Unveiling the Hidden Potential of Terpenes in Cannabis Medicine

Cannabis has long been celebrated for its therapeutic benefits, with most attributing its effects to the well-known cannabinoids, THC and CBD. However, there exists a class of compounds within cannabis that has been present since the dawn of time and holds significant biological potential yet remains under-appreciated by the medical establishment—terpenes in cannabis medicine. These aromatic compounds, numbering in the hundreds, not only contribute to the distinctive smell and flavor of cannabis but also exhibit promising medicinal properties. A recent study, titled “Terpenes from Cannabis sativa induce antinociception in a mouse model of chronic neuropathic pain via activation of adenosine A2A receptors,” highlights the powerful antinociceptive (pain relieving) effects of terpenes, providing new insights into their potential therapeutic applications.

Understanding Terpenes and Their Current Realities

Terpenes in cannabis medicine are volatile compounds found in many plants, including cannabis. They are responsible for the distinctive aromas of different cannabis strains and have been used in traditional medicine for centuries. Despite their historical use, the medical establishment has largely overlooked their therapeutic potential, focusing primarily on cannabinoids. However, recent research is beginning to uncover the significant role that terpenes can play in pain management and other therapeutic areas.

What does “Terpene” even mean?

Did you know? Terpenes are fascinating compounds that serve as the fundamental building blocks of many natural substances. Simply put, a terpene is any carbohydrate molecule with a series of carbon atoms. Like the word “shape,” which can describe an array of forms such as squares, triangles, and circles, “terpene” signifies a vast variety of compounds found throughout nature. These molecules are integral to the structure and function of countless living organisms. In the context of cannabis medicine, terpenes are the aromatic compounds responsible for the plant’s distinctive smell and flavor. While they were once believed to only contribute sensory characteristics like aroma and taste, recent studies have revealed their significant medicinal properties. This paper helps us see precisely how powerful and impactful these terpenes really are in medicine, highlighting their potential to revolutionize therapeutic applications.

Key Takeaways from this Study on Terpenes

The study “Terpenes from Cannabis sativa induce antinociception in a mouse model of chronic neuropathic pain via activation of adenosine A2A receptors” brings us a few amazing findings:

1. Pain Relief Comparable to Morphine: Terpenes from Cannabis sativa, that includes examples such as geraniol (think the smell of a geranium and the smell of roses), linalool (think lavender and its smell and suggested powers of wellness), α-pinene (think pine needles and the smell of forest), α-humulene (think woody, earthy, slightly spicy, as in hops, cannabis, sage, ginseng) and β-caryophyllene (think spicy, woody, and peppery, found in black pepper, cloves, hops, rosemary). In this study, just like in previous ones, these terpenes have shown remarkable pain relief in both humans and animals. In mice with chronic pain, the terpenes provided pain relief that was on par with morphine and the synthetic cannabinoid WIN55,212.

2. How They Work: The study found that terpenes help reduce pain by targeting the adenosine A2A receptor (A2AR). Lab tests showed that these terpenes activate this specific receptor directly.

3. Better with Morphine: When terpenes were used together with low doses of morphine, they provided even better pain relief. This suggests that combining them could reduce the need for higher doses of opioids and their side effects.

4. No High: Unlike opioids, terpenes didn’t cause a “high” or addictive behavior in the tests, indicating a lower potential for abuse.

5. Multiple Targets: The pain-relieving effects of terpenes were blocked when the cannabinoid receptor 1 (CB1) was inhibited, showing that terpenes work on multiple important receptors to relieve pain. For example, imagine the CB1 receptor as a lock on a door that helps reduce pain when unlocked. Terpenes can unlock this door to let the pain relief in. However, if you use a special key (an inhibitor) to lock this door, the terpenes can’t get through, and the pain relief doesn’t happen. This tells us that terpenes rely on more than one door (receptor) to provide pain relief, making them versatile and potentially more effective in managing pain.

Wait a Minute, Is This Study Mousy? Does that even matter? 

The researchers used an animal model to study the effects of terpenes from Cannabis sativa. Simply put, they conducted their experiments on CD-1 mice. Mice are commonly used in scientific studies because their genetics are consistent and well-understood by scientists. Using an animal model is a crucial part of research as it allows scientists to control the environment and variables, helping them understand how things work before moving on to human testing. This way, they can gather a lot of valuable information about how terpenes might help with pain relief and other issues, potentially leading to new treatments for people.

