Janice Spurlock

The Entourage Effect May Help Improve Health

“There is not enough research!” That is the cry heard around the country as medical marijuana proliferates the states. This is not about the long-running TV show centered on young actors trying to make it big in Hollywood, but the effect of the whole cannabis plant on our health. It’s called the “entourage effect” –a slick name for a simple concept: the whole is greater than the sum of its parts. You may know this as synergy.

When we consume cannabis, we’re ingesting a collection of cannabinoids, terpenes, and flavonoids, making up the group of ingredients sort of like an entourage that follows a celebrity. In the medical cannabis world, the “entourage effect” is widely advocated but narrowly–if at all–formally studied in research projects. That’s why it’s creating buzz in the industry and among our patients.

Many are touting their success by using a broad-spectrum or full-spectrum therapy.

They Work Together

As a patient, you are most likely aware of the two most famous compounds, THC and CBD. Organic Remedies Pharmacist Shannon Ye says, “I start off with the two primary cannabinoids, THC and CBD, and describe their properties and potential synergistic effect.” Then, Ye moves into a deeper realm by discussing strains.  “Afterwards, I explain the general differences between sativa, hybrid, and indica strains.”

Starting with strains is just the beginning of delving into the entourage effect of cannabis. Ye’s interest in the effect is helping patients make their way through what can be a daunting first experience and lead to a better overall cannabis therapy. Ye discusses hybrids then moves to terpenes saying, “I explain that cross-breeding over the years has led to many hybrid strains, and that the terpenes, the natural oils that provide aroma and medicinal value, greatly help to distinguish the potential effects and benefits.”

New Approach

This will be new territory for many first-time medical marijuana patients and going slow with the explanation goes well with the dosing mantra of “start low, go slow.”

Ye walks her patients through a major difference in their new medical therapy. We are working with a natural plant, not a synthetic compound developed in a lab. “With many patients only familiar with single compound synthetic pharmaceuticals and new to plant-based medicine, I distinguish cannabis as the ultimate combination medication.” Ye expands on that crucial difference between medical marijuana and synthetic meds. “Ultimately, I express that the benefits of cannabis do not rely on one component.  Rather, there may be a synergy when cannabinoids and terpenes are combined to deliver an enhanced pharmacologic effect.”

How Important is “Anecdotal” Evidence?

Ye agrees more research will help with defining and applying the entourage effect, but in the meantime, she’s seeing more patients benefitting from it. “I have observed from our patients that oftentimes the products containing a more abundant cannabinoid and terpene profile seem to offer greater benefits.”

Ye says the effects of cannabis are highly individualized. So too, are the effects of different products available at Organic Remedies. Ye says, “Many of our Organic Remedies’ extracted products are full spectrum concentrates because the specific cannabinoid and terpene profile of the plant is preserved during the manufacturing process.

Ye says patients can help a pharmacist dial-in a perfect entourage. “For example, one of my patients was having difficulty finding a capsule to help with sleep,” Ye says. “After a distillate 10 mg THC capsule was not effective, trying an indica-dominant full spectrum RSO 10 mg THC capsule finally provided the patient a good night's rest.”

Check Out the Terpenes!

Because of the entourage effect, patients may find that trying products with a different terpene profile creates a very different experience and can improve individual outcomes Ye relies on our lab’s work in extraction and production. “With patients, I often click on the product on our menu to look at the terpene contents obtained from the lab. Our Grape Cake dry leaf is an indica THC-dominant strain that is high in myrcene, a terpene that provides sedative effects.

Fortunately for patients, with the increasing number of strains, the various terpenes and new product forms coming to market, the benefits of the entourage effect can seem endless. “Our AK live crumble was created via an extraction process where the plant is fresh-frozen. It’s abundant in several terpenes. Also, check out strain-specific full spectrum tinctures which often provide a fuller "entourage" effect than our flavored tinctures.”

Research on the entourage effect includes the work of Dr. Ethan B. Russo. You can find his January 2019 study here: The Case for the Entourage Effect and Conventional Breeding of Clinical Cannabis: No “Strain,” No Gain (nih.gov)

An Organic Remedies Patient Care Consultant and Pharmacist are always available to answer your questions!

