What is the entourage effect and why is it important? Hint: it has nothing to do with HBO’s long-running (now retired) comedy-drama series -- "Entourage" -- produced by Mark Wahlberg. However, there are some parallels between the two. If you were a fan of the show, you remember the story revolves around Vincent Chase (a young A-lister in Tinseltown) and his buddies from high school (who are living "the dream" in Hollywood). Vince’s best friend (and manager) is Eric Murphy. In some ways, Vincent is like THC. He gets most of the attention, but where would he be without his BFF, Eric -- who like CBD, plays a vital role in their mutual success?
Like the minor cannabinoids, we’re less certain about the role of the other characters — the lovable (and quirky) characters Drama and Turtle (who play important supporting roles). At the end of the day, together, they make a team; together they are greater than the sum of their parts. And, without each other, the show would be lousy (or at least, would leave a lot to be desired).
The Whole Is Greater Than The Sum Of The Parts
What can we learn from the show Entourage that applies to cannabis and the “entourage effect?” Like the show, contrary to public perceptions, cannabis is not all about its leading “star” — THC. Hundreds of chemicals comprise cannabis, most of which (to varying degrees) contribute to cannabis’s effects (and overall value). Independently, many of these compounds — called cannabinoids, terpenes, flavonoids, etc. — have talent in their own right. But, let’s face it: THC, by itself, is not that great! Otherwise people would think Marinol (pharmaceutical THC) is a great drug. All of these constituents within cannabis work together synergistically to elicit benefits that — as mentioned — are superior than the simply the sum of all their parts.
The phrase, “entourage effect,” was coined by two Israeli scientists, Raphael Mechoulam and S. Ben-Shabat, to characterize botanical cannabis as a complex plant with numerous compounds that work better together than in isolation. Mechoulam, and many scientists who’ve followed his work, maintain all of the natural components of cannabis behave synergistically to produce therapeutic effects that are far greater than any single ingredient.
Science has to determine exactly how all of these constituents work, but they agree that when they come together, it’s like a symphony — working far better together than going solo. Think about it. I mentioned Marinol (the first pharmaceutically available drug based on a constituent in cannabis. Marinol became available during the 1980s; scientists and the medical establishment were elated, believing it would produce the same effects as whole plant cannabis. But, oh were they wrong.
Big Pharma Can't Compete With "Real" Cannabis
THC by itself, to put it bluntly, kind of sucks. The overwhelming majority of patients who’ve tried both prefer the plant over the synthetic. And, clearly, whole plant cannabis is far more therapeutically versatile than its synthetically derived cousin. In fact, British “baby-pharma” company, GW Pharma recognized the importance of the entourage effect early on. GW Pharma developed Sativex, a lab produced cannabinoid-treatment made up of THC and CBD.
GW Pharma ran into many of the same challenges that the manufacturers of Marinol ran into. They conducted over ten years of experiments, and concluded whole plant extract was superior to synthetic. So they bred botanical cannabis with equal parts of THC and CBD, finding the two plant-derived chemicals worked together far better to reduce the pain and spasms of Multiple Sclerosis than any medication synthetically created with a single compound.
CNN's Dr. Sanjay Gupta Agrees
CNN’s Dr. Sanjay Gupta agrees, claiming it should be obvious that whole-plant cannabis would work together better than pure synthetics: Gupta explains: “After all, eating real fruits, vegetables and other plants provides better nutrition than just taking vitamin pills with one nutrient or mineral in each. Science is showing us that we can likely say the same about cannabis.”
As we move forward with expanded access to clinical cannabis, it’s important that we don’t forget the importance of the “entourage effect.” Botanical cannabis is not in Big Pharma’s interest, and they’ve long been trying to suppress the thriving (albeit nascent) clinical cannabis industry. They've spent billions making arguments and lobbying Congress with the claim (a strawman argument) that synthetics are, in fact, superior.
How could they make an outrageous claim?
They put forth that synthetics are easier to test, and when they hit the market, it’s far easier to control consistency and quality. True. Pharma drugs, as lousy as they are, are in fact, easier to control for consistency. Likewise, one can make the defensible case that it’s easier to control the consistency of McDonald’s hamburgers than it is the consistency of your favorite Italian restaurant. But, between lackluster (and unhealthy) McDonald’s and your favorite Italian eatery, which would you choose?