However, using mouse models has its downsides. Mice have different physiological and genetic makeups compared to humans, so results seen in mice don’t always translate directly to humans. For example, a compound that works well in mice might not be as effective in humans or might have different side effects. Additionally, mice can’t fully replicate the complexity of human diseases, especially chronic conditions and the multifaceted nature of pain in humans. These differences highlight the need for further research and clinical trials in humans to confirm the findings from mouse studies and ensure that potential treatments are safe and effective for people.

Study Type

This was an experimental animal study using CD-1 mice to look at how terpenes relieve chronic neuropathic pain. The results are promising, but further clinical research is required to see if they translate to human treatments.

Exploring the Mechanisms and Therapeutic Potential of terpenes in cannabis medicine

The study closely examined how these terpenes work, revealing their interaction with the adenosine A2A receptor. Lab tests and experiments using a specific A2A receptor blocker called istradefylline, along with targeted genetic techniques, provided strong evidence for this mechanism. Additionally, the terpenes showed significant anti-inflammatory activity, suggesting another way they might help relieve pain.

Viability as a Treatment Methodology

The findings of this study highlight the potential of terpenes in cannabis medicine as an effective treatment for chronic neuropathic pain. By activating the A2AR and reducing inflammation, terpenes could offer a new approach to pain management. The study also showed that when terpenes were combined with morphine, they provided even better pain relief, suggesting they could help reduce opioid dependency and the risks that come with it.

Interaction with Morphine

The interaction between terpenes in cannabis medicine and morphine is particularly significant. The study showed that all the tested terpenes enhanced the pain-relieving effects of morphine in chronic neuropathic pain models. This suggests that terpenes can boost the effectiveness of morphine, paving the way for combination therapies that could improve pain management and reduce the need for high doses of opioids.

For example, imagine a patient suffering from chronic neuropathic pain who is currently being treated with morphine. While morphine is effective, it comes with a host of side effects and risks, including dependency and tolerance, which often require increasing doses to achieve the same level of pain relief. By incorporating terpenes into the treatment plan, the patient could potentially achieve the same, or even better, pain relief with a lower dose of morphine. This combination could not only enhance pain control but also minimize the adverse effects associated with high-dose opioid use.

In practical terms, a doctor might prescribe a lower dose of morphine along with a terpene-rich cannabis extract. The terpenes, by enhancing the pain-relieving properties of morphine, could allow the patient to experience effective pain relief while reducing the overall opioid load. This approach could significantly decrease the likelihood of developing opioid dependency and other related side effects, ultimately leading to a safer and more effective pain management strategy.

Did you read the other recent blogs about cannabis oil and pain relief?  Check out cannabis oil for chronic pain here.   Or check out cannabis and opioids here

Confidence in the Mechanism of Action

The study offers strong evidence that terpenes reduce pain by interacting with the adenosine A2A receptor. The adenosine A2A receptor is a protein found on the surface of certain cells throughout the body, including in the brain, heart, and immune system. It plays a key role in regulating various physiological processes, such as pain perception and inflammation. It works by binding to adenosine, a naturally occurring molecule in the body, which then triggers a series of cellular responses that can modulate pain and inflammatory signals.

These findings match up well with other research showing the A2A receptor’s role in managing pain, which boosts confidence in the explanation of this study. However, more research, including clinical trials with humans, is needed to confirm and fully understand these results, particularly has these effects change with things like the environment, our genes, and social factors.

How Do Terpenes Interact with Opiates for Pain Relief?

The study suggests a few ways that terpenes and opioids might work together to relieve pain:

Synergistic Effects: Terpenes combined with morphine can enhance pain relief

Receptor-Mediated Interactions: There might be some interaction or modulation between the signaling pathways of their respective receptors.

Anti-Inflammatory Effects: Both terpenes and opioids have anti-inflammatory properties, which could work together to reduce inflammation

Differential Receptor Activation: Terpenes and opioids might complement each other by activating different receptors to modulate pain.

Study Limitations

The study acknowledges several limitations, including:

Analgesic Tolerance: Lack of direct measurement of analgesic tolerance to A2AR agonists.

Translational Features: Need for further investigation of dosing routes and bioavailability.

Reward Liability Testing: Limited exploration of the affective properties of terpenes.

Clinical Translation: Necessity for additional clinical studies to evaluate safety and efficacy in humans.

Applicability to Humans

While the study gives valuable insights from preclinical tests, it doesn’t discuss in detail how these findings apply to humans. More research, including studies on how the body processes terpenes and clinical trials, is needed to understand their potential benefits in human pain management.

