The World Anti-Doping Agency (WADA) has reiterated its position regarding cannabis, whose active ingredient is delta9-tetrahydrocannabinol (THC). After the realization, by his Prohibited List Expert Advisory Group, of an extensive study on the use and effects of this substance, it was concluded that cannabis meets the criteria to be listed on the List of prohibitions. The use of cannabis therefore remains prohibited in competition.
WADA challenged
In recent years, five national anti-doping organizations and one sports federation have called on WADA to reconsider its position on the substance. In 2021, the Agency endorsed the establishment of a scientific review during 2022 by its Prohibited List Expert Advisory Group (LiEAG).
Last year, the LiEAG, composed of external and international experts in pharmacology, forensic toxicology, addiction, analytical sciences, pharmacy, sports medicine, chemistry, endocrinology, internal medicine, regulatory affairs, peptides and growth factors and Hematology has undertaken a comprehensive new review of the status of delta-9-tetrahydrocannabinol (THC) in sport.
To be registered on the List of prohibitions, a substance must meet at least two of the following three criteria:
- the potential to improve or actually improves athletic performance;
- the medical or scientific proof, the pharmacological effect or the experience demonstrating that the use of the substance or the method is a proven or potential risk for the health of the athlete;
- WADA's determination that the use of the substance or method is contrary to the spirit of sport as described in the introduction to the Code.
The LiEAG was tasked with deciding on each of these points.
A report without appeal
The LiEAG issued its conclusions for each of the criteria.
- There is compelling medical evidence that THC use is a primarily neurological health risk that has a significant impact on the health of young people, a cohort that is widely represented among athletes.
- The current body of objective evidence does not support physiological performance enhancement by THC, while the potential for performance enhancement through neuropsychological effects still cannot be ruled out.
- Considering the values encompassed by sportsmanship, as emphasized by the EAG Ethics, and noting in particular that respect for oneself and other participants includes the safety of one's competitors, the use of THC in competition contravenes the sportsmanship.
A clear position... which can evolve
Faced with this documented return, WADA could not take any other decision than to keep cannabis among the substances prohibited in competition.
Based on these three criteria defined by the Code, based on the available scientific evidence, it is concluded that THC meets the criteria for inclusion on the List.
However, the Agency intends to take into account the evolution of society and that of many national legislations around the world and does not remain closed to a possible modification of the criteria for triggering an Adverse Analytical Finding (AAR or " positive control”) to cannabis.
The Agency's position has also changed many times in recent years.
- 2013: The urinary threshold is increased from 15 ng/mL to 150 ng/mL with a decision limit of 180 ng/mL. The number of RAAs has been drastically reduced, from an average of 400-500 per year in the years 2009-2012 to less than 100 in 2021.
- 2018: Cannabidiol (CBD) is removed from the Prohibited List, allowing athletes who wish to consume it to have access to this non-psychoactive component of cannabis.
- 2021: The inclusion of the Substances of Abuse provision in the Code has dramatically reduced the length of suspension sanctions from two (or even four) years previously to three (or even one) months today for athletes who can establish that THC use occurred out of competition and was unrelated to athletic performance. Under article 9 of the Code, the sportsman will always lose his medal, his prize and his result.
