Education

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What is the entourage effect?

The Cannabinoid-Terpene Entourage Effect,1, 2, 3  refers to how the various compounds in cannabis, i.e. cannabinoids and terpenes, interact with each other to produce a specific effect that is greater than if the individual compounds were taken alone. The benefits of the entourage effect are twofold: it can enhance the effect and/or improve the tolerability. For example, one publication showed that when CBD was added to THC to treat cancer pain, twice as many patients that received the combined product (THC:CBD) felt the pain reduction compared to placebo, while the patients receiving THC only had results similar to placebo.4 Regarding tolerability, by adding CBD to THC, it is thought that the negative side effects of THC are mitigated. For instance, adding CBD to THC can reduce the anxiety caused by THC.5 Both of these effects are not mutually exclusive, but they can be complimentary. Having a higher CBD content in cannabis could reduce the anxiety caused by THC, which could allow a higher and therefore more effective dose of THC to be given for different symptoms, such as pain. References:
  1. Carlini, E. A.; Karniol, I. G.; Renault, P. F.; Schuster, C. R. (1974). Effects of marihuana in laboratory animals and in man. British journal of pharmacology, 50(2), 299--309.
  2. Russo, Ethan B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344--1364.
  3. Wilkinson, J. D.; Whalley, B. J.; Baker, D.; Pryce, G.; Constanti, A.; Gibbons, S.; Williamson, E. M. (2003). Medicinal cannabis: is delta9-tetrahydrocannabinol necessary for all its effects?. The Journal of pharmacy and pharmacology, 55(12), 1687--1694.
  4. Johnson, Jeremy R.; Burnell-Nugent, Mary; Lossignol, Dominique; Ganae-Motan, Elena Doina; Potts, Richard; Fallon, Marie T. (2010). Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. Journal of Pain and Symptom Management, 39(2), 167--79.
  5. Zuardi, A. W.; Shirakawa, I.; Finkelfarb, E.; Karniol, I. G. (1982). Action of cannabidiol on the anxiety and other effects produced by ?9-THC in normal subjects. Psychopharmacology, 76(3), 245--250.