Marijuana ‘Demonstrated Positive Findings’ For Managing Pain In NCAA Athletes, New Research Says

A new presentation reviewing research on student athletes’ use of cannabis finds that marijuana “has demonstrated positive findings as an alternative for pain management among NCAA athletes.”

The conference talk, by Jacksonville State University master’s student Aquriya Muller, drew from published studies into marijuana among athletes and for pain management.

Notably, the National Collegiate Athletic Association (NCAA) last year removed marijuana from its list of substances banned for Division I athletes, emphasizing that cannabis is not a performance enhancing drug and that it should be treated the same way as alcohol.

“Evidence indicates that marijuana use among athletes can improve oxygenation of tissues, reduce muscle spasm, and enhance pain management,” the new research paper says. “For patients with fibromyalgia, marijuana use displayed benefits in alleviating symptoms such as pain and stiffness, while enhancing relaxation and sleep.”

It further found that “marijuana’s anti-inflammatory properties also contribute to recovery and post-exercise treatment.”

Her presentation pointed to the example of a Division I basketball player who used marijuana to treat muscle spasms and pain as well as improve sleep.

Muller’s report encourages trainers and care providers to stay up-to-date on relevant findings and work to incorporate alternative and conventional treatments.

In all, the report reviewed 94 total articles, though it excluded 90 of those for not meeting the study criteria.

And while Muller noted the positive apparent benefits of marijuana, she identified a need for further research. The bulk of the studies, she noted, had a “lower level of evidence” and were “less reliable” overall.

“Despite these findings, effectiveness varies among individual athletes,” her report says. “In addition, concerns about behavioral health and performance are limited.”

“Athletic trainers and healthcare providers should remain informed about evolving policies and evidence to provide tailored, evidence-based care to their athletes and patients,” it continues. “This knowledge supports developing treatment plans for athletes that incorporate alternative and traditional pain management methods.”

Last year’s NCAA vote to remove marijuana as a banned substance built on a 2022 change that increased the allowable THC threshold for college athletes, a change meant to align NCAA’s rules with those of the World Anti-Doping Agency (WADA).

Historically, college athletes have been subject to testing during postseason play. Positive tests could mean an entire season of lost eligibility. Officials have said the changes are intended to focus more on problematic use than penalizing players for a single mistake.

“The NCAA drug testing program is intended to focus on integrity of competition, and cannabis products do not provide a competitive advantage,” Josh Whitman, chair of NCAA’s Division I council, said last year. “The council’s focus is on policies centered on student-athlete health and well-being rather than punishment for cannabis use.”

When an NCAA committee formally recommending the policy shift in September 2023, it said ending the cannabis ban “acknowledges the ineffectiveness of existing policy (banning, testing and penalizing),” affirms the body’s belief that cannabis is not a “performance-enhancing drug” and promotes the “importance of moving toward a harm-reduction strategy.”

“The timing of discussion and adoption of possible legislation is a decision that will be made by each of three NCAA divisional governance structures,” the panel said. “This recommendation is based on extensive study informed by industry and subject matter experts (including doctors, substance misuse experts and membership practitioners).”

Multiple sports organizations have moved to amend their marijuana testing policies for athletes amid the state legalization movement.

For example, the NFL and its players union agreed to end the practice of suspending players over marijuana or other drugs as part of a collective bargaining agreement in 2020.

Late last year, NFL also reached an agreement with its players union to further reform its marijuana policies, significantly reducing fines for positive tests while increasing the allowable THC threshold for players.

NFL has committed significant funding to research into whether CBD can serve as an effective opioid alternative, and it’s also explored the therapeutic potential of the non-intoxicating cannabinoid for pain management and neuroprotection from concussions.

The league announced early last year that it was partnering with Canadian researchers on a clinical trial to test the safety and efficacy of CBD for pain management and neuroprotection from concussions—key issues for many football players who experience injuries as part of the game.

The Ultimate Fighting Championship (UFC) announced in late 2023 that it was formally removing marijuana from its newly modified banned substances list for athletes, also building on an earlier reform.

However, ahead of a UFC event last year, a California athletics commission said they could still face penalties under state rules for testing positive for THC over a certain limit, as the state body’s policy is based around WADA guidance. UFC subsequently notified participants that the reform didn’t apply under California State Athletic Commission (CSAC) rules.

Nevada sports regulators voted in 2023 to send a proposed regulatory amendment to the governor that would protect athletes from being penalized over using or possessing marijuana in compliance with state law. Last October, regulators officially adopted the rule change.

While advocates have welcomed these changes, there’s been criticism of WADA over its ongoing cannabis ban. Members of a panel within the agency said in a 2023 opinion piece that marijuana use by athletes violates the “spirit of sport,” making them unfit role models whose potential impairment could put others at risk.

