THE MEDICINE IN MARIJUANA - Transcript

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[jaunty piano music]

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- [Dave Marash] It's Latin
name is cannabis sativa,

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and it's known by hundreds of others.

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But it's the slang word,
marijuana, that has spread

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around the world, naming
one of the oldest plants

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that man has cultivated as a crop

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and consumed as a medicine.

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[jaunty piano music]

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[machine beeping]

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- [Nicole] Yeah?

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- [Dave] Amylea's seizures
began soon after her birth,

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and they were relentless.

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None of the epilepsy medicines worked.

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She almost died.

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- She has a rare epilepsy disorder.

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She shouldn't be here today.

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So, because of cannabis...

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Saved her life.

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[machine beeping]
[baby babbling]

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You're okay, baby.

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You're okay.

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You're okay.

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[lively instrumental music]

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- I always say that
cannabis has been a medicine

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for a lot longer than it hasn't been.

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Archeological evidence suggests

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that cannabis has been a medicine

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or used for medicinal purposes
for probably 3,000 years.

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- [Dave] The non-psychoactive,
fibrous stalk

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of cannabis is called hemp.

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For centuries, it's been
traded around the world

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to make cloth, and oil and rope.

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- [Announcer] For the sailor
no less than the hangman,

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hemp was indispensable.

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[Scissors clicking]

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- [Dave] It's the cannabis
flower and its resins

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that make the medicine,

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and the earliest evidence
of its use comes from Asia.

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It apparently worked and word got around.

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Over centuries and across
cultures it was recommended

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by healers, for epilepsy, depression,

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inflammation, and pain.

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No doubt most folks who used it were aware

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that it had some interesting qualities.

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Those other pleasurable
effects were reason enough

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for a crusade against
the so-called evil weed

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by the first chief of the
Federal Bureau of Narcotics,

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Harry Anslinger.

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[Loud explosion]

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- Well, Harry Anslinger went on a campaign

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because Anslinger had a
passionate hatred of cannabis.

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He thought that cannabis was associated

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with black men having
relationships with white women.

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- [Announcer] Marijuana, the burning weed

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with its roots in hell.

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- [Dave] Anslinger was
also a very effective

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political bureaucrat,
and he pushed passage

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of the 1937 Marijuana Tax Act...

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[dramatic orchestral music]

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...that effectively made
it an illegal substance.

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But cultural traditions
that have been around

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for thousands of years are
difficult to stamp out.

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So, in spite of Harry Anslinger,

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people all over the world
continue to use cannabis

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for both its medicinal and
its pleasurable properties.

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[lively instrumental music]

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Dr. Rafael Mechoulam,
professor of chemistry

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at Hebrew University in Jerusalem,

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was interested in the pleasure part.

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What about cannabis makes people high?

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So, in 1964, the world found out.

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His lab isolated Delta 9-THC,

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the primary psychoactive
molecule in cannabis.

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And then his team identified
cannabidiol, or CBD,

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a molecule that's not psychoactive,

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but has important therapeutic properties.

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- And we know that in the
brain we have a receptor,

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the cannabinoid One or CB1 receptor.

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Turns out that this receptor

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is the single most densely
populated G protein-coupled

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7 transmembrane domain
receptor in the human brain.

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Nobody learns about
this in medical school.

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[clock ticking]

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[pulsing instrumental music]

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- [Dave] Scientists knew
that THC and CBD had to bind

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to receptors in our
bodies to have an effect.

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Receptors are chemical
molecules embedded in our brains

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and all our body's tissues.

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They can sense and lock
on to biochemical signals

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like insulin and adrenaline,
but also THC and CBD.

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Researchers found those
receptors and named them.

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The CB1 receptor is very
abundant in brain tissue,

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and the CB2 receptors
are in our immune system

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and all of our organs and tissues.

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Turns out those receptors are not just

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for the cannabis plant.

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Dr. Mechoulam and his team discovered

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that we have our own system
of cannabinoid-like chemicals.

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They're called endocannabinoids,

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and they attach to the same
CB1 and CB2 receptors as THC.

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Scientists now know that
the endocannabinoid system

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is present in all animal
species down to sponges.

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It helps us modulate pain and
stress, our mood and memory,

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our physical activity and sleep.

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It helps maintain balance, homeostasis.

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The discovery of the
endocannabinoid system led

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to an explosion in research.

