Advertisement

Cannabis: Exercise performance and sport. A systematic review

      Abstract

      Objectives

      To review the evidence relating to the effect of cannabis on exercise performance.

      Design

      A systematic review of published literature

      Methods

      Tetrahydrocannabinol (THC) is the principal psychoactive component of cannabis.
      A search was conducted using PUB med, Medline and Embase searching for cannabis, marijuana, cannabinoids and THC, in sport and exercise; the contents of sports medicine journals for the last 10 years; as well as cross references from journals and a personal collection of reprints. Only English language literature was reviewed and only articles that specified the details of a formal exercise program or protocol. Individuals in rehabilitation or health screening programs involving exercise were included as the study may have identified adverse reactions in the marijuana group. Review articles, opinion pieces, policy statements by sporting bodies and regulatory agencies were excluded.

      Results

      Only 15 published studies have investigated the effects of THC in association with exercise protocols. Of these studies, none showed any improvement in aerobic performance. Exercise induced asthma was shown to be inhibited. In terms of detrimental effects, two studies found that marijuana precipitated angina at a lower work-load (100% of subjects) and strength is probably reduced. Some subjects could not complete an exercise protocol because adverse reactions caused by cannabis. An important finding relevant to drug testing was that aerobic exercise was shown to cause only very small rises (<1 ng/mL) in THC concentrations.

      Conclusions

      THC does not enhance aerobic exercise or strength.

      Keywords

      To read this article in full you will need to make a payment

      References

        • Bartels E.M.
        • Swaddling J.
        • Harrison A.P.
        An ancient Greek pain remedy.
        Pain Pract. 2006; 6: 212-218
        • Tashkin D.P.
        UCLA conference “Cannabis 1977”.
        Ann Intern Med. 1978; 89: 539-549
      1. National Drug Strategy Household Survey 2007 ISBN 978-1-74024.

        • Volkow N.D.
        • Baler R.D.
        • Compton W.M.
        • et al.
        Adverse health effects of marijuana use.
        N Engl J Med. 2014; 370: 2219-2227
        • Andre C.M.
        • Hausman J.-F.
        • Guerriero G.
        Cannabis sativa: the plant of the thousand and one molecules.
        Front Plant Sci. 2016; 7: 1-15
        • Grotenhermen F.
        Pharmacokinetics and pharmacodynamics of cannabinoids.
        Clin Pharmacokinet. 2003; 42: 327-360
        • Mechoulam R.
        Marijuana chemistry.
        Science. 1970; 168: 1159-1166
        • Su M.K.
        • Seely K.A.
        • Moran J.H.
        • et al.
        Metabolism of classical cannabinoids and the synthetic cannabinoid JWH-098.
        Clin Pharmacol Ther. 2015; 97: 562-564
        • Chesher G.B.
        • Bird K.D.
        • Jackson D.M.
        • et al.
        The effects of orally administered Δ9-tetrahydrocannabinol in man on mood and performance measures: a dose-response study.
        Pharmacol Biochem Behav. 1990; 35: 861-864
        • O’Brien C.P.
        Drug addiction.
        Goodman and Gillmans the pharmacological basis of therapeutics. 12th ed. Mc Graw Medical Publishing, 2011: 663-664
        • Tetrault J.M.
        • Crothers K.
        • Moore B.A.
        • et al.
        Effects of marijuana smoking on pulmonary function and respiratory complications.
        Arch Intern Med. 2007; 167: 221-228
        • Johnson S.
        • Domino E.F.
        Some cardiovascular effects of marijuana smoking in normal volunteers.
        Clin Pharmacol Ther. 1971; 12: 762-768
        • Benowitz N.L.
        • Jones R.T.
        Cardiovascular effects of prolonged delta-9-tetrahydrocannabinol ingestion.
        Clin Pharmacol Ther. 1975; 18: 287-297
        • Beaconsfield P.
        • Ginsburg J.
        • Rainsbury R.
        marijuana smoking. Cardiovascular effects in man and possible mechanisms.
        N Engl J Med. 1972; 287: 209-212
        • Thomas G.
        • Kloner R.A.
        • Rezkalla S.
        Adverse cardiovascular and peripheral vascular effects of marijuana inhalation: what cardiologists need to know.
        Am J Cardiol. 2014; 113: 187-190
        • Sparling P.B.
        • Giuffrida A.
        • Piomelli D.
        • et al.
        Exercise activates the endocannabinoid system.
        Neuroreport. 2003; 14: 2209-2210
        • Lorente F.O.
        • Peretti-Watel P.
        • Grelot L.
        Cannabis use to enhance sportive and non-sportive performances among French sport students.
        Addict Behav. 2005; 30: 1382-1391
        • Dunn M.
        • Thomas J.O.
        • Swift W.
        • et al.
        Recreational substance use among elite Australian athletes.
        Drug Alcohol Rev. 2011; 30: 63-68
      2. World Anti Doping Agency. Available at https://www.wada-ama.org/. [Accessed 16 August 2016].

