Study: Terpene Levels in Cannabis Affect Patient Outcomes

A new study from researchers at the University of New Mexico found that, for medical cannabis patients seeking the most effective symptom relief, it all comes down to the terpene levels.

The research, published in the Journal of Cannabis Research, found that “[s]ymptom relief was greatest after consumption of plant variants with slightly higher than average levels of the terpenes myrcene and terpinolene and non-detectable levels of CBD.”

“In contrast, chemovars with any detectable levels of CBD (e.g., MC61 and MC62) provided the least relief, the fewest positive side effects, and the most negative and context-specific side effects. These findings are consistent with previous research showing that naturally abundant CBD in Cannabis flower may act as an inhibitor of optimal treatment for certain health conditions such as gastrointestinal pain,” the authors wrote. 

In their conclusion, they wrote that their “findings provide ‘proof-of-concept’ that a simple, yet comprehensive chemovar indexing system can be used to identify systematic differences in clinically relevant patient health outcomes and other common experiences across Cannabis flower products, irrespective of the product’s commercial or strain name.” 

“This study was limited by self-selection into cannabis and app use and a lack of user-specific information. Further research using this chemovar indexing system should assess how distinct combinations of phytochemicals interact with user-level characteristics to produce general and individualized Cannabis consumption experiences and health outcomes, ideally using randomized methods to assess differences in effects across chemovars,” they wrote. 

Terpenes are defined as “the primary constituents of essential oils and are responsible for the aroma characteristics of cannabis.” 

“Together with the cannabinoids, terpenes illustrate synergic and/or entourage effect and their interactions have only been speculated in for the last few decades,” read a 2020 study published at the National Library of Medicine. 

“Hundreds of terpenes are identified that allude to cannabis sensory attributes, contributing largely to the consumer’s experiences and market price. They also enhance many therapeutic benefits, especially as aromatherapy.”

As NORML noted in its own write-up about the study from the researchers at the University of New Mexico, preclinical data “demonstrates that select terpenes can modulate cannabinoid activity to produce enhanced therapeutic effects.”

NORML cited a case report “published late last year reported that an autistic patient responded more favorably to cannabis extracts containing select terpenes as compared to extracts without them.”

Participants in the study from the University of New Mexico self-administered the cannabis, and reported their results on a software program. 

“The initial dataset consisted of 252,344 sessions recorded by 13,771 users between June 6, 2016 and March 11, 2021,” the authors wrote. 

“Only the sessions using flower products (60.4% of total sessions) were included in the dataset, and 6.7% of the flower sessions included laboratory-provided information on the product’s terpene levels. Recorded potency levels for labeled THC, THCa, THCv, and THCva were aggregated (THC family), as were levels of CBD and CBDa (CBD family). To avoid confounding from user entry error, cutoff thresholds for cannabinoids and terpenes were selected based on the biological limitations of the Cannabis plant (Reimann-Philipp et al. 2020). The cutoff thresholds for reasonably labeled cannabinoid family levels were set at 35.0%/dry wt., and the cutoff for each of the 20 terpenes was set at 3.0%/dry wt. Sessions reporting levels that were higher than these cutoffs were excluded from the final analyses. Each product is unique at the user level, i.e., if two users were to purchase the same product, it would appear in the data as two separate products.”

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