Should cannabis be banned as a performance enhancing drug?

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Today it was announced that the American athlete Sha’Carri Richardson had tested positive for carboxy – THC (the main metabolite of THC, the active ingredient in cannabis), during the Olympic trials in Oregon in May.

Sha’Carri Richardson admitted to using cannabis after finding out that her mother had died. Unfortunately this was just prior to the Olympic trials. USADA confirms Richardson “has accepted a one-month suspension – as permitted under the applicable international rules – for an anti-doping rule violation for testing positive for a substance of abuse”. This means that she will likely miss at least the individual events she was selected for in the Olympics, but may make the relays. So why has she been suspended from sport for a discretion (albeit cannabis is legal in Oregon) that appears very much part of her private life?

WADA anti Doping operates under the terms of strict liability – which means an athlete has to be aware of the anti-doping rules and has to account for any positive findings in their urine samples. If they can provide a good explanation then this may be able to mitigate any sanction that may be applied.
Cannabis is classed as a drug of abuse by WADA and is one of a number of drugs whose use is prohibited on the day of competition only. If you can establish that the use was out of competition then you can get reduction in a likely ban from the initial 4 years down to 3 months, or even 1 month if you agree to a ‘treatment programme’.

Unfortunately for anyone who choses to use cannabis (legally) the time it takes to leave the body can be very long. The tests used detect the main breakdown product of THC (tetrahydrocannabinol, the main active ingredient in cannabis) in urine samples from athletes. For someone who may use frequently it can be months before it is fully cleared. To allow some wriggle room for use outside of sport, WADA regulations for detection state that the concentration of the THC metabolite in urine must be greater than 180 ng/mL. This is 12 times higher than the threshold used in many work place testing labs (European Guidelines for Workplace Drug Testing in Urine, which is 15 ng/mL). So if you are tested going to work (safety reasons or pre employment screening) you are subject to much tighter limits than athletes.

So how come cannabis is banned in sports and how did it get onto the prohibited list?

WADA has 3 tests to determine is a drug should be on the prohibited list, The drug has to ‘fail’ two of these. These state that the drug must:

  • Be detrimental (or potentially be) to athlete health,
  • Have the potential to enhance performance, and
  • Be against the spirit of sport.

So does cannabis meet two of those? This is very debatable. Yes it may have some negative health risks. The most serious of which is long term use being linked to development of serious psychotic illness (other risk factors seem to be involved also). Cannabis does have some positive health effects, particular licensed for relief of pain in MS patients and those undergoing chemotherapy. However cannabis (or purified THC in some cases) is now licensed for use for various ailments in many countries around the world.
So maybe this should be a tick on the potential to harm.

For the performance enhancing effects there not not likely to be many gains really. You could argue it helps with performance anxiety. Many athletes develop pain in their careers, I suspect some cannabis would be better for them in the long run than getting a TUE to use corticosteroids or other pain killers regularly. Could there be other gains such as performance recovery? I’m not so sure.
There is little evidence that cannabis can help enhance performance in the usual ways we would expect for a sprinter – strength and speed – see the summary tweet below. So that is a no from me for this second test.

The spirit of sport is slightly ambiguous. Using something purely for the means of performance enhancement seems to be a summary of it. The United States Anti-Doping agency say this about cannabis which suggests that by being illegal it violates the spirit of sport:

“Use of illicit drugs that are harmful to health and that may have performance-enhancing properties is not consistent with the athlete as a role model for young people around the world”.

However, as pointed out above cannabis is no longer illegal in many countries or states in the USA, including Oregon where the trials took place.

So should cannabis be banned?

Can this stance be justified any longer? Should cannabis now be treated like caffeine and paracetamol that are so widely used you would struggle to ban them?

I suspect there will be an increased focus on cannabis in sports after such a high profile athlete has been banned for its use. Many are arguing that this result is an invasion of the athlete’s privacy as it was not intended in any way to enhance sporting performance. On the other hand this athlete knew the current rules and should be treated with the strict liability in mind (as she has been).

I think it is a very hard sell to keep it on the prohibited list. Why test for a drug with little benefit that is used outside of competition? That isn’t really the remit of the ant doping authorities. It is interesting to note that WADA have removed CBD (the other major cannabinoid in the cannabis plant, now widely legally available as a ‘health supplement’) from the prohibited list. So why not now THC?

Cannabis coffee

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About Dr Tom Bassindale

Dr Tom Bassindale is a forensic scientist, and the founder of We Are Forensic. He is currently the subject lead for chemistry and forensic science at Sheffield Hallam University. He's managed hundreds of forensic toxicology cases, and is an experienced court witness. He has specialist expertise in forensic toxicology and drug testing in sport. And yes... he watches CSI.