Risky Business: Why CBD Products Could Possibly be Putting Professional Athletes at Risk of Failing Doping Tests.
If you follow any boxers or other athletes on social media, you’ll probably have heard of CBD. Some athletes talk about it more than they talk about their sport and many offer discount codes in case any of their followers want to share in the purported benefits of the chemical, found in cannabis plants. Various athletes believe in the product so much that they have invested in their very own brand of CBD.
Former Great Britain Olympic boxer Anthony Fowler — a now 12-1 professional — tweets almost exclusively about the benefits of CBD to his 66.9k followers.
Anthony Fowler (@afowler06)“I take 2 drops of CBD oil under my tongue 9pm daily, has so many health benefits some the best are helping with recovery, insomnia, depression or anxiety, there’s so many other boxers/athletes involved, Click link on my bio https://www.cbdvaperus.com/aff/91 and use code Fowler for 20%”
Henry Baldwin has been on a somewhat similar journey as Fowler. He works for 258 Management — the company owned by Anthony Joshua — and is responsible for the world heavyweight champion’s commercial endorsements and sponsorships. Around two years ago, some of the boxers in 258’s stable started asking him questions about this new supplement they kept hearing about.
What were the benefits? Was it safe? Baldwin started researching, and even using CBD himself. He’d always been a bad sleeper, and the anecdotal evidence for CBD improving sleep was strong.
It didn’t take long for him to feel the benefits. But when it came to his boxers using the product, he had some concerns.
Some Background on CBD
Short for cannabidiol, CBD is one of 113 identified cannabinoids (or chemicals) found in cannabis plants. It once sat alongside all the other cannabinoids as a banned substance by the World Anti-Doping Agency (WADA), but in January 2018 it was removed from the banned list (the US and UK anti-doping authorities followed suit), meaning that, in principle, athletes are free to add CBD products to their collection of vitamin pills and protein powders.
However in September 2019, 11-time Ironman champion Lauren Goss failed an anti-doping test and was slapped with a six-month ban after using a CBD cream to treat an ankle injury. The devil in the detail is a cannabinoid called tetrahydrocannabinol (THC), which is the psychoactive component of marijuana (the bit that will get you high). In Europe, CBD products must contain less than 0.2 per cent THC to be sold legally (it’s 0.3 per cent in the US). Anti-doping agencies permit a small amount of THC to be detected in urine, up to a threshold amount. Goss’ THC levels were found to be over that limit.
Goss announced her acceptance of the ban a few days before she was due to race at the Ironman world championships. She explained in an Instagram post that the cream she had been using twice a day for over a month had since been tested and was found to contain more THC than was stated on the container.
“If anything this should be eye-opening for athletes who also use CBD,” wrote Goss, who was immediately dropped by her main sponsors. “I am extremely depressed, nervous and unsure of what I will do next.”
She took full responsibility for using the cream, which she knew contained some level of THC, but said she thought little of it considering how mainstream the product was.
Mainstream, and incredibly lucrative.
Over the next five years, the CBD industry is predicted to be worth over £20 billion, and new brands are popping up almost daily. When such rapid growth occurs in a relatively new market — it was banned for sportspeople until just over two years ago, remember — it can take regulatory bodies years to catch up.
Which brings us back to Henry Baldwin. Having experienced the benefits of CBD, he was convinced by the product but not by many of the brands that were selling it.
“It was a bit hit-and-miss,” he said, “especially for athletes to know the THC level in the product and whether it was safe to use in sport.”
His solution was to get into the CBD business, co-founding Signature CBD 18 months ago to create what he describes as “a transparent brand that people could feel safe using and know exactly what’s in the product”.
That means sending Signature’s products to an independent testing facility, where they are checked for the exact contents.
“There are a couple of other good brands,” Baldwin said, “but it’s still a pretty murky market, if I’m completely honest.”
Not so Simple
While some brands target athletes with their products — including putting the word “Athlete” on the label, just to be really clear — Baldwin steers clear of following that path. That’s because as confident as he said he is regarding the contents of Signature CBD’s products and in the testing they undergo, he’s not quite confident enough to pass them on to the likes of Joshua or other boxers in the 258 stable, which includes Joshua Buatsi and Lawrence Okolie.
The absence of any internationally recognized, standardized laboratory tests means that while one lab might clear a product containing THC, another might conclude something different.
“I’d be confident AJ (Joshua) would be fine because we’ve had our third-party tests, but I think the benefits are so marginal for an athlete like that, I just think it wouldn’t be worth it — not until you can be 100 per cent sure,” Baldwin said. “Those who are taking it are taking a risk. But at the same time, they’re not if they have the lab certificates. It’s like taking a protein powder that you know doesn’t have anything (illegal) in it, but it’s not approved by Informed Sport. There’s always an element of risk.”
Informed Sport provide the gold standard of banned-substance supplement testing in the UK and across the globe. Most tested athletes check the packaging for their logo before adding any new powder, drink or tablet to their arsenal, reassured that they have done their due diligence in minimising the risk of inadvertently doping, and knowing the products have been subjected to a high level of quality control and that every batch has been tested.
Currently, Informed Sport do not accept any products on their programme that knowingly contain CBD. They don’t yet feel there is enough research out there to fully give clarity on the subject to athletes who want to take CBD, and so would not be comfortable with placing the Informed Sport logo on a product.
The complexity comes down to two things: While most people only talk about THC and CBD, the cannabis plant can actually create anything from 60 to 200 different types of cannabinoids depending on how it metabolizes. CBD is just one of those, and it’s the only one not currently banned by WADA.
