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FUTURE ACMES OF BHANGA (Cannabis sativa L.): AYURVEDA BACKGROUND AND CONTEMPORARY RESEARCHES

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Cannabis

ABSTRACT


Vijaya (Bhanga) or Cannabis sativa L. is a reputed plant ascribed in traditional system of medicine since centuries. Ayurveda enumerates the therapeutic use of Vijaya in the management of Shool (pain), Grahani rog (Irritable bowel syndrome), Nidra-naash (Insomnia), Jwara (Fever), Agnimandya (loss of appetite), Prameha (Diabeties) etc. Due to certain illegalities and drug abuse, the same has never received any recognition in the past decades despite hundreds of benefits. Recent studies suggest that the appropriate and ethical use of cannabis can help in treating number of diseases i.e. IBS, Epilepsy, multiple sclerosis, insomnia, anxiety and degenerative diseases. It has been found that various phytochemicals mainly cannabinoids are responsible for the therapeutic activity of Bhanga. Thus the salient observations of Bhanga are gathered from classical Ayurvedic and contemporary researches to highlight the therapeutic potential of the novel drug, Cannabis sativa in management of few important ailments, i.e. IBS, epilepsy and cancer and associated symptoms of ailments i.e. pain, insomnia etc.

BHANGA IN AYURVEDA LIERATURE:


Bhanga is one of the plant origin drug which has found its place in Ayurveda classics from medieval period due to its exceptional properties and actions. Since then, the detailed aspects of Bhanga has been explored including purification methods, therapeutic uses and contra-indications. Around 40 synonyms of Vijaya has been mentioned owing to its morphological characteristics i.e, Samvidmanjari (the drug having potent inflorescence), pharmacological properties i.e. Bahuvadini (it causes verbosity), Madini, Mohini, Ganja, Matulani (excessive use may cause delirium), Ananda (having soothing effect) and many more. Bhanga, Charas and ganja are three forms of its usage being Bhanga (dried leaves of plant) the most common (Acharya R. et al., 2015). It has tikta rasa, ushna virya, laghu tikshna gunas and katu vipaka. It alleviates kapha and vata doshas, increases pitta having dipana, pachana, ruchya, grahi, madkari and vyavayi properties. Rasshastra texts describes Vijaya as Upavisha vargaas the excessive use of the herb manifests toxic effects on the CNS. Sharangdhar also mentions this drug under madkaari dravyas which affects the buddhi (CNS) due to virtue of its tikshna, ushna properties and prabhav. It also increases agni (digestive fire) and pitta because of tikta rasa and ushna virya. It has been described for the treatment of various diseases which includes Nidranasha(insomnia), Atisara (diarrhea), Grahani rog (IBS), Mandagni(loss of appetite) (B.P.Ci.1.325), Kushtah(skin disorders) (VM.51.56-57 also SB.4.832), Prameh(Diabeties mellitus), Unmada( anxiety neurosis), Ardavabhedak(hemicrania), Nadi daurbalya (neurological weakness), Shosh (emaciation) and Dhanusthambha (stiffness of back). Besides its wide range of therapeutic utility, highest number of formulations is advised in Grahani (30), followed by Jwara (17), Atisara (9), Agnimandya (7) and Prameh (6) (Acharya R. et al., 2015).

CONTEMPORARY VIEW ON BHANGA:

