't expect,

he can be very
difficult to manage.

I'll just go home.

KEVIN PULLEY:
I want you to get up, please.

Uh-uh.
No, thank you.

KEVIN PULLEY:
We wanted to see

what can be done

to try to curb that behavior.

He was hitting,
being kind of violent.

LETITIA PULLEY:
And I'd never
forget one therapist

told me you want to get
a handle on it because

it affects his learning.

If you can't control
the behavior,

it's going to be hard
for him to focus in class.

♪ ♪

NARRATOR:
Children who have autism

have different brainwave
patterns

than children who don't.

♪ ♪

TRAUNER:
There is something
different about the way

the brain develops that causes
children to have

tremendous difficulty with
social interactions,

with social communication.

And it appears
that one of the problems

may be a type
of sensory overload.

RESEARCHER:
There you go, yeah.

Touch my finger
and then touch your nose.

NARRATOR:
To find out if Epidiolex
might treat severe autism,

Trauner is running a
double-blind clinical trial.

Keep them out,
and close your eyes.

NARRATOR:
Over two eight-week sessions,

children will take
either CBD or a placebo,

and researchers will
use a battery of tests

to see if the drug helps.

(overlapping chatter)

NARRATOR:
To study CBD's
impact on the brain,

in another part of the trial,

Alysson Muotri will work
with human skin cells.

♪ ♪

That's because skin cells
can be converted back

into master builder cells,

and then coaxed to develop
as brain cells do,

forming networks of neurons.

♪ ♪

ALYSSON MUOTRI:
These brain cells,

they will actually
self-arrange and form

what we call a brain organoid.

And as they mature over time,
they start to become

more and more
electrically active.

NARRATOR:
That activity is captured
by electrodes placed

beneath the cluster
of brain cells.

When their neurons fire,

they create electrical
signaling comparable

to a developing brain.

♪ ♪

Next, the brain cells
are treated with different

doses of CBD to see
if the drug has any impact.

♪ ♪

One of the biggest
surprise that we see

is that by adding
CBD in the culture,

we actually silence
or quiet the activity

of these brain cells over time.

This is not permanent.

We can wash it out, CBD,
from the system, and we see

that the brain is able to
restore electrical activity.

So what are you going
to do in the morning?

Wake up.
Wake up.

Wash up.
Wash up.

NARRATOR:
But will CBD calm
excess neuronal activity

in the brains of
children with autism?

Momma, car.
Yes, we're gonna drive...

NARRATOR:
The study is still blinded,

but Braylon's
parents are certain

CBD helped him in
phase one of the trial.

(overlapping indistinct chatter)

KEVIN PULLEY:
It was dramatic.

It was like night and day.

So, I could be wrong,

but, you know, I...
we both saw the difference.

All right...
LETITIA: Focus...

LETITIA PULLEY (voiceover):
Having eight weeks

of really no hitting,

no perseveration and things
like that was wonderful.

KEVIN PULLEY:
And then when we went on
the second half of the trial,

he was back to his normal self.

So, I'm hopeful the
first round was the CBD.

Here, I need you to take
this, take your medicine.

TRAUNER:
What we are hearing from the
parents is pretty remarkable.

And we don't know whether

they were on placebo or CBD.

But it's really
important to get good data

that demonstrates whether CBD

is effective
and whether it's safe,

because we're talking
about long-term treatment.

♪ ♪

NARRATOR:
Treatment that uses hundreds
of milligrams of Epidiolex.

Not the small amounts of CBD
you can buy in a dispensary.

HILL:
As little as four percent

and maybe as great as 20%

of the CBD that
you consume orally

actually gets into your body.

And so, it seems
like you need to take

around about 100 milligrams
of CBD oil orally

for there to even
really be a signal

in your bloodstream
that you have CBD on board.

HURD:
Most of the products being sold

are like ten and 20 milligrams.

And some people say that
they benefit from that.

And even if it's
a placebo effect,

I'm actually fine with it.

