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Chronic cannabis consumption and physical exercise performance in healthy adults: a systematic review

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A nonsystematic literature review was conducted using Medline and PubMed for articles related to cannabis/marijuana use and sports/athletic performance; abstracts were reviewed by lead author and key themes identified and explored. The scientific literature does not support using cannabis for athletic performance, and multiple studies have demonstrated notable impairments in objective athletic performance measures. The importance of adequate sleep in facilitating optimal athletic performance and recovery is increasingly recognised . High levels of pre-competition stress (or sports performance anxiety (SPA) ), can be detrimental to athletic performance .

Given the inseparable links of the cardiovascular and respiratory systems to support aerobic exercise performance, the effects of cannabis and THC consumption on respiratory function must be considered. Studies from these areas have generally been considered separately (for reviews of cannabis and performance see 9, 21, 27, 30,31,32,33,34,35,36; for reviews of cardiovascular effects of cannabis see 22, 25) with no comprehensive integration. It is worth highlighting that these studies were never designed to specifically address these questions, and this fact appears to be commonly overlooked in the context of interpretation and application for sport.

UFC fighter Nick Diaz received a five year suspension from the commission in 2015 for repeat cannabis violations, though the suspension was later reduced to a year and a half. In May 2021 he received the first such exemption in the U.S., granted by the Colorado Combative Sports Commission. Under the new policy, fighters will no longer be punished for cannabis use except in cases where “further evidence demonstrates the substance was taken for performance-enhancing purposes such as alleviating pain or anxiety”. He also noted in 2018 that multiple players have told him that cannabis helps them deal with their anxiety. Johnson and Sims (who are business partners), announced a partnership with Harvard University in 2019 to study the effects of cannabis on chronic traumatic encephalopathy (CTE) and its benefits in managing pain. WADA relaxed its policy towards cannabis in 2013, increasing from 15 ng/mL to 150 ng/mL the level of THC metabolite allowed in urine before an athlete is considered to have failed a drug test.

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The possible adverse health effects of cannabis in elite athletes have not been specifically addressed, but lessons may be drawn from other recreational cannabis literature. A lack of performance-enhancing effect has been echoed in more recent reviews,29,30 including the most recent systematic review,1 and this conclusion suggests that the reason for considering cannabis as a banned substance is due to safety concerns , see below, and the fact that use of an illicit substance is contrary to the spirit of sport.31,32 Athletes have also been shown to have higher pain thresholds than controls.27 Data on the effects of cannabis on quantitative sensory testing parameters are not conclusive but suggests that cannabinoids may increase punctate and pressure pain thresholds (Table 1).

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These changes could have implications for athletic performance, particularly in sports that require quick decision-making and strategic THC gummy microdosing overview thinking. Also worth noting — the long-term effects of cannabis on the cardiovascular system remain unclear and should not be overlooked as more research is needed to determine whether chronic use poses risks to athletes1. More research is needed to fully understand the long-term effects of cannabis on sleep and athletic recovery. Athletes may use CBD to aid recovery, manage pain, and reduce anxiety without the psychoactive effects of THC. For some (THC may reduce pre-competition anxiety), while for others, it may impair focus and decision-making.

Three of the included studies measured participants’ performance on a treadmill with a breathing apparatus to determine VO2Max, while the remaining study , Maksud and Baron 1980, utilized a bicycle ergometer. Relevant outcomes from among the selected studies were VO2Max — PWC, other pulmonary measures, strength and endurance measures (grip strength, side plank time, hip flexion torque, etc.), perceived exertion, resting heart rate, and blood pressure (See Tables 2 and 3). Studies were excluded that focused on acute effects of cannabis, reported on populations other than physically and mentally well adult humans, or had reduced cannabis use as an outcome measure. Several review articles were found, suggesting sufficient literature existed within this area.