Cannabis sativa is a dioecious and occasionally monoecious plant which belongs to cannabinaceae family and is found in regions ranging from sea level to the temperate and alpine foothills of the Himalayas. In the last few years, use of cannabis or medical marijuana is gaining momentum due to its wide range of therapeutic potential. According to WHO, it is the most commonly cultivated, trafficked and abused drug globally. Cannabis has bad reputation as it is the common psychotic and recreational drug. However, it has been used in folklore practices since ages as medicine, fuel source, source of paper, building materials and textiles (Small and marcus,2002). Marijuana is prepared from the dried flowering tops and leaves; hashish consists of dried cannabis resin and compressed flowers (Ashton, 2001) which are consumed by humans. Wide range of complex phytochemicals namely cannabinoids, terpenes and phenolic compounds have been found in cannabis which are responsible of its multipurpose therapeutic applications as well as psychotropic effects. Carbohydrates, fatty acids and their esters, simple amides, amino acids, phytosterols, phenolic compounds are also identified. Antibacterial (G. appendino, 2008), antimicrobial (Esra M. M. ali et al. 2011), analgesic and anti-inflammatory activities (formukong EA et al 1988) have also been reported. It is also used in the management of pain, chemotherapy-induced nausea and vomiting among cancer patients (Machado Rocha et al., 2008), post-traumatic stress disorder, epilepsy, cachexia, degenerative neurological conditions (CDPHE,2016; OHA-2016). and for relief of spasticity in multiple sclerosis patients (Sastre-Garriga et al., 2011) Pre-clinical and clinical studies conducted in recent era suggest its efficacy and medicinal importance, which is mainly due to the presence of cannabinoids. The Endocannabinoid system (eCBD) which consists of endogenously produced cannabinoids, receptors and metabolizing enzymes have been found in the various part of the human body including central nervous system, gastrointestinal system, connective tissues and immune cells. (M.B. Bridgeman,2017) plays an important role in the physiological and pathological processes. It acts as protective system against the pathology of certain diseases like IBS, migraine, anorexia, multiple sclerosis and schizophrenia. Lack or abnormalities in eCBD system ramificates these diseases. Hence, exogenous cannabinoids derived from cannabis sativa can act as potent medicine.

Phytochemicals


Delta 9 tetrahydracannabinol is the primary active cannabinoid present in cannabis sativa which is responsible for its pyschotic effects. It is a potent analgesic, antiemetic, anxioltic, appetite stimulant, hypnotic, antipyretic and anti-spastic agent (Jeffrey K Aronson 2014). The other important cannabinoid constituent of current interest is cannabidiol (CBD)The extract of Cannabis sativa contains more than 60 terpeno-phenolic compounds namely phytocannabinoids, cannabidiol and cannabinolic acid. Non-cannabinoid compounds are also found which are 30 times more efficacious than aspirin in pain. Proteins, amino acids, glycoproteins, sugars, ketones, aldehydes, fatty acids, steroids, flavonoids and vitamins are also identified. (Asati A. et al, 2017)

FUTURE PROSPETCS OF BHANGA FOR MEDICAL SCIENCE:


Pain
Pain is a crucial aspect of the body’s defence mechanism and it is a part of a rapid warning relay instruction the motor neurons of the central nervous system to minimize physical harm. (Emanuel LL et al, 1999; 1-37). In pathophysiology of neuropathic and inflammatory pain, receptors CB1 and CB2 along with prostaglandins, serotonin, bradykinin and epinephrine get involved in the mediation of inflammatory response. Cannabinoids present in cannabis are CB1 and CB2 agonist whereas Non cannabinoid compounds inhibit the release of prostaglandins and is 30 times more potent than aspirin. Preclinical and clinical studies have also been conducted which proves cannabis to be a promising analgesic. Thus, for quick and effective pain management, Bhanga may be used. The references for use of Bhanga in pain management can be retrieved from medieval Ayurvedic classics. Its rational use as a single or adjuvant drug candidate may be done in present scenario to relieve agony in a wide spectrum of diseases.

IBS
Irritable bowel syndrome or disease is characterized by abdominal pain, diarrhoea, constipation or a combination of both diarrhoea and constipation, mucus discharge along with stools and changes in the form (appearance) of stools. (Azpiroz F, Dapoigny M,2000). It is one of the most prevalent gastrointestinal problem affecting globally. Inflammation and hypersensitivity of the colon in response to stress, food, physical stimulant and idiopathic factors are of primary concern in the pathogenesis of IBS. Receptors CB1 and CB2 are found in all the layers of intestinal sections, including the mesenteric and sub mucosal plexus and the epithelium responsible for inflammatory response mediation. Cannabinoids by their agonist effects on CB1 and CB2 have proinflammatory effects and helps in the reduction of inflammation of intestinal mucosa which helps relieve the disease (Waseem Ahmed ,2016). In Ayurveda, Bhanga is the key plant for effective management of troublesome disease IBS.