But what I'm worried
about is that the CBD

that they're taking
has other chemicals.

NARRATOR:
Generally, only
products in legal states

that contain THC,

not CBD, are regulated.

Before they can be sold,
they must be tested

in licensed labs for
potency and contaminates

like pesticides,
molds, and heavy metals.

Using untested
cannabis is dangerous.

But when it comes
to assessing risk,

a key factor is your age,

because the
endocannabinoid system,

which cannabis targets,
changes over our lifespan.

♪ ♪

PIOMELLI:
As we grow from being a fetus

into becoming an adolescent,

eventually an adult
and an elderly person,

the endocannabinoid
system follows us

and, at each of these
stages of our life,

serves a slightly
different purpose.

♪ ♪

NARRATOR:
During adolescence,
our natural endocannabinoids

reach their highest levels,
as the brain rapidly changes.

It's also a time when
many first try cannabis.

♪ ♪

PIOMELLI:
So when one consumes THC,

you're basically
indiscriminately activating

all your cannabinoid
receptors in your entire body

and the entire brain.

HURD:
So, THC, it's like a hammer

on all of these receptors.

Our natural
endogenous cannabinoids

are never these hammers.

NARRATOR:
To understand
the impact of cannabis,

clinical psychologist
Joanna Jacobus

has scanned over
1,000 teenage brains

to search for
differences between those

who use the drug
and those who don't.

♪ ♪

Today, she is evaluating Angel,

who has smoked cannabis at least
once a week for the past year

and is curious
to learn about its impact.

♪ ♪

All I needed
to really hear is, like,

"Hey, do you want an
MRI of your brain?"

"Yes!"

Like that... to me,
that's like really cool.

I know it's nerdy, but, like,
the substance you're doing,

you don't get to see
what it does to your brain.

♪ ♪

NARRATOR:
Using functional
magnetic resonance imaging,

Jacobus can study
brain structures

that are critical for healthy
development in young adults.

♪ ♪

The brain is rapidly changing
from infancy through childhood,

adolescence,
into young adulthood.

Two types of tissue
are rapidly changing

that support
cognitive development.

So, gray matter
contains the cell bodies

and makes up
the cerebral cortex.

So, the outermost
lining of the brain.

And white matter
allows gray matter regions

to communicate
quickly and efficiently.

♪ ♪

NARRATOR:
During the teenage years,

white matter increases
and grey matter diminishes,

as weaker neural
connections are eliminated

and new ones formed to make
the brain more efficient.

♪ ♪

Jacobus has found that
teen cannabis users

have a thicker cerebral cortex,

suggesting that this pruning
of synapses has been disrupted.

JACOBUS:
Now I'm going to read
the same list again.

NARRATOR:
And it's not just
physical brain changes.

I want you to tell me...

NARRATOR:
Thousands of cognitive
tests reveal that teens

who use cannabis regularly

struggle more on learning
and memory tasks

than those who don't.

Bowl, dinner, mug...

It made me realize that memory

is probably the biggest thing

that impacts me with cannabis.

But definitely
if I stop for a little bit,

I have a feeling that, like,

it would be easy to
remember those things.

♪ ♪

NARRATOR:
Research shows after
a period of abstinence,

cognitive performance
can bounce back.

And the brain changes?

Other studies link
them to alcohol,

or genetic and
environmental influences.

ARPANA AGRAWAL:
It is possible that cannabis
itself is not the culprit.

That these differences
that we see in the brain

are preexisting and
that they come before

a child ever picks
up their first joint.

Go ahead and
release your breath.

NARRATOR:
To unravel the role of drugs,
genes, and the environment,

over 11,000 children
are being tracked

through their teenage years

in the Adolescent Brain
Cognitive Development Study.

And would you say that's
definitely a no, kind of no...

NARRATOR:
N.I.H. researchers will evaluate

the children's physical
and mental health,

academic achievement,
and drug use

with tests of saliva and hair.

♪ ♪

So far, few of the children
have tried cannabis,

but there is data from surveys

about their parents' use.

