Transdermal Medicine in Sports, A New Approach with Cannabinoids

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Whether national sports leagues are ready for the transition or not, cannabis is a growing component of sports medicine and athletic wellness. Players from across the sports spectrum are advocating for changing the current rules around cannabis consumption. From celebrity NFL quarterback Joe Montana, who is now a cannabis investor, to longtime MMA fighter Nick Diaz’ advocacy work, to Scott McCarron’s reported use of CBD oil for sleep, athletes are standing behind the benefits of cannabinoids.


While not all sports organizations are on board, some official opinions are changing. A primary example is the World Anti-Doping Agency (WADA), which may not allow for substances containing natural or synthetic cannabinoids, yet they have made an exception for cannabidiol (CBD). Major League Baseball has gone one step further. As of December 2019, it will treat cannabis-related offenses under protocols similar to those for alcohol.


What makes cannabis so attractive for both professional and amateur athletes? It’s a plant with the potential to soothe pain from lingering injuries, reduce inflammation, calm nerves, and improve sleep. The science is increasingly supportive of the plant’s many compounds in sports recovery. 


Additionally, topical and transdermal treatments are already well-established in sports. Muscle rubs and therapeutic transdermal patches are widely used and accepted within the sports community. Cannabinoids translate well into these methods, with research supporting their effectiveness when applied to the skin. Logically, cannabis makes sense in sports medicine.


Is Cannabis in Sports Ethical?


In study after study, the evidence-based consensus is clear: Cannabis is not a performance-enhancing substance. Although the United States Anti Doping Agency (USADA) and WADA may state otherwise, recent reviews of the literature strongly suggest cannabis may actually make athletic performance worse, not better.


In 2018, a team of researchers based in Quebec, Canada, released a nonsystematic literature review in the Clinical Journal of Sports Medicine. Their analysis explored themes within relevant publications related to cannabis (or marijuana) and sports (or athletic) performance. Following their assessment, they came to several conclusions:

  1. Athletes use cannabis for both medical and non-medical reasons.

  2. There is promising evidence supporting cannabis for pain management.

  3. Beyond the potential for abuse and mental health concerns, there is limited evidence that cannabis use is harmful to athletes.

  4. Finally, “there is no evidence for cannabis use as a performance-enhancing drug.”


When it comes to the question of sports ethics, the fourth and final point is the most important. Several studies contributed to this conclusion, starting with some of the first research completed in the 1970s. Since then, numerous scientific investigations have indicated cannabis use reduced physical work capacity and reduced maximal work capacity. There is no evidence suggesting cannabis is an ergogenic substance, which means there have been no measurable improvements to performance or stamina. 


Although many sports organizations ban cannabinoids based on a stated fear of enhanced performance, the authors of this literature review conclude otherwise. These international governing bodies may only ban cannabis out of fear of harmful side effects and the view that using “an illicit substance is contrary to the spirit of sport.” It remains to be seen how these organizers will evolve with the legalization of cannabis.


Topical and Transdermal Approach to Medicine


Topical and transdermal approaches to care and recovery are familiar to most athletes. There is already an entire industry built around sports medicine compounding, where pharmacies compound custom pharmaceuticals into topicals, creams, gels, and patches. It’s a method of application well-established in sports medicine.


Some of the most common transdermal formulas cover pain related to tissue damage (Ketoprofen). Both Cyclobenzaprine and Ketoprofen also help with muscle relaxation and even Ibuprofen is effective for pain relief. With cannabis and cannabinoids already well-established pain relievers, it makes sense there would be increasing interest in them for transdermal applications.


Cannabinoids work within the endocannabinoid system. This system manages several key operations like pain, inflammation, mood, memory, and more. Relatively recent research has uncovered endocannabinoid components inside the skin of humans and laboratory animals. Researchers are now exploring the role of the endocannabinoid system at the skin level for the management of disease, inflammation, and pain. There seems to be natural inherent scientific reasoning for exploring the therapeutic value of cannabinoids through both topical and transdermal applications.


According to “Cannabinoid Delivery Systems for Pain and Inflammation Treatment” published in Molecules in 2018, there are already several preliminary studies looking at topical or transdermal applications of cannabinoids as anti-inflammatories. The handful of studies with transdermal methods of application have almost exclusively examined preparations with CBD. Furthermore, the authors note that CBD seems particularly useful as it ”inhibits the proliferation of hyperproliferative keratinocytes” and possesses “remarkable antibacterial activity.”


An Argument for Transdermal Cannabinoids in Sports


Generally speaking, transdermal delivery comes with several immediate benefits, including improvements to bioavailability and avoidance of first-pass metabolism effect common from oral deliveries. As the RYAH Smart Patch demonstrates, there are also intelligent techniques, like the addition of a gentle heating element, to increase bioavailability even further. 


Medicines derived from cannabis, which are commonly smoked or consumed orally, lose much of their medicinal value through digestion. Cannabinoid-based medicines benefit from topical and transdermal approaches because they can increase bioavailability, which translates into smaller doses and fewer wasted products.


The transdermal format is also already well-established and familiar in sports medicine. Athletes and their doctors likely already use transdermal patches and gels for relief and recovery. Introducing cannabinoids into the mix won’t mean a steep learning curve or a new application method. A cannabis-based transdermal patch is simply a new compound presented within a familiar format. 


Most importantly, cannabinoids may be strikingly useful in sports because of the conditions they target. Pain and inflammation are ongoing issues for athletes, and these are both issues cannabinoids are proven to treat—at least according to the current research. 


As political and social opinions change, eventually there will also have to be a change among all sports leagues to reflect the world around them. With new research suggesting powerful benefits for pain, inflammation, performance anxiety, and more, the potential for cannabinoid medicine to enter into the big leagues is why so many professional athletes are risking their careers to use it already.