New research funded by the National Football League (NFL) highlights the growing acceptability of therapeutic cannabis in sports. But it also underscores the obstacles to marijuana research caused by ongoing federal prohibition that have hamstrung efforts to better understand the benefits and risks of cannabinoids for athletes.
Despite growing interest among athletes—and the recent relaxation of cannabis policies by major sports leagues and governing bodies—the authors of the scientific review article conclude there’s still a “knowledge gap” between demand for education and what clinicians actually know about marijuana’s effects.
“Due to prohibition, we currently have a generation of healthcare providers with minimal understanding of a substance that is increasingly available for both therapeutic and recreational purposes,” the report says. “This knowledge gap needs to be addressed. Restrictive policies and over-regulation have hampered an opportunity for Canada and the USA to be global leaders in cannabinoid research.”
The study, by authors at the University of Saskatchewan and University of Regina, in Canada, was published in the journal Sports Medicine. It was funded in part by a grant from NFL’s Pain Management Committee.
In 2022, the league announced $1 million in funding into how cannabinoids might be used for pain management and concussion protection. In addition to the latest project, that money also supported a clinical trial into CBD aimed at determining optimal dosage and whether the cannabinoid could potentially serve as an opioid alternative.
“While efforts are made to provide information to the public on potential harms, equal efforts should be made to research and understand potential benefits.”
It’s part of a paradigm shift away from prohibition-only policies that authors of the current study are highlighting.
“Education is a proven harm reduction strategy,” the paper says. “While efforts are made to provide information to the public on 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 a review of existing research into therapeutic cannabinoids, which the report says “suggests potential therapeutic value but also potential risks of cannabis use in athletes.”
To that end, the authors encourage a balanced approach to messaging around cannabinoids’ potential for athletes.
“Misinformation, stigma, and barriers to research continue to perpetuate the confusion of the public regarding the potential therapeutic use of cannabinoids,” they wrote, adding: “A focus primarily on negative messaging does not align with the anecdotal positive experiences of a growing number of people using cannabis products and contributes to a lack of trust in health policymakers.”
On the other hand, the review says the cannabis industry itself also contributes to the current confusion.
“The very profitable recreational use industry that dominates political and legal attention,” it says, “further complicates public understanding and validation of cannabinoid therapies.”
“Policymakers must encourage evidence-based research to better serve their citizens and keep them safe,” authors argued. “However, this will require an untangling of a labyrinth of research regulations that make it nearly impossible to research real-world products in a setting other than that which is funded by a commercial product developer.”
Among the obstacles to better education, the review says, is a limited body of research. It finds that available human studies “are limited in design and interpretability.”
The authors call cannabis policies and regulations in athletics “confusing and non-standardized.”
“Vast discrepancies exist on the basis of specifics of the study such as the cannabinoid(s) used, the population studied, and the administration route and dose,” it says. “Study findings only apply to the specifics of that study, and caution is warranted not to misinterpret the applicability of results to non-similar populations or cannabinoids.”
Further, the authors call cannabis policies and regulations in athletics “confusing and non-standardized,” saying that more “education and awareness on benefits and potential harm is needed for athletes, medical staff, and policymakers.”
A number of North American sports leagues have revised their stances on cannabis in recent years. In 2023, for example, the National Basketball Association (NBA) removed marijuana from its banned substances list and allowed players to invest in cannabis companies. The league had reportedly already stopped testing players for cannabis use for years at that point.
Major League Baseball (MLB), meanwhile, took marijuana off its banned substances list in 2019 and some baseball teams—including the Chicago Cubs and Kansas City Royals—have since partnered with CBD companies. In 2022, the MLB itself signed a CBD company to serve as the league’s first-ever cannabis sponsor.
As for NFL cannabis matters, a Denver Broncos player sued the team and league earlier in 2024, alleging employment discrimination after he was fined more than half a million dollars for testing positive for THC that he’s said was caused by doctor-recommended use of a synthetic cannabinoid to treat anxiety, post-traumatic stress disorder (PTSD) and pain.
In July, lawyers for the Broncos and NFL asked a federal court judge to reject the suit, arguing that the use of cannabis can lead to on-field injuries, poor job performance and “alienation of the fans.”
While the NFL and its players union agreed to end the practice of suspending players over marijuana or other drugs as part of a collective bargaining agreement in 2020, it has continued to fine players over positive THC tests. For the first through third positive test, the fine is half a week’s salary; a fourth and each subsequent positive test is punishable by a fine equal to three weeks’ salary.
With respect to the league’s commitment to funding more cannabis- and CBD-related research, NFL and the league’s players union previewed the funding plan in June 2022, emphasizing the strong interest among players and other stakeholders. The joint NFL–NFLPA committee also held two informational forums on CBD in 2020.
While advocates have welcomed these changes, there’s been criticism of WADA over its ongoing cannabis ban.
Other sports leagues and governing bodies have also adopted revised marijuana policies as the state-level cannabis legalization movement continues to spread.
The National Collegiate Athletic Association (NCAA), for example, recently voted to remove marijuana from its banned substances list for Division I players, a change that took effect in June.
The Ultimate Fighting Championship (UFC) announced in December that it was formally removing marijuana from its newly modified banned substances list for athletes, also building on an earlier reform.
However, ahead of a UFC event in February, a California athletics commission said competitors could still face penalties under state rules for testing positive for THC over a certain limit, as the state body’s policy is based around World Anti-Doping Agency (WADA) guidance.
Nevada sports regulators voted in 2023 to send a proposed regulatory amendment to the governor that would protect athletes from being penalized over using or possessing marijuana in compliance with state law.
While advocates have welcomed these changes, there’s been criticism of WADA over its ongoing cannabis ban. Members of a panel within the agency said in an August 2023 opinion piece that marijuana use by athletes violates the “spirit of sport,” making them unfit role models whose potential impairment could put others at risk.
Advocates strongly urged WADA to enact a reform after United States runner Sha’Carri Richardson was suspended from participating in Olympics events due to a positive THC test in 2021.
Following that suspension, the US Anti-Doping Agency (USADA) said that the international rules on marijuana “must change,” the White House and President Joe Biden himself signaled that it was time for new policies and congressional lawmakers amplified that message.
During the 2024 Olympics in Paris, the head of USADA blasted the “unfair” ban on marijuana for athletes competing in international sports events.
A survey released earlier in August also found that two in three Americans felt Olympic athletes should be able to use marijuana without facing penalties—a higher percentage than those who said the same about alcohol, tobacco and psychedelics. The poll found that 63 percent of respondents agreed that athletes who use cannabis should not be disqualified from performing, compared to 62 percent for alcohol, 60 percent for tobacco, 27 percent for psilocybin and 20 percent for LSD.
Overall, 42 percent of Americans polled said that athletes shouldn’t be punished for using recreational drugs on their own time. Another 26 percent said disqualification should depend on the type of recreational substance and 32 percent said drug use of any kind should be a disqualifying factor.
Separately, a recently released study on athletes’ attitudes toward psychedelic-assisted therapy (PAT) found that more than six in 10 would be willing to try treatment with psilocybin or other entheogens to aid recovery after a concussion or to help manage post-concussion symptoms. Among sports staff, more than seven in 10 said they’d support athletes using PAT.
Photograph by velo_city via Flickr/Creative Commons 2.0
This story was originally published by Marijuana Moment, which tracks the politics and policy of cannabis and drugs. Follow Marijuana Moment on Twitter and Facebook, and sign up for its newsletter.