While cannabis legalization in Canada and some states in the U.S. may have opened doors to additional research into the plant’s health benefits, one area where the move towards acceptance continues to face hurdles is within professional sports leagues—at least for now.
A growing number of professional athletes are coming forward as cannabis advocates, calling for reduced penalties—or none at all—for using the plant, and highlighting its benefits for pain relief compared to options like opioids.
World Anti-Doping Agency not down with dope
Cannabis has long been a prohibited substance in the eyes of the World Anti-Doping Agency (WADA), which considers the substance to be performance-enhancing and harmful to an athlete’s health. More recently, though, the organization has loosened its stance on cannabis. In 2013, WADA raised the threshold of allowable cannabis in an athlete’s system to 150 ng per ml compared to, for example, the 15 ng/ml the National Basketball Association (NBA) checks for.
In 2018, WADA removed cannabidiol (CBD), a chemical in cannabis that has therapeutic, but not psychoactive, effects, from its list of banned substances. The Canadian Centre for Ethics in Sports has further pushed for the removal of cannabis from the banned substances list.
In 2018, WADA removed cannabidiol (CBD), a chemical in cannabis that has therapeutic, but not psychoactive, effects, from its list of banned substances.
NHL lenient towards cannabis
Cannabis is not on the National Hockey League’s (NHL) list of banned substances, but is one of the many drugs tested for under the league’s Substance Abuse and Behavioral Health Program. The NHL tests players for performance-enhancing drugs, such as steroids, and in 2017, began testing players for illicit drugs.
Greencamp spoke to former NHL player Grant McNeill, who played a short stint with the Florida Panthers during the 2003-2004 season, on his experience using cannabis while in the NHL. Although he could not provide statistics league-wide, from his experience, McNeill estimates 50 percent to 70 percent of players use the drug. That said, “it is definitely not something guys will talk about in the dressing room, it is very low-key, hush-hush.”
“There’s no penalties (for cannabis) like there would be with steroids or harder drugs like cocaine (in the NHL),” he argues. “They’re not going to throw you into rehab over cannabis.”
While many players may use cannabis, there are no current plans to change the joint NHL and NHL Players’ Association joint drug-testing policy. “Right now, we think based on the education level and what we do test for and how we test, at least for the time being, we’re comfortable with where we are,” NHL Commissioner Gary Bettman said in October 2018.
A harsh stance in most leagues
Other leagues have a harsher stance towards cannabis than the NHL. The National Football League (NFL) can suspend players for cannabis-based infractions after two positive tests. After a first positive test, a player is put in NFL’s “stage two” intervention program, which means for up to 24 months, the player may be tested more frequently. Regularly, though, drug testing only happens between April and August.
In the National Basketball Association (NBA), a players is fined US$25,000 if he tests positive for cannabis twice, which is followed by a suspension of five games, then 10 and an additional five games for each subsequent positive test.
For Major League Baseball (MLB), a player can be fined up to US$35,000 if on a 40-man roster and found to use cannabis; those not on the roster, but testing positive, can receive 50- and 100-game suspensions for second and third positive tests, respectively.
The BIG3 is a 3-on-3 basketball league featuring retired professional players, co-owned by Ice Cube and Jeff Kwatinetz. Kevin C. Cox/Getty Images
One league, however, has gone a different direction on cannabis. BIG3, which features three-on-three, half-court basketball with former NBA players, became the first U.S. pro league in 2018 to permit CBD for pain management and recovery.
Cannabis as an alternative to opioids
Potentially, the best use of cannabis in sports is for recovery and pain relief, especially when considered next to the current use of opioids. McNeill explains that treatment for pain was a big reason he turned to cannabis, which has been found to have anti-inflammatory effects.
“I never liked taking Oxycontin and Tylenol 3; it was something that made my body feel very bad. And I also knew the potential addictions to those drugs,” McNeill says. “I used cannabis to offset the pain tolerance… I felt cannabis was a more natural way.”
The problem with using opioids is that it can lead to addiction. The U.S. is currently under an opioid epidemic, where in 2016, an estimated 40 percent of the 42,000 deaths from opioid overdoses, amounting to about 16,800, related to prescription opioid overdoses.
Survey findings, published in Drug and Alcohol Dependence in 2011, found 52 percent of former NHL player respondents reported using opioids during their career, and 71 percent reported misusing them. “It’s crazy to me, the hypocritical situation where it is okay for guys to drink themselves out of pain” or take several Oxycontin to get through a night, “yet if you smoke a joint, you’re a complete drug addict,” McNeill argues.
Brain injuries and cannabis
One professional athlete ailment for which cannabis may prove useful is chronic traumatic encephalopathy (CTE). CTE is a neurodegenerative disease that is caused by repetitive brain trauma, such as repeated blows to the head, and has been suspected of playing a role in the development of Alzheimer’s.
