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24 February 2015
Medicinal Cannabis: Much More Than Just THC and CBD
than 60 cannabinoids play important roles in providing the
therapeutic benefits associated with cannabis therapy. They work in
conjunction with around 420 additional compounds like
terpenoids, amino acids, proteins, sugars, enzymes, fatty acids,
esters and flavonoids, just to name a few, to give cannabis its
versatility in treating a multitude of medical ailments. Naturally,
you consume all of these compounds when medicating with whole plant
cannabis. The question is how do all of these compounds work together
to provide therapeutic relief? The answer can be found in a concept
called the “entourage effect”.
Entourage Effect: Chemical Teamwork
described in 1998 byIsraeli scientists, the basic idea of the
entourage effect is that cannabinoids within the cannabis plant work
together, or possess synergy, and affect the body in a mechanism
similar to the body’s own endocannabinoid system. This theory
serves as the foundation for a relatively controversial idea within
the pharmacology community, that in certain cases whole plant
extractions serve as better therapeutic agents than individual
"Synergistic effects can be produced if the constituents of an extract affect different targets or interact with one another in order to improve the solubility and thereby enhance the bio-availability of one or several substances of an extract. A special synergy effect can occur when antibiotics are combined with an agent that antagonises bacterial resistance mechanisms"...
to affect multiple targets within the body
to improve the absorption of active ingredients
to overcome bacterial defence mechanisms
to minimise adverse side effects.
studies have demonstrated the effectiveness of cannabis as a
therapeutic agent for muscle spasms associated with multiple
sclerosis. One particular study, Medicinal cannabis: is delta9-tetrahydrocannabinol necessary for all its effects? determined
that whole-plant extracts were more effective than THC alone.
Researchers compared 1mg THC vs 5mg/kg cannabis extract with the
equivalent amount of THC and found the whole plant extract to have
significantly more anti-spastic effect. The researchers attributed
this result to the presence of cannabidiol (CBD) within the cannabis
extract which helps to facilitate the activity of the body’s
Absorption Of Active Ingredients
entourage effect can also work to improve the absorption of cannabis
extracts. Cannabinoids are chemically polar compounds, which makes
them at times difficult for the body to absorb in
isolation. Absorption of topicals provides a prototypical
example of this problem. The skin is made up of two layers which
makes it difficult for very polar molecules like water and
cannabinoids to pass through. With the assistance of
terpenoids like caryophyllene, absorption of cannabinoids can be
increased and therapeutic benefits achieved.
Bacterial Defence Mechanisms
entourage effect also accounts for cannabis extracts being effective
in treating various bacterial infections. There are a number of
studies which show the antibacterial properties of cannabinoids.
However, bacteria develop defence mechanisms over time to combat the
effects of antibiotics ultimately allowing them to become resistant
to therapies which were previously effective. Thus, it is beneficial
that whole-plant cannabis extracts have non-cannabinoid constituents
that also have antibacterial properties. These molecules attack
bacteria through pathways which differ from cannabinoid pathways.
Given the attack on multiple fronts, the development of bacterial
resistance is limited.
Adverse Side Effects
the entourage effect allows certain cannabinoids to modulate the
negative side effects of other cannabinoids. The most fitting example
of this is CBD’s ability to modulate the perceived negative effects
of THC. Many patients have heard about (or experienced) the increased
anxiety and paranoia sometimes associated with cannabis consumption.
Thanks to the entourage effect, research has shown that CBD can be
effective in minimising the anxiety associated with THC, lowering
users’ feelings of paranoia. So, THC, CBD and the remaining
cannabinoids don’t compete with one another, they work in tandem
alongside the other components of cannabis to provide therapeutic
relief for a wide variety of ailments. Adapted from an article by Dr Malik Burnett MD The Entourage Effect of Whole Plant Cannabis Medicine