The Cannabis Question I Full Documentary I NOVA I PBS

♪ ♪ NARRATOR: Cannabis. A multibillion-dollar industry is moving from the illicit market into our daily lives, creating a stark divide. KASSANDRA FREDERIQUE: In a country where its medical use is talked about, every 58 seconds someone is arrested for

cannabis

. ♪ ♪ NARRATOR: A plant demonized to arrest millions is now marketed as medicine. EVELYN NUSSENBAUM: My son suffered from a devastating form of epilepsy and a

cannabis

compound gave him life. NARRATOR: How do the wide range of chemicals in cannabis activate a mysterious system in our bodies? YASMIN HURD: The cannabinoid receptor is the most abundant receptor in the brain. MATTHEW HILL: It's amazing how a single system can influence so many biological processes. ♪ ♪ NARRATOR: Will regular, even daily, use heal us or harm us?

PAUL DEBASSIO: If someone had told me that he was dependent on marijuana, he would have said no way, not at all. NARRATOR: Smoked, dabbed, vaped and eaten, today's cannabis is hyperpotent and far from understood. ZIVA COOPER: These products are available online much faster than we can actually research them. NARRATOR: While federal law blocks science, an unintended public health experiment is underway. CHINAZO CUNNINGHAM: Really the

question

s 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 is the correct dosage? Who should use cannabis?

Who shouldn't? STACI GRUBER: It's a very controversial topic, but it's not about personal thoughts or feelings. What do the data tell us? What does science tell us? The truth through science. We should know the answers. NARRATOR: "The Cannabis Question," right now on "NOVA." ♪ ♪ ♪ ♪ NARRATOR: More than 80 years after the United States ended one type of prohibition, it is ending another. Most people now live in a state where cannabis is legal. As a multi-billion dollar industry emerges, our country finds itself at a crossroads. ♪ ♪ HILL: Cannabis is truly one of the most fascinating topics of discussion I've ever seen because of how emotionally polarizing it is among people.

And it's very strange because the whole field of cannabis science is very underdeveloped. Not much research has been done and there is a lot we don't understand. And yet, what we have in society are groups of people who fervently believe that this panacea can cure any disease that exists, or that it is the devil's weed, and that it will cause the downfall of society, without recognizing that the reality of cannabis is somewhere in between. ♪ ♪ (birds singing) ♪ ♪ NARRATOR: Americans around the world are turning to cannabis for relief from a wide range of ailments, including veterans like Sean Worsley, who uses cannabis to treat his post-traumatic stress disorder caused by the combat in Iraq.

SEAN WORSLEY: Our sole purpose was to clear routes for passing supply convoys, looking for roadside bombs along the route. (explosion) I was on a mission and we went over a hole in the center of the road and unfortunately it was an improvised explosive device that exploded. (explosion) (overlapping screams) Knocking me unconscious, and when I woke up, the doctor was in my face, asking me if I was okay, if I could hear him. (screaming) ♪ ♪ NARRATOR: After his tour, Sean battled a traumatic brain injury and disturbing symptoms caused by post-traumatic stress disorder. 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. (gunshots) If I was shot in the dream, I would wake up clutching my chest because I felt the pain.

NARRATOR: Sean's medications for PTSD had concerning side effects, so he got a medical cannabis card. RYAN VANDREY: Low-dose cannabis can help reduce anxiety and relax someone. And people who have PTSD and are just starting to use cannabis report that it changes their lives. Then I can sleep for the first time in two years and I can go to the supermarket without being so intense and nervous. This is why people with PTSD gravitate strongly toward cannabis use. NARRATOR: For thousands of years, humans have cultivated cannabis for its fiber, seeds and medicinal properties. Ancient Hindu texts claim that it was brought by the god Shiva for the pleasure of humanity. ♪ ♪ The plant contains more than 400 chemicals, including cannabinoids, which are 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 opened a new chapter in neuroscience.

DANIELE PIOMELLI: Cannabis opened a window into the functioning of our body, a completely unexpected window. Because what was discovered was that THC binds to receptors in the brain and outside the brain, and when it does, when it binds to these receptors, the cells now behave differently. ♪ ♪ NARRATOR: Cannabinoid receptors, named after cannabis, are found in almost every organ in the body. They bind to our own cannabis-like molecules, called endocannabinoids, which regulate functions such as sleep, cognition, memory, and mood. ♪ ♪ Unlike other brain chemicals, they travel backward through the synapse, where they control the release of most neurotransmitters. ♪ ♪ GRUBER: One of the most surprising 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 main goal of the endocannabinoid system is homeostasis: keeping everything 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. The cannabinoid receptor is the most abundant receptor in the brain. When we looked at where these receptors were expressed, they were expressed in brain regions relevant to motor coordination, cognition, memory, emotional regulation, and reward. All of these areas of the brain are key to many normal behaviors, obviously, but also to psychiatric disorders.