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The plant has over 400 chemical entities

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and their actions,
alone or in combination,

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are just beginning to be explored.

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But there are big hurdles to
doing research on patients,

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mainly because it is still
classified as a Schedule One,

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dangerous drug by our
government, the same as heroin

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and cocaine, even though
its health risk is minimal.

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For example, there's never
been an overdose death

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due to marijuana.

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Although federal
prohibition hasn't stopped

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about 55 million people
from spending billions,

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that's with a B, on marijuana,

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it has seriously limited
therapeutic research.

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- The only legal source
of cannabis for research

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in the United States is from NIDA,

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the National Institute on Drug Abuse,

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and NIDA has a congressional mandate

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to only study substances of
abuse as substances of abuse.

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- [Dave] So if the
government won't allow it

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to be studied as a medicine,
where do the millions

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of patients go to get
advice on how to use it,

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information about different
strains and dosages?

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Not from their doctor or pharmacist

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but from a so-called bud-tender.

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- So, what we're trying to
do in terms of education,

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and I don't think most
dispensaries are doing it,

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is educating everybody how to use less.

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That's the one thing I think

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that should be going out there now.

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- [Dave] We say it's a cannabis conundrum.

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It's a messy mixture of
medicine, policy, and politics.

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Because of its impact on public health,

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the National Academy
of Sciences was tasked

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with looking at the
science, analyzing the data,

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and grading the evidence for
both the therapeutic benefits

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of cannabis and the risks.

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Dr. Abrams and a select committee reviewed

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over 10,000 studies.

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They found only a small number

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that were scientifically
strong enough to grade,

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but it's the best evidence we have so far.

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The most common conditions
for medical cannabis use

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are pain, epilepsy, cancer, and PTSD.

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We will look at the
evidence but, importantly,

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we'll hear people's stories.

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[lively instrumental music]

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Eva Ceskava is a retired
Unitarian Minister.

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She had severe back pain,
underwent three spinal surgeries

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and still suffered.

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She was taking a small dose of opioids.

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- I was visiting friends and Toby said,

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"Have you tried pot?"

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And I said, "For pain?"

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And he said, "Yeah, it's
supposed to help with that."

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So, okay. I smoked a little

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and my back felt better!

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It didn't hurt as much.

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But the cannabis really
takes the edge off.

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The pain is always there.

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But with the little bit of opioid I use

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and then the little bit
of cannabis that I use,

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it's bearable.

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I don't feel like leaving the planet yet.

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[chuckles]

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And I enjoy the things I do.

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I'm active in my church.

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I'm a docent at the Indian
Pueblo Cultural Center.

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And if I had to rely totally on opioids,

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I wouldn't be able to do it.

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You know, it requires some brains.

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I still have brains with cannabis.

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- And the cannabis, has it helped you?

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- Yes sir.
- Okay.

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- It sure has.

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The opiates were not doing it

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because they knock you out all day.

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With this, I can pick and choose,

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I can wait till the last minute.

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I know it's only going to
last a certain amount of time

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and I'm not worried about it.

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- Well, I think, uh,
definitely you are going

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to qualify for renewal.

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You always do and this is
your fifth year, so I'm going

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to go ahead and fill out
your paperwork for you.

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- [Dave] Recent studies
have shown that in states

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where medical cannabis is
legal and easily accessible

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to patients, opiate-related
deaths have declined.

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- I'm going to take a listen

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to your heart real quick.
- Okay.

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- [Dave] Dr. Anthony Reeve
noticed that when many

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of his patients came to renew
their yearly cannabis cards,

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their opiate use had decreased or stopped.

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At the time, New Mexico had one

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of the highest opioid
overdose rates in the country.

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He was intrigued.

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- We had a survey that
asked different questions,

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like what's your pain
level before and after,

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whether using other medications,
things of that nature.

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And then, at that point, I started

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to team up with Dr. Vigil.

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- So we conducted the study,
essentially comparing patients

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that were afflicted with
chronic pain conditions

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and were given the opportunity to enroll

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in a medical cannabis program
as compared to patients

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that were given the same opportunity

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but ultimately chose not to enroll.

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And what we found is that those patients

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that chose to enroll
ultimately, dramatically reduced

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their opiate usage and, more than that,

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multiple classes of
prescription medications.

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- [Dave] Drs. Reeve and
Vigil were the first

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to show a dramatic decrease in opioid use

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among cannabis card holders.