The immediate impacts of cannabis consist of a faster heart rate, which many people experience alongside symptoms such as low blood pressure, dizziness, disorientation, heightened feelings of euphoria or ‘highness,’ intoxication or being ‘stoned,’ and in some cases, psychotic episodes, panic responses, and paranoia. The scientific committees at WADA strive to leverage all available scientific literature to arrive at the most impartial assessment of how substances or techniques meet the criteria set forth by the Code. The literature presents contradictory findings regarding the long-term toxic effects of cannabis. Serious central nervous system depression can occur in children after accidental ingestion of cannabis. However (when provided with supportive care), most of these cases successfully resolve with minimal lasting health consequences.

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CBD effects on anxiety seem to depend on dosage; 300 mg is more effective than 150 or 600 mg for reducing anxiety-related symptoms , Linares et al., 2019,. CBD inhibits the degradation and absorption of endocannabinoids such as anandamide, increasing endocannabinoids’ binding to their receptors. These molecules, comparable to N-acyl ethanolamine’s , De Petrocellis and Di Marzo, 2009,, generate benefits similar to exercises, such as hunger control, inflammation reduction, anxiety relief, and prevention of excessive cell proliferation. Coaches, athletes, doctors, therapists, and scientists are constantly concerned with finding ways to improve the performance of athletes by making athletes faster, more resistant, more agile, rest and recover better from efforts and feel better. Graeme Close has received funding from Naturecan Ltd. “I was referred to the substance misuse cases and many of them had comorbid anxiety or depressive disorders along with their cannabis use disorder,” says McDuff.

Some mental health experts have expressed concern over the development of cannabis use disorders — which may lead to increased anxiety or depressive disorders. The United States Anti-Doping Agency must undo this archaic (inhumane), and unscientific policy. ” These concerns, the report notes, were “scientifically grounded” by the results of the 1999 Monitoring the Future survey, which concluded that youth steroid use increased roughly 50% over the prior year’s study. Some users even report that cannabis helps with pre-run anxiety and getting into a mental “flow” state.

This review aims to assess literature critically that describes the impact of whole cannabis, THC, and CBD on athletic performance and recovery. Despite ongoing speculation regarding potential beneficial uses, the influence of cannabis and its main components, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), remains largely unexamined. It is evident that the scientific rationale behind the alleged performance-enhancing effects of marijuana requires closer examination. The maximum suspension period is set at two years; however (an athlete can receive a minimum suspension of one month if it can be demonstrated that the use of cannabis was unrelated to their sport), as was the case for Richardson. An increasing number of anecdotal accounts indicate that individuals are using cannabis in conjunction with activities ranging from golfing and yoga to snowboarding and running. Although cannabis may present therapeutic advantages for sleep, pain relief, and anxiety reduction, its effects on heart health, cognitive abilities, and brain development deserve careful scrutiny.

Studies that investigate the joint cardiovascular strain of exercise combined with cannabis use in individuals diagnosed with cardiovascular disease provide limited insights into human aerobic performance; however, their broad acceptance as definitive evidence regarding the impact of cannabis or THC on general or elite athletic performance is probably misguided. Exercise serves as a frequent method for detecting and triggering signs and symptoms of underlying cardiovascular disease (CVD). Recognized as the second most widely used recreational drug after alcohol, cannabis’s prevalence and the growing belief in its potential health benefits make its appeal for athletes unsurprising.

Three studies evaluated resting heart rate, and one found that chronic cannabis users had a significantly elevated resting heart rate compared to non-users, which contradicts the findings from clinical trials on chronic cannabis use , Benowitz and Jones 1975,. The search for relevant data and its abstraction were conducted by AK, while the other authors reviewed the studies for potential inclusion. This systematic review seeks to augment existing evaluations that primarily focus on the acute effects of cannabis use by analyzing available data on (1) the influence of chronic cannabis use on fitness metrics; (2) any effects on levels of physical activity due to chronic cannabis use; (3) the impact chronic cannabis use has on actual sports performance. The formation of the World Anti-Doping Agency (WADA) and the subsequent penalties for athletes using cannabis have led to increased examination of cannabis’s effects on athletic performance (Hilderbrand 2011). A systematic review of literature, including cross-sectional, longitudinal, and intervention studies, has investigated the effects of cannabis consumption on sports performance outcomes, such as…

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