A key function of the endocannabinoid system is to control stress. In fact, the first endocannabinoid found in our body was given a Sanskrit name, anandamide, which means "bliss." HILL: In response to stress, our body mobilizes an endocannabinoid signal. And then, if something aversive happens to us and we suddenly see a threat in front of us, our body goes into high alert mode and we go into overdrive. However, once we have been removed from that threat, our body needs to deactivate that stress response. And what we've learned is that this explosion of endocannabinoids that occurs in response to stress is really critical to that recovery phase.

NARRATOR: Scientists suspect that this signal goes awry in people with PTSD, which is why THC, which mimics our own endocannabinoids, might help. VANDREY: So when we look at people who have PTSD and use cannabis, in short-term trials, you see very beneficial results. But if all they do is use cannabis and do not engage in other behavioral therapies to help overcome their trauma, they are 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. So really the

question

s 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, they are shades of gray. It's not black or white and it's complicated. ♪ ♪ NARRATOR: In 1996, cannabis was legalized in California for medical use. But at the federal level, it remains a Schedule One drug, like heroin, making research difficult and leaving patients like Elizabeth Pinkham alone. 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 nausea. You may have loss of appetite, have difficulty sleeping. So I was looking for something that wasn't another major, heavy-duty pharmaceutical. NARRATOR: On display are teas, sodas, candy, bath salts, psychoactive body washes and cannabis-infused flowers, with THC, which can relieve nausea when smoked.

PINKHAM: The effects are pretty immediate. I've definitely regained my appetite a little more. It also helps with neuropathy, which is like numbness in your fingers and toes. This is super medicinal. See how dark and dense that is? MMM. That indicates more of the indica family. Good for the body, good for the pain. STEVE D'ANGELO: My staff has to do the best they can to try to guide people to the products that will serve them the best. But my staff are not trained doctors and we really should be teaching cannabis medicine in all medical schools in the United States.

And that's not happening now because of federal law. It's actually a voter-approved "medicine," in quotes, so people say, "Oh, there's medical cannabis that's approved." It has not gone through the FDA's rigorous vetting process. And that is what is fundamental to medicine. PINKHAM: I think it would be great if there was a little more science behind this. But I think in the meantime you have to do what works for you and you have to figure it out as you go. ♪ ♪ NARRATOR: But it's a challenge. Scientists are not sure if cannabis sativa, indica and ruderalis are different species.

Most cultivars grown today are hybrids. They have different chemicals called terpenes, which create flavors and smells. And in addition to THC, the plant contains more than 100 other cannabinoids. One of them, called CBD, is flooding the market. COOPER: One in seven adults in the United States uses CBD. You see CBD everywhere, you see it in pet stores, you see it in Bed Bath and Beyond, you see it in Whole Foods. And so there's a multi-billion dollar industry built on this plant and there are all these different hypotheses about what these different chemicals can do to help us.

But these products are available online much faster than we can actually research them. ♪ ♪ NARRATOR: Despite the current availability of CBD, it took a group of determined parents to bring it to market. A search began in Palo Alto, California, where Stanford neuroscientist Catherine Jacobson set out to treat her son Ben's epilepsy. ♪ ♪ CATHERINE JACOBSON: Watching her son have a seizure is really scary. It's horrible, right? It's horrible because you know brain damage is occurring. The children get scared, they get confused. And with uncontrolled epilepsy, we all live in fear of dying. (gasping) NARRATOR: About a third of patients with epilepsy do not respond to medications.

Catherine knew that the longer Ben's seizures lasted, the less likely they would be controlled. Could she have just given him medicine? MAN: Mm-hmm. NARRATOR: And she wasn't alone. In Berkeley, California, her friends Fred Vogelstein and Evelyn Nussenbaum also felt helpless to control her son Sam's epilepsy. ♪ ♪ FRED VOGELSTEIN: What most people don't know about seizures is that there are dozens of different types. So the type of seizures that most people are familiar with are grand mal seizures where you just lay down on the floor and start falling. The other attack that many people are familiar with are stare attacks.

