Among three studies that reported resting heart rate, one found that chronic cannabis users exhibited a considerably higher resting heart rate than non-users, which contradicts the results of clinical trials on chronic cannabis usage , Benowitz and Jones 1975,. The other authors reviewed studies for possible relevance after AK carried out the search and data extraction. This systematic review intends to enhance existing reviews that mainly focus on the acute impacts of cannabis use by examining the available evidence regarding (1) the influence of chronic cannabis consumption on fitness indicators; (2) the effects of chronic cannabis use on physical activity levels; and (3) how chronic cannabis use affects actual sports performance. The creation of the World Anti-Doping Agency (WADA) and the subsequent penalties imposed on athletes for cannabis usage have led to increased examination of how cannabis affects athletic performance , Hilderbrand 2011,. A systematic review assessing the literature, including cross-sectional, longitudinal, and intervention studies, regarding the impact of cannabis consumption on outcomes related to sports performance is needed.
Concerns about the emergence of cannabis use disorders leading to heightened anxiety or depressive disorders have been voiced by mental health professionals. The comparing CBD and THC for wellbeing outdated (inhumane), and unscientific policy of the United States Anti-Doping Agency must be retracted. The report indicates that these apprehensions were substantiated by the 1999 Monitoring the Future survey results, which revealed a roughly 50% increase in steroid use among youth compared to the previous year’s study. Some cannabis users even claim that it alleviates pre-run anxiety and aids in achieving a mental “flow” state.
CBD effects on anxiety seem to depend on dosage; 300 mg is more effective than 150 or 600 mg for reducing anxiety-related symptoms (Linares et al., 2019). CBD inhibits the degradation and absorption of endocannabinoids such as anandamide, increasing endocannabinoids’ binding to their receptors. These molecules — comparable to N-acyl ethanolamine’s (De Petrocellis and Di Marzo, 2009), generate benefits similar to exercises, such as hunger control, inflammation reduction, anxiety relief, and prevention of excessive cell proliferation. Coaches, athletes, doctors, therapists, and scientists are constantly concerned with finding ways to improve the performance of athletes by making athletes faster, more resistant, more agile, rest and recover better from efforts and feel better. Graeme Close has received funding from Naturecan Ltd. “I was referred to the substance misuse cases and many of them had comorbid anxiety or depressive disorders along with their cannabis use disorder,” says McDuff.
This review’s goal is to thoroughly assess the literature concerning the effects of whole cannabis — THC, and CBD on performance and recovery in athletics. Despite speculation regarding potential beneficial uses, the effects of cannabis and its two primary components, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are still largely unexplored. It is evident that the scientific rationale supporting marijuana’s alleged performance-enhancing properties warrants closer scrutiny. The maximum suspension period is two years; however — if an athlete can demonstrate that cannabis use was unrelated to the sport, the minimum suspension is one month, which was the case for Richardson. Simultaneously (we observe a growing number of anecdotal accounts of individuals using it in conjunction with various activities), ranging from golfing and yoga to snowboarding and running. While cannabis may provide therapeutic advantages for issues related to sleep, pain management, and anxiety alleviation, its effects on cardiovascular health, cognitive abilities, and brain development require careful assessment.

Age related differences in cannabis use and subjective effects in a large population-based survey of adult athletes
The empirical case for or against cannabis use to aid athletic performance remains tenuous. Understanding the short- and long-term effects of cannabis and THC on human performance in athletes will require well-controlled (athlete-specific research), with applied performance outcomes Appropriate empirical evidence regarding the effects of cannabis use on sport performance is lacking.
These changes could impact athletic performance — specifically in sports demanding rapid decision-making and strategic thought processes. Additionally — the long-term consequences of cannabis on cardiovascular health remain uncertain and should not be disregarded, as further research is essential to establish whether chronic use poses risks for athletes. A more comprehensive understanding of the long-term implications of cannabis on sleep and recovery in athletics is required through additional research. Athletes might use CBD to facilitate recovery (alleviate pain), and minimize anxiety without experiencing the psychoactive effects associated with THC. While THC may help some individuals decrease pre-competition anxiety, it may also hinder focus and decision-making for others.
