The Entourage Effect: Fact or Fiction?

The Entourage Effect: Fact or Fiction?

Published on November 1, 2021 by Kristina Willis

Due to legalization and media promotion, therapeutic cannabis use has risen in popularity over the past decade. To promote their products, industry influencers and commercial manufacturers grab onto every promising discovery and shape it into the next big marketing ploy. The entourage effect is one such trending theory that continues to pop up everywhere. 

While the entourage effect has its merits, much is still unknown about the precise mechanisms behind how cannabis compounds enact physiological change. Preliminary observation suggests that different chemical makeups produce varying effects. However, there is not nearly enough supporting evidence to push entourage-based products, such as full-spectrum extracts, on the market.

In essence, retail companies have taken something that is propitious in theory but still lacks the foundational research and twisted it to suit their economic agendas. Premature product development based on presumed benefits is dangerous for consumers who might not know better.

Read until the end if you’d like to know more about the validity of the entourage effect and how it might influence future drug therapies.

What Is the Full Entourage Effect?

The basis of the entourage effect is the idea that cannabis compounds interact with one another to produce varying or heightened effects. By working in harmony, a cocktail of chemicals can provide greater benefits than they would on their own. Sounds reasonable, right? Most experts agree that the entourage effect is real and likely contributes to higher success rates with cannabis blends when treating medical conditions.

However, available research is currently lacking, and very little is known about how different combinations of cannabis compounds impact the body. Consequently, both the beneficial and adverse side effects and the processes involved remain a mystery. Regardless, retailers choose to promote it as an indisputable truth.

What Are Cannabinoids?

Cannabinoids are chemical compounds found in the cannabis sativa plant. When consumed, they initiate physiological changes via the endocannabinoid system. Different types of cannabis contain varying levels of cannabinoids, affecting the body and brain in diverse ways. As a result, cannabinoids are also the determining factor for differentiating between marijuana and hemp. Though tetrahydrocannabinol (THC) and cannabidiol (CBD) are the primary compounds in cannabis, scientists have identified over 100 cannabinoids.

What Are Terpenes?

Terpenes are aromatic compounds found naturally in plants and essential oils. They are typically used by manufacturers to create desirable flavors and scents. Cannabis has a relatively high concentration of terpenes, and theories suggest that they play different roles in protecting the plant. For instance, some facilitate the healing process while others act as part of the immune system. As a result, many people believe that adding terpenes to cannabis products naturally enhances the mood-stabilizing effects of certain cannabinoids. To that end, research reviews often speculate about the interactions of specific terpenes but fail to provide any concrete evidence.

Is the Entourage Effect Proven?

The concept was first posited in 1998 by Raphael Mechoulam and Shimon Ben-Shabat, who observed that pharmacologically inactive monoacylglycerols modulated cannabinoid 2-arachidonoyl-glycerol activity. Their findings postulated that this was why botanical drugs were more efficacious than isolated compounds. Though only a hypothesis, people took the idea and ran with it as if it were definitive evidence.

Despite the potential significance, few published studies investigate beyond the surface. Research shows that the entourage effect is likely real; however, it is still undoubtedly unproven. No one knows its precise impact, and some studies have found an absence of an entourage effect at all. For instance, a 2020 study found that pure CBD was more potent at reducing cell viability than botanical extracts. Proponents and critics alike agree that the entourage effect is understudied and over-endorsed without factual findings.

Moreover, people often attribute the positive effects to terpenes, assuming that combining them with cannabinoids like THC and CBD enhances beneficial effects while simultaneously counteracting the negative. However, such claims remain unverified.

Furthermore, several studies found that the most common terpenes do not produce an entourage effect through suspected avenues, including CB1, CB2, TRPV1, or TRPA1 receptors. On the other hand, it is worth noting that a few studies have found increased efficacy with botanical cocktails for treating cancer and inflammation.

“Although current medicine is mostly based on the use of pure compounds that have single targets, it is increasingly obvious that for diseases as complex as cancer, multi-target approaches could conceivably be more effective.”

Sandra Blasco-Benito et al.

Criticism Surrounding the Entourage Effect

Criticism of the entourage effect is not so focused on its existence. The issues mostly revolve around how it is promoted and abused as a solely beneficial phenomenon. Even if chemicals interact with each other to produce heightened or specific effects, there is no reason to assume that the results are always positive. Certain combinations likely have harmful side effects. Yet, consumers are often only made aware of the benefits.

There are more than 400 chemicals found in cannabis, all of which interact with our endocannabinoid system in different ways. Available research has barely scratched the surface regarding both the benefits and adverse side effects of cannabis compounds. When you add in the fact that cannabinoids and terpenes likely produce varying effects at different dosages, it becomes clear that it is too soon to assume that more chemicals always invoke better results.

Excerpt from The ‘entourage effect’ or ‘hodge-podge hashish’: the questionable rebranding, marketing, and expectations of cannabis polypharmacy (2019):

A highly critical review of the entourage effect in commercial and academic circles.

“Claims of a cannabis entourage effect invoke ill-defined and unsubstantiated pharmacological activities which are commonly leveraged toward the popularization and sale of ostensible therapeutic products. Overestimation of such claims in the scientific and lay literature has fostered their misrepresentation and abuse by a poorly regulated industry. . . . Literature on the entourage effect is unjustifiably optimistic regarding its presumed benefits and this is commonly translated into unfounded marketing claims.”

—Peter S. Cogan

How Important Is the Entourage Effect?

At the moment, there is no real way to know precisely how important the entourage effect is. Cannabis has a complicated molecular profile, and research is so very limited. While the entourage effect is likely real and relevant to medicinal treatments, we don’t yet know how to accurately manipulate products with it in mind. Researchers require additional support and means to conduct evidentiary research that will illuminate how cannabis compounds interact to produce varying effects. Only after we expand our understanding can we think about utilizing it for enhanced therapeutical results.

Of course, this begs the question, should the entourage effect be of significant concern to consumers at all?

While it is certainly helpful to keep it in mind, you probably should not make medical decisions based on the existence of the entourage effect. For instance, do not jump on the full-spectrum bandwagon without first researching how the product’s chemical ratios will affect your condition. When it comes to retail, full spectrum and broad spectrum are just buzzwords. What’s important is to find the right strain for your specific condition or symptoms. Above all, never rely on the word of retailers who have a vested interest in selling you cannabis products. If you need help identifying a strain for a specific medical concern, consult with a doctor who is both knowledgeable and experienced with cannabis treatments.