“The Cannabis Question,” an hour-long documentary, debuted on PBS Sept. 29 and is now streaming on a screen near you. Cannabis clinicians may find it worth watching because 1) many of your patients will have seen it. 2) You can put faces to names you’ve been seeing in print, like Daniele Piomelli, Yasmin Hurd, Ryan Vandrey, and Nora Volkow. 3) It points out that the war on marijuana is ongoing and that it upholds mass incarceration. 4) It reflects and reveals Big Pharma’s strategy as Total Prohibition crumbles: hold the line at the Under-21s and expectant mothers, and maintain the Treatment Racket’s reason for being. 

PBS supposedly doesn’t run ads, but immediately preceding “The Cannabis Question” on Channel 9 was a 25-second trailer for a coming attraction in which knights of olde slay each other with swords. Next came a warning in white letters against a black screen: “The following program contains content that may not be suitable for all audiences. Viewer discretion is advised.” Unspoken message: swordplay okay, pot maybe not.

The Koch Brothers are the main funders of PBS these days, and we’re told up-front, “Major funding for The Cannabis Question was provided by the David H. Koch Foundation For Science.”  The budget was ample and the production values are top-notch.

“The Cannabis Question” pretends to tell a history, but it’s a denatured history devoid of struggle. “Reefer Madness” gets ridiculed, of course, but there is no mention of NIDA-funded researchers upholding 50 years of Prohibition. (All the researchers taking part have been beneficiaries of addictive grants from the National Institute on Drug Abuse.) There’s no mention of Everybody in Power opposing the 1996 initiative by which California voters legalized marijuana for medical use. No mention of Capital-M Medicine’s longstanding assumption that smoking marijuana causes lung cancer, debunked by Tashkin et al in 2005. 

NOVA’s history is nice and smooth: “Cannabis: a multi-billion-dollar industry is moving from the illicit market into our daily lives, creating a stark divide,” says the Narrator.  “More than 80 years after the US ended prohibition, it’s ending another. A majority of Americans now live in a state where cannabis is legal… As a multibillion dollar industry rises… As federal law blocks science, an unintended public health experiment is underway.”

Actually, it was an intended public health experiment, initiated by a Berkeley-based physician, Tod Mikuriya, MD, a San Francisco pot dealer, Dennis Peron, and a crew of allies. By 1995 they had compiled enough evidence to convince them it would succeed. In November ’96 some 5.6 million California voters passed Proposition 215, the ballot measure legalizing marijuana for medical use. O’Shaughnessy’s editorialized that President Bill Clinton, instead of closing the first Cannabis dispensaries by civil injunction, should have reassured his fellow Americans that his Administration was closely monitoring the “public health experiment” being conducted in California. Then, as the feared spikes in cancer, schizophrenia, etc. did not materialize, the Democrats could have taken credit for ending Prohibition. 

Although director Sarah Holt’s tone is one of Total Objectivity, her documentary of course has a political POV. On the victimization of African-Americans she couldn’t be more right on. On the safety and efficacy of cannabis as medicine, she couldn’t be more equivocal. Some examples from the script:

MATTHEW HILL (University of Calgary): “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.

ZIVA COOPER (UCLA Cannabis Research Initiative): These products are coming online much faster than we can actually research them.

CHINAZO CUNNINGHAM (Albert Einstein College of Medicine): 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?

RYAN VANDREY (Johns Hopkins University):  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.

YASMIN HURD: It’s really a voter-approved, quote/unquote, medicine. People say, “Oh, there’s medical cannabis that’s approved.” It has not been. It has not gone through F.D.A. rigorous research process, and that’s what’s critical for Medicine.

STACI GRUBER (McLean Hospital)  “It’s a highly contentious subject, but it’s not about your thoughts or feelings. What does the data tell us? What does the Science tell us? Truth through Science!” she proclaims reverently.

Gruber is a darling of NIDA who has not abandoned her career-long search for cannabis-induced brain damage but is now also getting money to look for benefit. Working both sides of Safety Street, she exudes self-satisfaction.

“The Cannabis Question” imparts a tremendous amount of useful, accurate information at a very fast and choppy clip. The camera cuts from Expert to Expert, each saying two or three interesting sentences. Younger viewers may be accustomed to a rushing stream of factoids, but your correspondent needs time and repetition to absorb things. And sometimes, for the sake of speed, the factoids seemed incomplete. For example:

NARRATOR: 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. 

