Last year, the World Anti-Doping Agency (WADA), the group responsible for drug testing Olympic athletes, finally removed CBD from the list of banned substances. The Agency claimed that CBD does not have the potential to enhance performance, nor does it represent a health risk to the athletes. However, CBD and other marijuana constituents are still banned by the NCAA, NBA, NFL, and many other professional sports organizations.

Despite the ban, the pressure remains on athletes to perform at their highest levels with unwavering consistency through grueling seasons and off-season training. As a result, athletes have been searching for supplements and prescriptions, as well as natural remedies, for recovery and longevity. One negative consequence of this has been the rise in use of prescription painkillers, which Calvin Johnson, an NFL wide receiver, likened to eating candy.

A wealth of knowledge has accumulated over the past decade on the effects of marijuana, touting its strength as a reliever of many daily ailments, such as pain and anxiety. Many athletes have been vocal about their support for marijuana’s medical potential for athletes—even those who don’t use it themselves, such as Karl Anthony-Towns—and a few of professional sports leagues have begun to discuss loosening their death grip on the substance. According to Joe Rogan, the comedian, podcast host, and MMA commentator, most UFC athletes are using marijuana as a training aid.

As the social stigma surrounding marijuana reduces and legalization efforts continue nationally at the state level—and even perhaps the federal level as some presidential hopefuls have announced their desire to see nationwide legalization—marijuana will continue to become more prevalent in our everyday lives. It is my opinion that as people become more comfortable speaking about the substance, and prominent societal figures or professional athletes voice their support, we will see an increase in the use of marijuana in sports.

This begs the questions of its designation as a performance enhancing drug: If marijuana was more prevalent in sports, would it provide an unfair advantage to some athletes? Would marijuana be harmful to the athlete’s health?

Performance enhancing drugs 101

Performance enhancing drugs are various substances, chemical agents, or procedures designed to provide an advantage in athletic performance. The classes of commonly used PEDs are anabolic agents, nutritional supplements, stimulants, and others, such as blood doping and human growth hormone.

The use of PEDs is not a new development. For example, during the original Olympic Games athletes would consume a type of opium juice called “doop”, which is where the word “doping” originates. Further, Gladiators of Roman times ingested strychnine to avoid injury and decrease fatigue. Documentaries, such as Icarus, show that PED use is widespread, and even sometimes, state-sponsored.

One of the major concerns, and additional designation criteria for substances to be labeled as PEDs is that they can be harmful to the body. The U.S. Anti-Doping Agency touts this proudly on their website as the reason to not get involved with PEDs. Not only is it unethical to ‘cheat’ by enhancing your ability to a level not naturally achievable, but it is also putting yourself at risk.

So, what do you think? Before reading forward, take a second to think to yourself about whether marijuana should classify as a performance enhancing drug.

Here’s what I have learned:

Marijuana 101

Marijuana refers to all parts of the cannabis sativa plant. The primary active ingredients are called cannabinoids and there are over 80 of these that have been identified. Peak blood concentrations of these occur 3-8 minutes after inhaling and 60-90 minutes after eating.

The THC, the psychoactive component of cannabis binds to the CB1 receptor of the endocannabinoid system, which is localized in the brain. However, CBD does not bind to a specific receptor and instead acts directly through other pathways that relate to the receptor, having powerful indirect effects (scientists are still trying to figure out how this works!).  CBD has emerged on the market as a natural remedy for many common ailments, from anxiety to chronic pain to epilepsy. Check out one of my previous blog posts to learn more about the endocannabinoid system! Its main job is to maintain homeostasis in the body.

Bioavailability is an important factor when taking any substance. It is the proportion of a drug or other substance which enters the circulation when introduced into the body and so is able to have an active effect. When smoking, 50-60% of the cannabinoids like THC are absorbed into the bloodstream and the rest is lost to sidestream smoke. There is slightly less than half a gram of marijuana in each joint so for each hit you could get between 1 to 15 mg. When consuming edibles, only 10-20% of the cannabinoids are absorbed, but the liver converts THC to 11-hydroxy-THC which has stronger psychedelic effects and lasts twice as long in the body.

Further, most marijuana strains on the market are genetically engineered to have a high THC to CBD ratio (~18% THC vs. 1% CBD is common). Therefore, you have to consume much more cannabis to get the desired (health) effect, but less to get the ‘high’. However, with the recent emergence of CBD this could change leading to more effective marijuana products for athletic performance.

Marijuana as a performance enhancer

Marijuana is currently banned by the United States Anti-Doping Agency, unless you have a Therapeutic Use Exemption (TUE). USADA can grant a Therapeutic Use Exemption (TUE) in these situations where athletes have an illness or condition that requires use of a banned substance. The USADA actually has a detailed page on their ruling in regard to marijuana.

What are the benefits of using marijuana? Why is it listed this way? Some of the oft-cited benefits are alleviating pain, muscle relaxation, decreasing nausea, improving mood, and increasing pain threshold. It also has been shown to ease anxiety and tension which can help an athlete perform better under pressure. It can increase focus and risk-taking behaviors, allowing athletes to forget recent blunders or past fears in competition.

Marijuana as a performance diminisher

What are the drawbacks to using marijuana? It is no secret that marijuana can decreases the motivation to workout. I’ve felt this before myself after a Saturday morning session that has left me ‘couch-locked’ the entire day. The comfort and relaxation felt due to marijuana can make you not want to do anything active. However, this is extremely person and strain dependent, so we can’t really extrapolate this out at the moment.

