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Athletes are increasingly turning to cannabis—particularly the non-psychoactive cannabinoid CBD—for everything from pain relief to anxiety reduction. Research is finding evidence of CBD’s therapeutic benefits. And while the federal government remains slow to change its views, other regulatory bodies are starting to recognize CBD’s potential to benefit recovery.
In September 2017, the World Anti-Doping Agency, a foundation started by the International Olympic Committee to monitor drug use in sports, announced that it was removing CBD from its list of banned substances. While CBD remains banned in the NFL and in American collegiate athletics, the NHL and MLB have lenient policies toward cannabis use, focusing instead on banning performance-enhancing drugs. Even the NBA, which has historically been stringent about its cannabis restrictions, is beginning to rethink its policies.
As an athlete, how do you navigate this convoluted world of cannabis? We’re here to help.
There is evidence that CBD reduces inflammation, muscle soreness, muscle spasms, and pain. It also can help with insomnia, depression, and anxiety. CBD has been shown to have neuroprotective properties, which could help athletes with the neurodegenerative disease CTE. CBD might even even protect athletes’ brains from developing CTE, a potentially life-changing development for athletes who play full-contact sports, explains Perry Solomon, M.D., Chief Medical Officer at HelloMD, a startup dedicated to educating people about marijuana.
“CBD is being looked at for its neuroprotective ability in the nerves themselves,” Solomon explains. “It prevents the inflammation that happens in the nerves from constantly getting banged. The amount of trauma that you get is minimized because inflammation in the nerve cells is reduced.”
Despite CBD’s potential for fighting CTE, doctors will need to see a lot more research before they can rule decisively on CBD’s neuroprotective effects, says Jeff Chen, M.D./M.B.A., director of the Cannabis Research Initiative at the Semel Institute for Neuroscience and Human Behavior at UCLA.
“Research on the role of cannabinoids in treating brain-related traumatic injuries is incredibly preliminary, with no human studies,” Chen says. “In the case of CTE, the neuroprotective properties of cannabinoids could theoretically help in its prevention, but there have been no animal or human studies investigating cannabis or CBD for preventing CTE,” he says.
In the eyes of the federal government, marijuana remains a schedule-1 drug, which creates major barriers in licensing, funding, and government approval for studies. To put that into perspective, heroin and peyote are also classified as schedule 1 (meaning there is no potential for medical use and a high risk of abuse) while cocaine and meth are schedule 2 (meaning there are medical benefits, but still a high risk of abuse).
“The biggest problem with anything to do with cannabis is the amount of legitimate studies that can be done because of its schedule 1 classification,” says Solomon. “My feeling is that it should be de-schedulized completely and treated like alcohol, where you have to prove that you’re over a certain age and it’s standardized across the country. It’s tested for pesticides and strength and it shows what’s in there—terpenes, THC, CBD, et cetera.”
Erich Anderer, M.D., chief of neurosurgery at NYU Langone Hospital – Brooklyn agrees that more work needs to be done. “Cannabidiol is getting a lot of attention because there have been studies on the positive effects of marijuana in the treatment of various psychiatric disorders and pain, but that benefit comes without the intoxication. The problem is that right now there is no scientific evidence it works in humans,” he says. “Given the theoretical advantages of CBD—including treatment of muscle spasms, better sleep, and appetite stimulation—it is a potentially interesting subject to study for use in athletes both in training and as a recovery aid.”
Honestly, not much—that we know of. So far, researchers haven’t found any definitive negative side effects of CBD use. While marijuana’s primary psychoactive compound, THC, causes intoxication and can lead to depression and anxiety with chronic use, CBD has not been found to stimulate those these psychoactive effects. Also, CBD is often taken orally or topically, so smoking-related problems (like, say, lung and throat health) aren’t an issue.
