What is the CBD Entourage Effect?
When does 2 + 2 = 5?
When you're comparing a medicine's pure synthetic form to the same substance in its natural form, particularly plants.
A large part of alternative medicine is based on using the entire plant for medicinal purposes rather than isolating or producing the active ingredient in a laboratory. It's called whole plant medicine, and herbalists excel at matching holistic, plant-based treatments to a variety of ailments. In a world inundated with Western medicine, pills, and quick fixes, this approach may seem old-fashioned, but mounting evidence suggests that medical substances may be more effective in plant form than in pill form.
This phenomenon, called the “entourage effect,” results when hundreds of natural components within a plant interact together and with the human body to produce a stronger influence than any one of those components used alone. It's a synergistic effect. When we combine multiple compounds in their natural state, we don't end up with the sum of the parts; we get a multiplying effect instead. The different compounds can amplify each other's effects, making the overall plant more effective in treating the unwanted medical symptoms (1).
Thus, in herbal medicine, 2 + 2 doesn't equal 4. It equals 5 or more.
The entourage effect becomes especially evident when comparing the effects of tetrahydrocannabinol (THC), the psychoactive component of the cannabis plant (marijuana), with the effects of using the whole plant. When pure, synthetic THC became available as the drug Marinol in the mid-1980s, scientists expected it to work just as well as using the entire cannabis plant. However, they quickly learned that patients preferred to use the whole plant rather than take Marinol (2).
As it turns out, cannabis contains many more active compounds than just THC. A number of cannabinoids have been found to work in conjunction with THC to produce the overall effect of symptom relief. Cannabidiol (CBD), in particular, modulates the effect of THC on the human body. Experimentation has revealed that a marijuana plant which contains far more THC than CBD makes the user feel “stoned.” Hemp, which contains the reverse—much more CBD than THC—relieves symptoms somewhat, without the psychoactive effect of marijuana. However, specially bred marijuana that contains roughly equal amounts of THC and CBD offered the most effective treatment for symptoms and pain (2). This indicates that the ratio of THC to CBD plays a key role in determining the efficacy of the cannabis plant for therapeutic applications.
If using the entire plant—or plant extract—is so much more effective than using lab-produced drugs, then why don't we use the whole plant more often?
Several obstacles must be overcome become the “whole plant medicine” approach can become feasible on a widespread scale in the U.S. (3):
1. Quality control is poor, resulting in potentially contaminated, adulterated, less effective, or even unsafe herb products. The Food and Drug Administration (FDA) does not closely monitor herbal medicine products as it does for medical products.
2. The potency of botanical extracts is inconsistent because the environment and weather affect each year's crop of plants.
3. Botanical products are not standardized due to insufficient knowledge and understanding of all the components that contribute to the therapeutic effect.
In the coming years, ongoing research should shed more light on whole plant medicine, enabling us to harness to full medicinal power of plants.
- (1) Rasoanaivo, P., Wright C.W., Willcox, M.L., and Gilbert, B. (2011). Whole plant extracts versus single compounds for the treatment of malaria: synergy and positive interactions. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059462/.
- (2) Gupta, S. (2014). Medical marijuana and ‘the entourage effect.' Retrieved from http://www.cnn.com/2014/03/11/health/gupta-marijuana-entourage/.
- (3) Benzie, IFF, Wachtel-Galor S, Editors (2011). Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK92773/.
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