      3. WADA Technical Document—TD2014DL.

      4. WADA Accreditation Laboratory Reports. Available at https://www.wada-ama.org/en/resources/laboratories/anti-doping-testing-figures. [Accessed 16 August 2016].

        • Aronow W.S.
        • Cassidy J.
        Effect of marijuana and placebo-marijuana smoking on angina pectoris.
        N Engl J Med. 1974; 291: 65-67
        • Aronow W.S.
        • Cassidy J.
        Effect of smoking marijuana and of a high-nicotine cigarette on angina pectoris.
        Clin Pharmacol Ther. 1975; 17: 549-554
        • Steadward R.D.
        • Singh M.
        The effects of smoking marijuana on physical performance.
        Med Sci Sports Exerc. 1975; 7: 309-311
        • Hollister L.E.
        • Richards K.R.
        • Gillespie B.A.
        Comparison of tetrahydrocannabinol and synhexyl in man.
        Clin Pharmacol Ther. 1968; 5: 783-791
        • Avakian E.V.
        • Horvath S.M.
        • Michael E.D.
        • et al.
        Effect of marijuana on cardiovascular responses to submaximal exercise.
        Clin Pharmacol Ther. 1979; 26: 777-781
        • Renaud A.M.
        • Cormier Y.
        Acute effects of marijuana smoking on maximal exercise performance.
        Med Sci Sports Exerc. 1986; 18: 685-689
        • Shapiro B.J.
        • Riss S.
        • Sullivan S.F.
        • et al.
        Cardiopulmonary effects of marijuana smoking during exercise abstract.
        Chest. 1976; 70: 441
        • Shapiro B.J.
        UCLA conference “Cannabis 1977”.
        Ann Intern Med. 1978; 89: 539-549
        • Wong A.
        • Montebello M.E.
        • Norberg M.N.
        • et al.
        Exercise increases THC concentrations in regular cannabis users.
        Drug Alcohol Depend. 2013; 133: 673-767
        • Westin A.A.
        • Mjones G.
        • Burchardt O.
        • et al.
        Can physical exercise or food deprivation cause release of fat-stored cannabinoids?.
        Basic Clin Pharmacol Toxicol. 2014; 114: 467-471
        • Huestis M.A.
        • Mazzoni I.
        • Rabin O.
        Cannabis in sport: anti-doping perspective.
        Sports Med. 2011; 41: 949-966
        • Buchowski M.S.
        • Meade N.N.
        • Charboneau E.
        • et al.
        Aerobic exercise training reduces cannabis craving and use in non-treatment seeking cannabis-dependent adults.
        PLoS One. 2011; 6: e17465
        • Bailey S.P.
        • Adler E.
        • Hamilton L.
        Impact of aerobic exercise of varying intensities on craving in cannabis-dependent adults.
        Med Sci Sports Exerc. 2012; 44: 862-863
        • Maksud M.G.
        • Baron A.
        Physiological responses to exercise in chronic cigarette and marijuana users.
        Eur J Appl Physiol. 1980; 43: 127-134
        • Thaskin D.P.
        • Shapiro B.J.
        • Enoch Lee Y.
        • et al.
        Effects of smoked marijuana in experimentally induced asthma.
        Am Rev Respir Dis. 1975; 112: 377-386
        • Lach E.
        • Schachter E.N.
        Marijuana and exercise testing.
        N Engl J Med. 1979; 301: 438
        • Tashkin D.P.
        • Reiss S.
        • Shapiro B.J.
        • et al.
        Bronchial effects of aerosolized Δ9-tetrahydrocannabinol in healthy and asthmatic subjects.
        Am Rev Respir Dis. 1977; 115: 57-65
        • Schweizer A.
        • Bircher H.-P.
        Reposition of a dislocated shoulder under use of cannabis.
        J Wilderness Med. 2009; 20: 301-302
        • D’souza D.C.
        • Ranganathan M.
        Medical marijuana: is the cart before the horse?.
        JAMA. 2015; 313: 2431-2432