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Studies in other states have
now confirmed their findings.

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[lively instrumental music]

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- You probably know the numbers.

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There's about 1% of the
population has epilepsy,

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which is a large number, and
of that 1% of all the people

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that have epilepsy, 30%
are not controlled--

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and that's with all the latest
medication and so forth.

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- Actually before I left
Children's Hospital,

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they told me that I would have to have her

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in a special wheelchair
because she would never be able

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to lift up her head and she
would probably never talk.

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She would never eat.

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She would never crawl.

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And she would never walk,
she would never do anything.

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- I have...
- Say cheese!

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- [Dave] Amylea is getting ready

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to celebrate her second birthday.

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She's made remarkable progress.

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- [Camie] So, uh, Tess in on
a CBD-THC blend of cannabis.

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- [Dave] Tess has a rare
chromosome abnormality

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and has had constant seizures since birth.

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- She would be asleep, you know.

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I mean, she would be
living her life not aware

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of her surroundings.

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- [Dave] Neither Tess nor
Amylea has been diagnosed

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with Dravet syndrome, the
severe seizure condition

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that researchers studied.

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But their seizures have
responded to cannabis,

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both CBD and THC.

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- She gets everything
through her feeding tube

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which is a MIC-KEY.

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So this is Tess's CBD/THC.

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She gets this every day.

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She gets 0.4 mls twice a
day, once in the morning

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and once in the evening.

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- Now once they've gone
through several medications

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and the seizures are still continuing

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and the family is interested
in trying medical cannabis,

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then we have a discussion

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about the parameters for trying it.

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We have paperwork that
needs to be filled out

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by myself, and I do that.

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- [Dave] At the time, CBD
oil was only available

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in Colorado, so Amylea
was airlifted to Denver.

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- They signed her up for a clinical trial

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at Children's Hospital and
she started taking cannabis

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the following day.

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She got almost instant relief.

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We did have to switch
oils because the first one

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we tried didn't work so well,

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and then the second one is what
truly stopped her seizures.

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- Obviously there's no FDA oversight yet,

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so I don't know what's in that bottle

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and I don't really know about dosing,

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and I'll hopefully know
better in a few years

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what seizure types medical
cannabis might be good for,

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what specific side effects
or monitoring programs

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we should have the kids on--

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because we don't know that yet.

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[dog barks]

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- [Camie] Having the cannabis
is one of those things

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that have afforded us to get her off some

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of these medications that have
had horrible effects on her.

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- But I think that when you
are looking at children,

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you want to help children,

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and we don't have other good choices.

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It's certainly better
than some other options

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that some people might try.

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- [Dave] Now, the first
cannabis medication

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for Dravet syndrome and
severe childhood epilepsy

[00:15:07.01]
has been approved for use by the FDA.

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And the reason it's been OK'd
is because it's not THC--

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it is pharmaceutical grade,
non-psychoactive CBD,

[00:15:18.09]
meeting precise dosage
and safety requirements.

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- Adding the cannabis on top

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of the pharmaceutical medications kind of

[00:15:26.00]
cut the side effects of
what the pharmaceuticals

[00:15:28.07]
were doing to her

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and let her be a child, a baby.

[00:15:37.05]
[lively instrumental music]

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- I think cannabis is
a very useful medicine

[00:15:58.07]
for symptom management
in patients with cancer.

[00:16:02.02]
It's the only anti-nausea drug

[00:16:04.01]
that can also increase appetite.

[00:16:06.04]
It's also useful for pain,
anxiety, depression, sleep.

[00:16:12.00]
My studies have demonstrated
that it augments the benefit,

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potentially, of opiates,

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and I've seen cancer patients
wean off of their opiates.

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- Hi, Tom.
- Hello.

[00:16:22.06]
- [Woman] How are you?

[00:16:23.09]
- [Dave] Tom Dellaria is
a writer and filmmaker.

[00:16:26.09]
He'd felt fine, but his doctor
felt a mass in his abdomen.

[00:16:30.09]
It was a cancerous tumor.

[00:16:33.00]
- It was subsequently
removed and weighed 10 pounds

[00:16:38.08]
and was about a foot by
a foot by five inches,

[00:16:43.06]
kind of like a big fat gigantic pancake.

[00:16:48.05]
- [Dave] Lenny Maietta
and her husband Frank

[00:16:50.07]
are kinesiologists, movement therapists,

[00:16:53.07]
who help disabled people around the world.

