Can athletes benefit from cannabidiol (CBD)?
Todd Subritzky, PhD
That’s an excellent and timely question, thank you. This issue has really caught the attention of sportspeople (and to a lesser extent researchers) in the last few years. The potential of CBD benefitting athletes is at the cutting edge of emerging research around cannabis and its individual compounds.
So, just to recap, you don’t get high from CBD. Cannabidiol is a “non-euphoriant, anti-inflammatory analgesic” cannabinoid that is extracted from the genus cannabis sativa (somewhat confusingly, according to many researchers this species includes hemp), which contains over 100 (phyto)cannabinoids and 400 plus compounds (ElSohly & Waseem, 2014; Russo, 2008, p.1). But you knew that right?
In this segment, I will focus specifically on CBD, while evidence relating to the potentially beneficial relationship between sports activity and cannabis generally is discussed in more detail later.
Part 1: The (limited) emerging literature of CBD and sports
CBD has generated quite the stir in recent times with multiple world-renowned cannabis scholars highlighting its therapeutic potential. For example, Mechoulam, Peters, Murillo‐Rodriguez, and Hanuš (2007) and Russo (2017) noted a range of areas where studies are indicating positive trends from epilepsy to cancer. Indeed, reports on the efficacy of CBD are now relatively common in mainstream media in the US (e.g. New York Times, 2019, May 14).
For athletes, particularly those participating in contact sports, it’s likely that emerging evidence (largely based on animal studies) around the potential efficacy of CBD in relation to neuroprotectivity and inflammation and personal experience has contributed to the surge in interest (El-Remessy et al., 2003; García-Arencibia et al., 2007). Considering this, it’s not surprising that high-performance athletes would explore treatment options involving the compound.
So, what do we know, scientifically speaking, about the benefits of CBD for athletes in a clinical sense? The short answer is not that much really. Traditionally, research into the relationship between cannabis compounds such as CBD and sporting activity has been examined through the lens of abusive behaviour or anti-doping categorizations as a banned substance (e.g. Saugy et al., 2006). Also, while cannabis policy in the US continues to evolve, there remain numerous hurdles (both regulatory and otherwise) to researching the potential benefits of CBD for athletes in clinical contexts.
While research into the therapeutic potential of CBD is limited with a paucity of clinically valid studies that have investigated the issue in the specific context of beneficial outcomes for athletes, studies are beginning to emerge (involving actual humans) that add to the evidence base. For example, a recent announcement that Canadian cannabis company Aurora has joined forces with UFC to test hemp-derived CBD products on elite athletes has promise. According to reports, it is hoped that the partnership “will significantly advance clinical science around how hemp-derived CBD impacts athlete recovery” (CNN Business, 2019, Jul. 25). It was reported that the research will initially focus on inflammation, recovery, pain management, and mental wellbeing. Nevada is right at the forefront of this latest development as the research will predominantly be undertaken right here in Las Vegas at the UFC Performance Institute, which is quite exciting. So watch this space!
Beyond this, based on a survey of over 1200 community athletes in the US, a recent study concluded that concerns about the potential misuse of cannabis products such as CBD by athletes may be overstated with perceived benefits (such as improved sleep, decreased anxiety, and less pain) potentially outweighing adverse impacts associated with consumption (Zeiger, Silvers, Fleegler, & Zeiger, 2019). As you will note, these subjective experiences reported by athletes differ from clinical trials, and as such the results are open to debate.
In contrast to the lack of validated clinical research into the efficacy of CBD for elite and social athletes, there appears to be an enormous weight of anecdotal evidence on the topic with a ton of well-publicised material from globally recognised athletes (Forbes, 2019, Feb. 4; Subritzky, 2018). I’ll now talk about some of the more prominent examples.
Part 2: A surge in anecdotal evidence
Anecdotal evidence of the benefits of CBD for athletes is growing rapidly, particularly after the passing of the Farm Bill in the US, which federally legalized CBD products extracted from hemp. Since then we have seen examples from prominent athletes emerging with regularity. The majority of these reports tend to emphasise the potential for CBD to aid recovery, reduce pain, and heal inflammation.
