Pain relief, cannabis, and sports.



Although I have never participated in cannabis use, for the past two years this topic has been of tremendous interest of mine. Before diving into the potential anesthetic effects of cannabis, I want to highlight a brief history of cannabis use in America. Ashton (2001) stated that the tetrahydrocannabinol (THC) content varies tremendously between different sources and preparations of cannabis. Over the past 20 years, sophisticated cultivation, and plant breeding techniques have greatly increased the potency of cannabis products. In the days of the 1960s and 1970s an average reefer contained about 10mg of THC. Now a joint made of skunkweed, netherweed and other potent subspecies of Cannabis sativa may contain around 150mg of THC, or 300mg if laced with hash oil. Thus, the modern cannabis smoker may be exposed to doses of THC many times greater than their counterpart in the 1960s and 1970s. This fact is important since the effects of THC are dose-related and most of the research on cannabis was carried out in the 1970s using doses of 5-25mg THC.



Positive anesthetic effects in athletes

In recent years, the use of marijuana in professional sports has gained considerable attention from the national media. The NFL has been front and center on this issue. Eugene Monroe, former offensive tackle for the Baltimore Ravens, stated “Whatever happens in terms of my professional football career, I will never stop pushing for the League to accept medical cannabis as a viable option for pain management. I will do everything I can to ensure the generations of NFL players after me will not have to resort to harmful and addictive opioids as their only option for pain management.” (Rafferty, 2018). These claims made by Eugene Monroe were supported by a review conducted by Texas A&M. In the review, Assi (2018) stated that studies have recently, and consistently, demonstrated the benefits of medical cannabis, not only for lower pain centralization, but also for reduction in opioid usage. For example, the University of Michigan conducted a study in June 2016 that suggests many chronic-pain patients, who were usually treated with opioids, experienced many benefits when medical cannabis was substituted in place of opioids. Those benefits included improvement in quality of life, decreased opioid use, fewer side effects, and less chronic pain.


Contrary to recent reports, and the current trend to decriminalize marijuana, the plant has maintained its decades long federal classification as a Schedule I drug by the United States Drug Enforcement and Administration. Drugs that are also currently listed as Schedule I drugs include heroin, LSD, ecstasy, and methaqualone (quaaludes). Yes, quaaludes. Marijuana is currently legal in twelve states, including Washington D.C. In eight states marijuana is considered fully illegal. Public perception is also a hendrence regarding marijuana. In 2019, the Pew Research Center reported that two-thirds of Americans support legalizing marijuana. Conversely, in the 1990s marijuana was viewed as a gateway drug. That stigma still remains.



Is the NFL changing its tune?

Although the negative stigma concerning cannabis still remains in certain political and social circles, the NFL has finally begun to trend more liberal. On March 15, 2020, the league finalized its 10 year collective bargaining agreement. The agreement featured looser cannabis policies. The NFL wiped out the potential for suspension following a failed cannabis testing. This was also in conjunction with a fourfold increase in the amount of THC that can yield a negative testing. Depending on who you ask, the move to loosen cannabis restrictions can be viewed as a victory for the NFL players, especially when considering that an estimated 50 to 90% of players engage in some form of cannabis use. Yet, when factoring in the physical violence of the sport along with the potential anesthesia effects, many would question the purpose of a marijuana policy altogether.


References

Ashton, C. H. (2001). Pharmacology and effects of cannabis: A brief review. British Journal of

Psychiatry, 178(2), 101-106. doi:10.1192/bjp.178.2.101


Assi, S. (2018). The NFL Should Stop Trying to Weed Out Marijuana. Texas A&M Law Review

Arguendo, 5(4), 33-36. doi:10.37419/lr.v5.arg.2


Belson, K. (2020, April 13). N.F.L. Bows to Marijuana's New Status. Retrieved January 06,

2021, from https://www.nytimes.com/2020/04/13/sports/football/nfl-marijuana-policy.html


Boehnke, K. F., Litinas, E., & Clauw, D. J. (2016). Medical Cannabis Use Is Associated With

Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain. The journal of pain : official journal of the American Pain Society, 17(6), 739–744. https://doi.org/10.1016/j.jpain.2016.03.002


Daniller, A. (2019, November 14). Two-thirds of Americans support marijuana legalization.

Retrieved June 28, 2020, from https://www.pewresearch.org/fact-tank/2019/11/14/americans-support-marijuana-legalization/

Drug Scheduling. (n.d.). Retrieved June 28, 2020, from https://www.dea.gov/drug-scheduling


Lopez, G. (2016, April 29). Is marijuana a gateway drug? Here's what the research says.

Retrieved January 05, 2021, from https://www.vox.com/2016/4/29/11528410/cannabis-gateway-drug-theory


Rafferty, S. (2018, June 25). Eugene Monroe on NFL, CTE and How Weed Changed His Life.

Retrieved June 26, 2020, from https://www.rollingstone.com/culture/culture-sports/eugene-monroe-on-nfl-cte-and-how-weed-changed-his-life-205616/


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