Epilepsy
Epilepsy affects about 50 million people throughout the world and is especially common in childhood and in elderly people. “Epilepsy” is the condition of recurrent, unprovoked seizures which has numerous causes, each reflecting underlying brain dysfunction (Shorvon et al. 2011). Root cause of epilepsy may either be at circuit level primarily abnormal synaptic transmission or at the receptor level. It has been found that cannabinoid receptors CB1 and CB2 are present in the central nervous system and are termed as endogenous cannabinoids. Control in Synaptic transmission and regulation of the rate of neuronal firing are vital role of CB1 and CB2 receptor respectively. Activation of these receptors with cannabinoids results in the inhibition of synaptic transmission along with glutamate release (Zou S. et al,2018). Various studies suggest that the therapeutic use of cannabinoids targets the signalling pathway which results in epileptic seizures.

Cancer

WHO defines cancer as the uncontrolled growth and spread of cells which can affect almost any part of the body. The growths often invade surrounding tissue and can metastasize to distant sites. The global cancer burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. Inflammatory conditions and carcinogenesis share same common pathways such as proliferation, increased survival of cells and migration where cytokines and growth factors play an important role. In the formation of tumour, inflammatory mediators regulate a number of proinflammatory responses through inhibition of protective immune response. (F. pellati et al ,2018). The presence of CB1 and CB2 receptors on immune cells suggests their important role in the regulation of the immune system. By targeting the ECS, cannabinoids affect many essential cellular processes and signalling pathways which are crucial for tumour development. Experimental studies using cancer cell lines and genetically engineered mouse models reveals that the activation of CB receptors by cannabinoids is antitumorigenic in most cases mainly breast, prostate and glioma cancer cell lines. it inhibits tumour cell proliferation, induces apoptosis in vitro, blocks angiogenesis and tumour invasion/metastasis in vivo (Darris et al, 2019). Derivatives from Bhanga, cannabinoids and cannabis-based pharmaceutical drugs have been the subject of intensive research for their potential antitumor activity.

CONCLUSION

Bhanga or Cannabis sativa L. has tremendous potential in the field of medicine which was described hundreds of years ago in Ayurvedic scriptures. The use of Vijaya is described in the management of Shool (pain), Grahani (IBS) and Apasmar (Epilepsy) in different Ayurvedic texts. The pharmacodynamics of the drugs may be explained on the basis of pharmacodynamics attributes i.e. Rasa, Guna, Veerya, Vipaka and Prabhava of the plant. The dosha dominance in Shool (pain) is Vata which get alleviated by Ushna virya of Bhanga. One of the important properties of the drug is Grahi, deepana and pachana due to its tikta rasa and ushna virya. Due to this activity, it is very beneficial in the management of Grahani and Sangrahani (vata-kaphaj). Ushna, tikshna and vyavayi gunas helps it to get absorbed efficiently in the body specially Srotas. As Apasmar is a disease of Manovaha-srotas, these Gunas help pacifies the doshas infiltrated in these srotas. The contemporary researches reveal that the various phytochemicals or cannabinoids mainly delta 9 tetrahydrocannabinol and CBD (cannabinol) are the most promising compound present in Cannabis sativa which are responsible for its therapeutic potential. Cannabinoids derived from cannabis acts as CB1 and CB2 agonists and activate these endocannabinoid receptors where the pathology exists whether in the Gastrointestinal system, CNS or Immune system. Anti-inflammatory, Anti-oxidant, Anti-bacterial and anti-microbial activities have also been identified. Bhanga (Cannabis sativa) can be a promising drug in future however few issues regarding its legalization, availability, quality and safety should be in consideration. Moreover, further extensive research should be done in order to enlighten about the use and implication of cannabis in diseases described in Ayurveda along with its pharmacokinetic and pharmacodynamic studies.

