Should athletes take CBD oil?

In September 2019, USADA banned triathlete Lauren Goss for six months after testing positive for THC (tetrahydrocannabinol), the psychoactive agent found in cannabis. Goss argued that the violation arose from treating an injury with a THC-infused salve. A month later, USA Triathlon announced a four-year partnership with Pure Spectrum, providers of CBD products. CBD is also found in cannabis. “It’s ironic,” says Graeme Close, professor of human physiology at Liverpool John Moores University, “and sums up the uncertainty around cannabinoids as an ergogenic.”

There are around 110 cannabinoids in the cannabis plant. All of these are prohibited by WADA except CBD, albeit WADA do warn that “some CBD oils and tinctures extracted from cannabis plants may also contain THC and other cannabinoids that could result in a positive test”. Which, Goss argued, is what happened to her.

But why was Goss taking CBD in the first place? “Pain relief and improved sleep are two reasons,” says Close. “We studied its use in rugby and showed that out of 500 players, 26% used it. That’s huge for an untested supplement where there’s a risk of an anti-doping offence.”

This risk is, as Goss’ case highlights, down to trace amounts of the other cannabinoids in the CBD product. This, Close says, is why he wouldn’t yet recommend natural CBD. On their own, those trace amounts might not register a positive test. “But cannabinoids are lipophilic. This means they’re stored in fat tissue. We don’t know if it builds up and is then released when you use fatty acids for energy.”

Breaking anti-doping rules is an area Close is looking into. He admits it’s the Wild West out there but hopefully, by March 2021, the industry will tighten up due to having to file their Novel Foods Application. “You’ll need to show toxicology reports and that you’ve undertaken safety studies,” he says.

This all sounds downbeat but Close is cautiously optimistic of CBD’s benefits, especially as there’s a physical pathway. “The body has an endocannabinoids system, which is crucial in pain management, and CBD is a cannabinoid that can bind to these receptors.”

Whether that effect is stimulated from the amount athletes take is debatable. Two CBD products, Sativex and Epidiolex, have licences to treat MS sufferers and epileptics, respectively. The Food Standards Agency sets a safe upper limit of CBD at 70mg a day; a typical Holland & Barrett product is 10mg. “With Epidiolex, you start at 500mg,” says Close. “Whether athletes would take it in those quantities, with the potential risk of anti-doping plus the cost (around £35,000 a year in that amount), is unlikely. But the evidence behind the smaller dosage isn’t quite there.” This reflected the experiences of those 26% CBD-using rugby players, who admitted little pain relief. They did, however, report a better night’s sleep.

You can take CBD by tinctures, pills and balms, with the market expected to harness $20-billion in sales by 2024, so expect the potential benefits (or not) to become clearer over the next 12 months.