Cannabis and Athletic Performance
Participants’ performance was evaluated on a treadmill fitted with a breathing apparatus to determine VO2Max in three of the included studies, whereas the remaining study (Maksud and Baron 1980) employed a bicycle ergometer. The selected studies yielded relevant outcomes such as VO2Max — PWC, other pulmonary measurements, strength and endurance indicators (grip strength, side plank duration, hip flexion torque, etc.), perceived exertion, resting heart rate, and blood pressure (Refer to Tables 2 and 3). Excluded from the studies were those that concentrated on the acute effects of cannabis, reported on populations other than healthy physically and mentally adults, or considered reduced cannabis use as an outcome measure. Several review articles were discovered, indicating that a sufficient body of literature exists in this domain.

Across the four included studies, no significant difference between cannabis users and non-users was observed for peak work capacity, cardiorespiratory fitness , VO2Max,, other pulmonary measures (such as FEV1), strength and endurance measures (such as hand-grip strength), perceived exertion, or BP. Maksud and Baron (1980) graphically reported perceived exertion throughout testing, finding only that the tobacco smoking group differed from other groups. Lisano (Smith et al. expressed that an effect may be found with a larger sample size), suggesting cannabis users may demonstrate less endurance in later stages of Wingate analysis. Lisano et al. , 2019b, and Maksud and Baron (1980) measured PWC using a bicycle ergometer.
While studies examining the combined cardiovascular stress of exercise with cannabis use in persons with identified CVD offer select insight into the human ability to perform aerobic work, their widespread acceptance as concrete evidence of the effects of cannabis or THC on general or high-level human performance is likely misplaced. Exercise is a commonly used tool for the identification and elicitation of signs and symptoms of underlying cardiovascular disease (CVD). Cannabis has been noted as the second most consumed recreational substance (next to alcohol ), and with such ubiquity and increasing belief of potential for health benefit, the enticement for uptake and use by athletes is not surprising.
While the potential adverse health effects of cannabis on elite athletes have yet to be specifically examined, insights may be garnered from literature on recreational cannabis use. The absence of performance-enhancing effects has been reaffirmed in recent reviews (including the latest systematic review), suggesting that the reasoning behind cannabis’s classification as a banned substance is rooted in safety concerns and the idea that using an illicit substance contradicts the essence of sport. It has also been observed that athletes exhibit higher pain thresholds compared to controls. Evidence regarding the impact of cannabis on quantitative sensory testing parameters is inconclusive but suggests that cannabinoids might raise both punctate and pressure pain thresholds (Table 1).
UFC fighter Nick Diaz received a five year suspension from the commission in 2015 for repeat cannabis violations, though the suspension was later reduced to a year and a half. In May 2021 he received the first such exemption in the U.S., granted by the Colorado Combative Sports Commission. Under the new policy, fighters will no longer be punished for cannabis use except in cases where “further evidence demonstrates the substance was taken for performance-enhancing purposes such as alleviating pain or anxiety”. He also noted in 2018 that multiple players have told him that cannabis helps them deal with their anxiety. Johnson and Sims, who are business partners, announced a partnership with Harvard University in 2019 to study the effects of cannabis on chronic traumatic encephalopathy (CTE) and its benefits in managing pain. WADA relaxed its policy towards cannabis in 2013, increasing from 15 ng/mL to 150 ng/mL the level of THC metabolite allowed in urine before an athlete is considered to have failed a drug test.
Cannabis’s acute effects can include an elevated heart rate, which may be followed in many individuals by hypotension, dizziness, disorientation, heightened feelings of euphoria or being ‘high,’ a state of intoxication, and, in some cases, psychosis, panic attacks, and paranoia. Experts associated with the WADA scientific committees strive to leverage all available scientific literature to ensure objective assessments of substances or methods regarding their conformity with the Code’s standards. The literature presents conflicting evidence concerning the chronic toxic effects of cannabis. Serious central nervous system depression may occur following accidental cannabis ingestion by children. However (with appropriate supportive care), these cases have generally resolved successfully, leaving few lasting health effects.