Cannabis has been used as a recreational drug by many societies for a very long time; and recent research has meant that it is now also being considered as a viable medical treatment for a range of health conditions.
However, cannabis has been banned for use in sport since the inception of the World Anti-Doping Code. It is currently banned for use in competition, but not prohibited out of competition. Athletes have gotten in trouble in the past for cannabis use, including track sprinter Sha Richardson and swimming legend Michael Phelps.
Even though cannabis is still an illicit substance in many countries around the world, it’s use is becoming more widely accepted. Does it still have a place on the banned substances list?
WHY IS CANNABIS ON THE BANNED SUBSTANCES LIST TO BEGIN WITH?
According to the World Anti-Doping Code, in order to be included on the banned substances list, a substance must meet 2 of the following 3 criteria:
- Be proven to enhance performance
- Cause harm to an athlete’s health
- Violate the spirit of sport
Obviously, to be included on the banned substances list, WADA has determined that cannabis does meet at least 2 of these 3 criteria. But with recent research into medical cannabis use and a societal shift around it’s recreational use, does cannabis still match the requirements?
CAN CANNABIS CAUSE HARM TO AN ATHLETE’S HEALTH?
In one word, yes. Studies have shown that short term use can lead to impaired memory, impaired motor co-ordination and altered judgement; while long term and heavy use of cannabis can lead to altered brain development, symptoms of chronic bronchitis, and in some cases, paranoia and psychosis…..and the quite obvious point here is that those under the influence of cannabis would probably pose a risk to both themselves and others during competition. I certainly wouldn’t want to be racing a bike against somebody who was stoned after smoking a couple of joints.
However, recent times have seen a big step forward in cannabis being used to treat many medical conditions. Here in Australia, approved doctors are now able to prescribe medical cannabis to help treat a range of health conditions, including anxiety, sleep disorders, mood disorders and neuropathic pain (as well as many other medical conditions).
The restrictions on prescribing medical cannabis are still rather stringent, with the vast majority of medical cannabis products being classed as Schedule 8 drugs. The rules regarding medical cannabis prescribing are gradually being eased though, and this trend will more than likely continue over time.
DOES CANNABIS USE VIOLATE “THE SPIRIT OF SPORT”?
When the banned substance list and the World Anti-Doping Code were developed, cannabis was an illicit substance pretty much world wide. It can easily be suggested that allowing athletes to use illicit substances could easily bring a sport into disrepute, as sporting role models getting high on drugs isn’t exactly a good look.
But there has been a recent shift in the social acceptance of cannabis use. Cannabis use has been legalised in countries such as Uruguay, Canada and the Netherlands, as well as some states of the USA….and with many countries, including the UK, Thailand and Australia, allowing the use of cannabis for medical purposes, the way we view marijuana is slowly changing.
IS CANNABIS PERFORMANCE ENHANCING?
Theoretically, cannabis can be used to help treat an athlete’s anxiety, as well as reduce pain from sore muscles and injuries. As a result, an athlete could be in a position to better focus on their performance, and maintain their endurance for longer periods due to a reduction in pain. For sports such as shooting, archery and darts, the relaxant effects of cannabis may also provide some performance benefits.
However, scientific research shows this is not the case. Results from some studies show that cannabis use before sport has a detrimental effect on sporting performance. Maximal exercise capacity and endurance were shown to be reduced; while undesirable effects such as increased heart and breathing rate, as well as negative effects on balance, were also present.
So while there is an underlying theoretical ability for cannabis to enhance sporting performance, the opposite is more accurate. Cannabis has been shown to impede performance rather than enhance it.
WHAT ABOUT CANNABIDIOL PRODUCTS?
Cannabis consists of 2 main active components – Tetrahydrocannabinol, or THC, and Cannabidiol, or CBD. THC is the main psyco-active constituent of cannabis and is the main focus of studies for medical treatment; but CBD can also be prescribed to assist with anxiety and pain, as well as some other medical conditions. However, the evidence behind the health benefits of CBD products for these conditions is still lacking.
Since 2019, CBD has been taken off the banned substances list. However, many CBD products actually still contain a small amount of THC, hence the use of CBD in sport is very much “conditional”. You won’t get in trouble for having CBD in your system, but THC is definitely a problem.
SO SHOULD CANNABIS STILL BE BANNED IN SPORT?
Obviously, there are arguments to support both sides of a decision like this. Traditionally, cannabis has been shown to fit the requirements needed to be included in the banned substances list. But with newer evidence now available, and a societal shift towards the acceptance of cannabis for both medical and recreational purposes, is this still the case?
With CBD being taken off the banned list, and research showing there is a possible role of it’s use in sports recovery; it can certainly be said that THC could be used for similar purposes in athletes. The potential to help with sleep and anxiety, as well as reducing inflammation and pain, would be beneficial for an athlete’s recovery.
As THC is currently only banned “during competition” in sport, theoretically athletes are able to use it as a recovery aid. However, due to the fact that some constituents of THC are stored in fat tissue, it can potentially remain the system for months after it’s use, and appear in drug tests as a result.
Perhaps a common sense approach is needed? The ability for athletes to obtain a Therapeutic Use Exemption for lower doses may be a good start? Maybe doses of THC could be allowed in sport conditionally, where doses are monitored and limited, in a similar fashion to Salbutamol?
***Update*** Currently, Adverse Analytical Findings are reported when tests show urinary concentrations of more than 150nl/ml. WADA states that this limit means those at risk of testing positive are “those who have consumed significant quantities of THC close to In-competition Doping
Control or are chronic users“)
Regardless of how the subject is approached, the use of cannabis as both a recreational drug and a medical treatment is only going to become more popular and openly accepted. The World Anti-Doping Agency should be putting their thinking caps on about the inclusion of cannabis on the banned substances list, and how they are going to deal with this topic in the near future.
The Sports Pharmacist 