[00:16:57.00]
- After a couple of very
short tests it was determined

[00:17:01.00]
I had a very large tumor,

[00:17:03.00]
and I was in surgery two days later.

[00:17:07.01]
- [Dave] Lenny was
diagnosed with a rare type

[00:17:09.03]
of ovarian cancer,
treated with chemotherapy.

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Tom's tumor recurred about a year later.

[00:17:17.05]
- And after five hours of fishing around

[00:17:21.08]
it was determined that it was inoperable.

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- I woke up one morning and thought,

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"It's the chemo that's
killing me, not the cancer,"

[00:17:32.07]
and I stopped, um...

[00:17:36.02]
Yeah, I stopped.

[00:17:39.04]
And so, we figured out
how to make suppositories.

[00:17:42.09]
My dizziness left, my nauseous-ness left.

[00:17:46.06]
And I have now been doing a
gram and a half to two grams

[00:17:50.06]
of cannabis a day for
just about three years.

[00:17:55.07]
- [Dave] Tom knew that cannabis could help

[00:17:57.07]
with symptoms associated
with cancer and chemotherapy,

[00:18:01.04]
like nausea, vomiting,
loss of appetite and pain.

[00:18:05.04]
- My surgeon connected
me with the oncologist.

[00:18:10.09]
I asked him if he had...

[00:18:12.07]
If he was familiar with
CBD, and he said, "Yes."

[00:18:18.02]
And I said, "Well, do you
have an opinion about it?"

[00:18:22.03]
And he said, "Well, I
should. I take it every day."

[00:18:27.00]
- [Dave] Tom is enrolled
in a clinical trial

[00:18:29.01]
at the University of New
Mexico Cancer Center.

[00:18:31.07]
He's getting two drugs
to target his tumor.

[00:18:34.07]
He's realistic about
his choices and chances.

[00:18:38.07]
- Might it help shrink
my tumor and, if not,

[00:18:42.05]
while I'm waiting and the chemo

[00:18:45.02]
or immunotherapy is working can I not

[00:18:50.09]
puke and feel terrible all the time?

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So that's what I was
hoping to get from it.

[00:19:00.00]
- It's not just that
my tumors get smaller,

[00:19:01.09]
it's that I get healthier every day.

[00:19:04.02]
All of my labs get better continuously.

[00:19:07.08]
And I'm able to do my life, I'm sure,

[00:19:11.07]
because of the cannabis.

[00:19:12.08]
Without it, I'm sure I would be sick.

[00:19:15.08]
- [Dave] Lenny consults
regularly with her oncologist,

[00:19:18.03]
and continues taking cannabis

[00:19:20.00]
along with intermittent chemotherapy.

[00:19:24.01]
Unfortunately, thousands of
people rely on cannabis alone

[00:19:27.06]
to treat their cancers,
on very scanty evidence.

[00:19:31.06]
- The plural of anecdote is
not evidence, is what we say.

[00:19:35.04]
True, oncologists are the
most demanding of evidence

[00:19:38.05]
because we treat a very serious disease

[00:19:40.09]
and we use very potent medicines.

[00:19:44.02]
- [Dave] There is evidence
that concentrations

[00:19:46.00]
of cannabis can kill certain cancer cells,

[00:19:49.05]
but only in animal
models in the laboratory.

[00:19:52.06]
Much of the animal research
is being done in Spain

[00:19:55.04]
and other countries, and it is promising.

[00:19:58.05]
- You know, I am not
saying that the evidence

[00:20:01.03]
in the test tube is not impressive.

[00:20:04.09]
Does that translate into having an effect

[00:20:07.00]
in human brain tumors, or
human tumors of any kind?

[00:20:11.04]
We don't know.

[00:20:13.08]
- [Dave] Here's the reality.

[00:20:15.00]
Surgery, radiation and
chemotherapy have proven effective

[00:20:18.04]
for many cancers.

[00:20:20.02]
Cannabis can help with symptoms,

[00:20:22.03]
but its potential
anti-cancer effect in people

[00:20:25.01]
is a long way from being studied.

[00:20:28.07]
[lively instrumental music]

[00:20:40.06]
- It's done really well
outside in our weather.

[00:20:45.00]
Very relaxing cerebral high.

[00:20:49.08]
Very good for evening time
when I'm trying to just relax

[00:20:52.03]
and go to sleep or watch
a movie with my family.

