R M Cullen MD MSc MFM BA DipStats DipProfEthics

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march 2017

Marijuana and the credibility of drug testing in sport

coffee beans	marijuana leaf	cigarette

Young elite athletes have a disdain for drug cheats. They understand that performance enhancing drugs are for losers. They also understand that perfomance enhancing drugs are a great temptation for those who aren't quite good enough on their own.

These same young elite athletes have limited respect for drug testing in sport. They don't see why marijuana is on the banned list. If the drug testers have this wrong, what do they have right?

Marijuana is prohibited in competition (as are narcotics, stimulants, and glucocorticoids), as are synthetic cannabinoids. The doping violation threshold level is 150ng/ml of the metabolite Carboxy-THC. Six years ago, the limit was 15ng/ml. The tenfold increase in tolerance was designed to minimise the risk that out of competition use of marijuana would result in a positive result once competition had commenced.

The inclusion of marijuana on the WADA list has always been controversial. Marijuana was placed on the list because it was illegal. For those of us who were involved in sport drug testing at the time, that was the controversy. It still is. Marijuana does not enhance performance any more than alcohol or tobacco. Caffeine enhances performance, and was once banned. Alcohol is prohibited in competition in air sports, automobile, archery, and powerboating. The doping violation threshold level is 0.1g/L.

In order for a substance to be placed on, or to remain on, the banned list it must do two of three things

• enhance performance
• harm the athlete
• be against the spirit of sport

There is, in theory, a threshhold for each of these criteria.

Cigarettes, for example, enhance performance by reducing anxiety. There is no debate that they 'harm the athlete' and they must meet that criterion. This suggests that their performance effect is too small to meet the criterion and that they are not sufficiently 'against the spirit of sport'.

Caffeine is performance enhancing. There is no debate about this, and it is the reason caffeine was banned prior to 2004. However, its use is not against the spirit of sport so any harm it does to the athlete is not sufficient to meet the criterion.

Marijuana reduces anxiety and reduces the appreciation of risk. These can be performance enhancing effects in some sports. However, this is something to consider sport by sport. In rugby league, marijuana is not performance enhancing.

It is difficult to argue that marijuana is more harmful than either tobacco or alcohol.

It is reasonable to argue that illegal behaviour is against the spirit of sport. However, as the United States increasingly legalizes the recreational use of marijuana, it becomes harder and harder to claim that marijuana use is against the spirit of sport.

New Zealand is against the inclusion of marijuana on the WADA banned list. Graeme Steel, CEO of Drug-Free Sport NZ until the beginning of this year, has for many years advocated against testing for recreational drugs, particularly marijuana.

According to the figures on the NZ Sports Disputes Tribunal rugby league is the sport with the biggest drug problem, with 23 out of 98 doping cases, almost all for marijuana. Powerlifting had 10 drug test failures. One NZ athlete, from Papakura, received a life-time ban from sport after he tested positive three times for marijuana.

So, where does this leave the young athlete in New Zealand?

The standard approach to get around the inconsistency is to advise teenage athletes that the anti-doping rules are just that, rules. They don't have to make sense but they do have to be obeyed.

Unfortunately, there are no penalties on the field unless the referee spots the infraction. Treating the WADA list as just another rule invites young athletes to disrespect it, to get around it.

The only lasting solution is to remove marijuana from the banned list. That will happen, but not this year!