Medicinal Cannabis in sport - FAQs
What is the current status of Cannabis in sport?
Cannabis is listed as Prohibited In-Competition under class S8: Cannabinoids on the World Anti-Doping Code’s Prohibited List. The status of substances in sport are also available on Global DRO.
What are Medicinal Cannabis, Cannabinoids and Cannabidiol?
It is important to understand the difference between some similar terminologies:
- Cannabinoids – Cannabinoids are a group of compounds which have an effect on the Cannabinoid receptors in the human body. The group has around 100 different chemicals including Tetrahydrocannabinol (THC) and Cannabidiol (CBD)
- Cannabidiol (CBD) – CBD is one specific cannabionoid compound which is not prohibited. (see below)
- Medicinal Cannabis – For Therapeutic Use Exemption (TUE) purposes, this is a product prescribed by a Doctor and accessed through a Therapeutic Goods Administration (TGA) approved process.
Why are cannabinoids prohibited?
All prohibited substances are added to the Prohibited List because they meet two of the three following criteria:
- Use of the substance has the potential to enhance performance;
- Use of the substance can cause harm to the health of the athlete; and
- Use of the substance violates the spirit of sport.
Are all types of cannabinoids prohibited?
All natural and synthetic cannabinoids are prohibited In-Competition with the exception of Cannabidiol. This includes:
- All cannabis (hashish, marijuana) and cannabis products
- Natural and synthetic tetrahydrocannabinols (THCs)
- Synthetic cannabinoids that mimic the effects of THC
Why is there an exception for Cannabidiol?
Cannabidiol (CBD) is a non-psychoactive component of cannabis. As of 2018, WADA no longer lists CBD as a prohibited substance.
Tetrahydrocannabinol (THC) remains a prohibited (banned) substance in-competition.
Many cannabinoid products contain a mix of THC and CBD. There are also examples of THC contamination of products marketed as ‘pure’ CBD.
Athletes who choose to take an over the counter or internet purchased (non-prescribed) cannabidiol product, even when marketed as ‘pure’ CBD oil are cautioned about the risk of contamination and advised to consider use akin to the risk of a supplement. Assessment of the risk of a supplement can be made through the Sport Integrity Australia app and is free to download from Google Play or Apple stores.
Are athletes able to compete if they have been prescribed medicinal cannabis?
Athletes prescribed cannabinoid products by a Medical Practitioner to treat a medical condition may be able to apply for a Therapeutic Use Exemption (TUE).
A TUE is an exemption which permits an athlete to compete while taking the prohibited substance.
For a TUE to be granted, the athlete and their doctor must submit a completed application form and detailed medical information to the Australian Sports Drug Medical Advisory Committee (ASDMAC), an independent advisory group of experienced sports physicians.
ASDMAC must assess whether the application meets the four criteria for granting a TUE that are documented in the WADA International Standard. These are:
- The prohibited substance or method is needed to treat a medical condition and the athlete would experience a significant impairment to health if the substance were to be withheld.
- The Therapeutic Use of the substance or method is highly unlikely to produce any additional enhancement of performance beyond what might be anticipated by a return to the athlete’s normal state of health following the treatment of the medical condition.
- There is no reasonable therapeutic alternative.
- The necessity for the use of the prohibited substance or method is not a consequence of the prior use (without a TUE) of a prohibited substance or method prohibited at the time of such use.
What documents are required for a medical exemption for cannabis?
For ASDMAC to be able to consider a TUE application, the following information must be included:
- A completed TUE application form signed by the treating doctor and athlete.
- Detailed typed clinical letter(s) from prescribing specialist/doctor that includes:
- Accurate diagnosis – full clinical history and thorough examination
- Summary of diagnostic test results relevant to the diagnosis (e.g. blood tests, x-ray or other imaging reports)
- Name of cannabinoid(s) prescribed including dosage, frequency, administration route
- Evidence of use of either the Special Access Scheme (SAS) or TGA indication (include SAS approval certificate)
- Treatment plan, including duration of proposed treatment
- Other relevant medical opinions
- Explanation of why alternatives (e.g. anti-depressants, anticonvulsants, tramadol, capsaicin, lidocaine) were or could not be used.
- Diagnostic Test Results including:
- Imaging findings: CT or MRI results (if applicable)
- Other test results: electromyography, nerve conduction studies, blood tests (if applicable)
For a checklist of information required to obtain a TUE for medicinal cannabis, check out our Cannabinoids/Cannabis TUE Checklist.
How can athletes minimize the risk of a doping violation?
Athletes using cannabis for medical purposes can reduce the risk of an anti-doping rule violation by:
- Having a valid TUE in place, or
- Having the appropriate medical information should a retroactive TUE be required.
Athletes should check their eligibility for an in advance TUE here.
Does having a TUE for Medicinal Cannabis give me legal authority to possess Cannabis?
No. Being granted a TUE does not endorse or support the use of cannabinoids more generally. Nor does it imply legal authority to carry or transport cannabinoids. The exemption only accepts that the use meets the WADA International Standards for Therapeutic Use Exemptions criteria.
Where can I find more information about TUEs?
More information about TUEs is available here.
Where can I find more health information about medicinal cannabis?
More information about medicinal cannabis is available through the Therapeutic Goods Administration (TGA).