[00:20:57.02]
- [Dave] Matthew Eisenhower,
a marine staff sergeant,

[00:21:00.03]
served five tours of duty
in Afghanistan and Iraq.

[00:21:04.00]
He has PTSD, post-traumatic
stress disorder.

[00:21:08.04]
Over the centuries and the wars,

[00:21:10.04]
it's been called soldier's heart,

[00:21:12.07]
shell-shock, and combat fatigue.

[00:21:16.01]
- My heart was racing

[00:21:18.02]
and I've never felt this
feeling before of anxiety

[00:21:21.07]
or panic, and it confused me tremendously.

[00:21:26.02]
And I had to hide it
throughout my military career

[00:21:29.05]
because it was almost like a hindrance

[00:21:31.08]
to my performance at times.

[00:21:33.06]
- I had several assassination
attempts on my life

[00:21:38.04]
while I was in the Black Panther Party.

[00:21:41.03]
- [Dave] Aaron Dixon has
always been an activist.

[00:21:44.00]
After leaving the Black Panther Party,

[00:21:46.04]
he wrote a book about his experiences.

[00:21:48.06]
He's even run for Congress.

[00:21:50.06]
- You know, we always had to have guns.

[00:21:52.08]
The guns were to protect
ourselves from the police and FBI

[00:21:57.08]
and whoever else our
enemies might have been.

[00:22:02.01]
But after I left the party
and I started raising my kids,

[00:22:06.08]
I realized I had
post-traumatic stress syndrome

[00:22:11.00]
and I had a lot of anger, um...

[00:22:16.03]
...you know, built up inside of me.

[00:22:19.06]
- [Dave] Josh Willis developed
PTSD after he was arrested

[00:22:23.00]
and beaten by police.

[00:22:25.00]
- To make a long story short,
they took me to a field,

[00:22:27.06]
hogtied me, beat me severely,

[00:22:31.04]
threw me back and forth
to their coworkers.

[00:22:34.07]
- [Dave] After an hour
he was finally taken

[00:22:36.05]
to an emergency room.

[00:22:37.07]
- They're pulling teeth out,
they're pulling rocks out

[00:22:40.09]
of my body for months after that.

[00:22:43.09]
- [Dave] He did jail time.

[00:22:45.00]
But in the end, it was a
case of mistaken identity.

[00:22:50.05]
- It was easy for me to
self-medicate in the military,

[00:22:52.05]
just to drink a lot of alcohol
and drown that anxiety.

[00:22:58.05]
It was very easy to use benzos
like Xanax and Temazepam

[00:23:04.01]
and Lorazepam to give you
that quick release of panic.

[00:23:09.02]
- Sometimes I've had a smell
or see a security guard,

[00:23:12.01]
and I'll just start...

[00:23:14.05]
I can't talk, I just start...

[00:23:18.00]
I don't know how to explain it.

[00:23:19.03]
It's just gets real bad, I'm sorry.

[00:23:22.09]
[clears throat]

[00:23:24.01]
- Death didn't seem like a big deal to me,

[00:23:26.03]
or the aspect of suicide didn't
seem like it was a big deal.

[00:23:32.02]
But I realized eventually
that it was just a temporary--

[00:23:38.00]
I mean, it was a permanent
fix to a temporary problem.

[00:23:42.04]
- If I did not have cannabis, you know,

[00:23:45.06]
to help me through the
years, um, you know,

[00:23:51.01]
things would have been
very difficult for me.

[00:23:54.06]
- And then, um, talking to
other vets, I've found cannabis,

[00:24:00.08]
and I thought, "Hey, what--

[00:24:02.03]
give it a try."

[00:24:04.01]
And I did, and it was a...

[00:24:08.08]
It was a miracle, it changed my life.

[00:24:11.00]
- For the vast majority of
people who use cannabis,

[00:24:13.05]
we don't see large negative
problems resulting.

[00:24:18.04]
So, only about 10% of
people who use cannabis

[00:24:21.08]
with any regularity will
develop an addiction to it

[00:24:24.02]
or cannabis use disorder,
leaving 90% of people

[00:24:28.02]
not having particularly bad outcomes.

[00:24:31.00]
- I would say easily 90%

[00:24:33.00]
of my clients report dramatic benefit

[00:24:36.02]
in their functioning and symptoms.

