Sports & Cannabis #Flowertothepeople

As a former athlete and now a physician this particular topic is of great personal interest to me. Like many people of my generation- the regulations implemented by sports leagues with regards to marijuana use created a lot of harm to athletes. As  time progressed, the use of cannabis, both recreational and medicinal, is becoming increasingly accepted in the United States and around the world. This has led to a growing debate about the use of cannabis in sports as many of the most influential and outspoken advocates for marijuana policy change have been athletes. Despite emerging evidence to the contrary,  some people still believe that cannabis should be banned from sports because it is a performance-enhancing drug, while others believe that athletes should be allowed to use cannabis for medicinal purposes or simply because it is their right to do so.

In recent years, there has been a shift in the way that sports organizations view cannabis. Many professional sports leagues have relaxed their policies on cannabis use, and some have even allowed players to use cannabis for medicinal purposes. This change in approach has followed societal/ cultural changes in how cannabis is regarded. Organizations are slowly moving away from the zero tolerance and punishment models,but there is still a great deal of variation in the way that different sports organizations approach cannabis use. Some recent and notable news stories of athletes testing positive for marijuana and the consequences they faced illuminate the need for more understanding of this topic:

• In 2022, NFL wide receiver Josh Gordon was suspended indefinitely for violating the league's substance abuse policy. Gordon had previously been suspended for multiple seasons for violating the same policy.

• In 2021, Olympic sprinter Sha'Carri Richardson was suspended for one month after testing positive for THC. Richardson had won the 100-meter dash at the US Olympic Trials, but she was unable to compete in the Olympics due to her suspension.

• In 2020, NBA center DeMarcus Cousins was suspended for 12 games after testing positive for THC. Cousins had previously been suspended for eight games for violating the league's substance abuse policy.

• In 2019, NCAA basketball player Moses Wright was suspended for 10 games after testing positive for THC. Wright had led his team to the Sweet Sixteen of the NCAA Tournament, but he was unable to compete in the remainder of the tournament due to his suspension.

This post will provide an overview of the latest information on THC and CBD drug testing in the major American sports leagues, European soccer, Olympic, NCAA, and high school sports. We will discuss the thresholds to test positive, false positives, how long THC can stay in your system to trigger a positive drug test, the physiological reasons for that, and how to prevent testing positive.

THC and CBD Drug Testing Thresholds

The threshold for a positive drug test for THC varies depending on the sports organization. In the major American sports leagues, the range is anywhere from 35 nanograms per milliliter (ng/mL) of urine to 150 ng/ml (for reference, a nanogram/ng is 1/1000 of a kilogram). The NCAA, which is the largest collegiate sports organization, recently raised its threshold to 150 ng/mL. The World Anti-Doping Agency (WADA), which oversees drug testing for the Olympics and other international competitions, has a threshold of 150 ng/mL.

CBD is not prohibited by WADA or most sports organizations. However, some athletes have tested positive for THC after using CBD products that were contaminated with THC. This is because CBD and THC are both cannabinoids, and they can be difficult to separate completely.

National Basketball Association/ NBA

The NBA changed its marijuana policy as part of its new collective bargaining agreement with its Players Association. Under the new policy, NBA teams may refer players suspected of having marijuana use disorders to the Medical Director for a mandatory evaluation, but the league will no longer drug test players for cannabis use or exposure. In addition the NBA allows its players to invest in  and promote cannabis brands. 

Major League Baseball/ MLB

The MLB's Joint Drug Prevention and Treatment Program (JDPTP) was established in 2002. The program is designed to prevent and treat substance abuse among MLB players. The JDPTP includes a drug testing program that tests players for a variety of substances, including THC.

In 2019, the MLB and the MLB Players Association (MLBPA) agreed to relax the THC testing policy. Under the new policy, players will no longer be tested for THC during the regular season. The policy change was made in response to the growing legalization of marijuana in the United States.

National Football League/ NFL

The NFL's traditional drug testing policy and punishments rival the Olympics in terms of their harshness. Players were subject to random drug testing throughout the season. The threshold for a positive test is 35 ng/mL of urine.

If a player tested positive for THC, they were subject to a one-game suspension for the first offense, a two-game suspension for the second offense, and a four-game suspension for the third offense. If a player tests positive for THC four times, they are subject to a year-long suspension.

The NFL's drug testing policy has been tweaked in recent years, eliminating year round tests in favor of testing during a 2 month period from the beginning of training camp. The THC threshold has been increased from 35ng/ml to 150ng/ml of urine and immediate suspensions for positive tests have been eliminated in favor of referral to counseling. 

National Collegiate Athletic Association/ NCAA

The NCAA's drug testing policy was also one of the strictest and punishment heavy. Athletes were subject to random drug testing throughout the season. The threshold for a positive test was 35 ng/mL of urine. In 2022 The NCAA issued the following recommendations for positive tests:

• Increasing threshold to 150 ng/ml

• First positive test: No loss of eligibility if the school provides a management plan and education for the student-athlete.

• Second positive test: No loss of eligibility if the school provides additional management and education and confirms the student-athlete was compliant with the original management and education plan.  However, the student-athlete must be withheld from 25% of regular-season contests if they were not compliant with the original management and education plan.

• Third positive test: No loss of eligibility if the school provides additional management and education and confirms the student-athlete was compliant with the previous two treatment and education plans. However, the student-athlete must be withheld from 50% of regular-season contests if they were not compliant with the previous management and education plan.

