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Cannabis use in sport

The psychoactive chemicals derived from cannabis and their synthetic counterparts, called cannabinoids, are listed by the World Anti-Doping Agency (WADA) as Prohibited In-Competition under the ‘S8 Cannabinoid’ substance class.

Cannabis use in sport

The psychoactive chemicals derived from cannabis and their synthetic counterparts, called cannabinoids, are listed by the World Anti-Doping Agency (WADA) as Prohibited In-Competition under the ‘S8 Cannabinoid’ substance class. These substances are also included under the Substances of Abuse category, as a drug which is prohibited for use ‘In-Competition’.

Psychoactive drugs may affect a person’s cognition, moods, perceptions, consciousness and emotions and are therefore deemed unsafe for use.

The Substances of Abuse category was introduced as part of the 2021 Prohibited List and 2021 World Anti-Doping Code (Code). This category was introduced in consultation with global regulatory bodies such as Sport Integrity Australia, to allow more flexibility in how athletes are sanctioned if the positive test is related to substance abuse, as opposed to an attempt to enhance performance.

The Prohibited List is approved by WADA’s Executive Committee in September of each year and published three months before it comes into effect on 1 January. We promote the updated Prohibited List to Australian sports and athletes each year.

Cannabis use in sport FAQs

What is cannabis?

Cannabis in its original form is the leaves and bud of the sativa (or related) plant. It contains psychoactive cannabinoids including THC (delta9 tetrahydrocannabinol) and the non-psychoactive cannabidiol (CBD).

What forms can cannabis come in?

It’s important to be vigilant when it comes to Cannabis as it can come in many different forms.

  • Dried leaves or buds (marijuana) – this form can be ingested orally (drinking, eating) or smoked. 
  • Hash/ Hashish – made from cannabis resin and pressed into brown-coloured blocks which can be smoked or ingested orally and is very high in THC. 
  • Hash oil – is potent with a high concentration of THC and can be added to the tips of cigarettes. 
  • Concentrates – uses butane hash oil as a solvent to create extracts which are often vaporised or inhaled. 
  • Edibles – this is where the compounds of cannabis have been infused into an edible form such as sweets or cakes.

Are all forms of cannabis banned?

Yes. All forms of the cannabis plant which contain cannabinoids or THC compounds are banned In-Competition, this includes synthetic cannabinoids or products which mimic the effects of THC. CBD is the only exception, however athletes considering the use of a CBD product need to be aware of the risk of use. 

Banned:

Permitted: 

  • Cannabidiol

What about CBD use?

Athletes considering the use of CBD need to be aware that many CBD products will also contain prohibited cannabinoids. This means there is a risk of testing positive for other cannabinoids after use of a CBD product.

Many cannabinoid products contain a mix of THC and CBD and other substances. There are also examples of THC contamination of products marketed as ‘pure’ CBD.

Athletes who choose to take an over the counter or internet purchased (non-prescribed) cannabidiol product, even when marketed as ‘pure’ CBD oil, are cautioned about the risk of contamination and advised to consider use akin to the risk of a supplement.

Assessment of the risk of a supplement can be made through the Sport Integrity app and is free to download from Google Play or the Apple App Store. Athletes prescribed CBD products by a Medical Practitioner for a documented medical condition, may be able to apply for a Therapeutic Use Exemption (TUE).

What are the health risks of using cannabinoids?

In addition to risking your career the reported health risks of cannabinoid use are broken down below according to recreational use and chronic use.

Recreational / acute use effects: nausea and vomiting, hallucinations, memory impairment, coordination impairment and delusions, paranoia or psychosis at high doses. Importantly for athletes, there is an increase in heart rate following marijuana use (first 3 hours). This could put increased strain on an athlete’s heart and has the potential to lead to an irregular heartbeat.

Chronic use effects: bronchitis (from smoke irritation on the respiratory tract), mood disorders and psychosis, Cannabinoid Hyperemesis Syndrome (persistent vomiting) with secondary dehydration. Importantly for athletes, chronic marijuana can be associated with a decrease in cardiovascular response to exercise (due to reduced sympathetic and increased parasympathetic activity) which has the potential to impair athletic performance.

What are the health impacts of using cannabinoids under exertion?

According to the Gatorade Sports Science Institute the use of cannabinoids under exertion can have adverse effects on cardiovascular and respiratory health and performance. 

Why are cannabinoids banned substance in sport? 

All prohibited substances are added to the Prohibited List because they meet at least two of the three following criteria:

  • Use of the substance has the potential to enhance or enhances performance; 
  • Use of the substance represents an actual or potential health risk to the Athlete; and 
  • Use of the substance violates the spirit of sport

Can a Therapeutic Use Exemption (TUE) be obtained for medicinal cannabis and medicinal cannabinoids?

Athletes prescribed cannabinoid products by a Medical Practitioner to treat a medical condition may be able to apply for a Therapeutic Use Exemption (TUE). A TUE is an exemption which permits an athlete to compete while taking the prohibited substance.

For a TUE to be granted, the athlete and their doctor must submit a completed application form and detailed medical information to the Australian Sports Drug Medical Advisory Committee (ASDMAC), an independent advisory group of experienced sports physicians.

ASDMAC must assess whether the application meets the four criteria for granting a TUE that are documented in the WADA International Standard. 