North American football players may be at increased risk of long-term neurological conditions, particularly CTE. A study in the Journal of the American Medical Association found that among 202 deceased brain donors, seven of eight (88 percent) of Canadian Football League (CFL) players and 110 of 111 (99 percent) of NFL players examined had CTE.
Cannabis may provide a way to tackle CTE since it has been found to have neuroprotective qualities. One study on rats, published in the Annals of the New York Academy of Sciences, found that cannabis had neuroprotective qualities as an antioxidant, while another out of Israel found endocannabinoids can reduce brain damage in rats and mice.
In 2014, Dr. Lester Grinspoon, associate professor emeritus of psychiatry at Harvard Medical School, wrote an open letter to NFL commissioner Roger Goodell about cannabis’ neuroprotective properties. “Cannabis… can, indeed, provide significant protection against the damage of repetitive concussions,” Dr. Grinspoon wrote.
The evidence may be having an effect on the NFL. In 2017, the NFL offered to work with the NFL Players Association to examine the science behind cannabis as a pain-management tool for players.
Is cannabis performance-enhancing?
The debate is ongoing about whether or not cannabis is performance-enhancing. WADA defines drugs on the prohibited list as those meeting two of the three following criteria: it has the potential to enhance or enhances sports performance; it represents an actual or potential health risk to the athlete; and it violates the spirit of the sport.
The stance of the U.S. Anti-Doping Agency (USADA) is that cannabis can enhance sports performance because it can cause muscle relaxation and reduce pain post-workout, as well as decrease anxiety and fear, resulting in better sport performance. To USADA, cannabis can present a health risk because of its negative effects on the lungs, its ability to cause a higher heart rate that could heighten the risk of heart attack and, when use is chronic, its connection to mental illness, including paranoia and psychosis.
In terms of the spirit of sport, since cannabis is still illegal in many countries and U.S. states, it infringes on the moral and ethics judgment that upholds the spirit of the sport.
McNeill says he did use cannabis to calm his nerves after a game. While cannabis may have a calming effect for some, it does affect motor control, balance, reaction time and coordination, which are all needed in athletic performance. Some studies also show that cannabis can disrupt sleep’s REM cycle, during which growth hormones needed for muscle growth are released.
A study by McGill University concluded “there is no evidence for cannabis use as a performance-enhancing drug.” Researchers further found “the potential beneficial effects of cannabis as part of a pain management protocol, including reducing concussion-related symptoms, deserve attention.”
Cannabis advocates gaining profile
Over the years, a growing number of current and former professional athletes have come forward advocating for cannabis, with a few facing consequences for doing so. One of the more famous examples of a player pushing cannabis is UFC (Ultimate Fighting Championship) fighter Nate Diaz vaping CBD oil at a presser after his fight with Conor McGregor at UFC 202 in Las Vegas in 2016. “It helps with the healing process and inflammation and stuff like that,” he told reporters. “Before or after the fight, in training, it’ll make your life a better place.”
The move landed Diaz a public warning from USADA, but not a suspension. UFC at the time banned cannabinoids up to six hours after a fight, but has since changed its policy, due to the Diaz incident, to after a sample has been collected post-competition.
Diaz’s brother, mixed martial arts fighter Nick Diaz, was suspended from the UFC after testing positive for cannabis at UFC 183.
In the NFL, running back Mike James is reported to have developed a dependency after being prescribed opioid painkillers in 2013 when he injured his left ankle. He opted to switch to medical cannabis to manage his pain.
James made history as the first player to file for a therapeutic use exemption specifically for cannabis. The NFL denied the exemption, but James has said he will not stop pushing for cannabis use to be allowed in the sport.
In 2014, former Denver Broncos tight end Nate Jackson wrote an op-ed for the New York Times advocating for cannabis to be used for pain relief rather than opioids. Before retiring, Baltimore Ravens offensive tackle Eugene Monroe publicly called out the NFL for not allowing players to use medical cannabis in a New York Times article. Monroe was later cut by the Ravens, who mentioned his cannabis advocacy in their departure announcement.
In 1998, Olympic snowboarder Ross Rebagliati won gold at the Nagano Winter Olympics in Japan, but was stripped of the medal after testing positive for cannabis. The decision was later overturned. He now runs a cannabis company that focuses on CBD consumables, nutrients and home-growing kits.
One of the more outspoken people in favour of cannabis is former Philadelphia Flyers player Riley Cote, who has since helped form Athletes for Care, a non-profit dedicated to improving current and retired athletes’ lives through alternative medicine and better health care.
Cote told Leafly that he has found cannabis to be helpful in managing pain naturally, much like McNeill has also said.
A possible role in sports
While professional sports leagues may be slow to embrace cannabis, evidence and anecdotal reports are growing regarding its potential benefits for sports-related issues, such as injuries and pain. When taken into consideration next to opioids, it does seem like there could be a place for cannabis within the official rules, but when that might happen will likely depend on a mixture of perception, acceptance and additional research.