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The Medical Cannabis Research Challenge

Although medical cannabis has been legal in Canada since 2000, stigma is still pervasive, especially in sports communities. How do sports communities view and understand the role of cannabis in delivering healthcare needs and what are the research gaps and challenges?

Editor’s Note: The acceptance of cannabis for both medical and recreational use has grown tremendously in North America in the past decade.  Despite the growing acceptance, much more research is still needed to guide future efforts.  In this interesting article, Arundati Dandapani discusses the Canadian experience with medical uses of cannabis and the challenges that she sees moving forward.

History of Medical Cannabis in Canada

Medical cannabis is used for exclusively medical treatment, and in Canada, can be legally obtained by patients authorized by their healthcare provider by buying from a federally licensed seller, growing it themselves after registering with Health Canada or designating someone else to produce it for them in limited quantities.

According to Vividata’s Canadian Cannabis Study 2018,  7% of Canadian cannabis consumers consume for medical purposes exclusively and just short of a fifth (18%) of all Canadian cannabis users (aged 19+) consume medical and recreational cannabis. Nearly half of all medical cannabis consumers in Canada last consumed cannabis in the past six months or longer, with about 15% consuming it in the past three months establishing higher recency of medical use than recreational use. Close to half (44%) of all Canadians (19+) who suffer from depression are current or potential users of cannabis, which is about the same proportion as there are medical cannabis users in Canada. Forty-four percent of Canadians consume medical cannabis daily  (compared to only about 20% of recreational users who consume daily). This should be no surprise with close to half of all current and potential users of cannabis suffering from medical conditions like migraines (48%), arthritis (44%) and depression (44%).

Athletics Relationship to Medical Cannabis

Among athletes, medical cannabis can fill a crucial gap in sleep aid, recovery from injuries, depression, anxiety, minor sprains to major brain concussions and more. However, cannabis use becomes problematic for players when stigma around use informs the rules of competitive sports. The use of cannabis in sports (especially team sports) has always been controversial. Former Leaf and 1989 Stanley Cup winner Ric Nattress has experienced it first-hand as a long time cannabis user.

What is Allowed, and What is Banned in Professional Competitive Sports?

According to the World Anti-Doping Agency (WADA), the list of banned substances is harmonized across all sports and a substance may be considered for inclusion if it meets two of the following three criteria:

  1. It has the potential to enhance sports performance;
  2. It represents a health risk to the athletes
  3. It violates the spirit of sport.

Cannabis is performance enhancing but its exact effects depend on the amount consumed, which could be inverse and varies with use. Can society distinguish between medical and more casual use? Do competitive athletes consume for fun or for medical reasons or both?

The Statistics

Among leisure team-sports participants (Basketball / Baseball / Softball / Football / Soccer / Volleyball / Curling / Ice Hockey), at least a fifth of all Canadian adults (aged 19+) was motivated to consume cannabis for personal relaxationstress reductionfun, and concentration purposes (Vividata 2018). According to the same study, close to or over half of all those who consumed medical cannabis to improve their meditation (46%), sex life (48%), mood (49%), concentration (50%), relaxation (51%), reduce stress (51%), heighten senses (51%), make activities interesting (52%), creativity (52%) and connect with others (54%) partook in leisure (non-team) sports activities in the past year (Basketball / Baseball / Softball / Football / Soccer / Volleyball / Curling / Ice Hockey). Significantly, close to three-quarters (71%) of Canada’s medical cannabis users (19+) alone participated in leisure fitness activities (Aerobics/ Exercise At Home/Health/Fitness Club/Fitness-Jogging/Fitness-Swimming / Fitness-Walking / Hiking or Fitness-Yoga/Pilates) in the past year. This close relationship between cannabis use and impact on leisure team and non-team fitness activities merits more investigation.

Cannabis use is already known to reduce reliance on opiates and overdosing from opioids (freedom from addictions to Benedryl, Tylenol, Advil and more). A lot of sportspersons rely on opiates. 63% of Canadian cannabis consumers reduced their reliance on other medications since use (Vividata 2018). The scientific findings are far from conclusive, and it is worth digging into some medical cannabis research challenges.

Research Challenges

Jay Rosenthal, co-founder of The Business of Cannabis recently hosted a “Sports and Cannabis” event in conjunction with Medical Cannabis Week 2019. I attended to help frame medical cannabis research challenges in sports:

There is a lack of comprehensible research surrounding medical cannabis, and if the research is out, it’s not yet in accessible language.

Recommendation:  This signals the strong potential for B2B research, whether through a mix of academic papers, books and one-to-one interviews with medical cannabis professionals, organizations, athletes, leagues, policymakers, and users.

There is a heavy reliance on hard drugs and opiates among athletes who would prefer more knowledge of non-harmful alternatives to opioids.

Recommendation: More evidence, use cases and correlations and formulations between how cannabis consumption reduces reliance on hard drugs and offers relief from opioid use are needed. More clinical trials and modeling on humans (than just animals) will enable more conclusive evidence on medical cannabis’ benefits to humans. Benefits of Hemp-derived CBD are mostly proven, but the THC constituency is still in question and often gets misrepresented. Conduct research to establish optimal proportions of THC-CBD-opioid doses for every condition and patient to optimize entourage effects and enable speedy recovery. CBD-THC limits must be prescribed in sports/drug trials.

Need more research around brain concussions and the role of cannabis in helping recovery but also overcoming the side effects of other medications and allied traumas.

Recommendation: Scientific research and human modeled clinical trials and research around the efficacy of cannabinoids for the treatment of brain concussions are urgent. Weigh the risks vs benefits, performance vs risks and harms for every treatment and use case/ailment.

Athletes and cannabis advocates want to drive away from the stigma against the use of cannabis. Most competitive sports committees/leagues are not open proponents of medical cannabis use, and often prohibit it.

Recommendation: Engineer workshops and events that train on medical cannabis use inviting credentialed physicians and federally approved healthcare providers. Explain why cannabis is the new standard of healthcare. Sharing medical user stories is important to drive away from the stigma and create awareness with scientific evidence and data. Making medical cannabis accessible and affordable is important for the success of professional athletes and for building a strong healthcare system that benefits all users.

Sports leagues, athletes, physicians, and the public need more research to prove the harms prevented and benefits exemplified from medical cannabis use. Every ailment and prescription is different, so designing cannabinoid profiles is just a starting point in establishing tailored use and effects on long-term athlete health.

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One response to “The Medical Cannabis Research Challenge

  1. From a sports point of view there are two issues. 1) In places where a drug is illegal, then use of it is banned. 2) If the drug confers medical benefits which translate to sporting benefits it is banned. Many drugs you can buy in a pharmacy without a prescription are banned. In some sports alcohol in your bloodstream is banned (e.g. archery). In sports like snooker beta-blockers are banned because they help you control your heart-rate. If Cannabis and its derivatives have medical benefits, it is likely that their use by sports people will be regulated. The main reason we have regulation in sport is to prevent healthy athletes from being pressured to take drugs just because other people are taking drugs.

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