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DISCLAIMER: This content is NOT being updated and is only current as of the publication date.

Elite athletes must be very careful about the substances they use, including substances marketed as supplements or herbal products. The prohibited status of cannabidiol (CBD) is changing in 2018, but all other cannabinoids are still prohibited in-competition, including THC, which means there are still risks for athletes when it comes to CBD products.

Below is more information to help answer some of the top questions about CBD in 2018

Is the prohibited status of CBD changing in 2018?

Prior to 2018, CBD has been prohibited in-competition as a substance in the S.8 Cannabinoids category of the World Anti-Doping Agency (WADA) Prohibited List. As of January 1, 2018, CBD will be permitted at any time under the WADA Prohibited List. This means that after January 1, 2018, athletes will not face an anti-doping rule violation (ADRV) for the presence, use, or possession of CBD.

However, regardless of individual state laws regarding legalized medical and recreational marijuana or the anti-doping rules of sport, all cannabinoids, including CBD, remain illegal as Schedule I substances under the U.S. Federal Controlled Substances Act.

Why should athletes still be cautious about CBD?

Athletes should remember that all other natural and synthetic cannabinoids remain prohibited in-competition. For athletes, it is important to realize that CBD products may still contain prohibited cannabinoid components like THC. As such, athletes should continue to be cautious about using CBD products. Only Carboxy-THC, which is the psychoactive component of marijuana, cannabis, and hashish, is subject to a urinary reporting threshold of 150 ng/mL.

Athletes should also remember that it’s difficult to estimate clearance times of substances because detection levels are impacted by a wide range of factors, such as metabolism, product strength, and quantities used. When a substance is prohibited in-competition, like THC, it means the substance or its metabolites should not be detectable in a sample provided during the in-competition period.

Are CBD supplements legal?

No, dietary supplements containing CBD are not legal. Under federal law, it’s illegal for any dietary supplement, food, or medication to contain CBD, according to the U.S. Food and Drug Administration (FDA).

Moreover, CBD products can be created from very different strains of cannabis and those strains may contain high levels of THC. And because there are no pre-market safety, efficacy, or good manufacturing practice requirements for CBD products, it’s very difficult to know how much THC a product contains, or if there were other prohibited substances added to the preparation.

In recent years, the FDA has analyzed the chemical content of compounds in unapproved new drugs that claim to contain CBD, and many of those products contained levels of CBD that were different from what the product claimed. Given the number of unapproved CBD products on the market, the FDA has issued numerous warning letters to companies and cautioned consumers that unapproved “products with unsubstantiated therapeutic claims are not only a violation of the Federal Food, Drug and Cosmetic Act, but can also put patients at risk as these products have not been proven to be safe or effective.”

A JAMA study published by the American Medical Association in November 2017 also highlights the dangers CBD extract products pose to athletes and consumers, as inadequate regulation can lead to mislabeling of some CBD products. The study found that 69 percent of the products examined either over-labeled or under-labeled the true CBD concentration in a product. Even more concerning for athletes, prohibited THC was detected in 21 percent of the products tested, and the THC content in some of those products may be sufficient to produce intoxication or impairment.

Are there health risks associated with CBD and other cannabinoids?

At this point, reported research suggests there are significant and well-understood health risks from using marijuana and cannabinoids. A number of studies have indicated that using marijuana can lead to serious health issues, both physical and mental.

More specifically, cannabis has been implicated in uncontrolled cell growth and the impairment of DNA replication and repair, which are likely indicators of cancer. Respiratory conditions, such as lung cysts, chronic bronchitis, and lung cancer, have all been linked to the inhalation of marijuana smoke.

One population-based case-control study found that in terms of lung cancer risk, smoking one joint of cannabis was similar to smoking 20 tobacco cigarettes. In addition to the negative physical effects, which also include decreased immune function, higher rates of irregular heartbeat, and stroke, cannabis smoking has been linked to mental conditions, including depression, bipolar disorder, and psychosis.

Synthetic cannabinoids also pose a significant risk to users because the effects can be much more severe than those produced by marijuana. Some of the compounds in synthetic cannabinoids bind more strongly to brain receptors, which is why the effects could be more powerful and unpredictable. Moreover, synthetic cannabinoid products don’t always list every ingredient on the packaging label, so the effects of the product could be greater or different than expected.

More questions?

For questions about CBD, cannabinoids, and other substances, contact USADA’s Drug Reference Line at drugreference@usada.org or call (719) 785-2000, option 2.

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