Marijuana and Sports - Research Brief
This information was prepared by the National Cannabis Prevention and Information Centre in Australia, and used with permission. Some information may not be accurate for U.S. readers.
Marijuana is the most widely used illicit drug in the Western world and, correspondingly, is frequently detected via urine testing1,2 in the workplace and in competitive sport.3 Urine testing in the workplace is conducted under the assumption that the substance in question reduces productivity and increases risk of workplace accidents (thus is an ‘ergolytic’ drug).4 However, urine testing in competitive sport is conducted under the assumption that the substance in question unfairly increases performance (thus is an ‘ergogenic’ drug).5 This begs the question, what role does marijuana really play in competitive sports?
Participation in competitive sports has been shown to be a protective factor against drug use6 with the notable exception of anabolic steroids and other performance enhancing substances.7-12 It has been posited that some athletes are driven to use a range of substances, including alcohol, due to increased pressure resulting from difficulties in balancing a social life along with full course loads, as well as sport practice and work outs.13,14 Studies on the prevalence of performance enhancing substances in competitive sport highlight that two to three per cent of adolescents (most studies are conducted with students) have used at least one substance, although the frequency of performance enhancing substance use is likely to be higher for males compared to females, older competitors compared to younger competitors and for competitors in a higher or more intensive level of competition.15-22 However, the information available on the frequency of marijuana and other illicit drug use by athletes is less clear.
Cannabinoids have been included in an annually updated list of substances that are prohibited to elite athletes kept by the International Olympic Committee (IOC) and more recently by the World Anti-Doping Agency.23 The world Anti-Doping Agency was established in 1999 as an international independent agency composed and funded equally by the sport movement and governments of the world. The World Anti-Doping Code was created in 2004 and the revision of the Code in 2009 does not impact on any of the information provided from sources that pre-date this. Before competition and during periods of training, elite athletes are regularly checked via urine testing to determine if prohibited substances have been used and to sanction punishment where detected. Cannabinoids are treated differently to most other drugs on the prohibited drug list in two ways. Firstly, the prohibition is subject to an amount of marijuana in the urine greater than 15ng/ml in urine tests24 so as to allow for the possibility of passive inhalation.25 Secondly, the penalties for using cannabinoids are not explicitly outlined in the prohibited substances list and instead remain disparate and left to the particular sport’s federation rules.26
Recent research has highlighted the importance of making a distinction between drug use with the intent to enhance performance and recreational use. Waddington and colleagues27 investigated the percentage of English football players who personally knew of other players that used substances and found that recreational drug use was up to eight times more common than performance enhancing drug use. More recently Dunn and colleagues28 investigated the drug use patterns of 974 Australian athletes. In this study one-fifth (21%) of the sample reported having ever used (‘lifetime use’) marijuana and a small group (3.7%) reported past-year use (‘recent use’).
A recent meta-analysis has shed some light as to whether participation in competitive sport influences rates of alcohol, tobacco and illicit drug use.11 The authors concluded that the majority of research indicates that rates of alcohol use were increased while rates of tobacco and illicit drugs were decreased among competitive athletes. Regarding marijuana in particular, four of the articles reviewed found that this relationship was moderated by sport and gender.6,29-31 These articles found that marijuana use was higher in male athletes (particularly hockey players although not for soccer players) and that a ‘U-Curve’ between intensity of activity (taken as hours per week spent training) and drug use was found only in males and only for marijuana use. A recent article not included in this meta-analysis found that among Polish athletes, marijuana use was most popular in male competitors, aged 16-24 years, competing in the disciplines of rugby, skating, boxing, badminton, body building and acrobatic sports during periods of sport preparation (i.e., out of competition).32
In the sporting arena, using a substance or method which is potentially harmful to an athletes’ health and/or capable of enhancing performance is referred to as ‘doping’.33 Despite some recent debate regarding the utility of urine screening for doping,34 there is some evidence that athletes themselves approve of these tests. The majority of athletes surveyed in two studies endorsed testing for banned substances as an effective way of deterring drug use and believed that the associated punishments for using these substances were appropriate.27,35
Marijuana as an Ergolytic Drug
As described by Campos et al,36 many authors clearly consider marijuana as an ergolytic drug, and that “the intent to use [them] to enhance performance in sports activities will fail … Consequently, there are no circumstances in which they may be useful”. This is partly due to the increasing cardiac frequency and alterations to motor performance that marijuana produces.37 In particular, marijuana is known to increase heart rate while decreasing cardiac stroke volume, resulting in diminished peak performance. Several studies have supported this by directly investigating the effects of marijuana on the performance of cyclists,38,39 healthy non-athlete volunteers,40 and in a litany of driving capability studies.41 In addition, marijuana is harmful to the respiratory system when smoked and increases the risk of respiratory tract infection, bronchitis and lung cancer.42 This would result in greater difficulty for athletes to intake sufficient oxygen for peak performance. Further, marijuana use would result in reduced sport performance through slowed reaction time, problems of motor coordination, problems of hand-eye coordination, and problems of perceptual accuracy.43 It is apparent that the use of marijuana could be potentially dangerous in sports that rely on quick reactions and fast decision-making.