Sam had a version of those seizures because he would lose consciousness for about 15 seconds. NUSSENBAUM: When someone has a seizure, it can be compared to a thunderstorm or an overloaded power grid. We all have electricity in our brain. And when someone has a seizure, the electricity becomes irregular. FRED VOGELSTEIN: None of the medications we tried controlled the seizures, and some of them had pretty unpleasant side effects. NUSSENBAUM: One time he had hallucinations and thought he had holes in his skin and insects were coming 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 turned him into a zombie. NARRATOR: Then they came across research suggesting that cannabis could calm seizures. JACOBSON: I didn't know anything about cannabis, but I did some research and found out that there are obviously a lot of different chemicals in cannabis, the two most notable being CBD and THC. We know that THC gets people high. CBD doesn't do that. So my preference was, of course, to try CBD first. STORYTELLER:CBD does not bind directly to cannabinoid receptors, but its presence appears to reduce the impact of THC. ♪ ♪ It also increases levels of anandamide, our happiness molecule, and interacts with receptors such as serotonin, which affect our mood.

However, in 2011, extracts with high CBD content were difficult to find. JACOBSON: 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 or eight months of doing this and not seeing any benefit for 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 that her seizures would subside immediately. Unfortunately, Catherine only had enough for five days. And so we had this incredible five-day streak. And then we ran. ♪ ♪ NARRATOR: CBD also helped Catherine's son, Ben.

But the next batch of tinctures from him were too weak to use. Pharmaceutical companies receive a lot of abuse for their marketing tactics. But the only thing they do really well is make all the pickups exactly the same. It is disinfected, it has quality control. And I wanted that for my son. ♪ ♪ NARRATOR: Then they heard about an English company called GW Pharmaceuticals, with greenhouses

full

of cannabis and laboratories that could make chemically pure drugs. ♪ ♪ Since CBD was illegal in the US, Sam's family flew to London for treatment while Ben's family waited. (roarplane engines) After four days of taking GW's CBD, Sam's seizures dropped from 68 to six a day. ♪ ♪ On the eighth day of treatment, he was only three.

NUSSENBAUM: It worked and it worked fast. But the other thing about him getting better was that I saw this kid that I hadn't seen since he was four years old and he started having seizures, except now he was 11 years old and he was smart and funny and he wanted to ride a zip line over London. . ♪ ♪ NARRATOR: Sam no longer has seizures. His story led to clinical trials and, in 2018, the FDA approval of the first CBD drug, called Epidiolex. In certain types of epilepsy, it can reduce seizures by about 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 illness. I feel like he has reduced the severity of the more severe types of seizures that he has, so I feel like he helps. But Epidiolex is not a miracle drug. It is a tool in the toolbox, like any 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 is super important about a drug like Epidiolex is that, for the first time, you have a cannabis-derived drug that is completely legitimate for conventional medicine to study.

And we're just beginning to see where that can lead. ♪ ♪ Dozens of clinical trials are underway, including at U.C. San Diego Medical Cannabis Research Center. Watch each point until it explodes. NARRATOR: Braylon, 14, has severe autism. INVESTIGATOR: He Okay, look with your eyes, look right here. NARRATOR: His parents hope CBD can 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 is going to happen. And if something happens that he didn't expect, he can find it very difficult to manage. I'll go home.

KEVIN PULLEY: I want you to stand up, please. Uh-uh. No, thanks. KEVIN PULLEY: We wanted to see what can be done to try to curb that behavior. He was hitting, being a little violent. LETITIA PULLEY: And I would never forget that a therapist told me that you want to control him because it affects his learning. If you can't control behavior, it will be difficult for you to concentrate in class. ♪ ♪ NARRATOR: Children who have autism have different brain wave patterns than children who do not have it. ♪ ♪ TRAUNER: There is something different about the way the brain develops that causes children to have tremendous difficulties with social interactions, with social communication.

And it seems that one of the problems may be a type of sensory overload. INVESTIGATOR: There you have it, yes. Touch my finger and then touch your nose. NARRATOR: To find out whether Epidiolex could treat severe autism, Trauner is conducting a double-blind clinical trial. Keep them away and close your eyes. NARRATOR: For two eight-week sessions, children will take CBD or a placebo, and researchers will use a battery of tests to see if the medication helps. (overlapping talk) NARRATOR: To study the impact of CBD on the brain, in another part of the trial, Alysson Muotri will work with human skin cells. ♪ ♪ This is because skin cells can become master builder cells again and then induced to develop like brain cells do, forming networks of neurons. ♪ ♪ ALYSSON MUOTRI: These brain cells will actually self-organize and form what we call a brain organoid.