References:
Acharya R. et al. (2015) ‘Vijaya (Cannabis sativa Linn.) and its therapeutic importance in Ayurveda; a review’ J.D.R.A.S. Vol.1 No.1 pp 1-12.
Ahmed W. et al. (2016) ‘Therapeutic use of cannabis in Inflammatory Bowel Disease.’ Gastroenterology & hepatology volume 12, issue 11
Ashton, (2001) ‘Pharmacological and effects of cannabis: A brief review’ British Journal of Psychiatry 178,101-106
Appendino G., (2008) ‘Antibacterial cannabinoids from Cannabis sativa:A structure-activity study’ J. Nat. Prod. 71,1427-1430
Asati A. et al, (2017) ‘Pharmacological and phytochemical profile of Cannabis sativa L.’ Int. J. Ind. herbs drugs, Vol-2, Issue 2
Azpiroz F, Dapoigny M (2000) ‘Nongastrointestinal Disorders in the Irritable Bowel Syndrome’ S. Karger AG, Basel Vol.62, No.1
Bhavprakash Samhita 1.325
CDPHE,2016; OHA-2016
Darris et al, (2019) ‘Cannabinoids in cancer treatment: Therapeutic potential and legislation’ Bosnian Journal of Basic Medical Sciences

Esra M. M. ali et al. (2011) ‘Antimicrobial Activity of Cannabis sativa L.’ Chinese Medicine, 2012, 3, 61-64
Formukong EA et al (1988) ‘Analgesic and Anti-inflammatory activity of constituents of Cannabis sativa L.’ SpringerLink pages361–371(1988)
F. Pellati et al (2018) ‘Cannabis sativa L. and Non-psychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer’ Hindawi BioMed Research International Journal
Jeffrey K Aronson (2014) ‘Plant Poisons and Traditional medicines’ Elsevier manson’s tropical infectious diseases (23rd edition)
M.B. Bridgeman (2017) ‘Medicinal Cannabis: History, Pharmacology,And Implications for the Acute Care Setting’ P & T Vol. 42 No. 3

Sastre-Garriga et al. (2011) ‘THC and CBD oromucosal spray (Sativex®) in the management of spasticity associated with multiple sclerosis’ Expert Review of Neurotherapeutics Volume 11, 2011
Shorvon et al. (2011) ‘The etiologic classification of epilepsy’ Epilepsia journal

Small and marcus (2002) ‘Hemp: A new crop with new uses for North America’ p. 284–326. In: J. Janick and A. Whipkey (eds.)
VrindaMadhav.51.56-57
Zou S. et al (2018) ‘Cannabinoid Receptors and the Endocannabinoid System: Signalling and Function in the Central Nervous System’ Int. J. Molecular Science

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Telemedicine in cannabis

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telemedicine in cannabis

As far fetched these terms might sound together, the reality is shifting. While cannabis legalisation policies still remain a hindrance, many places across the world are gradually seeing cannabis being legalised. As both telemedicine and cannabis are rather contemporary subjects, it remains to be seen the evolution of telemedicine in cannabis

Telemedicine refers to the provision of remote clinical services, via real-time two-way communication between the patient and the healthcare provider, using electronic audio and visual means. In layman’s language, it is online appointment and treatment of the disease of a patient by a doctor.

Medicinal cannabis as well as telemedicine, merge of these relatively new concepts, has been done, as their evolution has been happening on a parallel note. Having said that, telemedicine in cannabis has a lot of scope, that is yet to be studied and explored. In this article, we look at few of the results that have been arrived at, to gain some insight into this relatively new fusion of the concepts.

Telemedicine in India

In a country like India, where 65 percent of the population is rural, telemedicine has proved to be an extremely effective and efficient method of treating people from a distance, as rural India has been bereaved of good health facilities providing a scope for improvement of the telemedicine sector.

In a developing country like India, it is the need of the hour that the new innovations made in the health and wellness sector, reaches to the poor in India, as they need it the most.

Ayushman Bharat Scheme, a government infused finance scheme for the health sector in India, has directed a significant amount of its funds for building infrastructure for the growth of telemedicine in India. It remains to be seen, how patients from the rural areas, react to this modern way of treatment.    

Cannabis and telemedicine: A partnership

The link between telemedicine and medicinal cannabis is coming up with medicinal cannabis emerging as a potential therapy for nicotine, alcohol and opioid use disorders. And since these disorders are primarily associated with psychotherapy, giving it over online is convenient.

Studies have revealed that amongst patients availing treatment using telemedicine, patients with drug related disorders have the highest patient satisfaction. Since telemedicine is a cross platform, cross devices method of treatment, the treatment is possible with an immediate effect, across long distances.