[00:24:38.02]
Of my patients on medications,

[00:24:40.04]
and this is just a ballpark figure,

[00:24:41.08]
I'd say maybe at least
half of them are able

[00:24:43.06]
to completely stop the medication

[00:24:45.07]
and maybe another quarter are able

[00:24:47.07]
to start cutting them down.

[00:24:50.04]
- [Dave] There are genuine
concerns about cannabis use

[00:24:53.02]
in people with psychiatric
illnesses like schizophrenia,

[00:24:56.06]
bipolar disorder and long-term depression.

[00:24:59.03]
But thousands of veterans
and others with PTSD

[00:25:02.07]
have found it helps.

[00:25:05.03]
- Ability to get a whole new set of pipes

[00:25:07.01]
to finish out the rest of the study.

[00:25:09.03]
- [Dave] Dr. Sue Sisley was
a psychiatrist on the faculty

[00:25:12.07]
of the University of Arizona

[00:25:14.07]
and cared for many veterans with PTSD.

[00:25:18.03]
- They started reluctantly
disclosing to me

[00:25:21.02]
that they were using
cannabis, and I say reluctant

[00:25:24.03]
because they knew how conservative I was.

[00:25:27.05]
You know, I'm a life-long Republican

[00:25:28.09]
who never used cannabis my whole life.

[00:25:32.05]
Yes, sir. How are you, Lorenzo?

[00:25:35.00]
Please, have a seat here.
- Thank you.

[00:25:37.00]
- [Dave] The more vets she saw,

[00:25:38.03]
the more she realized
cannabis was helping.

[00:25:40.09]
And when they couldn't
get it, they got worse.

[00:25:44.01]
- A lot of them would become
completely housebound,

[00:25:47.04]
and then with the use of cannabis,

[00:25:49.02]
the families would report
that not only were they able

[00:25:52.03]
to be more interactive but they were able

[00:25:55.07]
to often hold down a job
again for the first time.

[00:25:59.03]
- [Dave] Not only that.

[00:26:00.02]
Dr. Sisley realized that many
vets were no longer having

[00:26:03.04]
to use more addictive medications.

[00:26:06.07]
Because there was so little research,

[00:26:08.07]
she decided to do a
scientifically rigorous study.

[00:26:12.04]
It took seven years to
get federal approval,

[00:26:15.03]
which meant the cannabis would come

[00:26:17.04]
from the so-called government farm

[00:26:19.04]
at the University of
Mississippi-- the only facility

[00:26:22.05]
in America licensed to
grow cannabis for research.

[00:26:26.04]
And it finally came, FedEx.

[00:26:30.00]
- This is the whole thing.

[00:26:31.06]
Look at that!

[00:26:32.05]
- Look important.
- Yeah, we...

[00:26:33.03]
- Is this, like, your
first shipment, or...?

[00:26:34.08]
- Yes, first shipment ever.
- Yeah.

[00:26:36.08]
- Four kilos of cannabis in there.

[00:26:39.04]
- [Dave] Dr. Sisley's study is designed

[00:26:41.04]
to evaluate the participants'
response to smoked cannabis,

[00:26:45.06]
comparing the effects of plants
with high THC concentration,

[00:26:49.09]
high CBD, an equal ratio
of both, and placebo.

[00:26:55.05]
- I can tell you in general
that the veterans here seem

[00:26:59.01]
to be responding favorably
to the study drug,

[00:27:02.02]
but we've had patients with side effects,

[00:27:04.04]
we've had a few adverse events.

[00:27:06.05]
You know, it's not a perfect drug,

[00:27:09.05]
and none of the drugs are on the market.

[00:27:12.04]
- [Dave] Dr. Sisley, a
gifted teacher and honored

[00:27:15.03]
for her work in community mental health,

[00:27:17.07]
was fired by the University of Arizona

[00:27:20.03]
after she began the study.

[00:27:23.03]
[lively instrumental music]

[00:27:39.05]
- First I'm going to dictate
a report for the State.

[00:27:42.01]
- [Dave] Health practitioners
in the United States

[00:27:44.03]
cannot legally prescribe cannabis.

[00:27:46.07]
Their role is to certify that
patients have one or more

[00:27:50.05]
of the qualifying medical conditions,

[00:27:53.00]
and they may recommend it be tried.

[00:27:55.07]
Different states have
their own application,

[00:27:58.00]
licensing and reporting requirements.

[00:28:01.04]
- Edibles are really good for maintenance.