The Entourage Effect Overview horizontal business infographic illustration about cannabis as herbal alternative medicine and chemical therapy, healthcare and medical science vector.

Two is Often Better Than One

One thing you can always count on in the medical marijuana field is change. We are in a time of incredible advancement, development and innovative therapies involving cannabis. When perusing medical marijuana menus, you may come across a 1:1 product. This is usually a half and half combination of CBD (cannabidiol) and THC (tetrahydrocannabinol).

The THC Component is Important

Combining THC with CBD is showing promising results. The University of Western Ontario showed in 2019 for the first time the molecular mechanisms of CBD at work, block the psychoactive side-effects of THC. Uncovering those “molecular mechanisms” in mice, allowed the team to isolate the reaction of those given a CBD/THC combination. They presented fewer anxiety behaviors and other negative side effects.

The National Institutes of Health reports the 1:1 combination of THC:CBD appears to allow for higher doses of THC without increasing the risk of adverse side effects. It appears that CBD acts to antagonize some of the psychoactive and sedative effects of THC without interfering with intended THC effects, such as muscle relaxation and reduction of spasticity.

I Don’t Want to get High, So Why the THC?

Organic Remedies Pharmacist Tammy Royer says, “THC helps CBD bind to the receptors resulting in increased effectiveness of the CBD, while CBD lowers some of the euphoric effects of THC, without losing the value of THC. A one-to-one ratio has minimal euphoric effects, but can be very helpful for symptom relief for many qualifying conditions.”

Royer also points out an easy way for patients to open discussions about their treatment. All Organic Remedies products label the amounts of THC and CBD, “The higher the percentage of CBD to THC in a product, the less euphoria or psychoactive effect will be experienced,” says Royer.

CBD is beneficial as an anti-inflammatory, for nerve pain relief, and in relieving anxiety. Royer adds, “use of even minimal amounts of THC in a CBD product will mean greater levels of attachment to receptors and more relief, especially if taken regularly to saturate the receptors.”

Some Products to Consider

Dialing in your own CBD:THC ratio and dose can have a learning curve, but Organic Remedies Patient Care Consultants and Pharmacists can help. Ultimately, the goal is finding the right ratio of CBD to THC.

Patients can start off adding 1mg of THC at a time with their normal CBD dose and slowly build up to a level that produces the best result. Organic Remedies Pharmacist Patrick Gladfelter says, “By titrating up slowly, the patient can determine an effective dose, while achieving the desired relief. At the same time, he or she can perform daily tasks with minimal unwanted side effects.”

While both compounds can help reduce symptoms, including inflammation, pain, anxiety, and nausea, the concentration of CBD:THC can affect the experience. Gladfelter says, “When choosing a product and initial dosing, in general, I base my recommendation on THC concentration to avoid unwanted side effects such as anxiety or euphoria. Then as CBD builds up during the 7to10-day loading phase, the synergy of THC and CBD really kicks in!”

Available research and anecdotal evidence show that CBD and THC are a complementary pair. Gladfelter adds, “As new information and data is collected, we are gaining a better understanding of cannabis and its many components. These two important cannabinoids not only work better together, but may also provide the same amount of relief, possibly better, with less euphoria compared to a THC product alone.”

Organic Remedies can help you find the right product and ratio depending on your preference.

A beautiful sheet of cannabis marijuana in the defocus with the image of the formula CBD

Post-traumatic Stress Disorder and Cannabis

A shocking, scary, or dangerous event can cause the body to develop post-traumatic stress disorder (PTSD). It is natural to feel fear during and immediately after a traumatic situation. Split second decisions are made in the “fight or flight” response. But, when a person does not recover naturally from a trauma, the long-term effects can be devastating.

