Dr. Anden is a board-certified physician and a recommending cannabis doctor in her home state of Utah. We interviewed her about terpenes and how they can enhance a patient’s experience with medical marijuana.
Dr. Anden: Terpenes are the plant compounds that give cannabis, and all aromatic plants in fact, their flavors and aromas—such as roses, tea, or lemons. It’s the terpenes that give marijuana that distinctive, skunky smell. Strain by strain, though, it’s the terpenes adding their own twist: notes of pine or citrus or blueberries, etc. And there’s another big difference: terpenes are also medicinal. Each possesses certain properties ranging from treating inflammation, to pain, to insomnia. Some terpenes even have antibiotic and/or antifungal properties. And every kind of aromatic plant has a different, unique combination of terpenes.
In the cannabis family, terpenes explain how different strains of marijuana have wildly different effects — such as indicas that relax, or sativas that energize. In fact, you could have two identical strains in terms of their make-up — let’s say the same exact percentage of THC to CBD to CBN listed on the package — and yet it will be the terpenes that give a marijuana strain its unique characteristics and additional healing properties.
Terpenes can be isolated. They’re non-psychoactive, so like CBD, they’re sold legally in all 50 states as food additives or even as supplements, like you’d take fish oil capsules. Or, if desired, terpenes can be explored as a supplemental therapy alongside medical cannabis.
As for what conditions can be treated with terpenes, either in isolate or as part of the whole plant: the list is probably as long as the number of terpenes out there. And that number is currently in the two- hundreds, I believe. You really only ever hear of about 6-8, though. Myrcene is one of the most common, and can bring on a sedating or lazy effect. Linalool, the same compound found in lavender, can have a relaxing effect. Pinene has an antibacterial effect. And so on.
Dr. Anden: If a patient of mine comes in with a health complaint, we first and foremost aim to address that complaint. And that might start with my recommendation to work with cannabis medicine in a specific formula, whether a high-to-low or low-to-high ratio of CBD to THC. But then I go on to really talk to my patients about the details—and this is where terpenes come in—to find out how we can layer on and accommodate other preferences, habits, and health considerations, on top of the principal diagnosis.
Such as, the time of day they plan to take their medication, to determine whether I’d recommend a daytime sativa, or an indica strain for nighttime use. Or perhaps they want to treat anxiety, or at least not exacerbate anxiety, on top of their treatment for pain, for which I’d recommend a nice hybrid. Of course, as a doctor I can’t be at the dispensary helping my patient make strain decisions or purchases. But I’ll try to educate them on how to get the best effects, and greatest value, from their medicine.
Dr. Anden: Phytocannabinoids are plant compounds in cannabis that share a similar structure, and can therefore mimic our own endocannabinoids, and interact with receptors throughout the body. Terpenes, though not as strong, are helper-compounds that step in to support and activate the phytocannabinoids in cannabis. Funnily, both work better together than they do on their own, a phenomenon called the “entourage” effect. In other words, using the whole plant can be far more powerful than any of its components in isolate.
Dr. Anden: It depends on the person. Many patients of mine have been long time marijuana users and yet (due to access and legality), a large percentage don’t know the difference between sativa and indica, let alone have heard of a terpene or understand what it does. So I try to educate them. And if I get the sense that a patient is interested, we’ll go deeper. Or, if they’re new to cannabis, or seem happy to stick to the basics, we’ll skip a lot of the terpene talk. But we do discuss it, and often patients admit to having noticed many of these effects on their own, and are happy to know more about the terpenes responsible.
But yeah, folks can get really into it, as far into it as coffee connoisseurs or wine sommeliers—because this is where you get into the subtleties of flavor and nuance. There are even contests where you try to identify marijuana strains or even what terpenes are present—and therefore what effects that strain will have on the body—and the experts can do that with just a sniff. It’s amazing.
Dr. Anden: They’re related, but terpenes are a little different than aromatherapy. For starters, in aromatherapy you use the essential oils of a plant. Terpenes come from the essential oils of a plant, but they’re the isolated compounds that make up that essential oil—and while you can isolate terpenes themselves, they won’t have that carrier oil, or volume, that an aromatherapy product would, say, at the spa. Not to mention, aromatherapy uses only receptors in your nasal passage, your sense of smell. It’s still a direct input into your brain, which is one of the reasons why smell is so powerful. Cannabis can interact with a wider variety of receptors and can be taken several different ways.
Wine is another slightly problematic metaphor. Alcohol goes in pretty much one way: you drink it, and its single effect is pretty straightforward: you get drunk. But due in large part to its terpene content, cannabis has far more to offer in terms of versatility and health applications.
There is one manner in which the wine metaphor holds up though: the same way a grape varietal can be grown in a different geographical location and have a slightly different taste, so too can cannabis flower. The soil, topography, and climate can all affect which terpenes emerge—there are no two cannabis plants whose chemical signature is exactly alike. In other words, terroir can be as important to enthusiasts of cannabis as it can be to wine lovers, and most of that is about the terpene profile. Not only do my patients find it enjoyable from a flavor and aroma standpoint—terpenes are also what helps make marijuana the versatile and medically powerful plant that it is.
Dr. Corey Anden is a four-time board certified physician who’s been specializing in sports medicine and pain for over 35 years, and more recently as a cannabis-recommending physician for her patients in the Ogden, UT area. Her deep medical experience has meant that Dr. Anden is well versed in the many benefits—and little risk—of medical cannabis, and enjoys bringing more relief to her patients for a wider array of conditions.
Sarah A Lybrand is a writer specializing in lifestyle, health, finance—and fun. She’s written for Bust, Juno, Yahoo, MarketSmiths, and Toast Media, among many others. https://www.linkedin.com/in/sarahlybrand/