Wrapping This Up, Applying it to The Real World

This study highlights the often-overlooked potential of terpenes in cannabis medicine. By elucidating their mechanisms of action and demonstrating their synergistic effects with morphine, this research paves the way for developing novel pain management therapies that could reduce opioid dependency and improve patient outcomes. As the medical community continues to explore the therapeutic applications of cannabis, terpenes may emerge as a critical component in the future of pain management and beyond.

Prevalence of Terpenes:

Terpenes are incredibly prevalent in nature, found in a wide variety of plants beyond cannabis, including fruits, vegetables, and herbs. These aromatic compounds are responsible for the distinct smells and flavors of many plants, such as the citrus scent of oranges, the refreshing aroma of pine trees, and the soothing fragrance of lavender. The sheer abundance and diversity of terpenes make them an accessible and versatile resource for medicinal purposes.

Potential of Plant Medicine and terpenes in cannabis medicine:

The findings of this study underscore the significant opportunity for plant medicine to support, and potentially compete with, the efficacy of traditional anti-inflammatories. Terpenes, with their demonstrated anti-inflammatory properties, present a natural alternative to synthetic drugs like NSAIDs (non-steroidal anti-inflammatory drugs). NSAIDs, while effective, often come with side effects such as gastrointestinal issues and increased risk of cardiovascular problems. In contrast, terpenes could offer a safer, plant-based option for managing inflammation and pain.

Synergy with Traditional Treatments:

Furthermore, the study’s evidence of synergistic effects when terpenes are combined with morphine highlights the potential for integrated treatment approaches. By enhancing the pain-relieving effects of opioids, terpenes could allow for lower doses of these potent drugs, thereby reducing the risk of dependency and adverse effects. This synergy not only promises more effective pain management but also aligns with a growing interest in complementary and integrative medicine.

Broader Implications for Pain Management:

As research continues to uncover the therapeutic benefits of terpenes, their role in pain management could expand significantly. Terpenes’ ability to interact with multiple receptors and pathways in the body suggests a multifaceted approach to pain relief, addressing both nociceptive and inflammatory pain. This could lead to more personalized and holistic treatment strategies that leverage the natural compounds found in plants.

Economic and Environmental Benefits:

Beyond the health benefits, the increased use of terpenes in medicine could have positive economic and environmental impacts. Cultivating terpene-rich plants for medicinal purposes supports sustainable agriculture and reduces reliance on synthetic pharmaceuticals. This shift could lead to more eco-friendly production processes and a reduced environmental footprint for the healthcare industry.

Future Directions

The promising results from this study should encourage further exploration into the clinical applications of terpenes. Future research should focus on conducting comprehensive clinical trials to confirm the safety and efficacy of terpenes in human subjects. Additionally, studies should investigate the optimal methods for extracting and administering terpenes to maximize their therapeutic benefits.

As the landscape of medical treatment evolves, the integration of terpenes and other plant-based medicines into conventional healthcare could revolutionize how we approach pain management and inflammation. By embracing the potential of these natural compounds, we can look forward to a future where plant medicine plays a central role in promoting health and well-being.

References for Further Reading:

1.Russo, E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344-1364.

2.Cox-Georgian, D., Ramadoss, N., Dona, C., & Basu, C. (2019). Therapeutic and Medicinal Uses of Terpenes. In Medicinal Plants (pp. 333-359). Springer, Cham.

3.Blaskovich, M. A. (2016). Antibiotics: from chemical warfare to anti-infective therapeutics. Advances in Pharmacology, 73, 3-32.

4.Maida, V., & Daeninck, P. J. (2016). A user’s guide to cannabinoid therapies in oncology. Current Oncology, 23(6), 398-406.

5.ElSohly, M. A., & Slade, D. (2005). Chemical constituents of marijuana: The complex mixture of natural cannabinoids. Life Sciences, 78(5), 539-548.

6.McPartland, J. M., & Russo, E. B. (2001). Cannabis and cannabis extracts: greater than the sum of their parts? Journal of Cannabis Therapeutics, 1(3-4), 103-132.

7.Pertwee, R. G. (2006). The pharmacology of cannabinoid receptors and their ligands: an overview. International Journal of Obesity, 30(S1), S13-S18.

8.Parker, L. A., Rock, E. M., & Limebeer, C. L. (2011). Regulation of nausea and vomiting by cannabinoids. British Journal of Pharmacology, 163(7), 1411-1422.

9.Booz, G. W. (2011). Cannabidiol as an emergent therapeutic strategy for lessening the impact of inflammation on oxidative stress. Free Radical Biology and Medicine, 51(5), 1054-1061.

10.Hill, K. P. (2015). Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: a clinical review. JAMA, 313(24), 2474-2483.