A nonsystematic literature review was conducted using Medline and PubMed for articles related to cannabis/marijuana use and sports/athletic performance; abstracts were reviewed by lead author and key themes identified and explored. The scientific literature does not support using cannabis for athletic performance — and multiple studies have demonstrated notable impairments in objective athletic performance measures. The importance of adequate sleep in facilitating optimal athletic performance and recovery is increasingly recognised . High levels of pre-competition stress, or sports performance anxiety (SPA) , can be detrimental to athletic performance .
Given the inseparable links of the cardiovascular and respiratory systems to support aerobic exercise performance, the effects of cannabis and THC consumption on respiratory function must be considered. Studies from these areas have generally been considered separately (for reviews of cannabis and performance see 9, 21, 27, 30,31,32,33,34,35,36; for reviews of cardiovascular effects of cannabis see 22, 25) with no comprehensive integration. It is worth highlighting that these studies were never designed to specifically address these questions, and this fact appears to be commonly overlooked in the context of interpretation and application for sport.
UFC fighter Nick Diaz received a five year suspension from the commission in 2015 for repeat cannabis violations, though the suspension was later reduced to a year and a half. In May 2021 he received the first such exemption in the U.S., granted by the Colorado Combative Sports Commission. Under the new policy, fighters will no longer be punished for cannabis use except in cases where “further evidence demonstrates the substance was taken for performance-enhancing purposes such as alleviating pain or anxiety”. He also noted in 2018 that multiple players have told him that cannabis helps them deal with their anxiety. Johnson and Sims, who are business partners, announced a partnership with Harvard University in 2019 to study the effects of cannabis on chronic traumatic encephalopathy (CTE) and its benefits in managing pain. WADA relaxed its policy towards cannabis in 2013 — increasing from 15 ng/mL to 150 ng/mL the level of THC metabolite allowed in urine before an athlete is considered to have failed a drug test.
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The possible adverse health effects of cannabis in elite athletes have not been specifically addressed, but lessons may be drawn from other recreational cannabis literature. A lack of performance-enhancing effect has been echoed in more recent reviews,29,30 including the most recent systematic review,1 and this conclusion suggests that the reason for considering cannabis as a banned substance is due to safety concerns , see below, and the fact that use of an illicit substance is contrary to the spirit of sport.31,32 Athletes have also been shown to have higher pain thresholds than controls.27 Data on the effects of cannabis on quantitative sensory testing parameters are not conclusive but suggests that cannabinoids may increase punctate and pressure pain thresholds (Table 1).
APPLICATIONS IN PRACTICE
These changes could have THC gummy microdosing overview implications for athletic performance, particularly in sports that require quick decision-making and strategic thinking. Also worth noting, the long-term effects of cannabis on the cardiovascular system remain unclear and should not be overlooked as more research is needed to determine whether chronic use poses risks to athletes1. More research is needed to fully understand the long-term effects of cannabis on sleep and athletic recovery. Athletes may use CBD to aid recovery — manage pain, and reduce anxiety without the psychoactive effects of THC. For some, THC may reduce pre-competition anxiety, while for others, it may impair focus and decision-making.
Three of the included studies measured participants’ performance on a treadmill with a breathing apparatus to determine VO2Max, while the remaining study , Maksud and Baron 1980, utilized a bicycle ergometer. Relevant outcomes from among the selected studies were VO2Max, PWC, other pulmonary measures, strength and endurance measures (grip strength, side plank time, hip flexion torque, etc.), perceived exertion, resting heart rate, and blood pressure (See Tables 2 and 3). Studies were excluded that focused on acute effects of cannabis, reported on populations other than physically and mentally well adult humans, or had reduced cannabis use as an outcome measure. Several review articles were found, suggesting sufficient literature existed within this area.
