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 THC gummy microdosing overview 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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Although the specific adverse health effects of cannabis in elite athletes have not been thoroughly examined — insights might be gleaned from existing literature on recreational cannabis. More recent reviews (including the latest systematic review), have reiterated that there is no performance-enhancing effect from cannabis; this finding indicates that safety concerns are behind its classification as a banned substance, alongside the principle that using illegal substances goes against the spirit of sport. Furthermore — it has been shown that athletes generally possess higher pain thresholds compared to control groups. While the data concerning the impact of cannabis on quantitative sensory testing parameters is inconclusive, it indicates that cannabinoids could elevate both punctate and pressure pain thresholds , refer to Table 1,.
PRACTICAL APPLICATIONS
These changes could have 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.
Among the studies reviewed, three assessed participants’ performance on a treadmill using a breathing apparatus to evaluate VO2Max, whereas the last study employed a bicycle ergometer , Maksud and Baron 1980,. The pertinent outcomes identified across the chosen studies included VO2Max, PWC, additional pulmonary metrics, measures of strength and endurance (such as grip strength, side plank duration, and hip flexion torque), perceived exertion levels, resting heart rate, and blood pressure , See Tables 2 and 3,. Studies that concentrated on the acute effects of cannabis, reported on populations other than physically and mentally healthy adult individuals, or utilized reduced cannabis consumption as a measurable outcome were excluded. A number of review articles were identified, suggesting that a sufficient body of literature exists in this field.
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.
CBD effects on anxiety seem to depend on dosage; 300 mg is more effective than 150 or 600 mg for reducing anxiety-related symptoms (Linares et al., 2019). CBD inhibits the degradation and absorption of endocannabinoids such as anandamide — increasing endocannabinoids’ binding to their receptors. These molecules, comparable to N-acyl ethanolamine’s , De Petrocellis and Di Marzo, 2009,, generate benefits similar to exercises, such as hunger control, inflammation reduction, anxiety relief, and prevention of excessive cell proliferation. Coaches (athletes), doctors, therapists, and scientists are constantly concerned with finding ways to improve the performance of athletes by making athletes faster, more resistant, more agile, rest and recover better from efforts and feel better. Graeme Close has received funding from Naturecan Ltd. “I was referred to the substance misuse cases and many of them had comorbid anxiety or depressive disorders along with their cannabis use disorder,” says McDuff.
Some mental health experts have expressed concern over the development of cannabis use disorders, which may lead to increased anxiety or depressive disorders. The United States Anti-Doping Agency must undo this archaic (inhumane), and unscientific policy. ” These concerns, the report notes, were “scientifically grounded” by the results of the 1999 Monitoring the Future survey, which concluded that youth steroid use increased roughly 50% over the prior year’s study. Some users even report that cannabis helps with pre-run anxiety and getting into 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.
Three studies reported resting HR, one of which reported a significantly higher resting HR among chronic cannabis users than non-users, opposing the findings of chronic cannabis use clinical trials , Benowitz and Jones 1975,. The search and data abstraction were performed by AK, studies with potential relevance were reviewed by the other authors for inclusion. This systematic review aims to complement existing reviews, which primarily report on acute effects of cannabis use, by reviewing the available data on (1) the effects chronic cannabis use has on fitness measures; (2) any effects chronic cannabis use has on physical activity levels; (3) what effect chronic cannabis use has on actual sport performance. The establishment of the World Anti-Doping Agency (WADA) and subsequent penalisation of athletes for cannabis use has prompted greater scrutiny of the effects of cannabis effects on athletic performance (Hilderbrand 2011). A systematic review of the literature (cross-sectional, longitudinal, and intervention studies) concerning the effects of cannabis consumption on sports performance outcomes, e.g.