Step One: Talk to your Organic Remedies Pharmacist

If you have been diagnosed with PTSD and are considering medical marijuana therapy, Organic Remedies Pharmacist Shannon Ye says, “Information gathered from non-professional sources may not always provide the best results. Treatments can greatly differ among patients. Efficacy is closely tied to finding the appropriate dose and strains.”

While the most studied type of medications for treating PTSD are antidepressants, which may help control symptoms including sadness, worry, anger, and feeling numb inside, medical cannabis may also be helpful in alleviating many different symptoms as well. Other common problems associated with PTSD, that may be helped by medical cannabis, include loss of sleep and nightmares.

Right now, the National Institute of Mental Health says medical professionals and patients should work together to find the best medication or medication combination, as well as the right dose. Ye agrees that this is important with medical cannabis as well, saying, “For example, a dose too high in THC and pinene may worsen PTSD related symptoms therefore agitating anxiety and irritability. Having a traumatic experience from cannabis may not only worsen PTSD symptoms but may also prevent a patient from trying cannabis again in the future.”

Individualized Therapy

The NIMH also recommends psychotherapy, or “talk therapy,” for people with PTSD, but stresses every patient is different. What works for one, often does not work for another. “I always ask the patient about their goals of therapy and what dosage forms they may feel most comfortable using,” says Ye.  “Although more research is needed, there is evidence that supports cannabis alleviates difficult to treat symptoms of PTSD such as insomnia, nightmares, anxiety, and irritability. There is also evidence that cannabis can help a PTSD patient experience a "trigger" without an associated terror response.”

Not having that terror response to a particular “trigger” is key in treatment. Ye says, “The success in treating symptoms may be due to PTSD patients having changes in their endocannabinoid system. However, it is not realistic for patients to expect medical cannabis to cure their PTSD as it is not a substitute for conventional treatment.”

PTSD is Personal

PTSD diagnosis is based on many factors including re-experiencing symptoms, avoiding certain things, and changes in mood and cognition. With so many things to consider, both patient and pharmacist can work together to find a way to improve the quality of life.

Ye says every case is one-of-a-kind, “As an example, one of my recent patients I spoke to was suffering PTSD due to a car accident from 2 years ago. Ye says the symptoms were paralyzing, “They were experiencing anger that led to blackouts and anxiety that caused panic attacks when in a car. They have noticed significant improvement in managing PTSD symptoms since starting cannabis.”

Finding the Right Combo

Ye says finding a particular strain for PTSD patients is important but when she digs deeper into therapy, Ye finds hope in the terpenes. “It may be best to avoid strains high in pinene, as the alerting effects may be anxiety-provoking and memory-enhancing to past trauma. However, strains higher in linalool may be anxiolytic and calming.

With an Organic Remedies’ Pharmacist guidance, quality of life reports continue to improve with the help of cannabis. Ye’s patient from the car accident is getting results from a higher CBD strain during the day. “Any 1:1 (CBD/THC) may be a suitable option, especially during the day. Limonene is an uplifting, antidepressant terpene that may be preferable during the day as well.”

With quality of sleep ranking high in PTSD patients another treatment may help at night. Ye says, “higher THC indica-dominant "Kush" and "Purple" strains may be effective towards the evening in treating sleep disturbances.”

An Organic Remedies pharmacist is always available to answer questions.

RESOURCES

From National Institute of Mental Health

Some factors that increase risk for PTSD include:

  • Living through dangerous events and traumas
  • Getting hurt
  • Seeing another person hurt, or seeing a dead body
  • Childhood trauma
  • Feeling horror, helplessness, or extreme fear
  • Having little or no social support after the event
  • Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
  • Having a history of mental illness or substance abuse

Some factors that may promote recovery after trauma include:

  • Seeking out support from other people, such as friends and family
  • Finding a support group after a traumatic event
  • Learning to feel good about one’s own actions in the face of danger
  • Having a positive coping strategy, or a way of getting through the bad event and learning from it
  • Being able to act and respond effectively despite feeling fear

Learn More

https://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-cope-with-disasters-and-other-traumatic-events/

https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/

https://www.nimh.nih.gov/get-involved/education-awareness/shareable-resources-on-ptsd

https://www.ptsd.va.gov/index.asp

https://www.ptsd.va.gov/professional/treat/txessentials/clinician_guide_meds.asp

https://medlineplus.gov/posttraumaticstressdisorder.html

Head shape with PTSD Post traumatic stress disorder.