And as they mature over time, they begin to become more and more electrically active. NARRATOR: That activity is captured by electrodes placed beneath the cluster of brain cells. When its neurons activate, they create electrical signals comparable to those of 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 surprises we see is that by adding CBD to the culture, we actually silence or mute the activity of these brain cells over time. This is not permanent. We can remove it, 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 the excess neural activity in the brains of children with autism? Mom, car. Yes, we're going to drive... NARRATOR: The study is still blinded, but Braylon's parents are sure that CBD helped him in phase one of the trial. (overlapping confusing chatter) KEVIN PULLEY: It was dramatic. It was like day and night. So, I could be wrong, but, you know, I... we both saw the difference. Very good... LETITIA: Focus... LETITIA PULLEY (voice-over): Having eight weeks without hitting, without perseveration and things like that was wonderful.

KEVIN PULLEY: And then when we moved into the second half of the test, she went back to her normal self. So, I'm hopeful that the first round was CBD. Here, I need you to take this, take your medicine. TRAUNER: What we heard from parents is quite remarkable. And we don't know if they were taking placebo or CBD. But it's really important to get good data showing whether CBD is effective and safe, because we're talking about a long-term treatment. ♪ ♪ NARRATOR: Treatment that uses hundreds of milligrams of Epidiolex. Not the small amounts of CBD you can buy at a dispensary.

HILL: Only four percent and maybe up to 20% of the CBD you consume orally actually enters your body. And so it looks like you need to take about 100 milligrams of CBD oil orally to really have a signal in your bloodstream that you have CBD on board. HURD: Most of the products sold are ten and 20 milligrams. And some people say they benefit from that. And even if it's a placebo effect, I'm actually fine with it. But what worries me is that the CBD they are taking has other chemicals in it. NARRATOR: Generally, only products in legal states that contain THC, not CBD, are regulated.

Before they can be sold, they must be analyzed in authorized laboratories for potency and contaminants such as pesticides, mold and heavy metals. Using untested cannabis is dangerous. But when it comes to assessing risk, a key factor is age, because the endocannabinoid system, which cannabis targets, changes throughout our lives. ♪ ♪ PIOMELLI: As we grow from a fetus to becoming adolescents and eventually adults and the elderly, 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 changes rapidly.

It is also a time when many try cannabis for the first time. ♪ ♪ PIOMELLI: So when you consume THC, you're basically indiscriminately activating all of your cannabinoid receptors throughout your body and throughout your brain. HURD: So THC is 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 more than 1,000 adolescent brains to look for differences between those who use the drug and those who don't. ♪ ♪ her Today she is evaluating Angel, who has smoked cannabis at least once a week for the past year and is curious about its impact. ♪ ♪ All she really needed to hear is something like: "Hey, do you want an MRI of your brain?" "Yeah!" So... to me, that's really cool.

I know it's nerdy, but the substance you're consuming, you can't see what it does to your brain. ♪ ♪ NARRATOR: Using functional magnetic resonance imaging, Jacobus can study brain structures that are critical to the healthy development of young adults. ♪ ♪ The brain is changing rapidly from infancy, through childhood, adolescence and into adulthood. Two types of tissue that support cognitive development are changing rapidly. The gray matter then contains the cell bodies and forms the cerebral cortex. So the outermost lining of the brain. And white matter allows gray matter regions to communicate quickly and efficiently. ♪ ♪ NARRATOR: During adolescence, white matter increases and gray matter decreases, as weaker neural connections are eliminated and new ones are formed to make the brain more efficient. ♪ ♪ Jacobus has found that adolescent cannabis users have a thicker cerebral cortex, suggesting that this synapse pruning has been interrupted.

JACOBUS: Now I'm going to read the same list again. NARRATOR: And it's not just physical changes in the brain. I want you to tell me... NARRATOR: Thousands of cognitive tests reveal that adolescents who use cannabis regularly have more difficulty in learning and memory tasks than those who do not. Bowl, dinner, cup... It made me realize that memory is probably what impacts me the most with cannabis. But definitely, if I stop for a bit, I have the feeling that it would be easy to remember those things. ♪ ♪ NARRATOR: Research shows that after a period of abstinence, cognitive performance can recover.

