Medicinal cannabis in sport: An insight for athletes and support people

  • Integrity Blog

Athletes prescribed cannabinoid-containing products by a Medical Practitioner to treat a medical condition may be able to apply for a Therapeutic Use Exemption (TUE).

The Therapeutic Goods Administration (TGA) allows prescription and dispensation of medicinal cannabis/cannabinoid products to treat and manage illnesses such epilepsy, multiple sclerosis and chronic pain. This means some athletes may need to use cannabis or cannabinoids while competing.

The Chair of the Australian Sports Drug Medical Advisory Committee (ASDMAC), Dr Susan White, says these athletes may be granted a TUE to allow the athlete to continue to compete while taking a prohibited substance.

“Sometimes athletes will need to use a prohibited substance for legitimate medical reasons,” Dr White says. “We don’t want athletes who have to take medically prescribed substances to treat a diagnosed medical condition to have to stop competing because of their illness. The process of Therapeutic Use Exemptions exists to allow athletes who have a legitimate medical condition to take a prohibited substance.”

Cannabinoids, including Tetrahydrocannabinol (THC), the active ingredient in cannabis responsible for its psychoactive effects, are prohibited substances in-competition.

There are robust World Anti-Doping Agency (WADA) requirements and processes in place that all anti-doping organisations must use to assess whether athletes have a legitimate medical use for prohibited substances, including medicinal cannabis. 

In Australia, TUEs are assessed by ASDMAC, who are an independent advisory group of experienced sports physicians.

For a TUE to be granted, the athlete (and their treating doctor) must demonstrate to ASDMAC that the application meets the four criteria for granting a TUE that are documented in the WADA International Standard. These are:

  1. The prohibited substance or method is needed to treat a diagnosed medical condition 
  2. It will not provide additional performance enhancement beyond return to  normal health 
  3. It is an indicated treatment and there is no reasonable therapeutic alternative 
  4. The need for treatment did not arise from previous use of a prohibited substance without a TUE.

Dr White says it is crucial to provide as much information as possible when submitting your application.

“The more information both you and your doctor can provide ASDMAC with, the smoother the process for being granted a TUE becomes.”

While a TUE allows the use of cannabis, Dr White says that it’s important to remember that TUEs only apply to the use of a prohibited substance in a sporting context.

“In the case of medicinal cannabis, 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 TUE only accepts that the use meets the WADA International Standards for Therapeutic Use Exemption criteria.”

For more information on TUEs or on obtaining a TUE, visit Sport Integrity Australia’s TUE Information Page.

For a checklist of information required to obtain a TUE for medicinal cannabis, check out our Cannabinoids/Cannabis TUE Checklist.

Sport Integrity Australia encourages all athletes to check their medications on Global DRO or via the Sport Integrity App, available for download on Google Play or Apple Store.