Last Tuesday, the pain management committee of the NFL and NFL Players Associated announced funding for research into alternatives to opioids for pain management – including cannabis and cannabinoids like CBD.
According to the league’s announcement, the funding opportunity is intended to facilitate, at minimum, the following three areas of inquiry:
- The effects of cannabinoids on pain in elite football players (post-surgical and/or in daily pain management);
- The effects of non-pharmacologic treatments on pain in elite football players (postsurgical and/or in daily pain management); and
- The effects of cannabis or cannabinoids on athletic performance (e.g., psychomotor, reaction time, cardiorespiratory function) in elite football players.
The fact that the announcement explicitly mentions cannabis and cannabinoids signals that the committee has been listening to retired players who have spoken out about their use of cannabis to manage pain during their time in the league.
Until a new collective bargaining agreement was approved in 2020, the NFL could (and did) suspend players if they tested positive for marijuana multiple times. The new agreement doesn’t explicitly allow cannabis use, but the league has stated that testing will only happen during the first couple weeks of training camp (rather than April to August).
The agreement also significantly raised the threshold for the amount of THC that triggers a positive test was increased as well. The new threshold means that players that are using hemp-derived CBD oil that contains the legal maximum of THC (0.3%) should be safe from penalties.
We want to really find out," Hill said, "are these treatments safe and do they work? This research is aimed at trying to move toward getting more definitive answers to those questions.
However, while the rules have been loosened up, the league still has concerns about both the efficacy and safety of CBD and medical marijuana for their players:
“Unfortunately the level of interest exceeds the level of evidence about medical cannabis for pain,” said Kevin Hill, co-chairman of the joint committee on pain management between the players’ association and the league.
While there are, in fact, multiple studies which look at cannabis and cannabinoids for pain, Hill, who is also director of addiction psychiatry at Boston’s Beth Israel Deaconess Medical Center, said there are flaws in existing studies. The NFL wants to know these treatments are both safe and effective enough to be considered as potential treatments for elite athletes.
“That’s why we put out this request for proposals so that we can collectively with the PA, the players association, move towards finding better treatments for pain. Those treatments may include cannabis, and they may include CBD,” Hill said, speaking to the Associated Press.
He has stated further that the committee has heard mixed results from players about using marijuana to treat pain – and that they have concerns that using medical marijuana and CBD to treat pain may be riskier than most people realize.
Dr. Allen Sills, the league’s chief medical officer, points to another question that greatly concerns the league and their (highly paid) players: how does using cannabis and CBD to treat pain affect performance in elite athletes? Ultimately, the league wants to be sure that using cannabis products will not interfere with a player’s performance on the field.
Of course, it’s not only NFL players that have an interest in the efficacy of cannabinoids for pain. Chronic pain is a massive issue in the US, and any research the NFL funds will have widespread impact:
“This is really not an NFL issue or a sports issue,” Sills said. “This is a societal issue, which is how can we better understand and treat pain and what are the alternatives that may be out there for treatment in addition to opioids which have long been used.”