710! Downright Upside Down!

On the heels of the July 4th holiday weekend, we are headed into a big weekend in the cannabis industry. July 10th, known as 710, is National Dab Day. Cannabis concentrate lovers around the globe celebrate July 10. The day now includes the celebration of all cannabis concentrate forms. During extraction, organic plant matter is separated from the plant’s resin containing cannabinoids, terpenes, and flavonoids.

Here are some forms of cannabis concentrates:

  • Shatter
  • Wax
  • Crumble
  • Budder
  • Live Resin
  • Terp Sauce
  • Diamonds
  • Hash
  • Distillate
  • Oil
  • Isolate
  • Rosin

Organic Remedies is also adding a new dab called “sap.” Our Sap syringes are a combination of distillate and high terpene extract (HTE) oils, giving you the best of both worlds in THC and terpene content. It is fully activated and may be ingested or vaporized.

No matter what form you enjoy, 710 gives a nod to all cannabis concentrate forms.

710 is World-wide 

According to market research and consulting company,  Grand View Research, the global marijuana extract market size was valued at $7.3 billion in 2019. Grand View says there is no sign of slowing down. Growing medical and recreational markets around the world have increased the global presence and popularity of cannabis concentrates.

Why July 10?

710 has become a worldwide phenomenon due to legal cannabis markets’ introduction of cannabis concentrates to consumers. So, now under “concentrates,” we see a range from THC-potent wax to CBD-rich tincture that can be consumed orally or sublingually.

710 is now the unofficial designation for cannabis extracts solely because when you flip the 710 date upside down, it spells oil. (See the video!)

What is 710 Day?

Naturally, 710 Day turned into a special day to honor the resinous oil that comes from the cannabis plant. Every year, July 10th (7/10) is an international holiday for cannabis enthusiasts. People all over celebrate by vaporizing a wide selection of concentrates, and even the use of transdermal patches and creams fall under the “7/10” celebration.

It’s all in the number(s)

Like many things in the cannabis industry, the history of national oil day (7/10) is a mystery. 710 really took off with the legalization of cannabis in early-adopting states. As medical and recreational programs became popular, patients and grower/processors began to realize the benefits of a concentrated form of cannabis – or 710 in cannabis-speak.

710 became a mainstay in the cannabis community with the introduction of the 710 Cup in 2012, which takes place on the 10th of July. The event recognizes the best products in a number of categories including Distillate, Concentrate Sativa/Indica/Hybrid, CBD Concentrate, and more categories.

Since then, 710 has become an easy way to talk about dabs and dabbing, in general. 7/10 may not be as culturally significant as 4/20, but it is a great holiday to enjoy alone or with friends.

Do Not Confuse the Numbers!

By now, most cannabis patients and rec users know about 420. It refers to the decades-old marijuana holiday that occurs on April 20 (4/20). Cannabis users around the world gather to celebrate the psychedelic plant. 420 began in the early 70’s in California. A group of San Rafael High School students who referred to themselves as “The Waldos.” would meet up at 4:20 pm after school to search for a rumored weed stash on school grounds. It turns out, one of the Waldos, Dave Reddix, got a gig as a roadie for the Grateful Dead where the term started picking up steam. Eventually, the band produced flyers to invite fans to join them for some good tunes and smoke at, yes, 4:20 PM.

Happy 710 Day

7/10 events span far and wide in legal states such as Colorado, California, Oregon, and Washington. Check out your nearest dispensary and favorite cannabis business for steep discounts on product and gear. If you love Piña Coladas, you can also celebrate National Piña Colada Day on July 10th. Love cats and kittens? 7/10 is also National Kitten Day.

If you have any questions about concentrates, don’t think you have to ask on 710! Our Organic Remedies pharmacists are always available to answer your questions.

710