One of the things that
we are most interested in

was prenatal exposures,
and we saw that

there were a fair number
of mothers in the study...

just like what we're seeing
in the general population...

that used cannabis
during their pregnancy.

CYNTHIA ROGERS:
And we were able to look and
see, among those children

whose moms used cannabis
during pregnancy,

did we see any difference in
their developmental outcomes?

And one questionnaire
that really stood out to us

was the psychosis-like
experiences assessment.

And although you couldn't
see anything or anyone,

did you suddenly
start to feel that

an invisible energy, creature,

or some person was around you?

Uh, yeah.

RESEARCHER:
Yeah, okay, and
did that bother you?

Uh, no.
Not so much.

AGRAWAL:
And this data set
gave us an opportunity

to roll back the tape

to a period of time
in an individual's life

where they're being
exposed at a time

when their brain is
exquisitely vulnerable.

Did you start to worry
at times that your mind

was trying to trick you
or wasn't working right?

Uh, yeah.
Okay.

RYAN BOGDAN:
So, among kids who
were exposed to cannabis

following their mother's
knowledge of their pregnancy,

they experienced more
psychotic-like experiences,

they experienced more depression
and anxiety-like behavior,

they're breaking more rules,

they have more
attentional thought problems.

♪ ♪

NARRATOR:
Psychotic-like experiences
are also associated with

an increased risk
for mental illnesses

like schizophrenia
and depression.

♪ ♪

ROGERS:
We know that the use of cannabis

during pregnancy is increasing.

We've seen
advertisements online,

social media,
targeting women saying

this is something that's
safe for you to use

during pregnancy for things
like nausea or insomnia.

And these women are not
trying to harm their babies,

they're just
trying to get through

what can be a challenging time.

As you know, we're
interested in looking at...

NARRATOR:
Rogers and Agrawal are
now scanning 250 babies

to see if brains exposed
to cannabis during pregnancy

are different from
brains that were not.

ROGERS:
THC crosses the placenta.

So, we know the baby's
brain is exposed to it.

We also know that
the receptors in the brain

that THC binds to

develop very early
during pregnancy.

The endocannabinoid system
is critical for hard wiring

of the brain during development.

So, if cannabis comes on board

while the endocannabinoid
system is regulating

neural circuits
that are laid down,

how the cells communicate
as they're being developed,

obviously, it can have
an impact on that.

And that is the thing that

is critical for
people to understand,

cannabis is not a benign drug.

♪ ♪

NARRATOR:
While scientists
worry about the risks,

most agree that far greater harm

has come from
criminalizing cannabis,

starting in 1937.

The treasury department
intends to pursue

the despicable,
dope-pedaling vulture...

NARRATOR:
Harry Anslinger,
head of the Bureau of Narcotics,

stoked racism towards
Mexican immigrants

by demonizing their word
for cannabis, marijuana,

and claiming "the evil weed"
corrupted users.

NEWSREEL NARRATOR:
Debauchery, violence,

murder, suicide.

(woman screaming)

If you look at the way

that they talked
about marijuana,

part of the strategy
was to make cannabis

something that wasn't
acceptable, make it foreign,

and create the hysteria
to put laws in place

that control a group
of people that were not white

and push forward a narrative

that the government
is keeping us safe.

NARRATOR:
In the 1970s, Richard Nixon
ignored an expert panel

recommending decriminalization

and declared a "war on drugs."

Soon drugs would
become the key reason

for being arrested in the U.S.

Do you mind if we
search the car?

NARRATOR:
Since 2000, over 14 million
people have been arrested,

and some 40,000 Americans
are now behind bars

for cannabis...
Mainly for possession charges.

FREDERIQUE:
Someone gets arrested
for cannabis every 58 seconds.

In a country where we
are now legalizing cannabis,

people are talking
about its medical use,

in the midst of COVID-19,
it is an essential service,

cannabis is one
of the driving forces

fueling mass incarceration
in this country

and it is disproportionately
targeting poor people

and communities of color.