And does the brain change? Other studies link them to alcohol or genetic and environmental influences. ARPANA AGRAWAL: Cannabis itself may not be the culprit. That these differences that we see in the brain are pre-existing and that they arise before a child takes the first joint of it. Go ahead, release your breath. NARRATOR: To unravel the role of drugs, genes and environment, more than 11,000 children are being followed through their adolescence in the Adolescent Brain Cognitive Development Study. And I'd say that's definitely a no, kind of a no... NARRATOR: N.I.H. Researchers will assess the children's physical and mental health, academic performance, and drug use with saliva and hair tests. ♪ ♪ So far, few of the children have tried cannabis, but there is survey data on their parents' use.

One of the things we're most interested in is prenatal exposures, and we saw that there were a good number of mothers in the study (just like what we're seeing in the general population) who used cannabis during pregnancy. CYNTHIA ROGERS: And we were able to look and see, among those children whose mothers used cannabis during pregnancy, did we see any difference in their developmental outcomes? And one questionnaire that really caught our attention was the assessment of psychosis-like experiences. And although you couldn't see anything or anyone, did you suddenly start to feel that an invisible energy, a creature or some person was around you?

Oh yeah. INVESTIGATOR: Yes, okay, and that bothered you? Uh no. Not so much. AGRAWAL: And this data set gave us the opportunity to roll back the tape to a period of time in an individual's life where he is exposed at a time when his brain is exquisitely vulnerable. Did you sometimes start to worry because your mind was trying to trick you or not working right? Oh yeah. Well. RYAN BOGDAN: So among the children who were exposed to cannabis after their mother found out about her pregnancy, they experienced more psychotic experiences, they experienced more depression- and anxiety-like behaviors, they are breaking more rules, they have more attentional thinking. issues. ♪ ♪ NARRATOR: Psychotic experiences are also associated with increased risk of mental illnesssuch as schizophrenia and depression. ♪ ♪ ROGERS: We know that cannabis use during pregnancy is increasing.

We've seen ads online and on social media aimed at women saying this is something that's safe to use during pregnancy for things like nausea or insomnia. And these women aren't trying to harm their babies, they're just trying to get through what can be a difficult time. As you know, we're interested in looking... NARRATOR: Rogers and Agrawal are now scanning 250 babies to see if brains exposed to cannabis during pregnancy are different from brains that weren't. ROGERS: THC crosses the placenta. We know that the baby's brain is exposed to it. We also know that the brain receptors that THC binds to develop very early during pregnancy.

The endocannabinoid system is essential for wiring the brain during development. So if cannabis comes into play as the endocannabinoid system regulates the neural circuits that are established, the way cells communicate as they develop can obviously have an impact on that. And that's what's critical for people to understand: cannabis is not a benign drug. ♪ ♪ NARRATOR: While scientists worry about the risks, most agree that much greater harm has been done by criminalizing cannabis, starting in 1937. The Treasury Department intends to go after the despicable vulture drug dealer... NARRATOR: Harry Anslinger, head of the Bureau of Narcotics, stoked racism toward Mexican immigrants by demonizing their word for cannabis, marijuana, and claiming that "weed" corrupted users.

NEWS NARRATOR: Debauchery, violence, murder, suicide. (woman screaming) If you look at the way they talked about marijuana, part of the strategy was to make cannabis something that was not acceptable, make it foreign, and create hysteria to implement laws that control a group of people. who were not white and push a narrative that the government keeps us safe. NARRATOR: In the 1970s, Richard Nixon ignored a panel of experts recommending decriminalization and declared a "war on drugs." Soon drugs would become the number one reason for being arrested in the US. Do you mind if we search the car?

NARRATOR: Since 2000, more than 14 million people have been arrested and about 40,000 Americans are now behind bars for cannabis, primarily on possession charges. FREDERIQUE: Every 58 seconds someone is arrested for cannabis. 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 state in the United States, regardless of whether cannabis is legal or not, black people are arrested for cannabis-related crimes more than white people. (sirens wailing) FREDERIQUE: Even though all the government data shows that usage is the same across all races.

