Put very simply, the ‘entourage effect’ is the theory that cannabis may be more effective when it’s in its natural state than when specific cannabinoids are singled out and used alone. While the supposed effect is not entirely confirmed by scientific research or literature, the term was coined back in 1999 by scientist Raphael Mechoulam who theorised that when the various compounds of the plant are used together they elicit more therapeutic effect than when the compounds are used in isolation. The most studied and well-known example of the entourage effect in cannabis is the way in which CBD seems to mitigate the psychoactive effects of THC – cannabis products with a high CBD to THC ratio appear to have less detrimental psychoactive effects upon patients.
This theorisation has been anecdotally supported by scientists investigating the use of Marinol (otherwise known as Dronabinol) – a form of pure, unadulterated THC. It was presumed by these scientists that the use of pure THC for the treatment of MS symptoms would be far more effective than treatment with regular cannabis containing various other terpenoids and cannabinoids. However, many patients reported that they preferred treatment via the whole cannabis plant rather than treatment with the purer Marinol alone.
More recently, GW Pharmaceuticals has found that, following over a decade of investigation, extracts of the whole plant that have been specifically bred to contain a relatively equal ratio of THC to CBD (alongside other components of the plant) proved more effective in treating the spasms and pain associated with MS than other medications containing only single compounds.
How does the entourage effect work?
As previously mentioned, the entourage effect is by no means confirmed as of yet by scientific research. It is only theorised.
However, the main classes of the effect that are suggested by experts are cannabinoid and terpenoid interactions, or cannabinoid and cannabinoid interactions. Terpenoids are chemicals produced by the cannabis plant that are known for giving it its aroma whilst cannabinoids are the cannabis plant’s naturally occurring compounds. The cannabis plant is said to have over 400 chemical components, so the number of possible synergistic interactions between such compounds is great and requires further study by scientists.
For now, it is suggested that a variety of reasons may exist as to why the entourage effect works better than singled out compounds. Firstly, it has been suggested that many different compounds within the cannabis plant that are yet to be studied individually may be responsible for the better effects when using the whole plant. Alternatively, the interaction between the different compounds could be responsible for the improved effects. Or, a combination of both of these factors could explain the theorised phenomena. Again, it is hoped that further research in the future will elucidate these mere suggestions.
Why don’t we use the whole plant more often then?
The potency of the plants in terms of their relative CBD and THC contents are often inconsistent, meaning that when the plant is used as a whole botanical product rather than as isolated compounds, it is harder if not impossible to standardise the product due to a current lack of knowledge around the multitudinous components that might be making up each cannabis plant.
Additionally, as the plant would likely be considered a botanical product as opposed to a standardised medication, the quality control of the product would most likely be poorer than quality controls imposed upon medications. This might mean the whole plant would be less safe to use than standardised medications.
It is important to stress that, as stated throughout this article, the entourage effect is simply a theory, not scientific fact.
However, with continued research on the topic as expertise around cannabis and medical cannabis grows, there are hopes that such an effect may be uncovered and better understood in the near future. As suggested by Ethan B. Russo in a review for the British Journal of Pharmacology: ‘A better future via cannabis phytochemistry may be an achievable goal through further research of the entourage effect in this versatile plant that may help it fulfil its promise as a pharmacological treasure trove’.
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