Despite these observations, a study on Australian athletes has shown that almost two thirds (60%) believed marijuana to be an ergolytic drug, but were unable to clearly explain how marijuana use would negatively impact on athletic performance.44 Indeed, a small number (3%) of athletes indicated that they believed marijuana use would not impact negatively on their performance. These athletes referred to ergogenic effects including relaxation and calming and increased confidence, although these effects were identified to depend on frequency and timing of use.
Marijuana as an Ergogenic Drug
Some authors have recognised that marijuana could have indirectly ergogenic effects, such as producing a euphoric effect, reducing anxiety and increasing the sociability of a player. 45-48 This may result in a more balanced performance from a competitor who may otherwise be too nervous before an important event. Lorente and colleagues46 reported that relaxing, pleasure, and improved sleeping were the main motivations for using marijuana as indicated by French students. However, to date no research has objectively demonstrated that marijuana use has resulted in observable increases in performance through relaxing the athlete or improving their sleeping patterns. In contrast, for some users, the acute adverse effects of marijuana use have been demonstrated to result in increased anxiety, panic, nervousness and restlessness, thus causing disruption to sleeping patterns.49
The Role of Marijuana in Sport
Marijuana is thought by the majority of authors and athletes to have a negative impact on performance. Despite this, a minority of athletes persist with using marijuana – a percentage significantly lower than the general population. The likelihood that an athlete uses marijuana appears to be moderated by the actual sport and level of competition as well as gender. Available evidence suggests that those at greatest risk are adult males in intensive sports that involve a greater number of hours spent in training and are in a high level of competition.
- Mottram, D.R. (1999). Banned drugs in sport. Sports Medicine 27, 1-10.
- Mottram, D.R. (2005). Prevalence of drug misuse in sport. In D.R. Mottram (ed.) Drugs in sport. Routledge: New York.
- United Nations Office on Drugs and Crime. (2009). World Drug Report, 2009. United Nations: New York.
- Frone, M.R. (2004). Alcohol, drugs, and workplace safety outcomes: A view from a general model of employee substance use and productivity. In. J. Barling & M.R. Frone (eds.). (2004). The psychology of workplace safety. American Psychological Association: Washington, DC. pp. 127-156.
- Lippi, G., Franchini, M. & Cesare Guidi, G. (2008). Doping in competition or doping in sport? British Medical Bulletin 86, 95-107.
- Pate, R.R., Heath, G.W., Dowda, M., & Trost, S.G. (1996). Association between physical activity and other health behaviors in a representative sample of US adolescents. American Journal of Public Health 86, 1577-1581.
- Ambrose, P.J. (2004). Drug use in sports: A veritable arena for pharmacists. Journal of the American Pharmaceutical Association 44, 502-514.
- Hoberman, J. (2002). Sports physicians and the doping crisis in elite sports. Clinical Journal of Sports Medicine 12, 203-208.
- Juhn, M. (2003). Popular sports supplements and ergogenic aids. Sports Medicine 33, 921-939.
- Kutscher, E.C., Lund, B.C. & Perry, P. (2002). Anabolic steroids: A review for the clinician. Sports Medicine 32, 285-296.
- Lisha, N.E. & Sussman, S. (2010). Relationship of high school and college sports participation with alcohol, tobacco, and illicit drug use: A review. Addictive Behaviors 35, 399-407.
- Millman, R.B. & Ross, E.J. (2003). Steroid and nutritional supplement use in professional athletes. American Journal of Addiction 12, 48-54.
- Heyman, S.R. (1986). Psychological problem patterns found with athletes. Clinical Psychologist 39, 68-71.
- Martens, M.P., Dams-O’Connor, K. & Beck, N.C. (2006). A systematic review of college student-athlete drinking: Prevalence rates, sport-related factors, and interventions. Journal of Substance Abuse Treatment 31, 305-316.
- Laure, P. (2001). Epidemiologie du dopage. Immunoanalyse and Biologie Spécialisée 16, 96-100.
- Laure, P., Lecerf, T., Friser, A., & Binsinger, C. (2004). Recreational drug use and attitudes towards doping of high school athletes. International Journal of Sports Medicine 25, 133-138.
- Melia, P., Pipe, A. & Greenberg, L. (1996). The use of anabolic-androgenic steroids by Canadian students. Clinical Journal of Sports Medicine 6, 9-14.
- Pillard, F., Grosclaude, P., Navaro, F., Godeau, E., & Riviere, D. (2002). Sport-practice and doping among a representative sample of adolescents attending school in a French region. Science and Sports 17, 8-16.
- Rosenberg, M. (1979). Conceiving the self. Basic Books: New York.
- Spielberger, C.D. (1983). Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press: Palo Alto.
- Turblin, P., Grosclaude, P., Navarro, F., Riviere, D., & Garrigues, M. (1995). Epidemiologic survey of doping in schools of the French Midi-Pyrenees region. Science and Sports 10, 87-94.
- Pillard, F., Cances-Lauwers, V., Godeau, E., Navarro, F., Rolland, Y., & Riviere, D. (2001). Sport practice and cannabis consumption in a representative sample of French high school adolescents. Annales de Medecine Interne 7, 28-36.
