We have had a long-standing relationship with the cannabis plant, ancient in fact. Dating back at least 10,000 years, this medicinal herb has been part of our shared consciousness for millennia. Yet, its mind-altering potential led to outlaw and condemnation. In recent times, however, science has begun to unravel its various compounds and unique properties that can calm distress and pain.
What is the entourage effect, what are cannabinoids and why are these compounds so special, and what does the science say about their reported potential to ease physical pain and calm emotional unrest?
The entourage effect
Generally, the word “entourage” means a group of attendants or associates, as of a person of rank or importance. It refers to a collection of individuals being able to propel the star and, together, produce greater outcomes.
When applied to cannabinoids, this is most succinctly defined as various related compounds that enhance the primary effects of the main endogenous cannabinoids. In effect, the whole is greater than the sum of its parts.
The history of the entourage effect
In 1988, Dr. Raphael Mechoulam, organic chemist and professor of Medicinal Chemistry, and Dr. Shimon Ben-Shabat, senior lecturer at Ben Gurion University, theorized that there was an “entourage effect” at play within the endocannabinoid system. Where others felt that individual compounds such as cannabidiol and tetrahydrocannabinol displayed their therapeutic effects in a non-magnifying manner, and that the minor or “inactive” metabolites were merely present rather than active, these two professors believed each compound acted synergistically to produce effects far greater than the sum of their parts.
Proof of the entourage effect
Growing evidence supports the presence of the entourage effect and the additional benefits of consuming full or broad spectrum CBD oil as opposed to CBD isolate alone. From greater cannabinoid activity to enhanced pain relief and reduced inflammation, the entourage effect may deliver better remedial outcomes.
Greater cannabinoid activity
In the study, An entourage effect: inactive endogenous fatty acid glycerol esters enhance 2-arachidonoyl-glycerol cannabinoid activity, Mechoulamin and Ben-Shabat investigated 2-Arachidonoyl-glycerol (2-Ara-GI). This endogenous ligand is able to bind with cannabinoid receptors CB1 and CB2. 2-Ara-GI is accompanied by several esters that had previously been considered inactive, with no capacity to exert effects from binding with the cannabinoid receptors themselves. However, this research showed these esters increased the binding ability of 2-Arachidonoyl-glycerol. They could increase cannabinoid activity.
Enhanced pain relief
For those with severe pain who respond inadequately to opioid medication, continued suffering can be unrelenting. Natural alternatives, including medical marijuana, provide a possible analgesic option. A study published in the Journal of Pain and Symptom Management investigated whether THC alone or in combination with CBD offered greater respite. The combination brought significantly greater relief than THC alone.
The potential to reduce inflammation
Substances that are able to “fit” the cannabinoid receptor type 2 (CB2) lock, and act to turn it on, have been shown to reduce inflammation. Previously, the only cannabis compounds believed capable of activating this receptor were tetrahydrocannabinol (THC, Δ8 and Δ9) and cannabinol (CBD). However, (E)-β-caryophyllene — a terpene that forms a major component of cannabis — has also been shown to exert this effect. This may contribute further to the already established anti-inflammatory effects of THC and CBD.
Cannabinoids and the Entourage Effect
The entourage effect is an important piece of the cannabis puzzle. To appreciate the depth of its benefits, we must look to the compounds contained within this plant including the cannabinoids.
What are cannabinoids?
The word ‘cannabinoid’ simply refers to any compound that can attach to the cannabinoid receptors in the brain and body. Our cells have areas that respond to certain chemicals, whether they be hormones, antigens or, in this case, cannabinoids. Like a key placed in its twinned lock, when the right messenger fits into its complementary receptor it matches. A response can occur. The body can react. A change can be made.
Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the most famous and well researched cannabinoid constituents of cannabis, the flowering herb with a history as complex as its vast array of bioactive compounds. Additionally, an estimated 483 compounds have been identified as uniquely belonging to the cannabis plant, including more than 60 cannabinoids and around 100 terpenoids. We know in nature that compounds often work synergistically and, as research continues, we expect to glean greater insight into the widespread ways these different substances lead to a multiplication (“entourage”) effect.
With this in mind, let’s answer the questions we are most often asked…
How can cannabidiol be beneficial?
The groundswell of evidence and patient support has reached critical mass. Research shows that cannabidiol may…
- Relieve pain – Pain can be exhausting, depressing and isolating. Sadly, even with the best of science and the strongest of medications, pain can be incredibly difficult to treat. Yet research shows that cannabidiol is able to calm physical distress, without side effects. As the authors note, “Topical CBD application has therapeutic potential for [pain] relief.”
- Reduce anxiety and depression – Mental illness can be debilitating, potentially stripping quality of life from a sufferer’s grip. The Anxiety and Depression Association of America shared two sobering facts:
As with ongoing pain, this compound may have an important role to play in mental illness. CBD offers a natural, unique alternative to the often harsh pharmaceutical agents prescribed for mental illness. Research shows cannabidiol may calm anxiety including social phobia and may relieve the signs and symptoms of depression.
