Major League Sports are Shifting their Perspectives on Cannabis Use

As states continue to legalize the consumption of medicinal and recreational marijuana, research on the nature and benefits of cannabis can take on a more robust perspective; for example, testing regulations can be enhanced, or expanded on, for the sake of consumer safety. Alongside that, public opinion around it is shifting. This has led to a country-wide discussion around how (and if) cannabis use should be allowed and monitored in sports.

In late 2019, the MLB announced that they have reached an agreement with MLB players to eliminate marijuana from the list of banned substances and “will begin to treat its consumption by players in the same way that alcohol is handled” (Jaeger, 2019). The MLB Communications department tweeted a picture of the revised drug program on December 12th, 2019, which read that they will be testing players for opioids, fentanyl, cocaine, and synthetic THC but will no longer be testing for natural cannabinoids. The same document announced that they are moving towards a medical healing approach to addiction, instead of relying on punishment for drug use.

During the COVID-19 pandemic, the NBA temporarily halted randomized testing for marijuana use as the players finished out the 2019-2020 “bubble” season in Orlando, Florida (Jaeger, 2020). Leading into the 2020-2021 season, freelance journalist Ben Dowsett tweeted that the NBA would be continuing the testing suspension (Jaeger, 2020). Shortly thereafter, NBA Commissioner Adam Silver told NBC Today that the league is leaning toward testing players who show dependency and away from casual usage (Stump, 2020).

The NFL is headed in the same direction. In 2020, players voted to drastically change the league’s stance on marijuana testing, which eliminates the threat of suspension for positive tests and instead institutes a tiered list where players are fined for repeated offenses (Florio, 2020). To back up this change, the NFL Communications Department announced in February 2022 that they are pledging “$1 million in research funding to researchers at (University of California San Diego) and (University of Regina) to study the impacts on cannabis and CBD on the pain management of elite athletes.” The co-principal investigator and director of the Center for Pain Medicine at UC San Diego Health said of the new funding, “Our team is excited to receive this to conduct a systematic, ‘real-world, real-time’ study with professional athletes, and which should shed further light upon the many anecdotal reports that cannabis is helpful in reducing post-competition pain” (NFL Communications).

Expanding on cannabis research will allow for the study of the relationship between cannabis and pain relief. Joshua Aviram, a clinical research manager at the Israel Institution of Technology Center for Biological Research, et al completed a systematic review of randomized control trials and concluded, “The current systematic review suggests that cannabis-based medicines might be effective for chronic pain treatment” (2017). In 2018, Eric P. Baron, a headache specialist and neurologist at the Cleveland Clinic, wrote “there is accumulating evidence for various therapeutic benefits of cannabis/cannabinoids, especially in the treatment of pain, which may also apply to the treatment of migraine and headache.”

In their piece, ‘“The two sides of the same coin” – medical cannabis, cannabinoids, and immunity: pros and cons explained’ for the Pain Physician Journal, Mona Khoury et al. say, “Cannabis-based products isolated from plant extracts exhibit potent immunoregulatory properties, reducing chronic inflammatory processes and providing much-needed pain relief” (2022). They also note that cannabis use can create “an overall potent immunosuppressive impact among users” which could cause negative effects on immuno-compromised individuals (Khoury, 2022).

With the consistent presence of opioids in the discussion around sports and pain management, Baron claims that evidence in support of cannabis' therapeutic potential is mounting, especially when it comes to treating pain, which could also apply to the treatment of migraines or persistent headaches. Interestingly, Baron also claims, “there is supporting evidence that cannabis may assist in opioid detoxification and weaning, thus making it a potential weapon in battling the opioid epidemic” (Baron, 2018).

The Journal of the International Association for the Study of Pain published a narrative review on cannabis, cannabinoids, and cannabis-based medicines for pain management in rodents. David P. Finn et al. says:

Preclinical (rodent) models have advanced our understanding of the underlying sites and mechanisms of action of cannabinoids and the endocannabinoid system in suppressing nociceptive signaling and behaviors. We conclude that substantial evidence from animal models supports the contention that cannabinoids and endocannabinoid system modulators hold considerable promise for analgesic drug development, although the challenge of translating this knowledge into clinically useful medicines is not to be underestimated (Finn, 2021).

These conclusions, although undoubtedly hold a need for more research, have prompted major U.S. sports leagues, as mentioned above, to re-evaluate their cannabis consumption rules for athletes.

The National Women’s Soccer League is an outlier in terms of drug policies – they allow for use of cannabinoids like CBD for pain management and even allow for cannabis sponsorships (Cash, 2020). The option of sponsorships has allowed for women-led companies like Mendi, an athlete-developed CBD company, to back the Utah Royals and the NC Courage (Cash, 2020). Mendi’s CEO, Rachel Rapinoe, twin sister of famed USWNT player Megan Rapinoe, said of the partnership with the NWSL, “Partnering with teams whose players can attest to the benefits of Mendi’s products without breaking the rules of the league was obviously a draw” (Cash, 2020).

Most other major sports, such as Major League Soccer, the International Tennis Federation, and the Professional Golfers Association maintain strict drug testing programs (Levenson, 2022).

While this shift in mindset is occurring gradually, it is happening. In leagues that allow for cannabis use, players might find alternative measures to pain and muscle management through cannabis. Depending on what this new NFL funding churns up, we might see increased support for conducting research on the use of cannabis as a treatment method for pain management, particularly concerning sports-related injuries.

