Medical Cannabis - the ABC of CBD
With the use of medical cannabis on the rise, athletes should bear in mind that some types of cannabinoids are still Prohibited Substances and if an athlete tests positive, they could still face a lengthy ban.
In a recent blog my colleague Shannett Thompson set out the legal framework governing the use of Cannabis-Based Products for Medicinal use in humans, or CBPM, which can be accessed here. In short, cannabis is a controlled Class B drug under the Part II, Schedule 2 of the Misuse of Drugs Act 1971. Whilst it has a recognised medical use in some cases, a licence is required from the Home Office in order to legally produce, possess and/or supply it. As to CBPM’s, they must meet the legal test set out in Regulation 2 to allow a specialist doctor to prescribe without the need to obtain a licence.
Cannabis itself contains over 100 known types of cannabinoids, one of them being cannabidiol, otherwise known as CBD. CBD is the cannabinoid thought to possess medicinal benefits, including pain relief; however there are doubts about whether CBD is effective in itself without the presence of other cannabinoids, such as THC. THC, or tetrahydrocannabinol, is arguably the most well-known of the cannabinoids as it possesses the psychoactive properties relied upon by users to get ‘high’.
The World Anti-Doping Agency (WADA) Prohibited List sets out the Prohibited Substances which are prohibited at all times, and those that are only prohibited ‘in-competition’ (i.e. 12 hours before competition through to the end of the competition and sample collection).
Section 8 states that both natural and synthetic cannabinoids, including THC, are prohibited in-competition only. The only exception is CBD, which athletes are permitted to use at any time.
It is important to note that unlike with all other banned cannabinoids, the level of THC must reach a certain threshold in order to return a positive test (a positive test may also be referred to formally as an Adverse Analytical Finding or ‘AAF’). The threshold for THC to return an AAF is 150 nanograms per millilitre of urine.
The short answer is yes. Athletes can take CBD at any time, even in-competition, and they can take cannabis any time deemed to be out of competition. But athletes who choose to take CBD products in-competition should proceed with extreme caution. This is because there is no way to guarantee that CBD products will be 100% free from THC or other cannabinoids; a risk of contamination will always remain. Unlike with supplements, where athletes can take steps to minimise the risk by checking Informed Sport who batch test supplements, there is no way of independently verifying the contents of CBD products. Even if the manufacturer of the product guarantees its ingredients are 100% free from banned cannabinoids, this may not be the case.
Athletes need to remember the principle of strict liability that operates in anti-doping means they are responsible for everything they ingest, including food, supplements and medicines. Therefore as with any supplement or medicine, ingesting products containing CBD is at their own risk.
Cannabis is defined as a specified substance, which allows for a greater reduction in sanction than non-specified substances, so the starting point for the length of the Period of Ineligibility (i.e. ban) is two years. However, if a Panel determines that an Athlete knew that a CBD product contained another banned cannabinoid, or knew that there was a significant risk this would be the case, the ban could be extended by up to four years.
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