Endocannabinoid Systems_ Pain and Performance

Cannabis is touted as a near-perfect cure for those suffering from many diseases.

According to one scientific journal entitled Cannabis, the Endocannabinoid System and Immunity, “The medical use of Cannabis is several thousand years old. The first historical evidence of Cannabis use in traditional medicine is documented in the ancient Chinese Pharmacopoeia, written in the first century BCE. In Chinese medicine, Cannabis was used to treat rheumatic pain, constipation, malaria, beriberi, and gynecological disorders. Evidence of Cannabis use in ancient traditional medicine was uncovered in Japan, India, Iran, and Egypt as well as in Arabic medicine. The medical use of Cannabis spread to the west only around the first century CE. Across the ancient world, the Cannabis treatment was documented to relieve a wide range of ailments including otitis, diarrhea, asthma, arthritis, and as a topical treatment of swellings and bruises” (Almogi-Hazan and Or 4448)

Both ancient and modern science has proven that cannabis has disease mitigating attributes. It only seems fit that such a powerful yet delicate plant be used on the body’s system. So, why hasn’t this been picked up by high-performance athletes? According to research done in 2020, “limited high-quality studies exist for use of cannabinoids for acute pain, chronic pain, or concussion. None of the trials involving cannabinoids included the athletic population...More robust evidence exists for the treatment of chronic pain conditions through meta-analysis and systematic reviews. Cannabinoid therapy exhibits moderate efficacy as a treatment for some chronic pain conditions. Investigations included a broad spectrum of chronic pain conditions, including neuropathic, musculoskeletal, inflammatory, and central pain conditions, and revealed reduction in pain and improvement of quality of life with limited adverse effects. For concussion, evidence is based on preclinical in vitro and animal models revealing possible neuroprotective effects as well as 2 clinical studies involving the presence of cannabinoids for concussion (some sports-related), but there are no high-quality trials evaluating efficacy for treatment with cannabinoids at this time.” (Maurer et al. 544)

Meaning modern science has yet to fully delve into the clinical trials and study Cannabis for high-performance athletes and their use of cannabis at least in the pre and post-training aches and pains. But, science and history already know how wonderful Cannabis is for our body. Why is that?

The short answer is that cannabis is still tied to the stigma of illegality and narcotics. If cigarettes are sold to the public with a proven track record of detrimental disease-causing effects, then why shouldn’t high-performance athletes be able to use cannabis with all its anti-cancer and many other positive attributes?

Science has concluded, with much scientific evidence, that our body naturally has an endocannabinoid system directly built-in to it. According to a Harvard paper by Grinspoon, “The ECS comprises a vast network of chemical signals and cellular receptors that are densely packed throughout our brains and bodies. The "cannabinoid" receptors in the brain — the CB1 receptors — outnumber many of the other receptor types on the brain. They act like traffic cops to control the levels and activity of most of the other neurotransmitters.

This is how they regulate things: by immediate feedback, turning up or down the activity of whichever system needs to be adjusted, whether that is hunger, temperature, or alertness. To stimulate these receptors, our bodies produce molecules called endocannabinoids, which have a structural similarity to molecules in the cannabis plant. The first endocannabinoid that was discovered was named anandamide after the Sanskrit word ananda for bliss. All of us have tiny cannabis-like molecules floating around in our brains. The cannabis plant, which humans have been using for about 5,000 years, essentially works its effect by hijacking this ancient cellular machinery. The second type of cannabinoid receptor, the CB2 receptor, exists mostly in our immune tissues and is critical to helping control our immune functioning, and it plays a role in modulating intestinal inflammation, contraction, and pain in inflammatory bowel conditions.”

Another research paper states, “Various biochemical explanations exist on the use of cannabinoid therapy through modulation of the endocannabinoid system for several medical issues affecting athletes; recommendations from clinicians must be extrapolated from a majority of research done in the non-athletic population. Lack of strong-quality clinical evidence, coupled with inconsistent federal and state law as well as purity issues with cannabis-based products, make it difficult for the sports medicine clinician to widely recommend cannabinoid therapeutics at present.” (Maurer and others (544)

Many athletes fear losing their position and prestige as they dedicate their lives ’ work to the sport they are involved in. Although cannabis is legal in Canada, cannabis use for pre and post-training has not been normalized or legalized within the Canadian sport domain, nor has it been used in the same capacity worldwide.

This argument brings to mind athletes such as Elias Theodorou, a professional MMA fighter in his thirties who has competed professionally for ten years of his life.

He has bilateral neuropathy and had to submit a medical letter for cannabis use five times to the USADA (USA Drug Administration). He never got to the point where they said no, but his medical use letter was just always denied. After the fifth submission, the USADA finally acknowledged the fact he suffers from bilateral neuropathy. Or Sha’Carri Richardson, the fastest woman in America. Back in July of 2021, she was denied being able to compete after testing positive for marijuana. She was suspended for one month. She claimed that she smoked after learning of her mother’s death. Her statement to this suspension was that “I am human." Yes, she is correct! As a human, she has endocannabinoid receptors built into her body to mitigate both mental and physical stress. Hopefully, high-performance athletes can see real reform with cannabis use internationally soon.

Sources: Almogi-Hazan, Osnat, and Reuven Or. “Cannabis, the Endocannabinoid System and Immunity—the Journey from the Bedside to the Bench and Back.” International Journal of Molecular Sciences, vol. 21, no. 12, 2020, p. 4448. Crossref, https://doi.org/10.3390/ijms21124448.

Grinspoon, Peter, MD. “The Endocannabinoid System: Essential and Mysterious.” Harvard Health, 11 Aug. 2021, www.health.harvard.edu/blog/the-endocannabinoid-system-essential-and-mysterious-20 2108112569.

Maurer, Gretchen E., et al. “Understanding Cannabis-Based Therapeutics in Sports Medicine.” Sports Health: A Multidisciplinary Approach, vol. 12, no. 6, 2020, pp. 540–46. Crossref, https://doi.org/10.1177/1941738120956604