There’s nothing unusual about a plant containing hundreds of chemicals. There are more that 500 in carrots… The important thing is that Cannabinoids are unique to Cannabis, it’s the only plant that produces them… . It was Mechoulam and Yechiel Gaoni who first isolated THC in 1963. (The tendency to credit one person when others deserve recognition may be a function of our celebrity culture. It was Daniel Ellsberg and Anthony Russo, his RAND Corporation colleague, who copied and leaked the Pentagon Papers. It was Lawrence Ferlinghetti and Shigeyoshi Murao who were indicted in San Francisco for selling Howl. Who remembers Russo and Shig? Usually it’s a woman whose name gets forgotten.) 

Enough caveats for now. By far the best aspect of “The Cannabis Question” is its treatment of The Race Question. About 10 minutes in Holt begins the story of Sean Worsley a Black vet who suffered Traumatic Brain Injury in Iraq, came home with severe PTSD, and got relief from cannabis.

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 (Medical cannabis user): Our sole purpose was to clear the routes for supply convoys that came through, looking for roadside bombs that were on the route. I was on a mission, and we rode over a hole that was in the center of the road, and unfortunately it was an LED. that went off, knocking me unconscious. And when I woke up, a medic was in my face, asking me, was I okay, could I hear him.

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. If I was shot in the dream, I would wake up grabbing my chest, because I felt the pain.

Cut to the Narrator saying something about the God Shiva. Almost a half-hour later Worsley will be reintroduced, along with his wife, to make the crucial point. Fortunately, Holt slackens her pace.

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.

KASSANDRA FREDERIQUE (Drug Policy Alliance) : 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.

CHINAZO CUNNINGHAM: 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.

KASSANDRA 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 (Sean Worsley’s wife): We needed gas. We had no idea, especially in a place where you are not familiar with, when is the next place you will 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. He startled me. When I looked up, he’s, like, you know, “Where are you heading?” And I’m like, “We are 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 I.D.s., and he said, “Well, you won’t need these where you are going.”

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

LEAH NELSON (Research Director, Alabama Appleseed Center for Law & Justice): 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.

LEAH 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 are 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.

“The Cannabis Question” touches on Harry Anslinger and the infamous Reefer Madness campaign of 1937, but doesn’t mention NIDA’s Cannabis-Causes-Cancer campaign, which for decades was a major rationale for Prohibition. 

NARRATOR: In 1996, cannabis was legalized in California for medical use. But federally, it remains a Schedule I 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 (Medical cannabis user): 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.

The scene cuts to a Cannabis dispensary. Note the four-word euphemism for Budtender:

ELIZABETH 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.

CANNABIS RETAIL SALES REPRESENTATIVE: This is super medicinal. You see how, like, dark and dense that is? That’s indicating more of the Indica family: good for the body, good for pain.

STEVE DEANGELO (Founder of Harborside, Inc.): 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 is cannabis medicine being taught at every single medical school across the United States. And that’s not happening now, because of federal law.

DeAngelo makes a good point —one that O’Shaughnessy’s had been making before he and his partner Dress (a big, hirsute heterosexual man who wears ladies’ schmatas and changed his name legally) opened their magnificent Oakland dispensary in 2006. In its early years Harborside used to carry thousands of copies of our paper. (Dr. Mikuriya’s business plan was to sell it for $1/per copy to doctors and dispensaries, who would give them away free to patrons.) DeAngelo’s support was much appreciated. Also appreciated was his investment in a lab that would test cannabis for its CBD content (which we had been calling for in O’S). But DeAngelo’s main interest was in ascertaining THC content so he could put a higher price on the more potent buds. By the winter of 2015/16, when he was in on the planning of California’s tax-and-regulate scheme, DeAngelo’s dispensary stopped carrying O’Shaughnessy’s. The money-mad crafters of California’s Adult Use of Marijuana Act would force medical users to pay a 15% excise tax, as if the herb wasn’t really medicine.) 

“The Cannabis Question” segment on CBD —which one in seven adults in the US are now using— is a paean to Epidiolex, the first cannabis-based medicine approved by the Food & Drug Administration.  The families of two children are tracked.

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, when a Stanford neuroscientist, Catherine Jacobson set out to treat her son Ben’s epilepsy.

CATHERINE JACOBSON (Tilray): 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.

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. 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… Jacobson says she did research and learned about the anti-seizure potential of CBD. After months of getting inconsistent products at dispensaries, she made her own CBD-rich tincture, which she shared with the Nussbaums.  It didn’t help Ben Jacobson but it gave Sam Nussbaum five days of dramatic relief before their supply ran out… 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. After four days of taking GW’s CBD, Sam’s seizures dropped from 68 to 6 per day. On the eighth day of treatment, he only had three.

