Looking at recent cases like that of Sha’Carri Richardson, who was barred from competing in the 2020 Tokyo Olympics over a failed THC test, it’s clear that cannabis use among athletes is still a somewhat taboo topic. Still, looking at the slowly changing regulations in institutions like the NBA and NFL, the sports world is steadily embracing the potential benefits that cannabis has to offer athletes in regard to recovery and chipping away at the penalties for cannabis use of years past.
And it’s evident when we look beyond these large stages that the status quo is beginning to shift. Namely, a new anonymous survey of physicians from the American Medical Society for Sports Medicine (AMSSM) looking to assess opinions on the use of CBD and cannabis found that these doctors generally have favorable attitudes toward the substances, though there are still varying views.
The study, which appears in the journal Translational Sports Medicine, also found that most sports medicine physicians from the survey showed support for legal medical and recreational cannabis use.
Exploring Sports Physicians Views on Cannabis Reform, in Sports and Beyond
The study begins noting the “growing evidence regarding cannabinoid use in sports medicine and performance,” highlighting CBD as a particular point of interest. Authors note that cannabis and cannabinoid use has been studied through other areas of medicine, though data in regard to sports medicine is sparse.
To analyze sports physicians’ views on cannabis, physician members of the AMSSM received a survey via email on two separate occasions, with a total of 333 completed responses.
According to the results, 72% of the respondents supported the 2018 removal of CBD from the World Anti-Doping Agency’s banned substance list, while 66% supported its removal from the National Collegiate Athletic Association’s (NCAA) banned substance list. Fewer, 59%, supported removing cannabis as a whole from the WADA banned substances list, though 81% said that sports physicians should have formal training on cannabis and cannabinoids and an overwhelming 93% majority were interested in continued medical education for cannabinoids.
A majority of respondents also showed support for medical cannabis legalization, 77%, and recreational legalization, 57%.
Cannabis and CBD Relating to Sports Performance
As many conversations around cannabis use in sports, including those surrounding Richardson back in 2021, revolve around its potential as a performance-enhancing substance, the survey also recorded physicians’ opinions on that topic.
A majority of respondents said that CBD and THC are not performance enhancing (approximately 76% and 66%, respectively). Most physicians also agreed that CBD was not detrimental to athletic performance (approximately 61%), though the opinion shifted when it came to THC, at approximately 37% saying it was not detrimental to athletic performance.
The survey also examined demographic information, finding that women, older doctors and rural respondents were less likely to favor legal adult-use cannabis. Authors note that these factors were also associated with a higher likelihood of disagreeing with the WADA removing cannabis from the prohibited substances list and the NCAA allowing college athletes to use cannabis.
Men and younger physicians were also less likely to identify cannabis as performance enhancing.
An Invitation For Further Research on an Understudied Topic
The study concludes noting that a number of sports doctors are already recommending CBD and cannabis products, noting that they are often used for chronic musculoskeletal and neuropathic pain. Authors also claimed that this was the first study to reveal that providers are recommending these products for sports-related concussions and performance anxiety.
“This advancing cultural shift motivates ongoing research and education for sports medicine providers to better answer questions posed by athletes about the safety, dosing, and potential effects of CBD and cannabis in sports,” researchers wrote.
When looking at data from the survey showing that more doctors would recommend CBD (40.8%) instead of cannabis (24.8%), authors said that the reasons “are not entirely clear.” Though, “given the overall safety profile of CBD, its lack of ‘intoxicating’ effects, and the general infiltration of CBD into mainstream consumer products, providers may see CBD as a safer option for patients compared to Cannabis and THC-containing products.”
Similarly, authors said that the reason more doctors believe that cannabis is detrimental to performance than CBD is unclear but that these perceptions could influence how sports medicine providers counsel athletes using these products.
“It is important to note that the ergogenic versus ergolytic effects of CBD compared to cannabis are still largely unknown,” the authors said. “Therefore, these perceptual differences can largely, if not exclusively, be attributed to marketing and advertising. In addition, one must recognize the seemingly ubiquitous addition of CBD to countless consumer products, which may also contribute to this evolving distinction.”
Authors also acknowledged the small sample size, accounting for only about 7% of the membership in the AMSSM, and due to the data coming from a single point in time, the study also can’t describe changing opinions.
“Lastly, although the survey was anonymous, this is still considered a fringe topic by many in sports medicine and medicine in general, which may limit the divulgence of actual behaviors and attitudes of respondents,” authors conclude.