For years now THC has been the most popular and widely researched cannabinoid in cannabis science. However, nowadays like CBD has stolen the spotlight given its ability to provide therapeutic relief to children suffering from various epileptic disorders, while lacking the psychotropic effects (i.e. high) of THC. It’s even gotten to the point that state legislature are passing laws “CBD-only” medical marijuana legislation.

Given all of this, it is easy to see how CBD and THC can be viewed as being in competition. But the reality is that both compounds, along with as many as 66 other cannabinoids, play important roles in providing the therapeutic benefits associated with cannabis therapy. They work in conjunction with approximately 420 additional compounds (terpenoids flavonoids, etc.) to give cannabis its versatility in treating a multitude of medical ailments.

As good students of the Cannabis Classroom, you are probably familiar with the previous pieces which featured what can simply be described as the Big Six cannabinoids: THC, CBD, CBN,CBC and THCV. Each cannabis plant contains these and many other cannabinoids at various percentages as part of the plant’s total chemical profile.

“The chemical profile of the cannabis plant contains other compounds like terpenoids, amino acids, proteins, sugars, enzymes, fatty acids, esters, and flavonoids…”

In addition to cannabinoids, the chemical profile of the cannabis plant contains other compounds like terpenoids amino acids, proteins, sugars, enzymes, fatty acids, esters, and flavonoids, just to name a few.
Naturally, you consume all of these compounds when medicating with 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.”

The Entourage Effect: Chemical Teamwork

First described in 1998 by Israeli scientists Shimon Ben-Shabat and Rapahael Mechoulam, 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 pharmacology community, that in certain cases whole plant extractions serve as better therapeutic agents than individual cannabinoid extractions. The entourage effect theory has been expanded in recent times byWagner and Ulrich-Merenich, who define the four basic mechanisms of whole plant extract synergy as follows:

-Ability to affect multiple targets within the body
-Ability to improve the absorption of active ingredients
-Ability to overcome bacterial defence mechanisms
-Ability to minimise adverse side effects.

Affecting Multiple Targets

Many studies have demonstrated the effectiveness of cannabis as a therapeutic agent for muscle spasms associated with multiple sclerosis. A study conducted by Wilkinson et al. determined that whole-plant extracts were more effective than THC alone.
Researchers compared 1 mg THC vs. 5 mg/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 endocannbinoid system.

Improving Absorption Of Active Ingredients

The entourage effect can also work to improve the absorption of cannabis extracts. Cannabinoids are chemically polar compounds, which makes them at times makes them difficult for the body to absorb in isolation.

“With the assistance of terpenoids like caryophyllene, absorption of cannabinoids can be increased.”

Absorption of topicals provides a prototypical example of this problem. The skin is made up of two layers, also known as a bi-layer, which makes it difficult for for very polar molecules like water and cannabioids to pass through. With the assistance of terpenoids like caryophyllene, absorption of cannabinoids can be increased and therapeutic benefits achieved.

Overcoming Bacterial Defence Mechanisms

The entourage effect also accounts for cannabis extracts to be effective in treating various bacterial infections. There are a number of studies which show the antibacterial properties of cannabinoids.

“Whole-plant cannabis extracts have non-cannabinoid constituents which also have antibacterial properties.”

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 consituents 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.

Minimising Adverse Side Effects

Finally, 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.

As you can see, THC, CBD, and the remaining cannabinoids don’t have to compete with one another – they can work in tandem alongside the other components of cannabis extracts to provide therapeutic relief for a wide variety of ailments.

Source: August 15 – Medical Jane

The Ministry of Health asked the Trimbos Institute to research the health effects of cannabis regulation in four states in America from 2012 till 2016.

The report looks at features of the policy on production, transport, sales, possession and use of recreational cannabis in the states of Colorado, Washington State, Oregon and Alaska. Also described in the report are measurements to possibly reduce health impact of cannabis use, based on desk research and scientific documents. The report looks at use, addiction, accidents and acute incidents in states with cannabis regulation.

In all four States with regulation of recreational cannabis the medical use of cannabis was allowed first. The allowance of the recreational use of cannabis in these states  was implemented after a referendum, but the health objectives for not predominant in this matter, so the health impact policy with the regulation has its limits.
The regulation of cannabis looks like the regulation of alcohol in the USA, so it seems that cannabis has become a usual consumer product. The sales and production of cannabis is organised through state-licenses, but local governments don’t have to allow the sale or production on their territories.

The general conclusion of the Trimbos report is that it’s still to early to draw solid conclusions on the health impact of the implementation of recreational cannabis regulation.

Source: June 13 (including a link to the dutch report):