In every single state
in the United States,

whether cannabis
is legal or not,

Black people are arrested

for cannabis-related offenses
more than white people.

(sirens wailing)

FREDERIQUE:
Despite the fact that all
government data shows

that usage is
equal across races.

NARRATOR:
Although many Americans believe
the war on cannabis is over,

for Black people especially,

like Sean and Eboni Worsley,

it's a war that's
still going on.

♪ ♪

To manage his
post-traumatic stress,

Sean had gotten a medical
cannabis card in Arizona.

But as he and Eboni
began a cross-country trip

to see family, they would
drive through states

where cannabis is illegal

and racial profiling common.

♪ ♪

EBONI WORSLEY:
We needed gas.

We have no idea,
especially in a place

you are not familiar with,

when is the next place you're
gonna be able to stop for gas?

SEAN WORSLEY:
I get out of the car.

As I'm walking away,

a vehicle pulls in front of
my wife's car

and it is a police vehicle.

EBONI WORSLEY:
And all of a sudden,

I am approached by an officer.

It startled me, when I looked
up and he's like, you know,

"Where are you heading?"
and I'm like,

"We're heading
to North Carolina."

And then he began
speaking to my husband,

who is outside of the vehicle.

SEAN WORSLEY:
He asked me about any weed

being in the vehicle
and I just was honest

and I told him,
"Sir, you know, I am a medical

"cannabis patient from Arizona
and I do have my cannabis,

but it's zipped up
and it's in the trunk."

At that point,
he puts me in handcuffs

and proceeds to
search the vehicle.

I give him my IDs,

and he said, "Hmm, well
you won't need these

where you're going."

NARRATOR:
The officer found a third of
an ounce of medical cannabis.

LEAH NELSON:
He charged them as
severely as he could

with possession for
other than personal use,

and that was because Sean
had with him a grinder

and he had rolling papers,

and he had a scale.

All of those things were
recommended by his doctor.

If you smoke
marijuana medically,

it's not uncommon for a doctor
to tell you to use a scale

so you know how
much you are smoking.

♪ ♪

NARRATOR:
Eboni and Sean spent six days

in jail before
getting a hearing.

At the Pickens
County Courthouse,

they were charged
with multiple felonies.

♪ ♪

After struggling
to pay a bondsman

and impound fees for the car,

the couple returned to Arizona.

♪ ♪

EBONI WORSLEY:
The fines and the fees
became astronomical.

By the time we made it
back to Arizona,

we literally couldn't afford
to pay our rent or bills,

and we ended up evicted.

We were homeless.

NARRATOR:
Under stress,
Sean had a stroke.

Eventually, Eboni's
charges were dropped,

but due to prior
minor convictions,

Sean was sentenced to five
years and put on probation.

NELSON:
Probation requires
a stable address,

it requires you to pay money,

and one of the conditions
of Sean's probation

is that he needed
to get drug treatment.

And the V.A. looks
at him and says,

"You have a medical
marijuana card, man,

"We're not going to treat you.

You don't qualify because
you don't have a drug problem."

♪ ♪

SEAN WORSLEY:
Probation and parole,

they're just traps
to send you right back,

to keep you in their grasp.

You want to lock me up
for not having a job,

you want to lock me up for
not having a place to stay.

How am I supposed
to get these things

if I can't get a job because
you have me labeled as a felon?

♪ ♪

NARRATOR:
In March 2020, Sean was
extradited to Alabama

to serve the remainder
of his sentence behind bars.

CUNNINGHAM:
I see the harms
of the war on drugs

every single day in all
of my patients' lives.

It is so clear.

There's not a single
family that I know

that doesn't have some member

who's been arrested
or incarcerated.

And what I see is that

what happens
in society, the arrests,

the incarceration, the poverty,

dramatically affects
people's health,

their lives,
their quality of life.

NARRATOR:
As criminalization
destroys lives,

at the same time,

the cannabis wellness
industry is thriving.

