What Is The Entourage Effect?

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Entourage Effect


Much has been written on the entourage effect, yet it is still one of the more mysterious and oft-debated concepts surrounding cannabis research. Read-on to discover the history of this theory, and to see why it may be the future of medical marijuana.

THE ENTOURAGE EFFECT: ONE OF CANNABIS’ GREAT MYSTERIES

The entourage effect is a somewhat mysterious concept that is boggling the minds of cannabis researchers all around the globe. It argues that the essence of cannabis and its powerful effects result from the complex interplay between its various chemical constituents. Could cannabis owe its unique properties to the entourage effect?

WHAT IS THE ENTOURAGE EFFECT?

What Is The Entourage Effect

The entourage effect was first described by Raphael Mechoulam, a renowned Israeli cannabis chemist. Mechoulam is credited as the foremost innovator and pioneer of marijuana research.

The term coined by Mechoulam refers to how the different compounds within cannabis synergise to influence a wide variety of outcomes on the body. Moreover, the entourage effect posits that the compounds in cannabis work better together than they do in isolation.

Mechoulam and his team of researchers published their findings in 1998 in the European Journal of Pharmacology. In this study, Mechoulam et al describe the intricate ways in which different compounds within cannabis seem to work in concert to give the plant its distinct effects.

Today, science has proven the medical potential of a variety of cannabinoids. THC, for example, is renowned for its ability to stimulate appetite, curb nausea, and more. Hence, the FDA has approved the sale of Marinol, a pharmaceutical drug made from synthetic THC.

While Marinol is used by many patients, studies have shown that its effects vary greatly to that of cannabis flower, for example.

Marinol, unlike regular cannabis, contains Dronabinol, a synthetic compound made to mimic the effects of THC. It is currently approved in the US to treat wasting syndrome in patients with HIV/AIDS, and nausea and vomiting in cancer patients undergoing chemotherapy.

While the compound in Marinol is very similar to THC, it isn’t as effective as whole-plant cannabis in treating many of the symptoms it is prescribed for. Being a pill, Marinol is very hard to stomach for patients dealing with nausea/vomiting. Moreover, it produces psychoactive effects that are much stronger than those you’d experience after smoking regular cannabis.

WHY IS THE ENTOURAGE EFFECT IMPORTANT FOR MEDICINE?

CBD & THC

Since Mechoulam first isolated THC in 1964, we’ve discovered that the cannabis plant contains over 480 natural compounds including cannabinoids (like THC, CBD, CBN, CBG, etc) and a variety of terpenes.

Terpenes, unlike cannabinoids, are best described as fragrant oils within cannabis and many other plants. Apart from giving plants aromatic properties, these terpenes also have medicinal characteristics.

Compounds like pinene and caryophyllene, for example, have been noted for being powerful anti-inflammatories, as well as helping to manage muscle spasms, insomnia, and more. These benefits are supposedly even more powerful when ingested with cannabinoids.

Today, most research into cannabis focusses on using a single cannabinoid (either natural or man-made) in isolation. Although this is important to further understand the properties of each individual compound, the bigger picture tells an even more compelling story. This is why whole-plant medicine appears to be the future of medical cannabis.

When we consume cannabis, be it through smoking a joint or by ingesting a tincture, we take-in a unique mix of all the chemicals in the plant, not just THC or CBD on their own. Therefore, understanding the entourage effect is extremely important to clearly understanding the possibilities of whole-plant therapy. It also may reveal why synthetic drugs like Marinol don’t provide the same relief as regular marijuana.

It seems logical to want to extract certain beneficial compounds from the cannabis plant and offer them in a concentrated medicine. However, the science of the entourage effect makes it clear that whole-plant approaches are more well-rounded. To use a popular example, whole-plant medicine can be compared to Marinol like one would compare fresh fruits and vegetables to vitamin tablets. The latter simply isn’t as effective.

DOES THE ENTOURAGE EFFECT ACTUALLY WORK?

Does The Entourage Effect Actually Work?

While our research on cannabis is far from complete, studies seem to suggest that Mechoulam’s theory is valid. Research on Marinol has shown that harnessing the positive effects of medical cannabis isn’t as simple as extracting a single compound from the plant. This same problem almost happened with Sativex, a cannabis-based drug developed by GW Pharmaceuticals designed to treat multiple sclerosis.

CBD AND THC

Other simple ways scientists have observed the entourage effect is by studying the effects of certain cannabinoids together. CBD, for example, is often said to “counteract” the psychoactive effects of THC. Studies have shown that, when used together, the painkilling properties of THC and CBD are much more powerful than when either cannabinoid is taken on its own.

CBD can also help diminish some of the negative side effects of THC. For many people, strong doses of THC can generate feelings of anxiety and paranoia. A 1982 study, however, found that CBD could help combat some of these adverse side effects.

Psychopharmacologist and cannabis researcher Ethan Russo has been quoted with a very interesting example that suggests the entourage effect is a scientifically sound concept. We’ve paraphrased his findings below.

A dose of 10mg of pure THC produces toxic psychosis in roughly 40% of people. However, a dose of Sativex (which contains equal amounts of THC and CBD) equivalent to 48mg of pure THC produced toxic psychosis in only 4 of 250 patients.

CRITICISM

Criticism

While this evidence isn’t conclusive in and of itself, it is encouraging for those in support of the entourage effect. As is often the case when it comes to cannabis research, there is still no consensus. In fact, Mechoulam’s theory has received its fair share of criticism.

Margaret Haney, a neurobiologist at Columbia University (and cannabis researcher) says there isn’t a lot of data to support the existence of the entourage effect.

“The lay public has really taken on the notion of the entourage effect, but there’s not a lot of data,” she said in an interview.

“The cannabis field can say anything and it does. I’m not against marijuana. I want to study it carefully. We know it can affect pain and appetite but the large majority of what’s being said is driven by anecdotal marketing. These guys are really trying to make money.”

Unfortunately, the verdict on the entourage effect still depends on who you ask about the topic. Hopefully, as more research goes into this field, we’ll come to more solid conclusions about how cannabinoids and other compounds in cannabis interact.

Steven Voser

Written by: Steven Voser
Steven Voser is an Emmy Award Nominated freelance journalist with a lot of experience under his belt. Thanks to a passion for all things cannabis, he now dedicates a lot of his times exploring the world of weed.

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