Cannabis and athletes: what the research shows

The short answer

Plenty of athletes use cannabis, and plenty of people wonder whether it helps with sore muscles, sleep or recovery. The honest answer is that the research is thin. There is little evidence that cannabis improves performance or recovery, THC is still banned in competition under anti-doping rules, and cannabis can affect coordination and judgment. Here is what is known so far.

How common is it?

A 2020 systematic review in Sports Health pooled 11 surveys covering more than 46,000 athletes and found that about 1 in 4 (23.4%) reported using cannabis in the past year.

Performance: no evidence of a boost

The same review found that the handful of studies measuring performance showed either no effect or a negative one, and the authors called the overall body of research generally poor. A 2021 review in Sports Medicine reached a similar conclusion: studies of whole cannabis and THC have generally shown either no effect or a harmful effect on strength and aerobic performance, though there still aren't enough rigorous studies to say for certain. The reviewers also flagged THC's effects on the cardiovascular system as an open question for athletes.

Recovery, pain and sleep: early and limited

When the Sports Health review searched the literature, it found no published research at all on cannabis and athletic recovery. Much of the interest since then has focused on CBD. The Sports Medicine review noted that CBD's possible effects on sleep, pain and mild traumatic brain injury may interest athletes, but that none of these had been thoroughly studied in athletes. The same goes for topical products: they are popular for sore muscles and joints, but well-designed studies in athletes are lacking.

Outside of sports, pain research is mixed. The 2017 National Academies (NASEM) report found substantial evidence that cannabis is effective for chronic pain in adults. Chronic pain conditions, though, are not the same thing as post-workout soreness or a fresh injury. And a 2018 Cochrane review of cannabis-based medicines for chronic nerve pain found only small benefits supported by low-quality evidence (about 21% of people on cannabis-based medicines got substantial relief versus 17% on placebo). More people dropped out because of side effects, and the reviewers concluded the potential benefits might be outweighed by potential harms.

Anti-doping rules: THC is still banned in competition

If you compete under World Anti-Doping Agency (WADA) rules, which cover Olympic and many international sports, here is what to know:

• THC is prohibited in competition. As the U.S. Anti-Doping Agency (USADA) explains, WADA prohibits natural and synthetic cannabinoids in-competition, and a test above the THC urinary threshold of 150 ng/mL is reported as positive.
• CBD is the exception. Starting with the 2018 list, CBD is no longer prohibited. USADA warned at the time that CBD extracted from cannabis plants may contain THC, which is still prohibited.
• CBD labels aren't always accurate. A 2017 JAMA study of 84 CBD products bought online found THC in about 21% of them, and only about 31% were accurately labeled for CBD content.
• Rules vary by sport and league. The Sports Health review found THC thresholds ranging from 15 to 150 ng/mL across athletic organizations. WADA updates its prohibited list every year, so check the current rules with your governing body before you compete.

Safety and impairment

NIDA notes that cannabis can impair thinking, memory and body movement, and the NASEM report found moderate evidence that acute cannabis use impairs learning, memory and attention. NASEM also found substantial evidence linking cannabis use to a higher risk of motor vehicle crashes. For sports that depend on timing, balance and quick decisions, or that carry real injury risk, that matters. Don't train, compete or drive while impaired.

Smoking anything is also tough on the lungs: NASEM found substantial evidence that long-term cannabis smoking is associated with worse respiratory symptoms and more frequent chronic bronchitis. And according to NIDA, studies have estimated that 22% to 30% of people who use cannabis have cannabis use disorder.

Talk to your doctor

If you are dealing with pain, an injury or trouble sleeping, see a doctor or a sports medicine professional who can diagnose the problem and recommend treatment with good evidence behind it. Don't stop or replace any prescribed treatment with cannabis, and tell your doctor if you use cannabis, especially if you take other medications. If you are subject to drug testing, check with your team physician or anti-doping organization before using any cannabis or CBD product.

The bottom line

Cannabis is not a proven sports medicine. Research suggests it doesn't improve performance, the evidence on recovery is very limited, and THC can affect coordination and lead to an anti-doping violation. If you are an adult who chooses to use cannabis, keep it away from training, competition and driving, and know the rules of your sport.

This article is general information, not medical advice.

Sources

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