Although telemedicine in cannabis, has not yet experienced a full fledged growth, mainly due to the limitations imposed on policies based on both telemedicine as well as cannabis. Setting up a telemedicine appointment as well as prescribing medicinal cannabis, both require a validated license. Doctors not only need to meet the clinical and legal guidelines for each program, they also need to follow their state medical board’s recommendations on how to mix the two. The future of telemedicine in cannabis is hinged on how these policies will be eased in the future. 

Word from Hempstreet

As you would have understood about telemedicine in cannabis through this article, it is a topic that is on the path of experimentation and research. In an initial stage like this, it is very important that while purchasing from a cannabis dispensary, make sure you have a full proof prescription after consultation, including the dosage and the form of medicinal cannabis in which it should be consumed, be it CBD oil, cannabis tinctures, etc. In future, with systematic guidelines put in place, let us hope that  everyone can avail this opportunity and benefit from the same. 

References

https://www.news-medical.net/health/What-is-Telemedicine.aspx

https://blog.evisit.com/medical-marijuana-telemedicine-perfect-partnership

https://www.sciencedirect.com/science/article/abs/pii/S0740547218304288

https://health.economictimes.indiatimes.com/news/health-it/outlook-2019-the-future-of-telemedicine-in india/67366188#:~:text=In%202018%2C%20telemedicine%20has%20expanded,next%20frontier%20in%20the%20healthcare.

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Health benefits offered by THC

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Health Benefits of THC

THC, or delta-9 tetrahydrocannabinol, is one of the cannabinoids found in cannabis. THC, has been fighting a long drawn battle against its bad reputation. While it is infamous for being the component in cannabis that makes one “high”, its benefits have long been sidelined. Medicinal cannabis is made up of over 500 chemical compounds ranging from cannabinoids, terpenoids, etc. to fatty acids. From amongst the 61 cannabinoids that have been identified, THC happens to be one of the cannabinoids that is significantly studied, along with CBD, or cannabidiol. Although there is no denying that THC is psychoactive, this article will help you understand the health benefits offered by THC. With cannabis legalisation surfacing as an obstacle every now and then, it is interesting to see how the benefits of THC have managed to reach users in certain parts of the world.

THC composition

THC has the chemical formula C21H3oO, with a molecular mass of 314.464 g/mol. While the chemical composition does not differ much from CBD, the arrangement of atoms within THC is different from that of CBD.

These cannabinoids function in a similar manner like that of endocannabinoids, that are produced by our own body. This collateral property of cannabinoids allow them to attach to the receptors present in the body and produce the effect.

Benefits of THC

THC is the cannabinoid responsible for protecting the plants from insects and pests. Historical evidence suggests that THC metabolites were found inside a tomb in Israel, where it was used as an aid by a women for giving birth. Since then, studies have suggested the medicinal use of THC for various diseases. While CBD remains to be the holding ground for medicinal cannabis, CBD without THC cannot produce the desired effect. Let us look at few of the health benefits offered by THC.

  • Anti-inflammatory: This condition is associated as a symptom with a whole range of diseases, from arthritis and asthma to pain caused due to chemotherapy. THC has been effective as an aid for each of these diseases, as THC has successfully managed to combat the condition of inflammation.
  • Chronic Pain relief: THC has potential uses in treating and alleviating chronic pain. Be it mental pain or physical, anxiety or broken ankle, THC always comes to the rescue and provides a ‘feel-good’ feeling. It is also competent for treatment of muscle spasticity, i.e, easing the pain of spasms in multiple sclerosis.
  • Glaucoma: While there have been research results that have pointed out the effect of THC, as an aid for the treatment of glaucoma, any substantial proof is yet to be established.
  • Low appetite: THC is also responsible for bringing back appetites – a crucial part of healing for those living with HIV and the side effects of cancer therapy.
  • Insomnia: THC has proven to be a potent sleeping aid, with little to no side effects. Results reflect that THC has been able to refurbish a person’s sleep cycle due to its analgesic and anti-anxiety properties that provides the user an enhanced and stree-free sleep. This is mainly due to the property of THC which reduces the amount of REM sleep, or sleep full of dreams and nightmares. This has also made THC particularly useful for PTSD patients.
  • Anti oxidant & Anti convulsant: As a powerful anti oxidant, THC has proven efficacious in protecting the skin. THC’s anticonvulsant properties, allows it be a part of almost all medicines that are used to cure seizures.

