Some athletes claim marijuana helps them. We look at the the science behind this newly-legalized substance and how it can impact performance, for better or worse.
This past May, Prem Linskey finished fourth in The Endurance Society’s Infinitus 250-miler– a rugged multi-day trail race through the Moosalamoo National Recreation Area. Linskey has also competed in a handful of other ultra distance trail races around the state.
One of his training secrets? Linskey uses cannabis. “It helps me deal with pain, inflammation and nausea and helps me eat,” he says.
The 29-year-old from Huntington has also raced in the Catamount 50K and the Jay Peak Trail Running Festival 50K. “Sometimes it helps me get in the groove of a run, [and] sometimes it makes it harder,” he says.
Linskey tries not to use cannabis during races unless he gets sick (after a bout with food poisoning, a few puffs from a vape pen helped him recover his appetite during the 250-miler).
Linskey takes small doses so he doesn’t get high when he exercises. “I smoke a vape pen or use edibles. When I take CBD, I take it in capsules,” he says. He doesn’t consider it to be performance-enhancing. “It’s medicine, like I would take ginger for a stomach ache, or turmeric for inflammation.”
Another local athlete, who is a prominent part of Vermont’s backcountry ski scene uses cannabis three to four days a week. In his early forties, he describes himself as a former competitive cross-country mountain bike racer who goes on hard rides three to four days a week in the summer and ski tours just as frequently in the winter. He’s smoked pot regularly for 20 years. “I use it after I exercise, along with CBD oil for inflammation,” he says. He says he wouldn’t smoke before a race, but that 9 of the 10 people he backcountry skis with smoke cannabis when they ski tour.
Another local athlete and competitive mountain bike racer, who also asked to remain anonymous, used to smoke pot before racing to calm his nerves. “I would wait and get warmed up sober to remind my muscles what we are about to do, then have a couple of hits before my race to calm my fears and focus,” he says. “I found it way easier to focus on my line, body position and what was ahead.”
When asked if he thought cannabis was a performance-enhancing drug, he said, “I’m not really sure it was an advantage because I think three quarters of the field was doing the same thing.”
As of July 1, 2018, cannabis is legal in Vermont. You can smoke it (in private), you can possess it (up to one ounce), you can grow it (up to two mature female plants per dwelling), but you can’t buy it, unless you have a medical card.
According to a 2016 study from The American Journal of Addictions, marijuana is the second most widely-used drug among athletes in the United States—after alcohol. Some athletes, such as professional ultra-runner Avery Collins and world-class age-group triathlete and personal trainer Clifford Drusinsky, have talked openly about using cannabis edibles to train for endurance events in interviews with Men’s Journal and The New York Times.
In a 2017 guest editorial for The LA Times, former National Football League tight end Nate Jackson wrote: “The truth is that NFL players have been proving the viability of cannabis as a pain medication for decades,” touting it as a safer alternative to opioids in treating both chronic and short-term pain.
For better or worse, the World Anti-Doping Agency bans the use of natural and synthetic cannabinoids in competition. The agency decided to allow CBD, the non-psychoactive compound in cannabis, in 2018. WADA’s reasoning for banning marijuana includes cannabis’ illegal status in most countries, the potential for smoking to negatively affect respiratory, cardiac and mental health and its potential to enhance performance. The agency’s website reads “a common misconception of marijuana is that its use impairs physical activity, including exercise performance… there are…effects that than can be performance-enhancing for some athletes.” WADA lists the substance’s potential to reduce anxiety and muscle tension and increase focus and risk-taking behaviors as performance-enhancing qualities.
There’s also evidence that runner’s high, the euphoria associated with endurance running, is caused by the same system of chemical interactions as the high from smoking or ingesting cannabis products.
In 2015, a group of German researchers discovered that mice who ran on wheels had higher levels of naturally-occurring endocannabinoids in their blood stream, which appeared to reduce their anxiety and sensation of pain. The study they published in The Proceedings of the National Academy of Sciences suggests that the endocannabinoid system plays a “crucial role in runner’s high.”
THC vs. CBD
Dr. Karen Lounsbury is a professor of pharmacology at the University of Vermont College of Medicine who teaches courses on cannabis and studies the way that cells use chemicals to communicate within the body.
The two most prominent compounds in female marijuana plants are THC, or tetrahydrocannabinol, and CBD, cannabidiol. The former gets you high and the latter doesn’t.
As Dr. Lounsbury explains, THC affects the body by binding to cannabinoid receptors that are located in nerve cells that regulate pain, and in cells in the brain that regulate higher processing like hunger and decision-making. When it binds to the cannabinoid receptors, it has the effect of “shutting off” pain. By the same mechanism, it also changes the way we experience hunger, nausea and executive decision making.
According to a 2006 study published by the National Institutes of Health, THC essentially functions as an off switch for pain, by mimicking the naturally occurring substance anandamide, an endocannabinoid which tells your neurons to stop telling your brain you’re in pain.
The same study found that CBD does not bind to these same receptors, and little is known about its chemical behavior within the body.
Additionally, a 1991 study in Planta Medica reported that THC has 20 times the anti-inflammatory power of aspirin and twice that of hydrocortisone. Similarly, a study published in The Proceedings of the National Academy of Sciences in 1998 concluded that CBD is a more powerful antioxidant than vitamin C or vitamin E, and a 2006 study published in by the National Academy of Sciences found that CBD also exhibits anti-inflammatory properties.
