Refresh Checked Unchecked Menu Search Shopping bag Geolocation Person Facebook Instagram Twitter YouTube Info Icon CBC Icon CBC Shape CBD Icon CBD Shape CBG Icon CBG Shape THC Icon THC Shape THCV Icon THCV Shape
Advertise on Leafly

Cannabis’s entourage effect: Why whole-plant medicine matters

October 28, 2015
Take a close look at your cannabis buds. They’re covered in a sticky dusting of crystal resin, which contains hundreds of therapeutic compounds known as cannabinoids and terpenoids. We assume you’re well acquainted with THC and CBD, but these are just two among many important players working together to produce specific effects. This interactive synergy between cannabis compounds has been coined the “entourage effect,” and once you know what this is, you’ll see why medicines containing only THC or CBD aren’t always sufficient for many medical conditions.

What are THC- and CBD-only medicines?

THC-only medicines primarily refer to synthetic renderings of THC, the two most popular being Marinol (dronabinol) and Cesamet (nabilone). These are legal pharmaceuticals primarily prescribed to treat cancer-related nausea, but their efficacy is questionable. A 2011 survey on forms of consumption found only 1.8% of 953 patients prefer synthetic THC pharmaceuticals over inhaled or infused methods. Furthermore, it can take hours for a THC-only pill to deliver relief whereas inhaled methods take effect immediately.

CBD-only medicines have been gaining momentum in recent years following the media frenzy around Charlotte’s Web, a non-intoxicating cannabis strain that was processed into a CBD-rich oil for an epileptic child. The miraculous remedy prompted several states to adopt CBD-only laws under which THC-rich medicines remain illegal. While CBD-only cannabis medicines have proven to be life-changing for many individuals, these laws mainly exist to help those suffering from seizures.

That is not to say that synthetic, hemp-based, and CBD-only medicines aren’t effective options for many patients, especially as laws limit access to alternatives. These types of products have served a monumental role both as medicine and as a legislative stepping stone. But what more can patients get from whole plant medicine?

What makes ‘whole-plant medicine’ different?

“Whole-plant medicine” is a term used to describe medicines utilizing the full spectrum of compounds cannabis has to offer, including cannabinoids and terpenes. These other compounds, which are absent in THC- and CBD-only medicines, can offer patients additional potentials benefits.

You’re already familiar with the most popular “whole-plant medicine,” which is inhaling cannabis smoke or vapor. Although most cannabis today is bred to contain a disproportionately large amount of THC compared to other compounds, the importance of chemical diversity is being realized as new strains emerge. Hopefully, we’ll soon start to see strains that not only narrow the gap between THC and CBD profiles, but emphasize other important cannabinoids and terpenes as well.

Cannabinoids and terpenes potentially work together

The diverse chemical availability in whole plant medicines is remarkable in its own right, but research looking into how cannabinoids and terpenoids work together adds another level of intrigue.

Instrumental in this area of science is Ethan Russo, M.D., a neurologist who has long studied cannabis compounds and their role in the body. In his study “Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects,” he details how cannabis compounds influence each other’s mechanisms. We aren’t just talking about the well-known THC-CBD tag team here—even small amounts of terpenes (fragrant oils that give cannabis its smell) can potentially make a difference.

Pinene, for example, may help counteract compromised cognition and memory caused by THC. A combination of terpenes pinene, myrcene, and caryophyllene may help unravel anxiety. Mixing terpenes linalool and limonene with the cannabinoid CBG shows promise in the treatment of MRSA. THC plus CBN potentially yields enhanced sedating effects. Linalool and limonene combined with CBD is being examined as an anti-acne treatment.

These examples only scratch the surface of all possible synergies made available to us by way of whole plant therapies. Think of all the medical possibilities waiting for us as the combinational potential of these compounds are unlocked. The thought of how many lives could be changed for the better by such discoveries is almost overwhelming.

  • Sarah Elaine Weeks

    Love the info graphics! So so so very helpful!

  • Chili Bu Tube

    first off, stop using the term ‘marijuana’
    if your going to attempt to educate people on Cannabis at least use the proper terminology,
    secondly it is ensemble effect NOT entourage effect…
    simply look at what the two words mean..

    en·tou·rage
    ˌänto͝oˈräZH/
    noun
    a group of people attending or surrounding an important person.
    “an entourage of bodyguards”
    synonyms: retinue, escort, cortège, train, suite;

    ********************************************************************

    en·sem·ble
    änˈsämbəl/Submit
    noun
    1.
    a group of musicians, actors, or dancers who perform together.
    “a Bulgarian folk ensemble”
    synonyms: group, band; More
    2.
    a group of items viewed as a whole rather than individually.
    “the buildings in the square present a charming provincial ensemble”
    synonyms: whole, entity, unit, body, set, combination, composite, package

    so now you know 😉

    #0peration0vergrow

    • jorel22

      good point.

    • Michael

      Down voted for the attitude. The mean-spiritedness wasn’t necessary as your point could have been conveyed in a more constructive, less condescending manner. Otherwise, yes, ensemble is a more accurate term, but we all understood what the author meant and he/she was most likely referencing Dr. Russo’s study.

