“Isolating an active constituent from a plant is an affront to nature. It is like taking the intelligence and leaving the wisdom behind.” -Deepak Chopra
Awhile back I posted the above quote on Twitter. I work in the cannabis industry, where whole-plant medicine evangelists are common, and it might fairly be said that I belong among their ranks. The “entourage effect” — the concept that when it comes to cannabinoids, flavonoids, and terpenes “the whole is greater than the sum of its parts” — is widely discussed and lauded, and I have seen enough evidence that I believe it.
But because this is social media, it only took a moment for someone to respond that aspirin, codeine/morphine, taxol, quinine, and digoxin are examples of vital medicines based on isolated chemicals from plants. And this is true. But it is also misses the point.
The scientific method relies on minimizing variables, ideally dealing with only one at a time. This gives us rock-solid data, and for this reason, Western medicine avoids treating disease with whole-plant compounds, preferring a single active ingredient delivered via inert carriers. However, Western science is excruciatingly slow in the face of complexity, particularly when research is politically and financially discouraged. And from cannabis there is massive and growing evidence that complexity can actually enhance and tailor efficacy.
Due to prohibition, cannabis plants have in recent history been bred to maximize THC, their marketable “active ingredient,” at the expense of all other components. However, when completely isolated, THC gives an unpleasant high—anxious and dissociative. Similarly, Marinol, the synthetic version of THC, is notoriously nauseating and ineffective. That’s because in the natural plant secondary cannabinoids, flavonoids, and terpenes serve to ballast the less desirable side effects of THC, and they are present in significant quantities in even the most THC-dominant flower. If the variously amplifying and insulating qualities we call the entourage effect are true for cannabis, could they be true for other plant-inspired medicines as well?
Take a classic plant-derived medicine as an example. Aspirin is acetylsalicylic acid, a synthetic analog of a compound in willow bark called salicin, which has analgesic and anti-inflammatory properties. However, the salicin in willow is present in quantities too low to be effective–aspirin is an order of magnitude stronger than willow bark tincture. But that proportion could easily be adjusted through compounding and, unlike aspirin, willow does not damage the intestinal mucosa. If salicin was delivered at high potency in the presence of native phytochemicals would it be more effective and have fewer side effects? In fact, this study found exactly that.
Or imagine if we bred to maximize the most effective ingredients, as we do with cannabis, but still delivered them in a native phytochemical context?
This is not to say that all synergies would be positive. It is possible that under some circumstances undesirable effects would be heightened and desirable ones muted. I am only encouraging an avenue of thought, and I’m likely not the first to have this idea. Herbal medicine practitioners are already working along these lines. I’m hopeful that the shaded and much winding path cannabis has taken to its present form can inspire new areas of exploration in medicine.
|Differences in receptor binding affinity of several phytocannabinoids do not explain their effects on neural cell cultures. – PubMed – NCBI www.ncbi.nlm.nih.gov Neurotoxicol Teratol. 2014 Nov-Dec;46:49-56. doi: 10.1016/j.ntt.2014.09.003. Epub 2014 Oct 12. Research Support, Non-U.S. Gov’t|
|Cannabis with high cannabidiol content is associated with fewer psychotic experiences. – PubMed – NCBI www.ncbi.nlm.nih.govSchizophr Res. 2011 Aug;130(1-3):216-21. doi: 10.1016/j.schres.2011.04.017. Epub 2011 May 17. Research Support, Non-U.S. Gov’t|