EVELYN 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 percent. Sam is now in college. But since seizures cause brain damage, for Ben, help came too late.

We learn that Epidiolex is now being tested as a treatment for autism.

NARRATOR: Scores of clinical trials are now underway, including at UC San Diego’s Center for Medicinal Cannabis Research. Fourteen-year-old Braylon Pulley has severe autism. His parents are hoping CBD might help… To find out if Epidiolex might treat severe autism, Pediatric Neurologist Doris Trauner is running a double-blind clinical trial. 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… The study is still blinded, but Braylon’s parents are certain CBD helped him in phase one of the trial.

KEVIN PULLEY: It was dramatic. It was like night and day. So, I could be wrong, but you know we both saw the difference.

LETITIA PULLEY: 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.

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.

Her sense of urgency, on a scale of 1 to 10, is zero.  We, the people, know damn well that CBD can treat autism. What’s misleading about this segment is that before Braylon’s parents deduced that Epidiolex was greatly easing his symptoms, tens of thousands of parents in the US and other countries had come to the same conclusion re CBD. Their doctors’ files document the safety and efficacy of the myriad non-corporate tinctures that have provided relief. But this vast trove of clinical evidence, compiled over 20 years, does not count as “good data,” according to Dr. Trauner and Capital-M Medicine. Now, at last, they’re going to get at The Truth.

(Prophetic Lester Grinspoon warned of the looming “pharmaceuticalization of marijuana” in O’Shaughnessy’s Summer 2003 issue. In 2010 he contributed A Novel Approach to the Symptomatic Treatment of Autism.” The victory of the neoprohibitionists is measured in years of unnecessary suffering.)

Turning her attention to the harm caused by cannabis, Holt interviews some amazing intellectual contortionists

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… 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. NIH researchers will evaluate the children’s physical and mental health, academic achievement and drug use, with tests of salvia and hair. So far, few of the children have tried cannabis, but there is data from surveys about their parents’ use.

RYAN BOGDAN (Washington University in St. Louis): One of the things we are most interested in was prenatal exposures. And we saw that there were a fair number of mothers in this study, just like what we’re seeing in the general population, that used cannabis during their pregnancy.

CYNTHIA ROGERS (Washington University in St. Louis): 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?

ARPANA AGRAWAL: And one questionnaire that really stood out to us was the Psychosis-Like Experiences Assessment.

Cut to a woman asking leading questions (that wouldn’t be admissible in a court of law) to a soft-spoken, passive kid who looks to be 12 or 13:

RESEARCHER: 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?

ADOLESCENT: Yeah.

RESEARCHER: Yeah, okay. And did that bother you?

ADOLESCENT: No.

RESEARCHER: Did you start to worry, at times, that your mind is trying to trick you or wasn’t working right?

ADOLESCENT: Yeah.

The Experts parlay such flimsy “evidence” into ostensible proof of brain damage! 

ARPANA AGRAWAL: And this dataset 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.

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.

CYNTHIA 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.

During Rogers’ riff there’s a graphic reference to Melanie Dreher’s study showing that Jamaican children born to moms who used Cannabis did well in school —as if the great anthropologist had been “targeting women.” 

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.

The harm that supposedly justifies the need for psychotherapeutic intervention is Addiction. “About nine percent of users will develop a cannabis addiction,” the Narrator asserts. The living example is 20-something Paul Debassio, who injured his back during a high school swim meet. The pain interfered with his sleep and he began using cannabis to treat insomnia. 

PAUL DEBASSIO: I loved how calming it was. I’d have the best night of sleep that I ever had in my life. And I said, “This is amazing.”

NORA VOLKOW (Director, National Institute on Drug Abuse): It would be fantastic if we have a drug that would actually calm you when you need it, that makes you feel groovy, more social and there’s no negative consequences. That would be extraordinary. But that’s not the case….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.

NARRATOR: Dependence can impair memory, mood and motivation. Paul didn’t know he had a problem, until he needed a drug test for a job.

PAUL DEBASSIO: And so I quit, cold turkey. And almost immediately, I noticed a big change in my mood.

DEEPAK CYRIL D’SOUZA (Professor, Yale University): They get irritable, they get aggressive, and they can feel depressed… 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…

NARRATOR: In a new clinical trial, Deepak D’Souza hopes to harness the endocannabinoid system to prevent cannabis withdrawal… 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 is a third chapter in the Sean Worsley story:

NARRATOR: In November, 2020, Sean was released from prison and placed on parole.

SEAN WORSLEY: 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.

Hardly a happy ending, and Sarah Holt deserves credit for that.