NARRATOR: Although many Americans believe the war on cannabis is over, especially for Black people like Sean and Eboni Worsley, it is a war that continues. ♪ ♪ To manage his post-traumatic stress, Sean had obtained a medical cannabis card in Arizona. But when he and Eboni began a cross-country trip to see his family, they drove through states where cannabis is illegal and racial discrimination is common. ♪ ♪ EBONI WORSLEY: We needed gas. We have no idea, especially in a place you don't know, when is the next place you can stop for gas? SEAN WORSLEY: I get out of the car. As I drive away, a vehicle pulls up in front of my wife's car and it is a police vehicle.

EBONI WORSLEY: And all of a sudden an officer walks up to me. I was startled when I looked up and he said, you know, "Where are you going?" and I said, "We're headed to North Carolina." And then he started talking to my husband, who is outside the vehicle. SEAN WORSLEY: He asked me if there was weed in the vehicle and I was honest and said, "Sir, you know, I'm a medical cannabis patient from Arizona and I have my cannabis, but it's locked and it's in the trunk." At that moment, he handcuffs me and proceeds to search the vehicle.

I give him my IDs and he says, "Hmm, well, you won't need them where you're going." NARRATOR: The officer found a third of an ounce of medical cannabis LEAH NELSON: He charged them as harshly as he could with possession other than personal use, and that was because Sean had a grinder and rolling papers with him, and he. He had a scale. All of those things were recommended by his doctor. If you smoke marijuana for medicinal purposes, it is not uncommon for a doctor to tell you to use a scale to know how much you are smoking. six days in jail before having a hearing.

In Pickens County Court, they were charged with multiple felonies ♪ ♪ After struggling to pay bail and car repossession fees, the couple returned to Arizona. ♪ ♪ EBONI WORSLEY: The fines and fees became astronomical. When we moved 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 suffered a stroke. Eboni's charges were eventually dropped, but due to previous minor convictions, Sean was sentenced to five years and placed 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. He 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 back, to keep you in their hands. Do you want to lock me up for not having a job, do you want to lock me up for not having a place to stay ♪ ♪ NARRATOR: In March? 2020, Sean was extradited to Alabama to serve the remainder of his sentence behind bars: I see the harm of the war on drugs every day in the lives of all my patients.

It's so clear. I know that it does not have any members who have been arrested or imprisoned. 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. While 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 sport. That explosive power... to propel my body and essentially crush people. (players grunting) Every time that happens, every time your brain vibrates in your skull, you pay a price.

The job creates an inherent need for pain relief, so I was put on a lot of opioid medications, which would allow you to go into a game with acute injuries and perform because you don't feel bad. I was taking my oxycodone as prescribed, I saw my daughter walking down the hallway and I didn't recognize her. And I realized they were causing a serious problem and I stopped taking them. And that's where I decided that cannabis is a better option. ♪ ♪ Cannabis not only allowed me to reduce my opioid use, but it also allowed me to eliminate all medications. ♪ ♪ It didn't cure my injuries, but what it did for me was relieve my pain, so I felt motivated to go to the gym, exercise, and take care of my body.

CUNNINGHAM: We know that cannabis causes less pain and impairs people's ability to tolerate it. Affects the immune system and reduces inflammation. It is certainly safer than other medications we have been using for decades. NARRATOR: Monroe is now a partner and consultant at one of the largest cannabis companies in the country. However, while many praise the benefits of cannabis, some scientists warn that there are risks, especially for those who use it daily. About nine percent of users will develop a cannabis addiction. One is Pablo. DEBASSIO: I was a junior in high school and it was a 400 freestyle relay.

In the last leg of the race, you should always go as hard as humanly possible. And when I came out of the turn and raised my head, I felt a twinge right between my shoulder blades, and it just killed me. But it wasn't until I entered college that it became harmful and recurring. And I started using cannabis to relieve a lot of pain and help me sleep at night, because I could never get a

full

night's sleep. ♪ ♪ NARRATOR: Cannabis seemed to cure Paul's insomnia. DEBASSIO: I loved how relaxing it was. I would have the best night's sleep I have ever had in my life.

And I said, "This is amazing." NORA VOLKOW: It would be great if we had a drug that could really calm you down when you need it, that makes you feel fun, more sociable, and that doesn't have negative consequences. It would be extraordinary, but it is not like that. Biology basically adapts to the stimuli you give it. NARRATOR: Cannabis is less addictive and safer than tobacco, heroin, cocaine and alcohol, which kill hundreds of thousands of people each year. But you can take too much. We are seeing an increase in the number of people ending up in emergency departments with full-blown psychosis due to high THC content.