- Improve sleep – The prevalence of insomnia has grown in recent years, with 23.8% of the population now battling to achieve sufficient shuteye. A study published in the Journal of Psychopharmacology noted that CBD seems to increase total sleep time, with the study Hypnotic and anti-epileptic effects of cannabidiol supporting these findings.
What makes cannabidiol so special?
There are a variety of reasons why CBD continues to gain in popularity, including its safety and effectiveness. With the entourage effect present in broad and full spectrum options, these options are especially attractive.
CBD might be a worthy alternative to opioids
Pharmaceutical agents come with significant risks. The National Institute on Drug Abuse has said that, in those who take opioids, a staggering eight to 12% of people will acquire an opioid-use disorder. An article published in the British Journal of Medicine concluded that medicine is the third leading cause of death.
With CBD, however, a World Health Organization report noted that there are no case reports of abuse or dependence. Plus, CBD has a better side effect profile. In essence, it is substantially less likely to cause its own symptoms.
As greater numbers of people discover the broad-ranging potential benefits of CBD, we expect this supplement to continue its popular rise. Able to relieve pain, reduce inflammation, calm anxiety and depression and improve sleep, its effectiveness at easing ill health may provide welcomed respite.
How does cannabidiol work?
We, as a society, have been conditioned to believe that therapeutic power rests in pharmaceutical agents. So, how can a flowering herb produce such profoundly beneficial effects?
What is the endocannabinoid system
Before we dive into the details, it is helpful to define its components…
What are Endocannabinoids
Endocannabinoids refers to cannabinoids that are made within the body. They are the molecules inside us that connect with cannabinoid receptors and trigger a response.
Endocannabinoid receptors are the lock that sits on a cell’s surface and responds specifically to an endocannabinoid. It is through this lock and key style mechanism that the virtual cell door is opened and this compound can produce a biological effect.
The endocannabinoid system is the name given to the complex, interconnecting structures that involve endocannabinoids, their receptors and the various components of this system. Found within the brain and connective tissues, glands, immune cells and our organs, the effects of the endocannabinoid system are spread widely throughout the body and the brain.
How does this system help to ease pain?
When a matching compound connects with an endocannabinoid receptor, it becomes activated. In essence, an effect can take place. There are two well researched receptors, known as CB1 and CB2. The vast majority of CB1 receptors are found within the central nervous system. THC meditates a CB1 response and is involved in altering pain transmission and modifying its effect. It also has psychoactive implications. CB2 receptors are found mostly in peripheral tissues and are important in immune and inflammatory responses. It is via this mechanism that cannabidiol is able to reduce inflammation, pain and mental illness.
We also have receptors for pain. Scientifically, these are called nociceptors and the process, nociception. Cannabinoids are able to exert anti-nociceptive effects, which means they can quell the experience of discomfort. This likely occurs by down-regulating the detection of pain at its receptors, and by altering nerve signals that are sent to the brain.
Greater understanding of cannabinoid, cannabidiol, the endocannabinoid system, and the entourage effect helps identify better therapeutic options, including the benefits of isolated versus full spectrum cannabinoids.
Types of CBD and The Entourage Effect
CBD isolate and the entourage effect
An isolated cannabinoid refers to a single compound that has been extracted to exist by itself. For example, cannabidiol isolate has had all other cannabinoids, flavonoids, and terpenes removed during processing to leave CBD alone.
- Isolated CBD oil includes this single compound only. It is beneficial for a range of symptoms, including those listed above. It does not contain terpenes. As it is an individual substance only it will not trigger the entourage effect. However, it is also THC-free so its consumption will not risk a positive drug test.
Broad and Full spectrum CBD oils and the Entourage Effect
- Full spectrum CBD oil contains cannabidiol, terpenes and flavonoids. The synergistic mix may harness the entourage effect. CBD may ease muscular spasms, lower high blood pressure, and improve acne. Terpenes may ease anxiety and promote sleep. Flavonoids may reduce inflammation and protect the heart and blood vessels. In some parts of the world, the percentage of psychoactive THC must remain below 0.3 percent to be considered legal. It is important to note that If you’re interested in the entourage effect you should always try to go with full spectrum products.
- Broad spectrum CBD is the same as full spectrum, minus the THC. Its cannabidiol, terpenes and flavonoids confer the same positive benefits without any risk of a positive THC-reading. The many cannabinoids which are found in this type of oil are fitting to promote the body’s entourage effect, but still, Broad spectrum oil is often considered inferior because it lacks any THC which is needed for a full-body entourage effect.
Cannabidiol is a safe, natural compound that brings potential relief for pain, inflammation and mental illness. Full and broad spectrum oils maximize medicinal effects by including a range of synergistic compounds. As with any therapeutic product, it is important to consider your needs and decide on the right fit for you. This information will help you to make an informed decision.