      • Jonathan Messer

        He didn’t have attitude. I found his information on point and informative, even though it’s something I already know.

        • Juergen Meixner

          Chili Bu Tube, you too, has it all. 🙂

          “And this hypocrisy I found among them the worst: that even those who command may pretend the virtues of those who serve.”

          Friedrich Wilhelm Nietzsche
          (1844-1900), German philosopher, essayist, lyricist and writer

          Source: Nietzsche, So spoke Zarathustra. A book for everyone and no one. 1883-1885 (1st complete edition 1892), first printing 1883. Third part, 1884. From the diminishing virtue

          Discovery of the ENDOCANNABINOID SYSTEM!

          VIVEKA

          https://www.facebook.com/photo.php?fbid=10204480226990566&set=a.1200745463650.2028330.1378976258&type=3

    • Sandee Glavas Waldo

      Chili Bu Tube.. If you understood a cancer cell….and how cannibinoids surround it….the word “entourage” IS quite appropriate 🙂

    • Ian

      Hi, Cannabis journalist here – entourage effect is indeed the correct term. It was first reported in 1998 by the famous Dr. Mechoulam and S. Ben-Shabat and further backed up in 2011 in an article in the British Journal of Pharmacology by Russo [https://www.ncbi.nlm.nih.gov/pubmed/21749363]. Whether or not it makes sense to you, it is the correct term and is in-keeping with progressive cannabis science. If you want to educate, first do your own research 😉

      • Avery

        Thank you!

    • Joe Adair

      You’re right about ‘marijuana’; it’s a racist term and needs to go.

      With regard to entourage v ensemble, it’s definitely ENTOURAGE; the important person the other elements surround, is THC.

    • Stéphane Blouin

      Relativise bro,

      Truly the latin name is Cannabis, and that slang term marijuanna is for a wild mexican tobbacco, and I think you are correct, a proper wording would be Synergy or Synergical effect,
      Synergy
      1. the interaction of elements that when combined produce a total effect that is greater than the sum of the individual elements, contributions, etc.; synergism.

      However that term Entourage has been used in the field for a very long time and it is almost universalized at this point. Sometime words are derived from their original meaning and distorted with common usage. This is referred to as connotation vs denotation.

      At the same time don’t be too harsh on people who are on our side. You know… it’s not like the author is a complete ignoramus just because of a couple words. This is very important information that can save millions of human lives, and how much suffering? Let’s calm down and relax.

    • Travis Cesarone

      You missed something. “Entourage 2: surroundings.”
      Entourage effects suggest modulating properties or surrounding effects on the pyschoactive structure. Not the effects of the entire chemotype including THC, as “Ensemble Effect” would suggest.
      Cheers Chili
      #freeandfair

  • Gina Bilotta Salminen

    I get Whole Plant Medical Cannabis products from Leafline Labs in Minnesota. They are fantastic!! I have adult onset Facio Scapulo Humeral Musculat Dystrophy. Despite progression, he Whole Plant Medical Cannabis oil based products of oral suspension mixed with coconut oil for long lasting benefits 8-12 hours. If flavoring is desired they use organic vanilla sugar, and pure orange oil. And I use vape oils, which I am allowed to have 6 puffs every 4-6 hours. But I usually save vaping for night time, unless it is a bad day with breakthrough symptoms. I have been through the Opiates, the awful epidurals, and things for pain for over 15 years. None of that gave me back the function and motivation, like the whole plant medical cannabis products. In Minnesota Leaf Product is not allowed. So the Whole Plant Medical Cannabis products come in Suspensions, vape oils, tinctures usually used sublingual, capsules, topicals, transdermal patches, other edibles besides measured suspension, and probably every other delivery method I am not able to think of right now, or don’t know of. I never knew I would get to relive and rediscover some parts of my life, because of Whole Plant Medical Cannabis. I am beyond thankful. I think I would die without it.

    • Suzy Qusy

      You aren’t getting true whole plant healing when using chemical solvents to create a product. True whole plant is literally the whole plant and not an extract of what was once flowers, leaves and seeds – that is assuming the product initially used the whole plant. Pushing chemical solvents through the plant material and then discarding the true plant material kills off 99% of the terpenes and 80% of the valuable broad spectrum cannabinoids. I know you are trying to sell product here, but it isn’t true Whole Plant Medicine. It’s an extract. Vaping is dangerous. It uses more dangerous chemicals than extracts. People need to look into Bubble Lungs. Anytime you take a whole plant product and turn it into something that is anything but the whole plant you can no longer call it whole plant.

      • Anytime you take a whole plant product and turn it into something that is anything but the whole plant you can no longer call it whole plant.

        Fair enough. Language is important. Consuming every herb, root, and plant in its 100% whole form, though, is not a requirement for longevity, and extracting compounds or parts of the plant for nutrition doesn’t lead to bad health.

        Product formulator and manufacturer here ($2M+ annual sales in Whole Food stores, etc). I’ve watched top Tibetan doctors create their herbal formulas in blackened backrooms outside of Jomsom, Nepal. People traveled for many miles to get their herbal concoctions, and in every case, these top-of-their-field docs used extractions of the plants they were using. Those final black balls were the result of soaking, steam, cooking, pressing, and alcohol extraction, just as they’d done it for hundreds of years.