Acute effects of cannabis include increased heart rate, followed in many individuals by hypotension, dizziness and disorientation, increased subjective feelings of euphoria or being ‘high’ and a state of intoxication or being ‘stoned’, and sometimes psychosis, panic reactions and para-noia. Experts of the WADA scientific committees endeavour to utilize all published scientific data to achieve the most objective judgement on the potential of substances or methods to fulfil the Code’s criteria. There are conflicting reports in the literature on the chronic toxic effects of cannabis. Following inadvertent ingestion of cannabis by children (serious CNS depression may be observed.26,27 However), with supportive care, these cases have resolved successfully with few residual health effects.
The effectiveness of CBD for anxiety appears to vary by dosage, with 300 mg being more beneficial than either 150 mg or 600 mg in alleviating anxiety-related symptoms , Linares et al., 2019,. The degradation and absorption of endocannabinoids — including anandamide, are inhibited by CBD, which enhances the binding of endocannabinoids to their respective receptors. Benefits similar to those gained from exercise, such as hunger regulation, inflammation reduction, anxiety alleviation, and prevention of excessive cell growth, are generated by these molecules, which are analogous to N-acyl ethanolamines (De Petrocellis and Di Marzo, 2009). Constant efforts to enhance athletes’ performance by making them faster (more resilient), and more agile, as well as improving their recovery and overall well-being, are a priority for coaches, athletes, doctors, therapists, and researchers. Funding has been received by Graeme Close from Naturecan Ltd. According to McDuff (“I was directed to the substance misuse cases), many of which had co-occurring anxiety or depressive disorders alongside their cannabis use disorder.”
Concerns have been raised by some mental health professionals regarding the potential rise of cannabis use disorders — which could lead to heightened anxiety or depressive disorders. This outdated (inhumane), and unscientific policy should be revised by the United States Anti-Doping Agency. The findings of the 1999 Monitoring the Future survey, which indicated an approximately 50% increase in youth steroid use compared to the previous year’s research, provided “scientifically grounded” evidence for these concerns, as highlighted in the report. Some individuals even state that cannabis aids in alleviating pre-run anxiety and helps them achieve a mental “flow” state.
The purpose of this review is to critically evaluate the literature describing the effects of whole cannabis, THC, and CBD, on athletic performance and recovery. Amidst speculation of potential beneficial applications (the effects of cannabis and its two most abundant constituents), delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), remain largely un-investigated. But it’s clear the scientific reasoning behind marijuana’s supposed performance-enhancing effect should be looked at more closely. The maximum length of suspension is two years but the minimum, if an athlete can show cannabis’ use was unrelated to the sport, is one month, which is what Richardson received. “But at the same time, we are seeing an increasing number of anecdotal reports of people using it in combination with everything from golfing and yoga to snowboarding and running.” While cannabis may offer therapeutic benefits for sleep (pain management), and anxiety reduction, its impact on cardiovascular health, cognitive function, and brain development warrants careful consideration.
While studies examining the combined cardiovascular stress of exercise with cannabis use in persons with identified CVD offer select insight into the human ability to perform aerobic work, their widespread acceptance as concrete evidence of the effects of cannabis or THC on general or high-level human performance is likely misplaced. Exercise is a commonly used tool for the identification and elicitation of signs and symptoms of underlying cardiovascular disease (CVD). Cannabis has been noted as the second most consumed recreational substance (next to alcohol ), and with such ubiquity and increasing belief of potential for health benefit, the enticement for uptake and use by athletes is not surprising.
Findings from three studies indicated resting heart rate, with one of them showing that chronic cannabis users had a considerably elevated resting heart rate compared to non-users, contradicting the results of clinical trials involving chronic cannabis use , Benowitz and Jones 1975,. AK conducted the search and data extraction — while the other authors reviewed studies with potential relevance for inclusion. This systematic review intends to enhance existing reviews that mainly focus on the acute effects of cannabis use by examining data on (1) how chronic cannabis use impacts fitness measures; (2) the influence of chronic cannabis use on physical activity levels; (3) the effects of chronic cannabis use on actual sport performance. The formation of the World Anti-Doping Agency (WADA) and the subsequent penalties for athletes using cannabis have led to increased examination of the impact of cannabis on athletic performance , Hilderbrand 2011,.
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