[00:28:04.03]
- [Dave] The patients'
next stop is a dispensary,

[00:28:06.07]
where your consultant is not
a pharmacist but a bud-tender.

[00:28:10.05]
- With edibles it's pretty much...

[00:28:12.00]
We can replicate everything.

[00:28:14.09]
- [Dave] The new drugstore in
town only sells one medicine.

[00:28:18.00]
- ...half an hour to two hours.

[00:28:19.00]
- It markets a mixed bag,

[00:28:20.02]
or baggie, of diverse plant genetics

[00:28:22.09]
with decidedly unconventional names.

[00:28:26.00]
[mellow piano music]

[00:28:33.05]
- [Dave] They have different percentages

[00:28:35.04]
and ratios of THC, CBD
and other cannabinoids.

[00:28:40.00]
How are folks to know what works for what?

[00:28:43.02]
- Even-- so I certify
people for medical cannabis,

[00:28:46.03]
if someone says to me,
"What strain should I use?"

[00:28:48.03]
I have to tell them, you
know, there are hundreds

[00:28:49.07]
of strains. I don't know. I can't say,

[00:28:52.08]
"You've got these symptoms,
there's this strain."

[00:28:54.03]
So what's happening is
exactly as you're saying,

[00:28:56.08]
that the main source of
information are the people working

[00:29:00.02]
in the dispensaries.

[00:29:01.05]
- You know, I generally tell people,

[00:29:03.02]
and it's become the mantra of
the cannabis medicine world,

[00:29:05.09]
is "Start low and go slow,"

[00:29:09.03]
especially for people that
have no prior experience

[00:29:12.04]
or exposure to cannabis products.

[00:29:14.06]
I think, you know, the
better part of valor is

[00:29:16.09]
to be conservative and
see what you can tolerate.

[00:29:20.06]
- I also tell people, you know,

[00:29:21.08]
"If you've been on pain
medicine, chances are

[00:29:24.06]
you've been getting high."

[00:29:26.00]
- [Dave] The problem is, because

[00:29:27.05]
of government research restrictions,

[00:29:29.03]
there is mainly anecdotal
evidence about what combinations

[00:29:32.07]
and dosages work best for
a particular condition.

[00:29:36.01]
It amounts to trial and error.

[00:29:39.00]
But some people are
trying to figure it out.

[00:29:41.06]
- If I was to put into one
sentence what my goal is

[00:29:45.09]
in this industry, it's to
solve the dosing conundrum.

[00:29:49.04]
That is what I focus all of
my energy on, is the dosing.

[00:29:53.04]
- [Dave] In a different life,
Mara Gordon was an engineer,

[00:29:56.04]
helping large companies
streamline production.

[00:29:59.06]
Now she's a medical cannabis entrepreneur,

[00:30:02.09]
an international lecturer, and researcher.

[00:30:06.09]
- We have been collecting all this data,

[00:30:08.02]
about 300 data points on
each patient going in,

[00:30:11.01]
plus pretty extensive
questions that we ask

[00:30:14.06]
on their previous-present cannabis use

[00:30:17.06]
and what their objectives are with it,

[00:30:19.03]
and then make a starting
point recommendation for them

[00:30:22.08]
as to what we believe will be
a targeted therapeutic dose.

[00:30:26.07]
- [Dave] In California, patients
in Mara's study have access

[00:30:30.03]
to cannabis with THC
and CBD concentrations

[00:30:34.04]
almost three times higher
than the government weed

[00:30:37.03]
from that Mississippi farm.

[00:30:40.03]
- Other countries have
been more open-minded.

[00:30:42.05]
There's a lot of excellent
research coming out of Israel

[00:30:45.00]
and of course various European
countries and even Canada.

[00:30:48.02]
But the bias in the medical establishment

[00:30:51.08]
in the United States is, if
the study wasn't done in the US

[00:30:53.09]
it's not as good.

[00:30:55.02]
- [Anthony] And no pain in the throat?

[00:30:57.01]
- [Dave] No matter where
the studies are done,

[00:30:59.00]
most physicians don't
know much about cannabis--

[00:31:02.04]
some are skeptical or opposed

[00:31:04.04]
and many are afraid to recommend it.

[00:31:07.04]
- Well, speaking for
myself, I learned nothing

[00:31:09.03]
about cannabis in medical
school or in residency,

[00:31:12.02]
and really even throughout practice.

