A comprehensive guide to the medicinal properties of cannabinoids, terpenes, and flavonoids in cannabis
An extensive review catalogued the individual medicinal properties of major and minor cannabinoids, terpenes, and flavonoids that contribute to the entourage effect, with accumulating evidence for pain and potential in opioid reduction.
Quick Facts
What This Study Found
This comprehensive review examined the medicinal properties of individual components in cannabis well beyond the usual focus on THC and CBD. The author catalogued the therapeutic potential of major and minor cannabinoids, primary and secondary terpenes, and flavonoids, explaining how these work synergistically to produce what is called the entourage effect.
For pain and migraine specifically, the review found accumulating evidence for therapeutic benefits, though most evidence comes from studies of general chronic pain rather than headache-specific trials. The review also identified supporting evidence that cannabis may assist in opioid detoxification and weaning, positioning it as a potential tool against the opioid epidemic.
The detailed profiling of individual compounds enables understanding of why different cannabis strains produce different effects. For example, the terpene beta-caryophyllene activates CB2 receptors and has anti-inflammatory properties, while myrcene has analgesic and sedative effects. Knowledge of these individual properties is necessary for developing strain-specific treatments targeted at specific conditions.
Key Numbers
Cannabis contains over 100 cannabinoids, numerous terpenes, and various flavonoids. The review covered major cannabinoids (THC, CBD, CBG, CBN, CBC, THCV), primary terpenes (myrcene, limonene, linalool, alpha-pinene, beta-caryophyllene), secondary terpenes, and multiple flavonoids with individual medicinal property profiles.
How They Did This
This was a comprehensive narrative review of the medical literature covering the use of cannabis and cannabinoids in pain, migraine, headache, and facial pain, combined with a detailed examination of the pharmacological properties of individual cannabinoids, terpenes, and flavonoids.
Why This Research Matters
Most cannabis research and clinical discussion focuses narrowly on THC and CBD, but cannabis contains over 100 cannabinoids plus numerous terpenes and flavonoids. Understanding the individual and synergistic properties of these compounds is essential for developing standardized, condition-specific cannabis medicines rather than treating all cannabis as a single drug.
The Bigger Picture
Cannabis science is moving from a THC/CBD binary toward precision medicine that considers the full chemical profile of cannabis products. This review provides the foundation for that approach by systematically documenting what each component does. As production standards become more regulated, this knowledge enables breeding and formulation of strain-specific therapeutic products.
What This Study Doesn't Tell Us
Much of the evidence for individual compounds comes from preclinical or in vitro studies rather than human clinical trials. The entourage effect, while plausible, has limited direct clinical evidence. The review necessarily covers a vast amount of pharmacological data, and the depth of evidence varies widely across compounds.
Questions This Raises
- ?Can the entourage effect be quantified and optimized for specific conditions?
- ?Will strain-specific clinical trials produce better outcomes than studies using single-compound preparations?
- ?How should the terpene and flavonoid profiles of cannabis products be regulated and labeled?
Trust & Context
- Key Stat:
- Over 100 cannabinoids plus terpenes and flavonoids work synergistically in the entourage effect
- Evidence Grade:
- This is a comprehensive narrative review synthesizing evidence across many compounds, with evidence quality varying from preclinical to clinical across different components.
- Study Age:
- Published in 2018. Cannabis science, particularly around minor cannabinoids and terpenes, has continued to advance rapidly.
- Original Title:
- Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science.
- Published In:
- Headache, 58(7), 1139-1186 (2018)
- Authors:
- Baron, Eric P(4)
- Database ID:
- RTHC-01586
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
What is the entourage effect?
The entourage effect refers to the synergistic interaction between cannabinoids, terpenes, and flavonoids in cannabis. Rather than each compound working independently, they enhance or modify each other's effects. This is why whole-plant cannabis products often produce different effects than isolated compounds like pure THC or CBD.
Can cannabis help with the opioid crisis?
This review found supporting evidence that cannabis may assist in opioid detoxification and weaning. Combined with survey data showing patients substituting cannabis for opioids, this suggests cannabis could play a role in reducing opioid dependence, though rigorous clinical trials are still needed.
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Cite This Study
https://rethinkthc.com/research/RTHC-01586APA
Baron, Eric P. (2018). Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science.. Headache, 58(7), 1139-1186. https://doi.org/10.1111/head.13345
MLA
Baron, Eric P. "Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science.." Headache, 2018. https://doi.org/10.1111/head.13345
RethinkTHC
RethinkTHC Research Database. "Medicinal Properties of Cannabinoids, Terpenes, and Flavonoi..." RTHC-01586. Retrieved from https://rethinkthc.com/research/baron-2018-medicinal-properties-of-cannabinoids
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.