So while people can think, ‘If we take the CBD out and it has minimal THC, then it’s all fine,’ the likelihood is that if a product is tested, there are likely to be varying amounts of other cannabinoids within that product. So it’s not as finite as it just being the THC and CBD as an issue.
The other problem is with the threshold limit of THC that WADA allows: 150 nanograms per millilitre as a ‘reporting threshold’ and 180 nanograms for a ‘decision limit.’ So an athlete would need to consume a certain amount of THC to break that threshold. The trouble is that amount of THC hasn’t been fully established. We don’t know what that level is within the legislative limit of THC, which was geared towards the CBD industry and the general consumer but not necessarily to drug-tested athletes.
Related to that is the fact that there has been no research done on the potential ‘accumulation effect’ of THC. So, if a boxer (or any athlete) was to take a product containing less than 0.2 per cent THC over a period of time, no one can yet say for certain whether they would eventually end up with a positive test.
“Those studies haven’t yet been done,” said Professor Graeme Close, a sports nutrition consultant who has worked with world-class athletes from across a range of sports. “So you could have an athlete who’s been taking CBD every day and passed a dozen anti-doping tests; then, on the 13th they fail because the THC has accumulated. I’m not saying that it will — just that we don’t know.”
Professor Close has had an interest in CBD ever since a couple of his athletes asked him about it six years ago. His response at the time was easy: The product is banned. End of discussion. But two years ago that stance changed when WADA removed it from the list.
He has undertaken some research (due to be published this week), which has found that some 26 per cent of professional rugby league and rugby union players have either used or are currently using CBD. That is a huge number considering the concerns that he and many other sports nutrition experts still harbour over the anti-doping risks CBD presents.
“There is some research that has come out showing that despite a product showing it contains less than 0.2 per cent THC, when it’s been analysed, it’s actually got illegal quantities of THC in it,” said Professor Close. “So you could buy something that said: ‘zero per cent THC CBD oil’ and think it’s fine to use, but when you try it, you light the sky up with THC. Before you know it, you’ve got a doping ban.”
Additional Research Necessary
Doctor Robin Thorpe, a director of performance and innovation, has worked with Manchester United and Olympic athletes. Last year, he was presented with the idea of trialling CBD with athletes who were going to be competing in the Olympic Games.
“It was something we took very seriously,” he said, “but because of the huge potential issue (around anti-doping violations), we actually just looked at: ‘What was the knowledge of CBD among track and field Olympic athletes in North America?’”
He and his team sent out a survey to around 70 athletes, and the results were telling: 50 per cent of all those athletes — around 40 in total — were unsure whether CBD was a banned substance. Doctor Thorpe said there were a large number of athletes who were supplementing with CBD.
“That awareness from elite athletes at the highest level is shocking,” he said. “Especially considering a number of those athletes were frequently — on a daily basis in some cases — supplementing with CBD.”
Those who were taking it said the benefits included recovery, sleep and anxiety reduction. Some also gave the answer: “I don’t know.”
The actual evidence of how CBD can help athletes is largely anecdotal at present. Away from the sports world, there is some evidence in terms of pain relief and sleep. Professor Close points out that most of the evidence on CBD is when it comes in combination with THC in various quantities.
“There’s something termed the ‘entourage effect’,” he explained, “whereby for CBD to work, the other cannabinoids need to be present. There isn’t yet any evidence that when you isolate it down to CBD with nothing else in there (as would need to be done for an athlete to use it) it would still be effective.”
That doesn’t mean athletes can’t or won’t benefit from using it. But there are obvious issues with the placebo effect that can come when taking something that you believe works — and that other athletes whom you respect have told you works.
“There has to be some basic-level research done,” said Doctor Thorpe. “If we are taking a CBD product, let’s see how much actually gets into the system to begin with. How long does it take to clear from the system? How much does that change depending on dosage? What is the timing of those dosages throughout the day, and how does that affect things?
“It’s one thing doing something that’s completely safe from a supplement point of view, but to take something with little evidence supporting it and have the knock-on effect of this is risky for coming back with a positive test, I think it’s a risky choice for an athlete.”
The problem is that, at the moment, athletes don’t realize it. And in boxing, it seems that neither do many of the trainers who support their athletes taking CBD.
“Athletes need educating that it’s a high-risk strategy at the moment,” said Professor Close. “Most of us with credibility in this world would currently recommend against it. Even in my study where a lot of rugby teams do have access to qualified people, the vast majority of players were getting their information off the internet rather than asking the qualified staff members in the organization.”
Many sports have issues with athletes becoming reliant on painkillers — popping them like Skittles to get through the grind of training or before competing. CBD presents a potential alternative. One that could provide effective pain relief, does not have side-effects and is not addictive. But it needs a huge amount of research before anyone really knows whether it’s effective, and for athletes to be sure it won’t pose an anti-doping risk.
Professor Close is trying to pull together the funding for the research that’s needed — a three-year PhD would cost around £75,000.
“I’m determined to get it,” he said. “Then athletes can have a bit more confidence of whether they can or can’t take it. Once they have every bit of information they need to make an informed decision, then it’s up to them.”
Until then, athletes are taking a risk for potentially very little reward.
“If someone came to me as a practitioner and said they were struggling with recovery or wanted to improve sleep and asked me about CBD, there are far more simple, more evidence-based strategies which are free and have zero risk whatsoever,” said Doctor Thorpe. “Yet these athletes are seeking this magic potion. One that has no evidence and carries a lot of risk with it.”
For those who are actively promoting its use on social media — potentially influencing the decisions of other athletes — perhaps this message is one that should be shared just as much as their discount codes.
Article by Sarah Shephard from The Coaches’ Voice, Photo Credit to Jaime Lopez/Jam Media/Getty Images.