These are:

  1. The prohibited substance or method is needed to treat a medical condition and the athlete would experience a significant impairment to health if the substance were to be withheld. 
  2. The Therapeutic Use of the substance or method is highly unlikely to produce any additional enhancement of performance beyond what might be anticipated by a return to the athlete’s normal state of health following the treatment of the medical condition. 
  3. There is no reasonable therapeutic alternative. 
  4. The necessity for the use of the prohibited substance or method is not a consequence of the prior use (without a TUE) of a prohibited substance or method prohibited at the time of such use. 

What documents are required for a medical exemption for cannabis? 

For ASDMAC to be able to consider a TUE application, the following information must be included:

  • A completed TUE application form signed by the treating doctor and athlete. 
  • Detailed typed clinical letter(s) from prescribing specialist/doctor that includes:
    • Accurate diagnosis – full clinical history and thorough examination 
    • Summary of diagnostic test results relevant to the diagnosis (e.g. blood tests, x-ray or other imaging reports) 
    • Name of cannabinoid(s) prescribed including dosage, frequency, administration route 
    • Evidence of use of either the Special Access Scheme (SAS) or TGA indication (include SAS approval certificate) 
    • Treatment plan, including duration of proposed treatment 
    • Other relevant medical opinions 
    • Explanation of why alternatives (e.g. anti-depressants, anticonvulsants, tramadol, capsaicin, lidocaine) were or could not be used. 
  • Diagnostic Test Results including:
    • Imaging findings: CT or MRI results (if applicable) 
    • Other test results: electromyography, nerve conduction studies, blood tests (if applicable).

For a checklist of information required to obtain a TUE for medicinal cannabis, check out our Cannabinoids/Cannabis TUE Checklist [PDF 294KB]. 

Does having a TUE for medicinal cannabis give me legal authority to possess cannabis? 

No. Being granted a TUE does not endorse or support the use of cannabinoids more generally. Nor does it imply legal authority to carry or transport cannabinoids. The exemption only accepts that the use meets the WADA International Standards for Therapeutic Use Exemptions criteria.

What is the ‘In-Competition’ period?

The In-Competition period generally commences at 11.59pm the night before a competition in which an athlete is scheduled to compete, through to the end of that competition and any sample collection process undertaken. 

International Federations may apply to WADA for permission to change their ‘In-Competition’ period if they have a compelling justification. Athletes should check with their International Federation to ensure that their ‘In-Competition’ period aligns with the 2021 Code.

Is it an Anti-Doping Rule Violation (ADRV) to test positive to cannabis? 

Yes, an athlete faces a ban of up to four years if a Substance of Abuse, such as cannabis, was deemed to be used In-Competition without a valid Therapeutic Use Exemption (for medicinal cannabidiol only).

Substance of Abuse arrangements introduced in 2021 recognises drugs frequently abused in society, outside the context of sport, however under the World Anti-Doping Code, Sport Integrity Australia is obliged to vigorously pursue all potential Anti-Doping Rule Violations within its authority.

If we become aware of information to indicate a further Anti-Doping Rule Violation (ADRV) in a Substance of Abuse matter, leniency is not available. Other Anti-Doping Rule Violations that may arise from an investigation are Use and or Attempted Use, Possession and Trafficking or Attempted Trafficking.

What is the penalty for testing positive to cannabinoids?

Athletes face a ban of up to four years if a substance of abuse is in their system In-Competition.

As of 1 January 2021, if an Athlete tests positive to a 'Substance of Abuse’, then the Athlete’s period of Ineligibility may be reduced to three months if the Athlete is able to prove that the substance was ingested or Used Out-of-Competition and was unrelated to improved sport performance.

The ban could be further reduced to one month if the athlete completes a Substance of Abuse treatment plan that is approved by the responsible Anti-Doping Organisation. The treatment plan adopted by Sport Integrity Australia includes the athlete being seen by a medical practitioner and the athlete completing a specific education program approved by Sport Integrity Australia. This treatment plan will be at the cost of the athlete.

When can an athlete be tested for cannabis use? 

There are differences in Out-of-Competition tests conducted by Sport Integrity Australia and those tests conducted by a National Sporting Organisation under an illicit drugs policy.

Sport Integrity Australia can only test for substances prohibited in-competition during the In-Competition period. In an Out-of-Competition environment, Sport Integrity Australia cannot test for recreational drugs but if an athlete uses an illicit substance Out-of-Competition, that athlete needs to be aware that these substances can stay in your system for a period of time, which might mean the substance could be detected in-competition.

Regardless of when an athlete takes illicit drugs, if they are still in their system on game day they will be penalised if a valid TUE has not been obtained.

How long does cannabis remain in my system?

The effects and traces of cannabis will vary from person to person depending on multiple factors such as size, weight, diet and activity. THC and cannabinoids are fat soluble meaning they can be stored in the body for long periods and released slowly and inconsistently. 

Additionally, as there are many different strains of cannabis containing varying degrees of cannabinoid compounds, each will metabolise at different rates, meaning there is no definitive timeframe in which cannabis, or its metabolites will become undetectable in the system.

What is the best way to avoid a positive cannabis result?

The simplest measure any athlete can take to avoid a positive result is to not use cannabis, or cannabis derived substances unless a TUE has been obtained.

Want to know more? 

Online education

The Illicit Drugs in Sport course is for any person involved in sport. It focuses on recreational illicit drug use. Learn how illicit drugs can affect your health and sporting career.

Resources 

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