We find out about research done by Liverpool John Moores University
“If we go back about five years, I had players I worked with asking me about CBD,” says Graeme Close, professor of Human Physiology at Liverpool John Moores University and nutrition consultant with England Rugby.
“Five years ago it was quite an easy conversation: ‘It may be useful, it may not – I didn’t know much about it – but it’s prohibited by WADA (the World Anti-Doping Agency)’.
“Then in 2018 they removed it (from the banned list). As an academic/practitioner, that was not a good enough answer anymore.
“The starting point for me was with all the anecdotes you hear about how often it’s being used, (we had to) assess as many pro rugby players as we could, how prevalent was its use, why are people turning to it, what are the main reasons? How much do they know about it from an anti-doping perspective, and what are the perceived benefits so far?”
You may have seen rugby personalities talk about CBD – the cannabinoid found in the hemp strain of cannabis that has been linked to enhanced recovery, better sleep, relief with muscle soreness. Yet as was suggested by Dr Mark Ware in our companion piece, Chronic Pain, Cannabis and Rugby, with quality research “there is nothing on human pain and CBD. It’s astonishing that we don’t have data on that.”
Read next: CHRONIC PAIN, CANNABIS AND RUGBY
So in August, Close, his colleague Andreas Kasper and LJMU released the results from a study they had done that highlighted the high prevalence of CBD use among professional rugby players, despite warnings that there are still risks attached to its use. They found 26% of professional players surveyed (517 professional league and union players from UK-based competitions) had tried CBD oil and 8% were currently using it.
Worryingly, the team at LJMU found that only 16% of professionals surveyed had sought advice from trained sport nutritionists. A whopping 73% were getting their information from the internet, despite the risks of anti-doping violations.
Although not prohibited by WADA, CBD often contains traces of other cannabinoids such as THC (the psychoactive compound tetrahydrocannabinol, the part of cannabis that creates the ‘high’), which is prohibited and illicit in quantities above 1mg per bottle. The real risk is that there is evidence to show that many CBD products have much higher levels of THC than stated on product packaging.
Close takes a balanced view. He tells Rugby World: “We published a paper, maybe five years ago now, which basically shows that rugby league players are in pain every day of their life during a competitive season. It subsides as it gets towards the game day but you’re never back down to zero.
“What we also know is that with some traditional pain medication (like non-steroidal anti-inflammatory drugs (NSAIDs)), even Ibuprofen, if you take it long enough it’s related to stomach ulcers. Then you move on to the opiates like tramadol, and we know that they are addictive. There are problems with players who have openly admitted at the end of their careers to being addicted to opiate-based painkillers.
“So if we’ve got something with a side-effect profile that appears to be less than the traditional (painkillers), and the anecdotes suggest it’s effective in pain relief, I do think as academics we’ve got a responsibility to investigate it.
“The huge caveat to all that is at the moment it’s still a big anti-doping risk. I do believe it is still too soon for any athlete to be using it. I think people like myself have a responsibility to research it, and if it’s safe and it helps with pain relief and it’s got less side effects, then we have to work together with the authorities to find a way to make it able for athletes to use.”
With the need for higher quality control in the field – as with the aforementioned issues with misleading labels – and new products coming out, quality research is imperative. There are different avenues yet to be explored, too.
While we may be aware of the reputable brands who have the low levels of THC they claim, there needs to be a study into the possibility of accumulating THC to such a level that a player fails a drug test.
Of course the issue is how to go about conducting such studies?
As Kasper points out, you cannot use elite athletes as a control group for something like this because you risk them failing a test. Certain amateur competitions come under the WADA code, too. You have to carefully consider who you use.
So is it an exciting time to be looking into this?
“If you were to ask me as an academic, with my professor of human physiology at LJMU, is this exciting or worrying, I’d say it’s exciting,” says Close. “We’ve got something here that has got so much potential.
“It’s like a skier finding (untouched) white powder snow. You can go and have some fun with it. Who knows what we’re going to find?
“You’ve got to remember that the way all this was discovered was people were trying to work out what was going on with cannabis, particularly THC – why was it having all these effects on the human body?
“And then we discovered the human endocannabinoid system. There’s a system in place whereby these cannabinoids bind to receptors and have major effects, and then you find a body producing its own endocannabinoids. It’s got so much potential.
“Then you say, ‘Graeme, as consultant nutritionist with England Rugby, is this exciting or worrying?’ I’d say it’s terrifying because it’s a failed drug test waiting to happen!”
He again brings up recent studies that showed it’s “the wild west out there”.
And in February, the Food Standards Agency (FSA) set a deadline of March 2021 for CBD businesses to provide more information about CBD products and their contents. It also advises the pregnant, breastfeeding or those taking any medication not to consume CBD products, and said healthy adults should take no more than 70mg a day.
From the elite sports perspective, Close and his cohorts are keen to get to the bottom of a few key issues: does it actually work, what dose does it work at, and what are the WADA and safety issues related to that? Know all that, they say, and they will be in a much better position to advise athletes.
As for the performer, it’s best they seek the advice of professionals away from the testimony of mates, instead of scrolling through the internet.
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