Ways to take THC for health benefits

THC can be taken in many ways, however the best one for the health are through; Cannabis Oil, Cannabis tinctures, Cannabis edibles and Cannabis capsules.

Takeaway

Through the article, we looked at various health benefits offered by THC. However, before consuming it is advised to consider the possibility of side effects as well as the consultation of a doctor or physician. Seek for reliable sources of information and scientific evidence and decide upon the dosage, before purchasing medications from the cannabis dispensary.  

References

https://www.healthline.com/health/medical-marijuana/benefits-of-marijuana

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What are cannabis terpenes?

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What are cannabis terpenes?

Certain elements of cannabis are highly necessary for an enhanced experience and a better understanding of the kind one consumes. A well-known quality of cannabis is that it affects the mind and behavior when consumed. The main compound that produces such psychoactive effects on individuals is THC or delta-9-tetrahydrocannabinol. Extensive research has been done on this compound. However, there exist a large number of other cannabinoids, flavonoids, and terpenoids in medicinal marijuana that play an important role in helping understand cannabis and its effects. Not a lot of people know about the terpenes present in cannabis. Through this article, we would understand what are cannabis terpenes, and why they matter.

Introduction to terpenes

Are you wondering what terpenes are? Well, you are already familiar with them! Terpenes are the aromatic organic hydrocarbons that are found in a number of plants. The cannabis plant has a variety of compounds and chemicals, and about 140 of them can be classified as terpenes. Often the terms terpene and terpenoid are used synonymously, despite them having different meanings. The difference between the two is that terpenoids are terpenes that are denatured due to chemical modification or oxidization, while terpenes are hydrocarbons.

Terpenes are produced inside the glandular trichomes of the secretory cells of cannabis, with the help of exposure to light. In simple words, they are the aromatic oils that cause different cannabis plants to have distinctive flavors such as: citrus, mint, pine, berry, etc. In cannabis plants, terpenes act as a repellant for predators, and help lure pollinators. Factors such as the climate, age, fertilizers, soil, and exposure to light, influence the development of terpenes in plants. Terpenes are important elements that help distinguish the effects of different cannabis strains.

Different terpenes serve different purposes, for instance, certain terpenes might have relaxing and calming effects on individuals, while some might help them focus properly. Myrcene, one of the known terpenes is present in strains such as Blue Dream and Granddaddy Purple, and helps users relax. Limonene, pinene, linalool, caryophyllene, humulene, etc. are some other known terpenes. Although basic information about terpenes is available, the subject needs more research.

Why are terpenes important?

Terpenes are important for a number of reasons, some of which are discussed below.

  • Hightened effects: A paper published in 2011 explored the way in which cannabinoids and terpenes work together in order to boost the effects of each other in our bodies’ endocannabinoid system or the ECS. Therefore, terpenes can help increase or decrease the effects of CBD, THC and other compounds in the body. Terpenes also affect the high and lead to the entourage effect on individuals. For instance, myrcene helps increase the effects of THC.
  • Medical benefits: Terpenes have certain medical benefits. Myrcene helps those struggling with insomnia and fatigue, and acts as a sedative. It is also anti-inflammatory, and helps alleviate pain. Another terpene called Limonene has energizing effects on people, and acts as an anti-depressant. It is also used in aromatherapy.
  • Taste and Flavor: Terpenes help accentuate the natural flavor of cannabis and vape oils. They help us experience the citrusy, the pine, the berry, and the mint aroma. They are used in essential oils as well.

Word from HempStreet

The information provided above helps one understand what terpenes are and the effects they have on consumption. Terpenes enrich the cannabis plants as well as other plants. They play an important role in the survival of multiple plant species. However, due to minimal research, a lot of its benefits remain unknown. More research is needed in the field, in order to uncover the potential medicinal and therapeutic benefits of terpenes.

References:

www.medicalnewstoday.com/articles/what-are-terpenes#summary

www.medicaljane.com/category/cannabis-classroom/terpenes/#related-articles

www.heylocannabis.com/post/what-are-terpenes

www.leafly.com/news/cannabis-101/terpenes-the-flavors-of-cannabis-aromatherapy

www.analyticalcannabis.com/articles/the-difference-between-cannabinoids-and-terpenes-311502

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