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Gruber has likewise observed that medical cannabis patients tend to reduce their use of conventional medications over time, which might itself be beneficial to brain structure and function. Whatever the explanation, Gruber believes greater scientific engagement with the CBD phenomenon is as important as more careful regulation. “People have been using cannabis forever,” she told me. “The question now is, How do we as scientists catch up?”

If there is a Patient Zero in the vernacular cannabis movement, that person is a girl in Colorado named Charlotte Figi. Her seizures began at 3 months, as Ben Jacobson’s had. Doctors diagnosed Dravet syndrome, in her case caused by a spontaneous genetic mutation. By the time she was 5, she was wheelchair-bound, receiving sustenance through a feeding tube, seizing about 350 times per week, and on several occasions she had to be shocked back to life after her heart stopped. Doctors once recommended a medically induced coma just so her body could rest.

Other possible applications of plant-derived cannabinoids could be just as groundbreaking. Scientists at New York University are studying CBD as a possible treatment for autism spectrum disorders. Spanish researchers are testing both THC and CBD on an aggressive brain cancer called glioblastoma. Israeli scientists have found that CBD can lessen the incidence of graft-versus-host disease in bone-marrow transplant patients, presumably because the cannabinoid calms the immune system and deters it from attacking the patient.

The drug, called Epidiolex, is not the first cannabis-related drug on the market. Marinol, used to suppress nausea and stimulate appetite, contains THC. But Epidiolex is the first drug that contains only CBD and the first one derived directly from the cannabis plant itself. (The THC in Marinol is synthetic.) As a new class of medicine, Thiele told me, it’s important for the reasons Jacobson recognized years ago: It hits different pathways than do currently available epilepsy drugs, thereby expanding the available treatments for difficult-to-treat childhood epilepsies.

Around the same time, Figi, Stanley and Heather Jackson, another mother whose epileptic son had benefited from CBD, founded a nonprofit called Realm of Caring. It helped families relocate to Colorado and offered them advice on how to negotiate the state’s medical- cannabis environment.

Charlotte Figi, now 12, continues to be almost entirely seizure-free. She’s developmentally delayed, Paige Figi told me. And she suffers from osteoporosis caused, Figi thinks, by the high doses of steroids she took to control seizures at a young age. But she is otherwise a happy, playful girl, Figi says. And what Figi discovered about CBD on Charlotte’s behalf came in handy for Charlotte’s fraternal twin sister, Chase.

After he returned to the United States, it was six months before Sam could take Guy’s extract again. Medical marijuana is illegal under federal law — its designation as a Schedule 1 drug means it is considered to have a high potential for abuse and without any known medical application — but Sam gained access to Guy’s extract through the F.D.A.’s compassionate-use program, which makes still-unapproved drugs available to patients with serious conditions. (In 2015 Sam’s father, Fred Vogelstein, a journalist, detailed Sam’s story in Wired magazine. In 2010, he also wrote in this magazine about using a ketogenic diet, since discontinued, to control Sam’s epilepsy.) With a petition from a U.C.S.F. epileptologist, Roberta Cilio, who was the doctor for both boys, Ben also received the medicine through the F.D.A.’s compassionate-use program. It helped, Jacobson thought, particularly with the most severe fits, which caused him to lose consciousness. But he was by no means seizure-free.

CBD stands for cannabidiol. It is the second most prevalent of the active ingredients of cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, which is a cousin of the marijuana plant. While CBD is a component of marijuana (one of hundreds), by itself it does not cause a "high." According to a report from the World Health Organization, "In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD."

CBD is readily obtainable in most parts of the United States, though its exact legal status is in flux. All 50 states have laws legalizing CBD with varying degrees of restriction, and while the federal government still considers CBD in the same class as marijuana, it doesn’t habitually enforce against it. In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials. Currently, many people obtain CBD online without a medical cannabis license. The government’s position on CBD is confusing, and depends in part on whether the CBD comes from hemp or marijuana. The legality of CBD is expected to change, as there is currently bipartisan consensus in Congress to make the hemp crop legal which would, for all intents and purposes, make CBD difficult to prohibit.

How is cannabidiol different from marijuana?

Cannabidiol (CBD) has been recently covered in the media, and you may have even seen it as an add-in booster to your post-workout smoothie or morning coffee. What exactly is CBD? Why is it suddenly so popular?

CBD may offer an option for treating different types of chronic pain. A study from the European Journal of Pain showed, using an animal model, CBD applied on the skin could help lower pain and inflammation due to arthritis. Another study demonstrated the mechanism by which CBD inhibits inflammatory and neuropathic pain, two of the most difficult types of chronic pain to treat. More study in humans is needed in this area to substantiate the claims of CBD proponents about pain control.

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