Advocates strongly urged WADA to enact a reform after U.S. runner Sha’Carri Richardson was suspended from participating in Olympics events due to a positive THC test in 2021.

Following that suspension, the U.S. Anti-Doping Agency (USADA) said that the international rules on marijuana “must change,” the White House and then-President Joe Biden himself signaled that it was time for new policies and congressional lawmakers amplified that message.

Last June, meanwhile, an NFL player sued the league and his former team, the Denver Broncos, for alleged employment discrimination after he was fined more than half a million dollars for testing positive for THC that he says was caused by his prescribed use of a synthetic cannabinoid. NFL and the Denver Broncos in asked a federal court to reject the suit.

Meanwhile, the Brooklyn Nets and New York Liberty last year entered into partnerships with a CBD beverage company—the first teams in the NBA and WNBA, respectively, to forge deals with the cannabis industry.

The New York-based clubs partnered with Mynd Drinks, a hemp-based CBD sparkling beverage company that also made history in 2023 when it became an official partner of the Major League Baseball (MLB) team the Chicago Cubs.

As for marijuana and pain, a study earlier this year found that cannabis and its constituent cannabinoids could be useful treatments for various types of chronic pain, in some cases helping to reduce the use of other medications. The paper also said select mixtures of cannabinoids could help minimize undesirable effects of cannabis, such as the psychoactivity of THC.

That is among a flurry of research in recent years into the use of cannabis to treat chronic pain, which is one of the most common qualifying conditions among patients in many states with medical marijuana programs.

Research published earlier this year in the journal Pain, for example, found that marijuana was “comparatively more effective than prescription medications” for treating chronic pain after a three-month period, and that many patients reduced their use of opioid painkillers while using cannabis.

The analysis “was able to determine, using causal inference techniques, that use of medical marijuana for chronic pain under medical supervision is at least as effective and potentially more effective in relationship to patients with chronic pain treated by prescription medications (nonopioid or opioid),” said the report, by authors at the University of Pittsburgh, Harvard Medical School and the National Cancer Institute.

A separate federally funded study found that legalization of marijuana in U.S. states is associated with reduced prescriptions for opioid pain medications among commercially insured adults—indicating a possible substitution effect where patients are choosing to use cannabis instead of prescription drugs to treat pain.

“These results suggest that substitution of cannabis for traditional pain medications increases as the availability of recreational cannabis increases,” authors of that report wrote, noting that there “appears to be a small shift once recreational cannabis becomes legal, but we see stronger results once users can purchase cannabis at recreational dispensaries.”

“Reductions in opioid prescription fills stemming from recreational cannabis legalization may prevent exposure to opioids in patients with pain,” the paper, published in the journal Cannabis, continues, “and lead to decreases in the number of new opioid users, rates of opioid use disorder, and related harms.”

Other recent research also showed a decline in fatal opioid overdoses in jurisdictions where marijuana was legalized for adults. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. Authors estimated that recreational marijuana legalization “is associated with a decrease of approximately 3.5 deaths per 100,000 individuals.”

“Our findings suggest that broadening recreational marijuana access could help address the opioid epidemic,” that report said. “Previous research largely indicates that marijuana (primarily for medical use) can reduce opioid prescriptions, and we find it may also successfully reduce overdose deaths.”

“Further, this effect increases with earlier implementation of [recreational marijuana legalization],” it added, “indicating this relationship is relatively consistent over time.”

Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. Overall, results of the study indicated that “cannabis has a substantial role to play in pain management and the reduction of opioid use,” it said.

Yet another study, published in 2023, linked medical marijuana use to lower pain levels and reduced dependence on opioids and other prescription medications. And another, published by the American Medical Association (AMA) last February, found that chronic pain patients who received medical marijuana for longer than a month saw significant reductions in prescribed opioids.

Separate research published found that more than half (57 percent) of patients with chronic musculoskeletal pain said cannabis was more effective than other analgesic medications, while 40 percent reported reducing their use of other painkillers since they began using marijuana.

In Minnesota, meanwhile, a state government report this year on chronic pain patients enrolled in the state’s medical marijuana program said recently that participants “are finding a noticeable change in pain relief” within a few months of starting cannabis treatment.

The large-scale study of nearly 10,000 patients also shows that nearly a quarter who were taking other pain relievers reduced the use of those drugs after using medical marijuana.

Another new study on the use of medical marijuana by older patients—age 50 and above—concluded that “cannabis seemed to be a safe and effective treatment” for pain and other conditions.

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Photo courtesy of Chris Wallis // Side Pocket Images.

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