For example, in the last few weeks alone multiple partnerships have been announced by CBDMD including with former NFL pros Steve Smith (wide receiver) and Jonathon Stewart (running back). Smith reportedly commented, and I paraphrase here, that ‘those closest to me have seen what CBD can do firsthand, I’m proud to have the opportunity to educate the public on the power of CBD’(CBD MD, 2019). Stewart made special note of the stress placed on the body of professional athletes in the NFL, particularly for running backs who tend to either retire early or get cut due to chronic pain, injuries or burn out. He reportedly stated “After the constant contact and injuries my body endured throughout my career in the NFL, CBD has been able to help me live a better quality of life during retirement, stay competitive with my golf game, and keep up with my little girl day in and day out” (CBD MD, 2019).
Other professional athletes such as former NHL star Riley Cote have been long term advocates for CBD. Cote founded the Hemp Heals foundation in 2011 and is also a co-founder of Athletes for Care, a non-profit organization dedicated to assisting athletes post-retirement, and also challenges individuals to rethink the healing and recovery process in the context of sports-related injuries. So while clinical evidence is still emerging around the efficacy of CBD products for athletes, in terms of recovery, pain management, and the reduction of inflammation there are certainly encouraging trends in this rapidly developing space.
Beyond these CBD specific examples, there is an even larger body of anecdotal evidence when it comes to cannabis products that include THC. I will outline this evidence in more details in coming segments so stay tuned.
CBD MD. (2019). Athletes. Retrieved 8/8/2019 from https://www.cbdmd.com/athlete.
CNN Business. (2019, Jul. 25). UFC teams with Aurora Cannabis on CBD study in fighters. Retrieved 8/8/2019 from https://edition.cnn.com/2019/07/25/business/ufc-aurora-cannabis-cbd-study/index.html.
El-Remessy, A., Khalil, I., Matragoon, S., Abou-Mohamed, G., Tsai, N., Roon, P., . . . Liou, G. (2003). Neuroprotective effect of (−) Δ9-tetrahydrocannabinol and cannabidiol in N-methyl-D-aspartate-induced retinal neurotoxicity: involvement of peroxynitrite. The American journal of pathology, 163(5), 1997-2008.
ElSohly, M., & Waseem, G. (2014). Constituents of cannabis sativa. In R. Pertwee (Ed.), Handbook of Cannabis. New York, NY: Oxford University Press.
Forbes. (2019, Feb. 4). Pot-Smoking Phelps Isn’t Alone Among Athletes. Retrieved 8/8/2019 from https://www.forbes.com/2009/02/04/michael-phelps-marijuana-opinions-contributors_0204_dana_larsen.html#20ae30122aee.
García-Arencibia, M., González, S., de Lago, E., Ramos, J., Mechoulam, R., & Fernández-Ruiz, J. (2007). Evaluation of the neuroprotective effect of cannabinoids in a rat model of Parkinson’s disease: importance of antioxidant and cannabinoid receptor-independent properties. Brain research, 1134, 162-170.
Mechoulam, R., Peters, M., Murillo‐Rodriguez, E., & Hanuš, L. (2007). Cannabidiol–recent advances. Chemistry & biodiversity, 4(8), 1678-1692.
New York Times. (2019, May 14). Can CBD Really Do All That? How one molecule from the cannabis plant came to be seen as a therapeutic cure-all. Retrieved 5/26/2019 from New York Times https://www.nytimes.com/interactive/2019/05/14/magazine/cbd-cannabis-cure.html.
Russo, E. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management, 4(1), 245.
Russo, E. (2017). Cannabidiol Claims and Misconceptions. Trends in Pharmacological Sciences, 38(3), 198-201. doi:10.1016/j.tips.2016.12.004
Saugy, M., Avois, L., Saudan, C., Robinson, N., Giroud, C., Mangin, P., & Dvorak, J. (2006). Cannabis and sport. British journal of sports medicine, 40 Suppl 1(Suppl 1), i13-i15. doi:10.1136/bjsm.2006.027607
Subritzky, T. (2018). Beyond deficit and harm reduction: incorporating the spectrum of wellness as an interpretive framework for cannabis consumption. International Journal of Drug Policy, 60(10), 18-23. doi:https://doi.org/10.1016/j.drugpo.2018.07.013
Zeiger, J., Silvers, W., Fleegler, E., & Zeiger, R. (2019). Cannabis use in active athletes: Behaviors related to subjective effects. PLoS One, 14(6).