        Definitely, the newly minted “entourage effect” is validation to the power of including a variety of compounds in plant formulas, something herbalists have known for a long time. But there’s no need for us to chew on Willow bark for its aspirin effect in order to stick with a whole plant belief.

  • Donna Gordon Pike

    So sad to see some alleged experts whacking the shit out of people about who knows more about a medicinal plant. This is a healing plant people, it actually kills pain and helps with a myriad of health issues so why don’t you alleged experts stop knocking other people’s knowledge and help them by either offering up sound advice, or assistance with delivering a good product to them to HELP them with sickness? Holy shit, would you argue about which pharmaceutical company makes the best amoxicillin?

    Help one another. If you want to be a hater, look in the mirror and do it there and if you don’t like it, don’t share it.

    • thank you

    • JuiB1966

      Beautiful message beautifully written. Let’s hope it’s heeded. Cheers!

    • BREEDER

      When you get scientific with it to at least some degree,,it is much more effective and credible.That’s the audience you have out there.
      p.s. the behavior of someone loaded on THC isn’t always the one who should present the argument. Nice page,,thank you http://www.leafly.com

  • Ryan Miller

    I find it so funny that people are saying hemp oil has no value. Depending on the strain of hemp, hemp can contain many cannabinoids, and terpenes that have huge medical benefits. Yes full plant extract with THC will work the best but you can not say that high CBD hemp oils have no value. I have seen people take some of Hempmeds RSHO gold label in the middle of a seizure and the seizure stopped immediately tell me how this is no medical value. This oil has low THC but is high in CBD and is a full spectrum oil with over 84 trace cannabinoids and natural terpenes. I have seen children having 100’s of seizures a day go down to 0 a day from these oil. So you so called experts can say what ever you want to but the truth is in the pudding. Also the companies oils are already used medically in Brazil for many illnesses and these products are from hemp oil containing only small amounts of THC: http://www.medicalmarijuanainc.com/health-authorities-brazil-approve-importation-rsho-first-time-multiple-sclerosis-patient/ .. Why are people fighting over this, both hemp and the cannabis plant have huge medical benefits.

    • Bill Landreth

      So true

    • Bee Mayes

      the answer is ‘reefer madness’. people are still blinded by the lies.

  • Robert Root

    I use medical marijuana to manage symptoms of Multiple Sclerosis which has been severely impacting my life in many ways. When I started using medical marijuana in March of 2017 I thought that just including CBD (Cannabidiol) would be enough to benefit me. What I discovered that the entourage effect is very real, some amount of THC needed to be taken to see the full effects. I’ve only been using approach for 6 months so I am still searching the exact mix that works for me, my Doctors (my PCP and prescribing Physician) couldn’t understand my resistance using THC but when I gave in and introduced THC to my daily regimen I started noticing many benefits that I did not expect, the best unexpected benefit is that I am able to urinate and fully empty my bladder. This is a huge problem of people with MS and is the cause of countless bladder infections which is extremely dangerous for people with compromised immune systems.
    I believe that there are many benefits to using whole plant medication as there are many terpenes and other compounds other beneficial compounds that cannot be obtained reliably by chemical and CO2 extraction. Also I believe that some edibles should be introduced as the benefits are more fully seen and longer lasting when consumed.

    • Thanks for your testimony – I too noticed a better urination pressure if you will. It makes everything work better, since we are cannabinoid deficient from 80 years of prohibition.

  • Steve Bogna

    I make my own coconut oil as a topical or an oral medicine–I usually get 13-14% THC and 2 to 3% CBD and CBN. I won’t buy someone else’s products. I broke 60 bones and had 100 surgeries from one motorcycle accident, so I don’t need additional side effects. All pain pills are poison. As an amputee, nothing works 100% but I won’t pay good money for serious negative side effects.

  • Rafael Ladeira

    The whole Plant = TRUE MEDICINAL

    Isolated compounds = Can help one or another individual, but its a GAME FROM PHARMACEUTICAL INDUSTRY! They can get PATENT isolating compounds. But cant patent a plant.

    Babylon

  • Lloyd W

    It is worth noting that the entourage effect is a proposed mechanism of modulation of the psychoactive effects of cannabis. It hasn’t been really been proven scientifically, reports of the entourage effect are mainly anecdotal. There needs to be more research before you make health claims like these.

    Source: https://www.scientificamerican.com/article/some-of-the-parts-is-marijuana-rsquo-s-ldquo-entourage-effect-rdquo-scientifically-valid/

  • Whole plant FTW!

  • yiehom

    I am lost. Do I follow THC? CBD? a mix of both? The whole plant? Please answer the question.

    • Anon Amos

      What is your goal? For most medical users it would be a mix, coming from the whole plant.

  • Duane Sugarbaker

    Sounds like the only way to get whole plant is to yip it out of the ground and start eating. Is there anybody that extracts the oils from the whole plant including the roots. And why isn’t that a good idea?