Cannabis use in active athletes: Behaviors related to subjective effects

Abstract

Cannabis use has not been well characterized in athletes. Studies primarily examine problematic use or its categorization by anti-doping bodies as a banned substance. Patterns of use, reasons for use, and responses to cannabis consumption have not been studied in a community-based sample of adult athletes. The Athlete PEACE Survey examined cannabis use patterns and subjective effects to cannabis in a community-based cohort of adult athletes. We used mainly social media and email blasts to recruit and SurveyGizmo to collect data. 1,161 (91.1%) of the 1,274 athletes taking the survey completed it. Current cannabis use was evaluated by asking “In the past two weeks, have you used marijuana (including THC and/or CBD)?” and cannabis type used was assessed by asking “What do you primarily use THC, CBD, or both?”. Cannabis benefits and adverse effects (i.e. subjective effects) and patterns of use were reported. 302 athletes (26%) currently use cannabis of whom 301 had complete data for cluster analysis. Cluster analysis was used to determine cannabis user phenotypes and exploratory factor analysis (EFA) was used to create subjective effects factors. Associations between cannabis user phenotype clusters and the subjective effects factors were explored using multivariate analysis. Cluster analysis identified t hree statistically distinct cannabis user phenotypes: (1) older athletes who primarily use medical CBD, (2) mixed age athletes who use cannabis mainly recreationally with both THC and CBD use, and (3) mixed age athletes who used cannabis the longest with primary THC and CBD use. EFA showed three subjective effects factors: (1) Well-being, (2) Calm, and (3) Adverse. Mean positive subjective were higher than mean adverse subjective effects (p<0.001). The cluster using THC and CBD showed the highest mean scores for all three subjective effects factors (p<0.001). Athletes who use a combination of THC and CBD exhibited the most benefit to well-being and calm with minimal adverse effects. Our methodology can be used to develop real-world evidence to inform future use of medical cannabis products.

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes

“…A simulation study found valid solutions for cluster analysis with samples as small as 20 (Henry et al 2015). Our results from the primary analysis manuscript showed that the present sample size was adequate to clearly cluster the participants into 3 clinically distinct clusters (Zeiger et al 2019a).…”

“…The present secondary analysis of a larger study (Zeiger et al 2019a) examined patterns of cannabis use and subjective effects to cannabis by decade in adult community-based athletes. Significant differences were observed across decades for cannabis use patterns and reported subjective effects to cannabis.…”

“…This cross-sectional quantitative survey study used a convenience sample (Zeiger et al 2019a). The study was approved with waiver of written consent by Solutions IRB (http://www.solutionsirb.com).…”

A Warning against the Negligent Use of Cannabidiol in Professional and Amateur Athletes

“…A survey of cannabis use patterns in the US detected that older athletes who are newer to cannabis tend to only use CBD. However, in these athletes it provided the least reported benefit (albeit, with the least adverse effects) [14].…”

“…The safety of the long-term use of CBD is understudied and there are indications of some adverse effects including liver toxicity and an influence of male fertility [12]. A risk-benefit analysis should carefully consider the possible, so far non-approved benefits of CBD for athletes [14] against its safety-profile.…”