Terpene compounds work to enhance the effects of the CBD or THC, just as an entourage of backup singers help enhance the lead singer’s voice
There is a great deal of current evidence claiming that cannabis (Cannabis sativa) represents a major breakthrough in treatment of chronic pain and mood disorders, especially with the entourage effect explained citing the legal 0.3% or less of THC in a dose of CBD in whatever form taken by patients.
At the same time, however, there remains a great deal of confusion regarding not only state and federal regulations regarding the cultivation, distribution and sale of certain cannabis products, but also which variety of cannabis is best suited to treat which condition.
There is also debate regarding the best ratio of CBD to THC for maximum effectiveness. Some of the more intriguing research regarding the question of ratios is also looking at what is known as the entourage effect, or how not just the proper ratio of CBD to THC can serve to enhance the overall effectiveness, but also the role of the other cannabidiols and terpenes in the cannabis plant. Let’s take a closer look at how finding the proper balance between all the cannabinoids and terpenes can provide your patients with the most effective combination to treat their particular health issues.
CBD and THC
Before we start in discussing the entourage effect, we should first understand the two best known cannabinoids in the cannabis plant: Cannabidiol (CBD) and tetrahydrocannabinol (THC). Although both of these active ingredients have healing properties, some medical conditions are best treated by one cannabinoid than the other.1-3 For example, THC has a stronger psychoactive property, so is well suited for treating mood disorders, while CBD may be better for some chronic pain conditions.
It is also important to remember that both CBD and THC come from the same plant (Cannabis sativa), but each is cultivated as a separate variety. Hemp plants have higher concentrations of CBD than THC, while marijuana plants have higher concentrations of THC than CBD.1-3 Nevertheless, both cannabinoids are full spectrum, meaning that there is a certain ratio of one to the other in both plant varieties. Both hemp and marijuana plants also contain more than 100 other cannabinoids, as well as terpenes and flavonoids, all of which also have beneficial health properties.3
The entourage effect
This concept of full-spectrum CBD that includes the legal limit for THC leads to what is referred to as the ensemble effect or, more commonly, the entourage effect. First, THC and CBD work on different receptors in the brain and central nervous system, so the healing properties will differ, depending on the ratio of CBD to THC.1-3 However, the other terpene compounds work to enhance the effects of the CBD or THC, just as an entourage of backup singers help enhance the lead singer’s voice.3,4
Both a 2005 and a 2011 review article in the British Journal of Pharmacology list a number of terpenes that are also present in cannabis plants, including imonene, myrcene, α-pinene, linalool, β-caryophyllene, caryophyllene oxide, nerolidol, and phytol.3,4 These terpenes are actually flavor and fragrance components found in standard diets that the US Food and Drug Administration (FDA) considers safe for human consumptions. Furthermore, they are a crucial part of the entourage effect that allows cannabis to effectively help treat pain, inflammation, mental health issues, epilepsy, some types of cancer, and fungal and bacterial infections.3,4
“According to its advocates, the group dynamics of the entourage effect can create emergent properties that would otherwise not be present in pure THC or CBD,” writes Sarah Ratliff, owner of Cannisbistech. “Many who work closely with cannabis believe the entourage effect can dramatically increase the medicinal utility of THC and CBD, either by magnifying their known effects or by expanding their menu of therapeutic applications.”
Cannabis compounds, she explains, bind with naturally occurring endocannabinoid receptors in the brain and throughout the central nervous system. Research remains ongoing. “While some still have doubts, experimental and anecdotal evidence has convinced many cannabis consumers and industry professionals that the entourage effect is real.”
In many ways, the healing effects of CBD and THC represent a ying-yang effect. Regardless of the ratio of one to the other, each compound draws on the properties of the other, as well as other powerful cannabidiols and terpenes within the cannabis plant order to provide the full spectrum healing effect that your patients need. This is why more research into the entourage effect of all the healing compounds in the cannabis plant.
- Hill KP. Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: A clinical review [published correction appears in JAMA. 2016 Sep 6;316(9):995]. JAMA. 2015;313(24):2474-2483.
- Weston Green K. The united chemicals of cannabis: Beneficial effects of cannabis phytochemicals on the brain and cognition, Recent Advances in Cannabinoid Research, Costain WJ, Laprairie RB. IntechOpen.
- Mechoulam R. Plant cannabinoids: A neglected pharmacological treasure trove. British Journal of Pharmacology. 2005;146(7):913-915.
- Russo EB. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology. 2011;163(7):1344-1364.