The Medical Cannabis Research Challenge

Medical cannabis refers to the use of cannabis for exclusively medical treatment purposes, and can be obtained by patients authorized by their health care 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 in cannabis consumers. 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%).

Among professional athletes, medical cannabis can fill a crucial gap in sleep aid, recovery from injuries, depression, anxiety, minor sprains to major brain concussions and more. Cannabis use thus becomes an obstacle for players when stigma around use informs the rules of competitive sports. However, 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 substances are banned in professional and competitive sports today?

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 sport performance;
  2. It represents a health risk to the athletes; and
  3. It violates the spirit of sport.

There is evidence that cannabis use is performance enhancing but it’s still all observational and the exact effects depend on the amount consumed, which could be inverse and varies with users, reminded Jay Rosenthal, introducing the “Sports and Cannabis” event hosted by the Business of Cannabis. The event aimed to explain the relationship between Cannabis and Sport in terms of player use cases, regulations and social and research challenges. Can society distinguish between medical and more casual use?

Do competitive athletes consume for fun or for medical reasons or both? Among leisure team-sports participants (Basketball / Baseball / Softball / Football / Soccer / Volleyball / Curling / Ice Hockey), at least a fifth of all Canadian adults (aged 19+) were motivated to consume cannabis for personal relaxation, stress reduction, fun, 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 the impact of cannabis use on both leisure team and non-team sports and fitness activities merits further investigation.

Cannabis use is already known to reduce reliance on opiates and overdosing from opioids (including freedom from addictions to Benedryl, Tyelenol, 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 below. The Business of Cannabis concluded their Medical Cannabis Week and I caught some highlights from their Cannabis and Sports final event to frame some medical cannabis research challenges.

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

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

There is heavy reliance on hard drugs and opiates among athletes who would prefer more knowledge on 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 is needed. More clinical trials and modelling 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 benefits of cannabis use in helping recovery but also overcoming the side effects of other medications and allied traumas.

Recommendation: scientific research and more human modelled clinical trials and research around efficacy of cannabinoids for the treatment of brain concussions is 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 the stigma against use. Most professional and competitive sports committees/leagues are not open proponents of medical cannabis use, and often prohibit it.

Recommendation: Engineer workshops and host events that train on the many uses of cannabis for medical purposes inviting credentialed physicians and federally approved health care providers talking about cannabis as the standard of healthcare and why/how. Sharing medical user stories is important to drive away the stigma and create actual awareness alongside the 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.

Overall 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.

Watch the full video of “Sports and Cannabis” here to gain more anecdotal accounts of cannabis user journeys in sports and the challenges ahead:

Medical Cannabis Week | Cannabis + Sport from Business of Cannabis on Vimeo.

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