The NCAA's drug testing policy has been criticized by some athletes and advocates, who argue that THC is not a performance-enhancing drug and that athletes should be allowed to use it in their own time. However, the NCAA has defended its policy, arguing that it is necessary to protect the health and safety of athletes. Recently the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports, said that testing should be limited to performance-enhancing drugs and found that cannabis does not enhance performance.

Olympics

The World Anti-Doping Agency (WADA) is responsible for overseeing drug testing for the Olympics and other international competitions. WADA's drug testing policy is very strict. Athletes are subject to random drug testing throughout the Games. The threshold for a positive test is 150 ng/mL of urine.

If an athlete tests positive for THC, they are disqualified from the Games. Most infamously in 2021, American 100 meter sprinting champion Sha'carri Richardson was disqualified from competing in the olympics for a positive test. 

WADA's drug testing policy has been criticized by some athletes and advocates, who argue that THC is not a performance-enhancing drug and that athletes should be allowed to use it in their own time. However, WADA has defended its policy, arguing that it is necessary to ensure fair competition.

Mixed Martial Arts/ MMA

The UFC (Ultimate Fighting Championship), the largest MMA organization in the world, has a relatively relaxed policy on THC testing. Fighters are only tested for THC out of competition. The threshold for a positive test is 150 ng/mL of urine.

If a fighter tests positive for THC, they are not subject to any punishment. However, if a fighter is caught using marijuana while in competition, they may be subject to discipline from the UFC.

The UFC's drug testing policy has been criticized by some fighters and advocates, who argue that THC should be banned from competition. However, the UFC has defended its policy, arguing that THC does not give fighters an unfair advantage.

THC and CBD Drug Testing in High School Sports

The National Federation of State High School Associations (NFHS) oversees drug testing for high school sports. The NFHS has a threshold of 50 ng/mL for THC. CBD is not prohibited by the NFHS. These are recommendations, as many high school sports leagues typically have their own drug testing policies. Some leagues have strict policies against the use of THC, while others have more relaxed policies.

In recent years, there has been a growing movement to relax the THC testing policies in high school sports. Some advocates argue that THC is not a performance-enhancing drug and that student-athletes should be allowed to use it in their own time. However, many high school sports leagues have so far resisted these calls. Amongst medical professionals, the consensus is that THC use should be avoided or limited to situations where the benefits outweigh the risk due to data that suggests high levels of THC can be harmful to the developing brain. 

False Positives

False positives for THC and CBD drug tests are rare, but they can happen. Some medications and foods can cause false positives. Additionally, some CBD products may contain THC, even if they are labeled as “THC free”.  Some medications, such as ibuprofen, naproxen, and promethazine, can cause false positive marijuana tests. These medications are known to interfere with the immunoassay test, which is the most common type of marijuana test. Here’s a summary:

• CBD products: Some CBD products may contain trace amounts of THC, even if they are labeled as THC-free. If you use CBD products, it is important to choose products from reputable companies that have their products tested for THC content.

• Poppy seeds: Poppy seeds contain trace amounts of morphine, which can cause a false positive for marijuana tests. If you are going to be drug tested, it is best to avoid eating poppy seeds.

• Secondhand smoke: If you are exposed to secondhand marijuana smoke, it is possible to test positive for marijuana, even if you did not use marijuana yourself. However, this is unlikely to happen unless you are exposed to a significant amount of secondhand smoke.

• Laboratory errors: Laboratory errors can also cause false positive marijuana tests. However, this is rare.

How Long THC Can Stay in Your System

The amount of time that THC can stay in your system depends on a number of factors, including your metabolism, body fat percentage, and how much THC you consumed. In general, THC can be detected in urine for up to 30 days after use. However, in some cases, THC can be detected for up to 90 days.

How to Prevent Testing Positive for THC

The best way to prevent testing positive for THC is to avoid consuming cannabis products altogether. However, if you do choose to consume cannabis, there are a few things you can do to reduce your risk of testing positive:

• Use products with low THC content. Hemp products, for example, contain very low levels of THC and are unlikely to cause a positive drug test.

• Avoid consuming cannabis products before a drug test. If you know you have a drug test coming up, it is best to avoid consuming cannabis products for at least 30 days beforehand.

• Drink plenty of fluids. Drinking plenty of fluids can help to flush THC out of your system more quickly.

• Exercise regularly. Exercise can help to burn fat, which can help to reduce the amount of THC stored in your body.

• Use topical products. Using products that do not enter your bloodstream allows for athletes to receive some of the pain relieving benefits of cannabinoids without risking positive tests. 

If you are concerned about testing positive for THC, you can talk to your doctor. They can help you to develop a plan to reduce your risk of testing positive.

Overtime!

In addition to the information above, here are a few other things to keep in mind about THC and CBD drug testing:

• CBD is not prohibited by most sports leagues and organizations. CBD is a non-psychoactive compound in cannabis that does not cause intoxication. However, it is important to note that some CBD products may contain trace amounts of THC. If you are concerned about testing positive for THC, it is important to choose CBD products that are guaranteed to be THC-free.

• Hair testing can be used to detect THC use for up to 90 days. Hair testing is not as common as urine testing, but it can be used to detect THC use for a longer period of time.

• There are a number of products on the market that claim to help people pass drug tests. However, there is no scientific evidence to support the claims of these products. In fact, some of these products may actually contain THC or other illegal substances.