The conventional wisdom is that recreational cannabis users are “stoners” and that medical users are too sick to be functional. What if I told you that a recent survey of adult athletes showed that cannabis use and exercise can be symbiotic? Furthermore, athletes who use a combination of THC and CBD showed the most benefits of calm and well-being compared to those who use THC-only or CBD-only?

Last fall, we initiated The Athlete Pain, Exercise, and Cannabis Experience (PEACE) Survey Study. Our goals were simple. We wanted to characterize cannabis use in community-based adult athletes and to understand the positive and adverse effects athletes were having to cannabis. You can read our recently published paper for all of the details. 

Out of the 1,161 athletes who took the survey, 62% were male and 68% were over 40. The primary sports were triathlon, running, and cycling with a smattering of swimmers, climbers, yogis, and winter sport athletes. Athletic level ranged from recreational to professional.

Any way you look at it, this group exercises a lot! Seventy-three percent indicated they workout 5-7 days per week with 89.5% reporting 6 or more hours per week of exercise. These numbers are staggering when you consider only 22.3% of the population meets the weekly exercise recommendation of “either moderate-intensity aerobic physical activity for at least 150 minutes per week, vigorous-intensity aerobic physical activity for at least 75 minutes per week, or an equivalent combination”.

Here’s another interesting statistic from our study: 49% of the athletes reported that they have some kind of pain, with 9% indicating acute pain (less than 3 months) and 40% had chronic pain (3 months or more). This far exceeds the national number of 20% reporting chronic pain. 

Now that I have set the stage, let’s get down to the nitty-gritty of the Athlete PEACE Survey study.

• 26% (n=301) of the athletes indicated that they used cannabis in the past two weeks and were considered current cannabis users.
• There was no difference in use by sex, but there were differences by age. Athletes under 40 used cannabis in the past two weeks more often than those 40 and over.
• About 60% of the current cannabis users revealed that they used cannabis for pain. 76%-85% indicated cannabis was “moderately” or “very much” helpful for specific types of pain (i.e. joint pain, muscle pain, migraine, nerve pain). 

We asked about 8 positive effects (increased energy, improved athletic performance, less pain, decreased nausea, helps with sleep, calms me down, fewer muscle spasms, decreased anxiety) and 7 adverse effects (respiratory, cardiac, anxiety, worse athletic performance, increased appetite, difficulty concentrating, gastrointestinal). Benefits seemed outweigh adverse effects.

Here the most common positive and adverse effects:

The big question that looms on most people’s minds is which is better, CBD or THC or some combination of both? Our survey delved into this question in an exploratory way – we asked the athletes which of three cannabinoid situations apply to them (i.e. THC-only, CBD-only, Both THC and CBD) and then looked to see if there were differences in subjective effects based on that situation.

• Athletes who used CBD and THC in combination showed the most positive effects but also the most adverse effects. 
• Athletes who primarily used CBD-only showed both the least positive and adverse effects.

Cannabis use in adult athletes will increase over time given the rise in states legalizing its medical and/or recreational use. Athletes, similar to the general population, are continually looking for ways to mitigate the effects of pain, anxiety, and insomnia. The Athlete PEACE Survey study is one step in the direction of understanding how cannabis can be used to manage these issues.

Future research should determine whether cannabis will be helpful for those conditions.  If so, cannabis could start to play a bigger role in health and wellness. However, there is a big caveat. Cannabis is not the be all, end all and certainly will not be the antidote to training mistakes and poor habits; however, cannabis can be used as part of a multi-modal approach to facilitate training enjoyment, recovery, and reduced pain. And let’s hope that the anti-doping laws soon change so that all athletes can determine if cannabis is right for them without falling afoul of the rules.

 Zeiger JS, Silvers WS, Fleegler EM, Zeiger RS (2019) Cannabis use in active athletes: Behaviors related to subjective effects. PLoS ONE 14(6): e0218998. https://doi.org/10.1371/journal.pone.0218998