Still, those studies are few and far between since marijuana’s status as a schedule 1 drug under federal law makes it difficult for researchers to secure funding to study it. A 2017 review in The Journal of Science and Medicine in Sport found only 15 published studies that looked at the effects of THC on exercise performance. For CBD, there are so few studies that no one knows for sure how the chemical affects the body.
“CBD doesn’t seem to bind to the cannabinoid receptors, and yet it has similar effects as THC on pain signaling and nausea,” says Dr. Lounsbury. “What gets people excited about CBD is that it seems to give you the same benefits as THC without getting you high.”
According to Shayne Lynn, Executive Director of Burlington-based Champlain Valley Dispensary and Southern Vermont Wellness, most of the people who frequent his businesses to use cannabis for health reasons don’t want to feel stoned. “CBD could be a larger market across the board than THC,” predicts Lynn. He sees a growing market for CBD oil that does not contain THC, which athletes concerned about a drug test could use.
Another perk of CBD? Dr. Lounsbury says it seems to reduce anxiety and counteract the high created by THC. However, she cautions: “At this point, there just aren’t enough studies to say clinically that we know what it is doing in your body.”
Smoking, Vaping and Edibles
The way you ingest cannabis also changes the way it affects your body. “When you smoke cannabis, it gets into the brain very quickly, so that the effects of the drug in your brain set in really fast and are intense,” says Dr. Lounsbury. “If getting high is the goal, smoking is the fastest way to do it.”
Both Collins and Drusinsky reported that eating edibles before setting out on a long run helped them maintain focus and push through pain. “If your goal is to treat pain, you might be better off taking an edible because the effects will last longer, be less intense and take longer to kick in,” Dr. Lounsbury says.
Edibles also allow users to bypass smoking the plant. “To be clear, there are carcinogens in joint smoke, and there are many fewer in the vapor from vaping cannabis,” she continues. “Cannabis is volatile, so they don’t have to put additive chemicals in the cartridges like they do for nicotine.”
A 2014 review of studies about cannabis and health risks published in Current Pharmaceutical Design states that there is no conclusive evidence to suggest that cannabis is carcinogenic when smoked. However, “all the right pieces are there to suggest that if you smoked enough, it could contribute to you being at a higher risk for cancer,” says Dr. Lounsbury.
A 2014 study in the journal Nicotine and Tobacco Research found that vapor from certain e-cigarettes contains formaldehyde, a known carcinogen. No comparably conclusive study has been carried out with the cartridges associated with cannabis vaping.
Lynn, who is not a medical professional, said that his staff recommend that those looking to try cannabis should start with small doses, whether experimenting with CBD or with THC. He and Dr. Lounsbury both warned that taking too much of the substances can cause the drug to have the opposite of its intended effect. Too much THC can make a person anxious, and it seems that large doses of CBD can be less effective at treating pain than smaller doses.
Memory Loss, Addiction and Other Risks
Cannabis appears to be less addictive than alcohol. However, according to a study published in the medical journal Lancet in 2009, one in six people who start using marijuana as teenagers will become addicted, as opposed to about one in ten who start using as adults. The same study reported that 25 to 50 percent of people (adult or otherwise) who use marijuana daily will become addicted.
A study published in 2014 in The New England Journal of Medicine drove this home: “There is… a bona fide cannabis withdrawal syndrome (with symptoms that include irritability, sleeping difficulties, dysphoria, craving and anxiety) which makes cessation difficult,” wrote the authors, researchers from the National Institutes of Health and National Institute on Drug Abuse. However, unlike withdrawal from alcohol or other drugs, withdrawal from cannabis won’t kill you.
Since doctors aren’t allowed to prescribe cannabis, they don’t have the chance to cater dosage to a patient’s metabolism and other drug regimen like they would any other prescription drug. “In high doses, THC and CBD do have the potential to interact with other drugs, and the research isn’t there yet to know for certain what that would look like,” Dr. Lounsbury warns.
All parties interviewed said kids and adolescents should not be smoking or ingesting pot. A 2012 study from Brain: A Journal of Neurology found that adults who smoked marijuana regularly during adolescence (up to age 21) had fewer axonal fibers, structures that facilitate communication between different parts of the brain, than non-pot-smokers.
The areas of the brain that were most affected were those responsible for tasks that require alertness, self-awareness, memory, learning and inhibition. The study said it is possible that the damage could be reversed once a person stops using cannabis, but that further research is needed to determine if this is the case.
According to Dr. Lounsbury and a 1975 study published in Clinical Pharmacology and Therapeutics, THC has also been proven to suppress a person’s rapid eye-movement, or deep sleep cycle. “It makes you sleepy, which is great if you’re an athlete, but you don’t actually get a full night’s sleep,” she said. It also inhibits dreaming.
And if you’re worried about a drug test, keep in mind THC typically stays in the brain for about a half hour to an hour when smoked, and two to four hours when ingested. At that point, the liver starts to metabolize it with special cannabinoid-eating enzymes. A standard drug test that uses urine or a blood sample tests for the presence of those enzymes. A standard anti-doping drug test will not detect CBD.
However, there is no strict rule about how long cannabis stays in the body. “For someone who has smoked once in a month or a week, it will probably leave the body in a couple of days,” she says. “If you’re a regular user? Like every day? That metabolite starts to build up and it could take up to two weeks to leave your system.”
So if you’re planning on going pro, you might think twice before lighting up.