[00:31:14.08]
So I think the general...

[00:31:16.02]
If I'm any example, I think the
general physician population

[00:31:20.01]
knows very, very little about cannabis.

[00:31:23.07]
- The patient feedback loop
to doctors is complicated

[00:31:27.04]
because there's a lot of doctors

[00:31:28.08]
who won't write medical
cannabis recommendations.

[00:31:31.04]
So our patients frequently
are going to a cannabis clinic

[00:31:35.00]
to get their recommendation,

[00:31:36.09]
and their actual regular
doctor may not even know

[00:31:40.00]
that they are consuming cannabis.

[00:31:42.04]
- [Dave] Lack of physician knowledge

[00:31:43.08]
is not the only problem.

[00:31:45.02]
Cannabis has rearranged
all health communication.

[00:31:48.07]
Normally, a practitioner
writes a prescription

[00:31:51.02]
for a condition, a pharmacist
fills it with a precise dose,

[00:31:55.01]
the patient reports if it works or not,

[00:31:57.03]
and it's all recorded in a chart.

[00:31:59.05]
But since physicians can't
legally write a prescription

[00:32:02.07]
for cannabis as they
would for other medicines,

[00:32:05.01]
pharmacists are out of the loop

[00:32:06.07]
and many practitioners are as well.

[00:32:08.09]
They're replaced by bud-tenders.

[00:32:12.00]
- I think that we need to have
a certification system put

[00:32:16.00]
in case, uh, in place, where,
if you are going to be working

[00:32:19.05]
on these environments, that you've had

[00:32:20.08]
at least minimum levels of education,

[00:32:23.03]
understanding some of
just the basic things,

[00:32:25.04]
understand plant medicine,

[00:32:26.06]
understand, certainly, the
endocannabinoid system.

[00:32:29.09]
- I think those bud-tenders
out there on the front line,

[00:32:33.08]
having experience
interacting back and forth

[00:32:36.09]
with people using cannabis
for medicinal purposes,

[00:32:40.07]
probably are those best informed

[00:32:43.06]
to know what works and what doesn't.

[00:32:45.07]
- [Dave] The National
Academy of Sciences' report

[00:32:48.01]
on cannabis-as-medicine

[00:32:50.00]
reviewed the best available
evidence, pro and con,

[00:32:53.05]
for common medical conditions.

[00:32:55.05]
You can read it.

[00:32:56.03]
It's available online.

[00:32:58.09]
- I was told that I'd
never walk unassisted again

[00:33:00.07]
after my accident, um, and
with cannabis treatment

[00:33:04.00]
I'm getting feeling back in my nerves.

[00:33:07.03]
- [Dave] People have been telling stories

[00:33:08.08]
about cannabis for 3,000 years.

[00:33:11.04]
But stories, anecdotes,
only become evidence

[00:33:15.00]
with good science, research,

[00:33:17.01]
and that's the major
recommendation of the NAS report--

[00:33:20.06]
getting rid of prohibitive
barriers so that research

[00:33:24.05]
and clinical trials can begin

[00:33:26.09]
and, hopefully, people's
health will benefit.

[00:33:30.02]
- I think that it's important
for both investigators

[00:33:33.05]
as well as providers and
patients to fully understand

[00:33:36.05]
that we're dealing with
something that's very different

[00:33:38.08]
than uniform prescription medications.

[00:33:42.00]
That is that cannabis is always variable

[00:33:43.09]
from plant to plant.

[00:33:45.01]
And what that means is
it requires patients

[00:33:47.03]
to take an active management
in their treatment decisions

[00:33:51.04]
and essentially engage in a
little bit of trial and error.

[00:33:54.05]
And that will probably always be the state

[00:33:57.02]
in which we are able to utilize

[00:33:58.09]
the medicinal effects of cannabis.

[00:34:02.05]
[gentle piano music]

[00:34:09.01]
- I don't understand how it can be allowed

[00:34:13.09]
that politics can reign

[00:34:18.07]
over medical practice.

[00:34:20.08]
You know, physicians have taken
an oath to maintain healing.

[00:34:26.08]
And anytime that they find a product

[00:34:32.05]
that improves health

[00:34:35.02]
and longevity over time,

[00:34:39.02]
that they're not allowed

[00:34:41.01]
to use it, it is just...

[00:34:43.06]
It's really, from my perspective, a sin.

[00:34:48.01]
[jaunty piano music]