One entrepreneur
is Eugene Monroe,

a former football player
who believes cannabis

can help address chronic pain.

EUGENE MONROE:
Playing in the NFL
was a lifelong dream.

I love the sport.

That explosive power...

to propel my body

and essentially flatten people.
(players grunting)

Each time that happens,
each time your brain

rattles in your skull,

you pay a price.

The job creates a need
for pain relief inherently,

so I was given
a lot of opioid drugs,

which would let
you go into a game

with acute injuries and perform
because you don't feel bad.

I was taking my oxycodone
just as prescribed,

and saw my daughter
walking down the hallway

and didn't recognize her.

And I realized that they
were causing a serious issue,

and I stopped taking them.

And that's the point
where I decided that

cannabis is a better option.

♪ ♪

Cannabis didn't just allow
me to cut back on opioids,

it allowed me to eliminate
all pharmaceutical drugs.

♪ ♪

It hasn't cured my injuries,

but what it did for me was

alleviate my pain,
so I felt motivated to go

in the gym and work out
and take care of my body.

CUNNINGHAM:
We know that cannabis
leads to less pain

and it alters people's
ability to tolerate the pain.

It affects the immune system

and reduces inflammation.

It's certainly safer
than other medications

that we've been
using for decades.

NARRATOR:
Monroe is now a
partner and consultant

for one of the nation's
largest cannabis companies.

Yet, while many praise
the benefits of cannabis,

some scientists
warn there are risks,

especially for those
who use it daily.

About nine percent
of users will develop

a cannabis addiction.

One is Paul.

DEBASSIO:
I was in my junior
year of high school

and it was a
400 freestyle relay.

The last leg of the race,

always you go just as hard
as humanly possible.

And as I came up from the flip
turn and I snapped my head up,

I just felt this
twinge just right

in between my shoulder blades,
and it just killed me.

But it wasn't until
I went into college that

it became a recurring
detrimental thing.

And I started using
cannabis to alleviate

a lot of the pain and
to help me sleep at night,

because I could never
get a full night's rest.

♪ ♪

NARRATOR:
Cannabis seemed
to cure Paul's insomnia.

DEBASSIO:
I loved how calming it was.

I'd have the best night of sleep
that I've ever had in my life.

And I said, "This is amazing."

NORA VOLKOW:
It would be fantastic
if we have a drug

that could actually calm
you when you need it,

that makes you feel
groovy, more social,

and there's no
negative consequences.

It would be extraordinary,
but that's not the case.

Biology basically adapts
to stimuli that you give.

NARRATOR:
Cannabis is less addictive

and safer than tobacco, heroin,

cocaine, and alcohol,

which kill hundreds
of thousands each year.

But, you can take too much.

We're seeing an increase
in the number of people

that end up in
emergency departments

with a full-blown psychosis

because of the high content THC.

Dependence can impair
memory, mood, and motivation.

Paul didn't know
he had a problem

until he needed
a drug test for a job.

♪ ♪

DEBASSIO:
And so I quit cold turkey,

and almost immediately

I noticed a big
change in my mood.

They get irritable,
they get aggressive,

and they can feel depressed.

DEBASSIO:
There were stretches
of weeks that I slept

for maybe two to three
hours a night, every night.

And that was all I could get.

DEEPAK CYRIL D'SOUZA:
We looked at sleep
architecture and what we found

was that when people
quit using marijuana,

slow wave sleep,

which is the kind of sleep
that makes you feel rested

the next morning,
was significantly disrupted.

♪ ♪

Okay, hi, Paul, how are you?

Good morning.

NARRATOR:
In a new clinical trial,

Deepak D'Souza hopes to harness
the endocannabinoid system

to prevent cannabis withdrawal.

I need to observe
you take the medication.

So let's just go through that.

NARRATOR:
When the brain is
repeatedly flooded with THC,

it reduces the number
of cannabinoid receptors.

Once a person
is dependent on cannabis,

abruptly quitting
triggers withdrawal.

To replace THC,

D'Souza is testing a drug
that increases our own

cannabis-like
molecule, anandamide.

