MMJ Patients' Guide to the Entourage Effect

Many medical marijuana (MMJ) patients search for full-spectrum products due to a theory called “the entourage effect.” But what is the entourage effect and how might it influence MMJ treatment?

The entourage effect theory proposes that the various compounds within the cannabis plant work together to create a stronger or more therapeutic outcome than any single cannabinoid alone. Understanding the entourage effect can help MMJ patients choose the most effective strains for their condition and leverage these strains for their specific needs.

Understanding Cannabis: Cannabinoids and Terpenes

Cannabis boasts a rich tapestry of chemical compounds, including cannabinoids and terpenes. According to the entourage effect theory, these components work together to produce the unique effects associated with different cannabis strains.

What Are Cannabinoids?

Cannabinoids are natural compounds contained in the Cannabis sativa plant. Cannabinoids are the powerhouses of cannabis. They interact directly with the body's cannabinoid receptors, which are part of the endocannabinoid system. THC, the most well-known cannabinoid, is responsible for the psychoactive effects of cannabis, while CBD offers a range of therapeutic benefits without intoxication.

THC and CBD are well-known cannabinoids and most products found in dispensaries will list their THC and CBD content. However, over 100 cannabinoids have been identified. According to the entourage effect theory, these minor cannabinoids also contribute to each strain's unique effects.

What Are Terpenes?

These fragrant molecules contribute to the distinct aroma and flavor profiles of cannabis strains. The citrusy, earthy, and floral aromas associated with cannabis occur because of the terpenes contained in cannabis plants.

Terpenes are also key components in essential oils. Lavender oil, for example, is rich in linalool, the terpene that gives lavender its distinctive, floral aroma. The medical benefits of terpenes have been known for centuries, with lavender oil being used for its relaxing effects since medieval times.

Terpenes alone don't produce any psychoactive effects. However, research suggests terpenes like limonene and pinene may enhance some of the therapeutic effects associated with cannabinoids.

Full-Spectrum Cannabis Products vs Cannabinoid Isolates

You'll find a vast array of products in your local MMJ dispensary. Some of these products will be full-spectrum (containing all the plant's natural cannabinoids and terpenes). You may also see cannabis isolates.

Cannabis isolates are a highly concentrated form of a single cannabinoid with all of the other compounds removed. For example, you may see cannabis extracts containing just THC or just CBD. Because the product doesn't contain other cannabinoids or terpenes, it won't offer the “entourage effect.”

Tip: Holding an up-to-date medical marijuana card in Arizona facilitates the purchase of full-spectrum cannabis products and cannabis isolates excise-tax-free. This makes experimenting with different treatment options more cost-effective for patients.

The Whole Is Greater than the Sum of its Parts

The entourage effect proposes that the synergy between cannabis compounds and terpenes creates a more potent and well-rounded therapeutic effect than any single component. A growing body of anecdotal evidence and scientific research suggests that the entourage effect theory could be correct.

The scientific support for the entourage effect includes the following:

• A 2010 study compared full-spectrum cannabis products with a THC isolate. These products were tested for their ability to relieve pain caused by multiple sclerosis. In this study, full-spectrum products were reported to be twice as effective in relieving pain as THC alone.

• Another study compared a full-spectrum CBD-rich cannabis extract with purified CBD. The ability of each to reduce seizures was measured. 71% of the patients receiving full-spectrum products reported a reduction in seizures. 46% of patients reported that they benefited from purified CBD.

Some detractors think the entourage effect is nothing more than a marketing gimmick for the cannabis industry. However, there seems to be both scientific and anecdotal evidence to suggest that there is something to the entourage effect theory.

How Cannabinoid-Terpene Interactions Could Help

More and more states—including Arizona—have paved the way for treating certain qualifying conditions with medical marijuana. Full-spectrum products could help treat these and potentially more conditions:

Nausea and Vomiting

A 2020 study concluded that using full-spectrum CBD with anti-nausea medications in patients suffering from vomiting and nausea caused by chemotherapy alleviated their symptoms. 85% of patients showed a preference for full-spectrum CBD over the placebo.

Marijuana’s effects on nausea from chemotherapy are noted among the medical and scientific community. A synthetic version of THC has been approved by the FDA to treat chemotherapy-induced nausea. Many high-THC cannabis strains also seem to be effective in reducing nausea and vomiting.

Seizures

A 2017 trial tested full-spectrum CBD on patients with Dravet syndrome, a condition that causes long and frequent seizures. The study concluded that 43% of the study subjects experienced at least a 50% reduction in the frequency of their seizures. This was compared to 27% in the placebo group.

Stress and Anxiety

Though stress and anxiety aren't qualifying conditions in Arizona, being diagnosed with a qualifying condition can lead to added stress and anxiety. A 2023 study compared broad-spectrum CBD with CBD isolate in their ability to reduce stress. The broad-spectrum CBD was reported to be more effective.

Lavender essential oil, which contains the terpene linalool, has been studied for its potential role in treating anxiety disorders. Strains like Do-Si-Dos and Kosher Kush are high in linalool and could go some way to reducing anxiety as you come to terms with your condition or undergo medical treatment.

Look Beyond THC and CBD Content to the Whole Plant

The entourage effect is an intriguing theory that could unlock the full potential of medical cannabis. Be sure to work with an MMJ healthcare professional to create a personalized treatment plan that is effective for your condition and complements your ongoing treatment regime.

Finding the best strains for your condition will be a question of experimenting and being open to new approaches. THC and CBD are powerful therapeutic compounds. However, looking beyond these two cannabinoids to the other compounds in Cannabis sativa could help you reap the added benefits of a full-spectrum experience.