References:

Anand U, Pacchetti B, Anand P, Sodergren MH. Cannabis-based medicines and pain: a review of potential synergistic and entourage effects. Pain Management. 2021 Apr;11(4):395-403. doi: 10.2217/pmt-2020-0110. Epub 2021 Mar 11. PMID: 33703917. https://pubmed.ncbi.nlm.nih.gov/33703917/

Aviram J, Samuelly-Leichtag G. Efficacy of cannabis-cased cedicines for pain management: a systematic review and meta-analysis of randomized controlled trials. Pain Physician. 2017 Sep;20(6):E755-E796. PMID: 28934780. https://pubmed.ncbi.nlm.nih.gov/28934780/

Baron EP. Medicinal properties of cannabinoids, terpenes, and flavonoids in cannabis, and benefits in migraine, headache, and pain: an update on current evidence and cannabis science. American Headache Society. 2018 Jul;58(7):1139-1186. doi: 10.1111/head.13345. PMID: 30152161. https://pubmed.ncbi.nlm.nih.gov/30152161/

Cash, M. (2020 April 9). Major professional sports leagues have been slow to embrace the cannabis revolution. the nwsl and the rapinoe sisters are breaking the trend. Insider. https://www.insider.com/nwsl-cannabis-policy-allows-cbd-use-rapinoe-backed-mendi-partnership-2020-4

Finn DP, Haroutounian S, Hohmann AG, Krane E, Soliman N, Rice ASC. Cannabinoids, the endocannabinoid system, and pain: a review of preclinical studies. The Journal of the International Association for the Study of Pain. 2021 Jul 1;162(Suppl 1):S5-S25. doi: 10.1097/j.pain.0000000000002268. PMID: 33729211; PMCID: PMC8819673. https://pubmed.ncbi.nlm.nih.gov/33729211/

Florio, M. New cba removes all substance-abuse suspensions for positive drug tests. NBC Sports. 2020 Mar 5. https://profootballtalk.nbcsports.com/2020/03/05/new-cba-removes-all-substance-abuse-suspensions-for-positive-drug-tests/

Godbout-Parent M, Nguena Nguefack HL, Angarita-Fonseca A, Audet C, Bernier A, Zahlan G, Julien N, Pagé MG, Guénette L, Blais L, Lacasse A. Prevalence of cannabis use for pain management in Quebec: A post-legalization estimate among generations living with chronic pain. Can J Pain. 2022 Jun 3;6(1):65-77. doi: 10.1080/24740527.2022.2051112. PMID: 35694144; PMCID: PMC9176231. https://pubmed.ncbi.nlm.nih.gov/35694144/

Jaeger, K. NBA could permanently end marijuana tests so it doesn’t become ‘big brother,’ commissioner says. Marijuana Moment. 2020 Dec 24. https://www.marijuanamoment.net/nba-could-permanently-end-marijuana-tests-so-it-doesnt-become-big-brother-commissioner-says/

Jaeger, K. NBA players won’t be tested for marijuana next year as league weighs permanent change. Marijuana Moment. 2020 Dec 4. https://www.marijuanamoment.net/nba-players-wont-be-tested-for-marijuana-next-year-as-league-weighs-permanent-change/

Khoury M, Cohen I, Bar-Sela G. "The two sides of the same coin"- medical cannabis, cannabinoids and immunity: pros and cons explained. Pain Physician Journal. 2022 Feb 10;14(2):389. doi: 10.3390/pharmaceutics14020389. PMID: 35214123; PMCID: PMC8877666. https://pubmed.ncbi.nlm.nih.gov/35214123/

Levenson, M.S. (2022 May 19). Which sports test for marijuana? Leafly. https://www.leafly.com/news/politics/which-sports-test-for-marijuana

MBL Communications [@MLB_PR]. (2019, Dec 12). Today, @MLB and the @MLB_Players jointly announced significant changes to the Drug of Abuse provisions of the Joint Drug Prevention and Treatment Program. https://twitter.com/MLB_PR/status/1205157274676682752?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1205157274676682752%7Ctwgr%5E%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fwww.marijuanamoment.net%2Fmlb-officially-removes-marijuana-from-banned-substances-list-for-baseball-players%2F

NFL. (2022, February 1). NFL awards $1 million to study impact of cannabis and CBD on pain management. NFL Communications. Retrieved June 14, 2022, from https://nflcommunications.com/Pages/NFL-AWARDS-$1-MILLION-TO-STUDY-IMPACT-OF-CANNABIS-AND-CBD-ON-PAIN-MANAGEMENT-.aspx

NFL Communications Department [@NFL345]. (2022, Feb 1). Today, the @NFL announced $1 million in research funding to researchers at @UCSanDiego and @UofRegina to study the impacts of cannabis and CBD on the pain management of elite athletes. https://twitter.com/NFL345/status/1488543218975350784?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1488543218975350784%7Ctwgr%5E%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fwww.marijuanamoment.net%2Fnfl-awards-1-million-to-study-marijuana-pain-management-and-concussion-protection-for-players%2F

Stump, S. NBA commissioner talks about decision to continue new season without the bubble. Today. 2020 Dec 22. https://www.today.com/news/nba-commissioner-adam-silver-talks-new-season-without-bubble-t204469