What about motor skills? Am a really slower on marijuana? Flight simulation studies of professional pilots taking 7-8 mg THC (1-4 joint hits) have shown that marijuana will lead to cognitive impairment, resulting in decreases reaction time, disruption to hand-eye coordination and perception, and division of attention for up to 36 hours following usage. The pilots showed an increase in major and minor errors through the study.

Why might this be? Studies involving imaging of the brain has shown that marijuana can alter the blood flow to different parts of the brain. It has been shown to reduce blood flow (and thus activity) in the temporal lobe, which is important for focused tasks. Poor performance in focused tasks has been correlated with low activity here. However, it increased blood flow to other regions of the brain, such as the frontal lobes and lateral cerebellum, that are important for decision making, sensory perception, sexual behavior and emotion, which could increase athletic performance in certain circumstances.

In fact, many studies have shown that only complicated tasks with fast decision-making are impaired by marijuana. Additionally, many of the studies use an unrealistic dosage, such as 100 mg THC which would be substantially more than someone might take before an athletic event. Imagine taking 40 joint hits and then fighting for your life in a UFC bout… YIKES!

What does it do to your muscles? PEDs are supposed to increase muscle mass, right!? Marijuana has been suggested to impair muscle building. This is through the downregulation of the expression and responsiveness of the CB1 receptor, in a similar manner to frequent blood sugar swings leading to insulin resistance, which interrupts the mTOR signaling pathway, a pathway important for protein synthesis. Another often referenced study suggests that THC may inhibit secretion of growth hormone (this study used an unrealistic dosage of THC). However, it has been suggested that CBD may counteract these detrimental effects… like I said, the science is still out on how CBD effects the body.

What about hormones? PEDs increase growth hormone and ramp up your body’s testosterone, making you a real-life Hulk. Variable effects have been found for marijuana’s effect on hormones, which are critically important for overall health and performance. The effects have been different for men, women, and our rodent friends, but primarily showing no long-term trend in hormonal changes for even chronic use.

For men, many believe that it can suppress testosterone, yet the pathway for which this has been cited to occur actually has very small effect (~5%) on the total testosterone production. For women, it has been suggested that THC acts like estrogen in the body, however, no definitive evidence has been found. Both males and females, showed a variable cortisone response, which is related to stress induction; a blunted one in chronic users and a dose-dependent one in non-users and frequent users. This is somewhat expected, as I have found my friends new to marijuana are more startled by the psychedelic effects.

The largest human study to date has shown no long-term hormonal changes in chronic marijuana users. So, no significant effect has been shown in hormones.

Lastly, marijuana has often cited effects on weight. But, does marijuana make you fat? Are the munchies real? There is no definitive evidence in one direction or the other. On one hand, it has been shown that marijuana users tend to have a lower Body Mass Index. This is thought to occur because the repeated stimulation of the CB1 receptors by THC may decrease receptor expression and sensitivity to hunger in the long-term. An additional cannabinoid in marijuana, THCV, has been shown to increase metabolism of fat cells, correlated with weight loss.

Further, one study found that regular cannabis consumers have fasting insulin levels and insulin resistance levels that are 16% lower and 17% lower than non-users. Lower insulin levels are generally associated with weight loss, because insulin is needed to break down fatty acids into fat molecules that can be stored.

So, on one hand, we know that when we smoke, we sometimes get the munchies. It’s possible that athletes could use THC to get hungry to intake more protein post-workout, but long-term use could lead to resistance and help appetite control. In summary, there is no definitive evidence that marijuana leads to weight gain.

Is marijuana harmful?

I am under the opinion that marijuana is not harmful. Additionally, there are many ways to consume marijuana that do not negatively affect the body, such as vaping and using creams. However, the USADA claims that it is. According to their website, negative effects include respiratory, cardiac, and mental health. It also cites chest illness and heightened risk of lung infections, and increased heart rate (heart attack susceptibility).

Is marijuana in violation of the spirit of the sport?

The last criteria that that USADA cites for banning performance enhancing drugs is an ethical one. Due to the illegal nature of marijuana in most countries, the use of it ‘does not uphold the spirit of the sport’…

With increasing legalization this could change.

Conclusion

I hope this provides you some insight into marijuana as a performance enhancing drug. My main takeaway from this was that there is great potential for it to assist in athletic recovery and enhanced mood. These could be important for longevity in athletes but should not be considered performance enhancing. In fact, from what I have read, marijuana would be detrimental to most athletic performance if taken day-of. For example, you wouldn’t want to ‘toke up’ right before a team-oriented or focus-requiring event due to the harmful effects of your focus and motor skills.

In pure speculation, it could assist (potentially) in a sport like long-distance running or power-lifting (for training), where pain tolerance is key, and the task is simple. However, this would be very person and strain dependent. Further, I do not think that marijuana can be considered harmful for your body as a whole, since there are no direct negative health consequences or addictive properties.

Be prepared to hear more about marijuana in sports as the social stigma decreases, additional products come online, and the science advances. Much more is to be learned about marijuana. Since cannabis has been classified as a Schedule 1 drug by the DEA, research has been inhibited and only a few double-blind placebo-controlled human studies exist. As a result, most findings have been extrapolated from rodent studies. It is known that this poses a challenge because there are significant differences between the endocannabinoid systems of rodents and humans.

Lastly, try it for yourself. Drop a comment below about how you use or avoid using marijuana either before, during, or after athletic performance/workout. I would be interested to hear your story.

This article benefited greatly from Ben Greenfield’s article “The Effect of Weed On Exercise: Is Marijuana a Performance-Enhancing Drug?, which can be found here.

– J