As more athletes use cannabis for aches and pain, there's more we need to know
As an Olympic triathlete in 2000, Joanna Zeiger, SPH '01 (PhD), would never have envisioned a future researching cannabis, which until recently was on the U.S. Anti-Doping Agency's banned list. But that was before Zeiger's devastating career-ending bike crash at the 2009 Ironman 70.3 World Championship in Clearwater, Florida—and her subsequent chronic pain.
Zeiger suffered a broken collarbone and structural and nerve damage to her rib cage, which led to intercostal neuralgia that causes intense muscle spasms and abdominal and rib pain. She later received a diagnosis of an autoinflammatory disease, which doctors suspect was linked to the accident.
Living with severe pain, Zeiger tried just about every remedy available to her. As she explored options such as acupuncture, nerve blocks, and physical therapy, she found only limited and temporary relief. Looking for alternatives, she turned to cannabis but found that information on it as a pain remedy was largely nonexistent. Cannabis in what form? What dosing? When and how often to take it? "I had to do a good deal of experimentation," she says, "starting with small amounts of edibles." Through trial and error, she found relief from both pain and nausea, along with better sleep.
Zeiger, the 2008 Ironman 70.3 world champion, is not the first professional athlete to explore cannabis use for pain relief. Retired NFL players Eugene Moore and Jake Plummer, former professional cyclist Floyd Landis, and many others have sought out its benefits, especially as an alternative to addictive opioids. Additionally, 34 states have now legalized marijuana, either for recreational or medicinal use. From oils and creams to edibles and beyond, cannabis is a big industry, expected to reach sales of over $106 billion by 2024, according to Marijuana Business Daily. Athletes of all types are experimenting with how the substance might fit into their regimens for training aches and pains and for injury recovery.
While the interest and need are there, detailed information on dosing for pain is not, and it continues to be an area in need of additional study. Research is largely inconclusive on the effects of nonpsychoactive CBD for pain, stress, and other conditions, but recent studies doesn't wholly reduce pain and inflammation, but makes the pain feel less unpleasant. Response to cannabis is also highly individual, Zeiger says, and can be impacted further by other medications, genetics, food, and method of consumption. There's also the balance between the plant's active ingredients THC (tetrahydrocannabinol) and CBD (cannabidiol) levels, and figuring out the right ratio.