What is the Entourage Effect with Cannabis?
Updated: Dec 24, 2019
One of the most common questions we receive here at Ohio Marijuana Card is inquiring into the difference between cannabis and hemp. Especially considering the explosion in the availability of CBD products across the country, many patients wonder why they need approval for a medical cannabis card in Ohio when they can go to the local convenience store and buy CBD products without a card.
Most consequentially, the medical efficacy and benefits of cannabis can be narrowed down to a theory called the entourage effect. No, this is not related to the hit HBO tv show with star Adrian Grenier; but rather, the theory that cannabis works most effectively when cannabinoids and terpenes interact synergistically. Another way to explain the entourage effect: cannabis is more medicinally effective when CBD interacts with other cannabinoids, like THC, rather than when interacting individually.
Hemp and CBD Are Federally Legal
In December of 2018, President Donald Trump signed into law the Agricultural Improvement Act of 2018, also called the 2018 Farm Bill; Ohio formalized this law in June of 2019, implementing its own hemp cultivation and CBD distribution program. With the passage of this law, hemp was federally defined to distinguish between cannabis and hemp. The law dictates that hemp can have a maximum THC content of 0.3% - which is ultimately a negligible amount of THC, far too small to create the entourage effect.
While hemp is not allowed to include THC above the 0.3% threshold, hemp does generally have a significant amount of CBD. For this reason, CBD products available without a medical cannabis card will be extracted and derived from hemp material. In the case of Ohio's medical cannabis program, the products available in Ohio dispensaries will be exclusively cannabis extracted and derived.
The Entourage Effect
It is generally argued that cannabis-derived products will have more medicinal efficacy when compared to CBD-derived products. This is because cannabis-derived products will be "whole plant medicine" that includes, not only CBD such as in hemp, but also other cannabinoids and terpenes that have additional medicinal benefits. For example, cannabis-derived products can include the cannabinoids THC, CBC, CBG, and THCVA, while hemp-derived products will only include the cannabinoid CBD and a negligible amount of THC.
Not only do cannabis-derived products include additional cannabinoids present that have additional medicinal benefits, but cannabis-derived products will generally also include terpenes. Terpenes are the fragrant aromas present in cannabis and other items, providing each cannabis strain's "personality". Individual terpenes have their own additional medicinal benefits, and the terpene and cannabinoid profile of a strain is generally what makes each strain so unique.
Overall, the interaction between cannabinoids and terpenes are truly what makes cannabis such an effective treatment option for such a wide range of medical conditions and symptoms. Furthermore, with cannabis having a larger possible range of cannabinoid and terpene profiles, cannabis also offers patients with a larger number of strain varieties that provide specialized and unique relief. While some hemp-derived products may be able to mimic some of these effects, in the grand scheme of things hemp does not have the necessary components to provide the same level and quality of relief when compared to cannabis.
What If I Don't Like The Effects Of THC, But I Want Cannabis-Derived Products?
The psychoactive component found in cannabis is the cannabinoid THC. While THC is a necessary piece of the puzzle for cannabis treatment for some conditions, other conditions may not require as much THC. For these patients, there is often a desire - for a range of reasons - to avoid the psychoactive effects of THC.
The good news for patients looking to avoid the psychoactive effects of THC is the fact that CBD actually acts as an inhibitor of THC uptake, allowing THC to provide the medicinal benefits it's associated with while also blocking the psychoactive effects associated with THC. For this reason, utilizing strains that are high or dominant in CBD content - especially in comparison to THC content - will provide patients with the symptomatic relief desired without the psychoactive effects. For many of Ohio's 21 qualifying conditions, a 1:1 CBD/THC strain can serve as the ideal tool for treatment.
Another technique that some patients prefer is to use THC-dominant strains and products, but also have CBD-dominant products available to offset the psychoactive effects if they become uncomfortable. As we have discussed in the past, using a CBD tincture can be a great option if you are having a negative experience with THC's psychoactivity. There is also some evidence to suggest that peppercorn can also reduce the psychoactive effects of THC!
All-in-all, the evidence thus far suggests that the entourage effect plays a central role in the medicinal benefits provided by individual cannabis strains. The individual cannabinoid and terpene profiles of each strain create "personalities" that can make certain strains ideal for treatment of PTSD and anxiety, while other strains may be more ideal for the treatment of Fibromyalgia or Chronic Pain.
While there are many great CBD brands out there, such as our partner Joy Organics, there are sadly many brands that mislead individuals about the purity and possible effects of their products, and without proper advertising restrictions these companies are able to make baseless and unverified claims in advertising hemp-derived CBD products.
It is important to note that all products sold within the Ohio Medical Marijuana Control Program have been tracked from seed-to-sale with some of the highest regulations in any state medical cannabis program. This ultimately means that you can feel comfortable purchasing cannabis-derived products at an Ohio dispensary as the products have been meticulously tracked and tested by independent laboratories. Furthermore, when discussing with knowledgeable budtenders at any one of Ohio's 57 dispensaries, you will be able to choose strains that are more so tailor-made for your specific medical condition(s) and symptomatic relief.
If you are an Ohioan suffering from one of these 21 medical conditions you may be eligible to treat your ailment with medical marijuana, which includes both THC and CBD products.
Click here to learn more about what Ohio Marijuana Card's state-certified medical marijuana doctors can do for you, or give us a call at (866-457-5559) and our friendly support team can walk you through the entire process, and set you up with an appointment.