Cannabinoids as a sports medicine? The surface is barely scratched.
Now that Canada has legalized cannabis under the Cannabis Act, it’s time to dig in and study the plant’s medicinal components. It’s not the typical course of action for drugs, to allow them to enter the market before they’re tested and approved but cannabis is no ordinary drug.
If you look at the development say of a new antibiotic or a new antidepressant or a new cancer drug, often that’s a process that starts with a bunch of chemists looking at a computer screen and modelling the interaction of a particular chemical or a specific target in the brain or body.
And then it goes through all these different phases of development, starting with in vitro tests and moving (slowly) toward trials on actual human subjects. It takes many years, billions of dollars, and some luck to end up with a drug product approved by Health Canada.
So, that process of drug discovery and drug development is incredibly complex. We know so far that it is relatively safe and that humans have been consuming it in one formulation or another for many hundreds of years, but cannabis isn’t just one drug. The cannabis plant can have something like 400 different bioactive chemicals, and they seem to work better together, doing the work of untangling all of the mechanisms of action (MOA)—that is, the biochemical interactions through which hundreds of different phytocannabinoids produce pharmacological effects.
Getting a clear picture of how cannabinoids affect athletic training, performance and recovery isn’t going to be a straightforward endeavour. Plus, there are also ethical issues to consider when getting athletes to participate in studies given that most national and international sporting organizations generally do not allow cannabis use.
One of the questions that could be answered thanks to cannabis reform in Canada is whether cannabinoids can improve the lives of competitive athletes years after sustaining a severe head injury? The National Hockey League Alumni Association along with NEEKA Health Canada will attempt to find out by studying the potential benefits of cannabinoids in managing the mental health challenges faced by former professional hockey players.
NEEKA boasts some of the world’s top neurology researchers, such as Dr. Amin Kassam, the research team leader who says this “legacy study” is potentially paradigm-shifting in the field of post-concussion care.
Kassam’s team allegedly understands something novel about concussion care: that cannabinoids may have a powerful and positive role in that brain-signalling pathway. The research team has already discovered a series of fibres on the emotional, motor and visual connectors that are very important in how the brain processes information.
His focus in this study will be less on figuring out what specific biomarkers predispose someone to suffer more from prior concussions, and rather than focusing solely on preventative therapies or reactive treatments, consider brain injury as a part of an individual’s mental health, and as something requiring ongoing support.
Around 100 retired NHL stars will take part in the year-long double-blind clinical study expected to start this summer. Eighty of the 100 participants will receive pills containing a CBD compound contributed by Canopy Growth, and 20 will get a placebo.
The NHL has faced plenty of criticism after several NHL players were found to have had concussions at the time of their deaths. When Steve Montador, former NHL defenceman who played for the Calgary Flames and the Boston Bruins, died in 2015 at 35-years-old, his brain sent for examination to see if his head injuries had resulted in chronic traumatic encephalopathy (CTE), a brain disease linked to repeated concussions.
Symptoms are wide-ranging and sometimes severe, including mood swings, aggression, depression, confusion, and dementia. For some CTE sufferers, these symptoms culminate in suicidal thoughts and attempts.
The neuropathologist who observed Montador’s brain through an autopsy of the brain confirmed he did suffer from the disease. “One of the saddest parts of the whole thing,” hockey legend Ken Dryden told the CBC in 2017, “is that Steve died thinking it was all his fault.” Montador’s case is unfortunately not unique. The disease is especially prevalent in ex-NFL players, with one study reporting that 99 percent of deceased football stars (from a sample of 202 who donated their brain posthumously) presented as having the brain disease.
If this study with ex-NHLers goes well, the plan is to explore the effects of cannabinoids on the brains of the general population, so that the science can be applied to non-athletes as well.