There was a two-week
period where I was taking

either the placebo
or the study medication

and still smoking
at the same time.

And then I had
to quit cold turkey.

And the day that I quit,

I thought that there was no way
I was going to sleep that night.

♪ ♪

I had no issues.

It was very, very easy.

I'll never forget
that first night

that I was able to sleep
after, after not smoking.

I, I woke up the next day
in absolute shock and awe.

Paul doesn't know if
he got the study drug.

But an earlier trial showed
that it helped people quit.

And PET scans reveal that
after cannabis is stopped,

the brain's own cannabinoid
receptors come back.

♪ ♪

HURD:
Our endocannabinoid
system is really powerful.

And that's why we
shouldn't really

play with it that much.

A drug may be fine
for one person,

but it isn't for everyone.

Dose matters.

When you take it during
development matters.

We need to really
understand what these drugs do

to the brain, even if
they will, and I do believe

have some medicinal benefits.

♪ ♪

NARRATOR:
So what does the future hold
for cannabis as a medicine?

Moving on to the sky walker OG.

NARRATOR:
To find out, Staci Gruber
is following adults

who buy cannabis
from dispensaries

to treat a range of ailments.

This is fantastic
for the afternoon.

Chronic pain is
the number one condition.

Anxiety is probably number two.

PTSD, difficulties with sleep.

And we have patients
who come to us and say,

"You know, I use these types
of products for this problem."

And then we go, "Hmm,
we should look at that."

How's the anxiety?

In all honesty, how is it?

Things are going really good...

NARRATOR:
Gruber's study has yet
to be peer reviewed,

but two years of clinical
and psychological tests

show patients improving.

Wow, so that's a decided change.

Yes.

Reduced symptoms of pain,

reduced anxiety, improved sleep,

and improvements
across the board

on a number of
different cognitive tasks

that require executive function.

The question is why?

It may very well be
that the restorative sleep

that people are starting to
get once they find something

that works for them is
the key to the improvement.

♪ ♪

I think this was the
most important document.

NARRATOR:
Back in Alabama,

Leah Nelson is working
with Eboni Worsley

to get her husband Sean paroled.

NELSON:
Alabama's war on
cannabis has failed.

People like Sean,
and particularly Black men,

are paying this horrific price

for doing something
that is already legal

in states where half
of Americans live.

♪ ♪

(laughter)

NARRATOR:
In November 2020,

Sean was released from
prison and placed on parole.

It's time to go.

You ready?

SEAN WORSLEY (voiceover):
It was scary being inside.

It rocked me to the core.

It was probably one of the most

difficult things I've had to do.

♪ ♪

I would pick going back to war

before going back to prison.

Most definitely.

♪ ♪

EBONI WORSLEY:
It set us back so far.

It's supposed to help
rehabilitate individuals.

Instead, it's putting us
in positions where we need

so much more mental help.

We need much more
financial help,

we need so much more
than we needed before.

♪ ♪

FREDERIQUE:
It is past time for us
to end the war on drugs.

We need to legalize cannabis.

We need to be pumping
money into research

to actually learn more
about this substance.

This moment is about
building new responses

to drugs that are
based in science

and that are based in
the rights of people.

NARRATOR:
There are still
many questions to answer.

Should cannabis
be marketed as candy?

Should the THC potency
of products have limits?

♪ ♪

From reducing harms,
to expunging convictions

and ensuring equity,

getting legalization right

is as complicated
as the plant itself.

GRUBER:
Cannabis is not one thing.

Our recreational consumers
have a different goal

for using cannabis than
our medical patients.

Our medical patients say,

"I'm not looking necessarily
to change how I feel.

I just want to address
this set of symptoms."

But we have
frighteningly little data

on the long-term effects
of medical cannabis use.

The plant is comprised
of over 400 compounds... 400.

If people turn to it,
we should know the answers.

♪ ♪

♪ ♪

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Listen at pbs.org/novanowpodcast

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♪ ♪

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