Opinion – In the Race: Cannabidiol is not doping: understand the use of the substance in sport

It was February 2020. Days before the start of the pandemic, journalist Roberta Palma had to be hospitalized due to a cerebrovascular thrombosis. She got over the episode, but sequels remained. She developed chronic pain in the cervical region, which compromised her performance both at work and in the practice of physical activities. “I could even run, but I ended up curling up, hunching over with pain in my back and neck,” she says.

Then came the anti-inflammatories and painkillers. She also resorted to massages and acupuncture. In one year, there were many remedies and little success. So she decided to give a chance to products that she found out about in one of her reports: cannabinoids.

It took three months to reach the ideal dosage. Today she is an enthusiast of these phytoderivatives. “I would say that 95% of my pain disappeared. I sleep better, I’m more energetic and I manage to train without pain”, says Roberta.

This is just one of many success stories in the medical use of cannabinoids. There are so many cases that I decided to investigate the subject a little more. Far from intending to exhaust the subject, this post seeks to answer basic questions about use, safety and sports application. Other texts on the subject will certainly follow. But for now, let’s get down to basics.

What is cannabidiol?

Cannabinoids are substances derived from cannabis – yes, the marijuana plant. Through chemical and mechanical processes it is possible to extract hundreds of different products, the best known of which are CBD (also called cannabidiol) and THC (responsible for the narcotic effects of marijuana).

Both in Brazil and in the USA, medical and health authorities recognize the effectiveness of cannabidiol in the treatment of specific epilepsy conditions in adults and children over one year old. However, encouraged by promising reports and the few side effects, doctors are expanding the use of these substances and incorporating cannabinoids in treatments for anxiety, sleep disorders, chronic pain, among others.

“My grandfather takes cannabinoids to relieve the symptoms of Alzheimer’s. My brother uses it to improve sleep. My mother uses it to treat depression, and I use it to accelerate my post-workout recovery”, explains doctor Roberto Beck, who gives lectures on the subject, has been prescribing cannabinoids for six years and is part of the Care Club medical staff.

“We are scratching the surface of the potential of cannabidiol, but we already have enough critical mass to be assertive about the advantages of this type of treatment”.

If positive effects are promising, low rejection and rare side effects encourage doctors to prescribe cannabinoids. “The risk of overdose is very small. The most common side effects are diarrhea, dry mouth and a little headache at the beginning of the treatment”, explains Beck.

Can or can not?

According to the current resolution of the Federal Council of Medicine (CFM), the doctor has the autonomy to prescribe any derivative of cannabis for your patients. That is, any doctor can give a prescription for the use of cannabinoids, regardless of their specialization.

This understanding even changed on October 14, when the CFM restricted the use of substances for specific diseases and prohibited courses and lectures on the subject. The noise was great, and 10 days later the CFM had to go back. The previous rule, from 2014, which guarantees the autonomy of the doctor is valid.

The production of cannabidiol and other marijuana derivatives is still prohibited in Brazil. In possession of the prescription, the patient will have to import the product – which can take a few weeks, in some cases. Not to mention the price, which easily reaches a few hundred reais.

Are there benefits for athletes?

CBD is not considered doping by Wada (World Anti-Doping Agency). That is, it does not improve the performance of athletes in competitions. No one is going to jump higher, or run faster just because they took cannabidiol. Even so, the use of these substances among athletes is increasing. The explanation is the search for the indirect benefit of the product. “The athlete sleeps better, reduces his stress level and reduces the period necessary for recovery between training sessions. All of this makes a difference for those looking to improve their marks”, explains Beck.

CBD use among athletes made news when American basketball player Brittney Griner was arrested in Russia. Even though it was a substance authorized by Wada, it was accused of drug trafficking. Her freedom was negotiated by the US government and she was released in early December.

It is important to note that Wada’s release applies exclusively to cannabidiol. THC and other cannabinoids are still banned by the agency, although there is hope among athletes that this ban will be lifted soon.

No ready recipe

Unlike allopathic remedies, cannabinoids do not have a fixed dosage. For each person, in each specific case, there is an individualized approach, which may include the association of one or more cannabinoids.

In this process, doctor and patient evaluate the results obtained with the first doses and discuss the need to increase, decrease or change the formula. This adjustment lasts three or four weeks on average.

unanswered questions

What happens to people who use CBD daily for years or decades? Can CBD be a ‘trigger’ for the emergence of other diseases? Are the impacts of CBD the same depending on how it is consumed (oral, topical, etc)? Does it affect the development of fetuses? Do children who use CBD have their brain growth impaired?

These are some of the questions that the Food and Drug Administration (FDA, the agency responsible for controlling drugs in the USA) considers that they have not been satisfactorily answered with the scientific studies available so far. Let’s be clear: nothing suggests that CBD causes any of the above problems. What the FDA does is work with the reverse logic and demand that it be proven that cannabidiol does not cause harm or side effects.

The sale of drugs derived from cannabis it is released in almost all of the United States, although most of the States require a specific medical prescription for the citizen to have access to the medication.

Although cannabinoids are used in an increasing number of treatments, the FDA has only approved and recommended one product for the treatment of epilepsy episodes related to Lennox-Gastaut Syndrome, Dravet Syndrome or Tuberous Sclerosis Complex (TSC). For everything else, it still does not attest to the effectiveness of substance use.

In summary: cannabinoids are promising and already have proven positive results in thousands of people. However, there is a lack of studies that lead control authorities in Brazil and the USA to recognize the medicinal effectiveness of these substances more widely. As it is a multibillion-dollar industry, the expectation is that these doubts will be clarified in the coming years. Until then, it is up to the doctor and patient to decide whether or not to use cannabinoids.

Is that you? Do you or intend to use cannabinoids? Tell us in the comments or write to [email protected]. If you prefer, you can send me a message on Instagram @rodrigofloresnacorrida.