A new study sponsored by the National Football League (NFL) highlights the growing acceptance of medical cannabis in sports. However, it also shows that marijuana research is hampered by the ongoing federal ban, hindering efforts to better understand the benefits and risks of cannabinoids for athletes.

Despite growing interest among athletes – and the recent loosening of cannabis policies by major sports leagues and governing bodies – the authors of the scientific review conclude that there is still a “knowledge gap” between the need for education and what doctors actually know about the effects of marijuana.

“Due to prohibition, we currently have a generation of health care providers with minimal understanding of a substance that is increasingly available for both therapeutic and recreational use,” the report said. “This knowledge gap must be closed. Restrictive policies and over-regulation have deprived Canada and the United States of the opportunity to become world leaders in cannabinoid research.”

The study, by authors from the University of Saskatchewan and the University of Regina in Canada, was published this week in the journal Sports Medicine and was funded in part by a grant from the NFL’s Pain Management Committee.

The NFL, NBA and MLB’s efforts to reduce marijuana penalties “signal a shift in the acceptance of cannabinoid use in sports.”

In 2022, the league announced $1 million in funding to study how cannabinoids could be used to manage pain and protect against concussions. In addition to the latest project, that money also supported a clinical trial on CBD aimed at determining optimal dosing and whether the cannabinoid could potentially serve as an opioid alternative.

This is part of a paradigm shift away from a policy that relies exclusively on bans, which the authors of the current study highlight.

“Education is a proven strategy for harm reduction,” the paper states. “While trying to inform the public about the potential harms of cannabinoid products, equal efforts should be made to research and understand their potential benefits.”

The 27-page report is largely devoted to reviewing existing research on therapeutic cannabinoids. The report says the research “suggests potential therapeutic value but also potential risks of cannabis use in athletes.”

To this end, the authors recommend a balanced approach to educating people about the potential of cannabinoids for athletes.

“Misinformation, stigma, and barriers to research continue to deepen public confusion about the potential therapeutic benefits of cannabinoids,” they wrote, adding: “A focus primarily on negative messages is inconsistent with the anecdotal positive experiences of a growing number of people using cannabis products and contributes to a lack of trust in health policy.”

On the other hand, the study says that the cannabis industry itself is also contributing to the current confusion.

“The highly profitable recreational industry that dominates political and legal attention,” it says, “further complicates public understanding and acceptance of cannabinoid therapies.”

“Policymakers must encourage evidence-based research to better serve their citizens and ensure their safety,” the authors argued. “However, doing so requires a mess of research regulations that make it nearly impossible to research real products in an environment not funded by a commercial product developer.”

According to the study, one of the obstacles to better education is the limited research available. The available studies on humans are “limited in their design and interpretability.”

“Health policies and regulations regarding cannabinoid use in sports are confusing and not standardized.”

“Large discrepancies exist due to study details such as the cannabinoids used, the population studied, and the method and dose of administration,” it says. “Study results apply only to the details of that study, and caution should be used not to misinterpret the applicability of the results to dissimilar populations or cannabinoids.”

In addition, the authors call cannabis policies and regulations in sports “confusing and inconsistent” and say more “education and awareness regarding the benefits and potential harms for athletes, medical personnel and policy makers” is needed.

Several North American sports leagues have changed their stance on cannabis in recent years. Last year, for example, the National Basketball Association (NBA) removed marijuana from its list of banned substances and allowed players to invest in cannabis-related companies. The league had reportedly not been testing players for cannabis use for years at the time.

Major League Baseball (MLB) removed marijuana from its list of banned substances in 2019, and some baseball teams — including the Chicago Cubs and Kansas City Royals — have since partnered with CBD companies. In 2022, MLB itself signed a deal with a CBD company to serve as the league’s first cannabis sponsor.

As for the NFL’s cannabis issues, a Denver Broncos player sued the team and league earlier this year, alleging employment discrimination. He was previously fined over half a million dollars for testing positive for THC, which he said was due to taking a synthetic cannabinoid recommended by his doctor to treat anxiety, post-traumatic stress disorder (PTSD) and pain.

Last month, lawyers for the Broncos and the NFL asked a federal judge to dismiss the lawsuit, arguing that cannabis use could lead to on-field injuries, poor job performance and “fan alienation.”

While the NFL and its players’ union agreed to end the practice of suspending players for marijuana or other drugs as part of a 2020 collective bargaining agreement, players have continued to be fined for positive THC tests. For the first through third positive tests, the fine is half a week’s salary; a fourth and each subsequent positive test is punishable by a fine of three weeks’ salary.

In light of the league’s commitment to fund more research related to cannabis and CBD, the NFL and the league’s players’ union previewed the funding plan in June 2022, emphasizing strong interest from players and other stakeholders. The joint NFL-NFLPA committee also held two informational forums on CBD in 2020.

Other sports leagues and governing bodies have also revised their marijuana policies as the movement to legalize cannabis at the state level continues to spread.

For example, the National Collegiate Athletic Association (NCAA) recently voted to remove marijuana from the list of banned substances for Division I players, a change that took effect in June.

The Ultimate Fighting Championship (UFC) announced in December that it was officially removing marijuana from its newly revised list of banned substances for athletes, also building on an earlier reform.

However, ahead of a UFC competition in February, a California track and field commission said that a positive THC test above a certain limit could still result in penalties under the state’s rules, as the state’s guidelines are based on those of the World Anti-Doping Agency (WADA).

The Nevada State Sports Commission voted last year to send the governor a proposed change to the law that would protect athletes from punishment if they use or possess marijuana in violation of state law.

While supporters welcomed these changes, WADA has been criticized for its continued ban on cannabis. Members of a panel within the agency stated in an opinion piece last August that marijuana use by athletes violates the “spirit of sport” and makes them unsuitable role models whose potential impairment could endanger others.

Advocates urged WADA to reform after U.S. runner Sha’Carri Richardson was suspended from competing in Olympic events in 2021 due to a positive THC test.

Following that suspension, the U.S. Anti-Doping Agency (USADA) declared that international rules on marijuana “need to change.” The White House and President Joe Biden himself signaled that it was time for a new policy, and members of Congress reinforced that message.

During this year’s Olympic Games in Paris, the head of USADA criticized the “unfair” ban on marijuana for athletes participating in international sporting events.

A poll released this month also found that two in three Americans believe Olympic athletes should be allowed to use marijuana without being penalized for it – a higher percentage than those who said the same about alcohol, tobacco and psychedelics. The poll found that 63 percent of respondents said athletes who use cannabis should not be barred from participating, compared with 62 percent for alcohol, 60 percent for tobacco, 27 percent for psilocybin and 20 percent for LSD.

Overall, 42 percent of Americans surveyed said athletes should not be penalized for using recreational drugs in their free time. Another 26 percent said disqualification should depend on the type of recreational drug, and 32 percent said drug use of any kind should be a disqualifying factor.

A recently published study on athletes’ attitudes toward psychedelic-assisted therapy (PAT) found that more than 6 in 10 would be willing to try treatment with psilocybin or other entheogens to aid in concussion recovery or to reduce post-concussion symptoms. Among sports staff, more than 7 in 10 said they would support athletes using PAT.

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Image element courtesy of Marco Verch.