Dependency can affect memory, mood, and motivation. Paul didn't know he had a problem until he needed a drug test to get a job. ♪ ♪ DEBASSIO: So I quit cold turkey and almost immediately noticed a big change in my mood. They become irritable, aggressive and may feel depressed. DEBASSIO: There were periods of weeks where I slept maybe two or three hours a night, every night. And that was all I could get. DEEPAK CYRIL D'SOUZA: We looked at sleep architecture and found that when people stopped using marijuana, slow-wave sleep, which is the type of sleep that makes you feel rested the next morning, was significantly altered. ♪ ♪ Well, hello, Paul, how are you?

Good day. NARRATOR: In a new clinical trial, Deepak D'Souza hopes to harness the endocannabinoid system to prevent cannabis withdrawal. I need to watch how you take the medication. So let's go over that. NARRATOR: When the brain is repeatedly flooded with THC, the number of cannabinoid receptors is reduced. Once a person becomes 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 when I was taking either the placebo or the study drug and at the same time I was still smoking.

And then I had to quit cold turkey. And the day I left him, I thought there was no way I was going to sleep that night. ♪ ♪ I had no problems. It was very, very easy. I will never forget that first night I was able to sleep after not smoking. I woke up the next day in absolute shock and amazement. Paul does not know if he received the study drug. But an earlier trial showed it helped people quit smoking. And PET scans reveal that after stopping cannabis, the brain's own cannabinoid receptors return. ♪ ♪ HURD: Our endocannabinoid system is really powerful.

And that's why we shouldn't play with it so much. A medication may be fine for one person, but not for all. The dose matters. When you take it during development is important. We need to really understand what these drugs do to the brain, even if they do, and I think they 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 at dispensaries to treat a variety of ailments. This is fantastic for the afternoon.

Chronic pain is the number one condition. Anxiety is probably number two. PTSD, sleeping difficulties. And we have patients who come to us and say, "You know, I use these types of products for this problem." And then we're like, "Hmm, we should look at that." How is the anxiety? Honestly, what is it like? Things are going very well... NARRATOR: Gruber's study has not yet been peer-reviewed, but two years of clinical and psychological tests show that patients are improving. Wow, so that's a decided change. Yes. Reduced pain symptoms, reduced anxiety, improved sleep, and overall improvements in a number of different cognitive tasks that require executive function.

The question is why? It is quite possible that the restful sleep that people begin to get once they find something that works for them is the key to 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 terrible price for doing something that is already legal in states where half of Americans live. ♪♪ (laughs) NARRATOR: In November 2020, Sean was released from prison and paroled. It's time to go.

Are you ready? SEAN WORSLEY (voice-over): It was scary being inside. She shook me to the core. It was probably one of the hardest things I've ever had to do. ♪ ♪ I would choose to go back to war rather than go back to prison. Definitely. ♪ ♪ EBONI WORSLEY: It took us back to now. It's supposed to help rehabilitate people. Rather, it is putting us in positions where we need a lot more mental help. We need a lot more financial help, we need a lot more than we needed before. ♪ ♪ FREDERIQUE: It's time we put an end to the war on drugs.

We need to legalize cannabis. We need to invest money in research to learn more about this substance. This moment is about building new responses to drugs that are based on science and people's rights. NARRATOR: There are still many questions to be answered. Should cannabis be marketed as candy? Should there be limits on the THC potency of products? ♪ ♪ From reducing harm to eliminating convictions and ensuring fairness, getting the right legalization is as complicated as the plant itself. GRUBER: Cannabis is not a single thing. Our recreational consumers have a different cannabis use goal than our medical patients. Our medical patients say, "I'm not necessarily looking to change how I feel.

I just want to address this set of symptoms." But we have very little data on the long-term effects of using medicinal cannabis. The plant is made up of more than 400 compounds... 400. If people turn to it, we should know the answers. ♪ ♪ ♪ ♪ ALOK PATEL: Discover the science behind the news with the "NOVA Now" podcast. Listen at pbs.org/

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nowpodcast or wherever you find your favorite podcasts. ANNOUNCER: To order this show on DVD, visit ShopPBS or call 1-800-PLAY-PBS. "NOVA" episodes are available with Passport. "NOVA" is also available on Amazon Prime Video. ♪ ♪ ♪ ♪