- The 2010 prohibited list world anti-doping code. (2010). Free online (last accessed 15.02.2010).
- International Olympic Committee. (1999). Prohibited classes of substances and prohibited methods. IOC: Lausanne.
- Wennig, R. (2000). Threshold values in toxicology: Useful or not? Forensic Science International 113, 323-330.
- Mareck-Engelke, U., Geyer, H. & Schanzer, W. (2001). Misuse of cannabinoids in high level competition. Deutsche Zeitschrift Fur Sportmedizin 52, 280.
- Waddington, I., Malcolm, D., Roderick, M., & Naik, R. (2005). Drug use in English professional football. British Journal of Sports Medicine 39, e18.
- Dunn, M., Thomas, J.O., Swift, W., & Burns, L. (2010). Recreational substance use among elite Australian athletes. Drug and Alcohol Review, In press.
- Ewing, B.T. (1998). High school athletes and marijuana use. Journal of Drug Education 28, 147-157.
- Ford, J.A. (2007). Substance use among college athletes: A comparison based on sport/team affiliation. Journal of American College Health 55, 267-373.
- Peretti-Watel, P., Francois, B. & Legleyel, S. (2001). Beyond the U-curve: The relationship between sport and alcohol, cigarette and cannabis use in adolescents. Addiction 97, 707-716.
- Pokrywka, A., Obminski, Z., Kwiatkowska, D., & Grucza, R. (2009). Cannabinoids cases in Polish athletes. Biology of Sport 26, 119-135.
- International Olympic Committee Medical Commission. (1999). Olympic Movement Anti-Doping Code. IOC: Lausanne.
- Kayser, B., Mauron, A. & Miah, A. (2007). Current anti-doping policy: A critical appraisal. BMC Medical Ethics 8:2 doi:10.1186/147-6939-8-2.
- Dunn, M., Thomas, J.O., Swift, W., Burns, L., & Mattick, R.P. (2010). Drug testing in sport: The attitudes and experiences of elite athletes. International Journal of Drug Policy 21, 330-332.
- Campos, D.R., Yonamine, M. & de Moraes Moreau, R.L. (2003). Marijuana as doping in sports. Sports Medicine 33, 395-399.
- Eichner, E.R. (1993). Ergolytic drugs in medicine and sports. The American Journal of Medicine 94, 205-211.
- Renaud, A.M. & Courmier, Y. (1986). Acute effects of marijuana smoking on maximal exercise performance. Medicine and Science in Sports and Exercise 18, 685-689.
- Tashkin, D.P. (1978). Cannabis: 1977 UCLA Conference. Annals of Internal Medicine 89, 539-549.
- Bird, K.D., Boleyn, T., Chesher, G.B., Jackson, D.M., Starmer, G.A., & Teo, R.K.C. (1980). Intercannabinoid and cannabinoidethanol interactions and their effects on human performance. Psychopharmacology 71, 181-188.
- Menetrey, A., Augsburger, M., Favrat, B., Pin, M., Rothuizen, L.E., Appenzeller, M., Buclin, T., Mangin, P., & Giroud, C. (2005). Assessment of driving capability through the use of clinical and psychomotor tests in relation to blood cannabinoids levels following oral administration of 20 mg dronabinol or of a cannabis decoction made with 20 or 60 mg delta9-THC. Journal of Analytical Toxicology 29, 327-338.
- Tetrault, J.M., Crothers, K., Moore, B.A., Mehra, R., Concato, J., & Fiellin, D.A. (2007). Effects of marijuana smoking on pulmonary function and respiratory complications: A systematic review. Archives of Internal Medicine 167, 221-228.
- Wilmore, J.H. & Costhill, D.L. (1999). Physiology of sport and exercise. Human Kinetics: Champaign, IL.
- Thomas, J.O., Dunn, M., Swift, W., & Burns, L. (2010). Elite athletes’ perceptions of the effects of illicit drug use on athletic performance. Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine 20, 189-192.
- Cherpitel, C.J., Meyers, A.R. & Perrine, M.W. (1998). Alcohol consumption, sensation seeking and ski injury: A casecontrol study. Journal of Studies on Alcohol 59, 216-221.
- Lorente, F.O., Peretti-Watel, P. & Grelot, L. (2005). Cannabis use to enhance sportive and non-sportive performances among French sport students. Addictive Behaviors 30, 1382-1391.
- Peretti-Watel, P., Guagliardo, V., Verger, P., Pruvost, J., Mignon, P., & Obadia, Y. (2003). Sporting activity and drug use: Alcohol, cigarette and cannabis use among elite student athletes. Addiction 98, 1249-1256.
- Pillard, F., Cances-Lauwers, V., Godeau, E., Navarro, F., Rolland, Y., & Riviere, D. (2001). Sport practice and cannabis consumption in a representative sample of French high school adolescents. Annales de Me´decine Interne 7, 28-36.
- Hall, W. & Degenhardt, L. (2009). Adverse affects of non-medical marijuana use. Lancet 374, 1383-1391.
This information adapted with permission from the National Cannabis Prevention and Information Centre in Australia.