\n<\/p>\n
Athletes can always partake of their \u201cinner cannabis,\u201d as the endocannabinoids have been called.1<\/sup> That\u2019s the basis of the runner\u2019s high. But when it comes to herb, weed, or extracts from the cannabis plant, Olympians and participants in hundreds of other sports organizations around the world still have to be careful. In September, the World Anti-Doping Agency (WADA<\/span>) ruled that THC<\/span> will remain banned during competition and at levels in urine that are indicative of frequent use outside competition.<\/p>\n Meanwhile, an article in the September issue of Internal Medicine Journal<\/em>2<\/sup> concludes that THC<\/span> does not enhance aerobic performance and strength; if anything, it impairs it. There\u2019s also ample evidence, of course, that THC<\/span> and other plant cannabinoids relieve pain and inflammation, promote neurogenesis, support sleep, stimulate appetite, and reduce stress \u2013 all of which make cannabis and its products seem tailor-made for sports recovery.<\/p>\n But frequent post-exercise use of THC<\/span>-rich cannabis could still trigger a failure at testing time and lead to a suspension of at least a month, even if the athlete can definitively establish that the THC<\/span> use occurred out of competition and was not intended to improve sport performance (which, again, appears unlikely to begin with). So what\u2019s a high-level athlete to do?<\/p>\n In response to requests from \u201ca small number of stakeholders\u201d that it reconsider THC<\/span>\u2019s non grata<\/em> status, WADA<\/span> launched a formal review last year. But at a recent meeting in Sydney, Australia, the agency\u2019s 14-member Executive Committee, composed of athletes and other representatives of sport from around the world, decided that THC<\/span> would stay on its List of Prohibited Substances and Methods for the foreseeable future.<\/p>\n To be included on the Prohibited list, a substance must meet at least two of the following criteria: 1) It has the potential to enhance sport performance; 2) It represents a health risk to the athlete; and 3) It violates the spirit of sport.<\/p>\n In a statement announcing the decision, WADA<\/span> noted that its Ethics Expert Advisory Group \u201ccontinues to consider cannabis use, at this time, to be against the spirit of sport across a range of areas\u201d \u2013 an unscientific assertion3<\/sup> that certainly smacks of stigma.<\/p>\n As for the other two criteria, it doesn\u2019t say. But a 2011 paper in the journal Sports Medicine<\/em>4<\/sup> suggests the agency considers cannabis to be potentially dangerous \u201cbecause of increased risk taking, slower reaction times, and poor executive function or decision making.\u201d This would seem to directly contradict the notion that THC<\/span> confers an unfair advantage, but there\u2019s no indication yet that the agency accepts the latest science concluding that THC<\/span> isn\u2019t performance-enhancing.<\/p>\n Fortunately for athletes still hoping to harness the therapeutic benefits of cannabis without fear of punishment, there are options. First and foremost, CBD<\/span> itself is allowed. In 2019 WADA<\/span> exempted the non-intoxicating, anti-inflammatory, and pain-relieving5<\/sup> cannabinoid compound from its blanket ban on pot and synthetic cannabinoids. But CBD<\/span> on its own is not as effective at easing aches and pains as when paired with THC<\/span>, a finding supported by a recently published analysis of 18 randomized, placebo-controlled trials.6<\/sup><\/p>\n Thus it\u2019s noteworthy that the THC<\/span> metabolite THC<\/span>–COOH<\/span> is technically also allowed in urine samples at levels below 150 ng\/mL, a threshold intended to serve as a proxy for either acute intoxication or chronic use. In a 2007 study, non-users who smoked a single low-potency joint (3.5% THC<\/span>) surpassed 150 ng\/mL in urine for a few hours,7<\/sup> suggesting that in naive and infrequent users, WADA<\/span>\u2019s limit may indeed be a reasonable indicator of current intoxication.<\/p>\n But among regular users, the approach could produce false positives. Cannabinoids, and especially THC<\/span>–COOH<\/span>, get sequestered into fat deposits in our bodies, which are then slowly released into the bloodstream. As a result, it\u2019s conceivable that a frequent cannabis user could still test above 150 ng\/mL a couple days after last use, despite being subjectively \u201csober.\u201d8<\/sup><\/p>\n The bottom line for elite athletes remains a bit blurry. The benefits of both THC<\/span> and CBD<\/span> for reducing inflammation, treating pain, relieving stress, supporting sleep, stimulating appetite, and even recovering from traumatic brain injury,9<\/sup> make cannabis an attractive remedy and prophylactic \u2013 and an increasingly popular one where it\u2019s permitted (if not fully legal), including in the United States\u2019 National Football League and the National Basketball Association.<\/p>\nAnti-THC<\/span> Stigma<\/h2>\n
Loopholes, Limits, and Traps<\/h2>\n
Cannabis and Sport<\/h2>\n