The Entourage Effect and Terpenes
The Entourage Effect, is the concept that the totality of the therapeutic constituents of the plant acting together are more effective than any single isolated compound acting alone. Many clinicians believe that using CBD as an isolated compound not only diminishes its therapeutic value but does not take full advantage of the medicinal value of cannabis.
Whole plant extractions typically include CBD, THC, and more than 400 trace compounds. Many of these compounds interact synergistically to create what scientists refer to as an “entourage effect” that magnifies the therapeutic benefits of the plant’s individual components—so that the medicinal impact of the whole plant is greater than the sum of its parts.
How the Entourage Effect Impacts Medication Formulation
When patients reported that cannabis consumption eased the weight loss caused by AIDS or the adverse effects of chemotherapy, medical researchers analyzed the plant to determine what caused these benefits. Research credited the cannabinoid THC for these benefits, so pharmaceutical companies isolated the THC to create drugs to address AIDS and chemotherapy symptoms. However, patients who used these THC-only drugs reported greater psychotropic side effects when compared to ingesting cannabis.
Further research into cannabis uncovered that the cannabinoid CBD, blended with other cannabinoids, reduced the hallucinatory effects of THC. Therefore, THC-only drugs eliminated the benefit of the rest of the cannabinoids. The Israeli chemist, Raphael Mechoulam, named this observed phenomenon the entourage effect.
Pharmaceutical companies used the concept of the entourage effect to reformulate their THC-only medications to include an equal measurement of CBD. The resulting formulations achieved a greater therapeutic benefit while reducing the adverse reactions of THC-only medications.
The entourage effect also impacts the work of scientists who want to breed certain strains of cannabis to treat specific health problems. Breeding these cannabis strains to increase specific cannabinoids that may treat common ailments, may result in new plants that can better assist patients with fewer side effects. However, such new strains also may create an imbalance within the different cannabis compounds that eliminate known benefits.
Whole Plant Medicinal Use: Barriers and Origins
For people who have observed or experienced the entourage effect in cannabis, it may be difficult to understand why some doctors hesitate to recommend botanical cannabis use and prefer medications with only THC or CBD cannabinoids. Many medical professionals prefer to prescribe a single compound used to treat a specific problem, disease or ailment because Western medical philosophy endorses this type of isolated-treatment medicine. While this approach may unintentionally eliminate the entourage effect of cannabis, doctors support this philosophy because it also serves to minimize adverse side effects.
However, to effectively use botanical cannabis, some researchers argue that doctors should reject the idea of creating a single potent drug to treat an isolated problem. Instead, these researchers believe that doctors should return to a philosophy of treating multiple possible problems with a low dosage of a single, wide-range medication. These scientists, including noted cannabis researcher Vincenzo Di Marzo, also believe that some cancers and other diseases may come from an imbalance of some natural systems within the human body.
This concept of poly-pharmacology remains in practice in traditional Chinese medicine. Instead of using a single herb to treat a specific problem, practitioners prescribe a combination of herbs called herbal formulas. The combinations of these herbs, some of which may have no discernible benefit on their own, are well-known to have many benefits from numerous past studies. Experts carefully combine the herbs to create the necessary treatment for a combination of related health problems.
Known Instances of the Entourage Effect in Cannabis
While the effect of CBD on THC is the most notable illustration of the entourage effect, research also indicates that cannabinoids and terpenes may also combine to achieve greater therapeutic advantages. Studies indicate that certain terpenes may impact the blood-brain barrier, which may explain why certain cannabinoids have greater efficacy when they do not operate in isolation.
In the whole-plant cannabis versus synthetic-cannabis medication debate, all researchers agree that the entourage effect is still not a concept that they fully understand. Further research into exactly how THC, CBD and other important cannabis compounds work will allow scientists to make better recommendations for how to use cannabis compounds to treat various diseases and ailments. With nearly 500 different cannabis components to explore, the field of whole-plant and synthetic-cannabinoid medications is wide open for new and exciting developments.
Terpenes, or isoprenoids, provide cannabis with its unique bouquet. The molecules are quite small and consist of repeating units of a compound called isoprene. Although less well-known than the major cannabinoids, terpenes are instrumental to the physiological and psychoactive effects of cannabis. The relationship between terpenes and cannabinoids, known as the “entourage effect,” ultimately differentiates one strain of cannabis from another.
Terpenes play a vital role in the plant kingdom; they deter insect predation, protect plants from environmental stresses, and act as building blocks for more complex molecules, such as cannabinoids. Many terpenes act synergistically with other varieties of terpenes, and some either catalyze or inhibit formation of different compounds within a plant. Understanding how terpenes function allows scientists to manipulate cannabinoids to desired ratios.
Terpenes are fragrant oils that give cannabis its aromatic diversity. They’re what give Blueberry its signature berry smell, Sour Diesel it’s funky fuel flavor, and Lavender its sweet floral aroma. These oils are secreted in the flower’s sticky resin glands, the same ones that produce THC, CBD, and other cannabinoids. Terpenes are by no means unique to cannabis; they can be found in many other herbs, fruits, and plants as well.
Around 200 terpenes have been found in cannabis, but only a few of these odiferous oily substances appear in amounts substantial enough to be noteworthy. Among them are monoterpenes, diterpenes, and sesquiterpenes.