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The Entourage Effect

Cannabis when taken as a whole plant extract, has repeatedly outperformed single drug extracts. Cannabis contains dozens, and perhaps hundreds of active compounds, which add to its therapeutic effect, often enhancing desired effects, and in some cases reducing undesireable effects. This was coined by Israeli scientist Raphael Mechoulam in 1999 as the “entourage effect“.

In the 1980’s a synthetic THC only pill was developed to help conquer nausea as the HIV Epidemic was in full swing. This became known as Marinol.  However many patients preferred the raw plant still, as the dosing was harder to manage with a pill of set strength, and the side effects of the pill could be more severe. This is because raw cannabis contained other cannabinoids other than THC, such as small amounts of CBD, which we now know counteract the negative effects of THC, this is a perfect demonstration of reducing harms compared to single chemical medicines.

The most recent demonstration of the enhancement of desired effects has been research in Israel comparing a high CBD whole plant extract of Avikedel (a strain of cannabis similar to Charlottes Web) with a pure CBD extract on inflammation.  The results suggested that the CBD only extract had a bell shaped response curve, where there was little improvement in symptoms past a certain dose of CBD, (imagine doubling a dose of morphine with no change in pain relief). On the other hand, the high CBD extract, as it provided the “entourage effect” with other cannabinoid chemicals in minor amounts, had a nearly linear response to higher doses, that kept improving the symptoms well beyond what the Pure CBD extract could.