One danger of CBD, Solomon warns, is that it could produce adverse reactions to other drugs. “CBD in high doses—I’m talking about very high doses, hundreds of milligrams—does act in the liver, specifically in something called the cytochrome P450 enzyme system,” he explains. “These enzymes break down various drugs. So if someone’s taking a high dose of CBD, the CBD takes space in the cytochrome so other drugs don’t break down as expected. For example: Taken with too much CBD, the blood thinner warfarin can make the blood too thin and cause bleeding issues.”
Another warning: If you do use CBD, know its source, Solomon says. “Extracted CBD concentrates anything in the hemp,” which is problematic “if it’s coming from overseas and they’re using pesticides and chemicals when they grow it.”
And as with any pain-reliever, masking pain during exercise can also lead to worse injuries, Chen says.
“There is substantial evidence for cannabinoids like CBD being effective for chronic pain, and there is preliminary evidence for the anti-inflammatory properties of CBD,” Chen says. “While these properties may be useful for recovery, it may also blunt the pain response during exercise, which could lead to overuse injuries.”
Using CBD is a personal choice. While existing studies have found that CBD is non-habit forming and doesn’t appear to have negative side effects, we still have a lot to learn. At the very least, it could be a promising alternative to opioids, which have been proven to be extremely dangerous.
“Advil or Aleve is worse than CBD in terms of possible kidney damage and stomach ulcers,” Solomon suggests. “But if an athlete is adamant about not taking anything, then CBD is not for them.”
Scott Chipman, the founder and chairman of CALM, an anti-marijuana nonprofit, thinks there’s no room for any drugs in sports: “Sports is about achievement, striving for improvement, making the most of your body and talents. Any drug use to achieve some physical goal makes the effort a phony one.”
WADA’s decision doesn’t exactly mean they’re embracing cannabis, and THC continues to be banned. “The removal of CBD from the prohibited list of the World Anti-Doping Agency isn’t due to the recognition that it may have benefits or that it lacks adverse effects,” explains Chen. Rather, CBD’s removal from the list signals a “recognition that it’s not a performance-enhancing drug,”
At least one aspect of existing American marijuana legislation is clear: It’s really damn confusing.
Two governing bodies shape our federal marijuana laws: the Drug Enforcement Agency (DEA) under the Department of Justice (DOJ) and the Food and Drug Administration (FDA). Marijuana is still federally illegal in all capacities under the Controlled Substances Act. But states also have the right to make their own cannabis laws, and currently, 22 states have legalized marijuana for medical use while eight states and Washington, D.C. have legalized marijuana for recreational use. Further complicating the matter, the regulations, carry limits, and restrictions attached to these laws vary state-to-state. It’s a lot to remember.
Marijuana dispensaries in states where medical marijuana was legal were still vulnerable to federal raids until 2013, when the so-called Cole Memo [PDF] created a federal policy of non-interference with states that had legalized marijuana as long as they had regulations in place. But in January 2018, attorney general Jeff Sessions rescinded the policy.
Chipman agrees with these regulations. “We support the FDA process for determining what is and is not a drug,” he says. “There are a couple of FDA-approved, cannabis-based drugs. They are properly regulated, fully tested with double blind tests proving effectiveness for specific ailments. There are medical exams and histories taken, follow-up visits and tight controls on potency. When the prescription runs out you have to get it refilled giving the doctor an opportunity to evaluate effectiveness and status of your condition.”
Even if your state has legalized marijuana, it’s still federally illegal, so using cannabis products is still a risk. You can be arrested by a federal officer, employers can do drugs tests for it, and moving it across any state lines is illegal. While the chances of an officer actually citing you for marijuana possession are low, you should absolutely research your state’s marijuana regulations and adhere to them.
Currently, it looks like the federal government is standing firm on its stance to keep it illegal. The FDA has a very high standard of proof when it comes to approving drugs and even then, it will approve very narrow, specific versions of drugs (never cannabis as a whole). With state governments beginning to legalize it more and public perception of it changing, there could be a federal shift, but if Sessions’ recent move is any indication, marijuana—CBD or otherwise—won’t be legalized under his watch anytime soon.