Key Takeaways
- Medical professionals in sports report a significant lack of cannabis education, leading to reliance on informal sources for information.
- The study identified six major themes including stigma, shifting attitudes, and ongoing conversations about cannabis use among athletes.
- Medical staff struggle to navigate evolving league rules on cannabis, creating anxiety and confusion when advising athletes.
- Trust is crucial for open conversations about cannabis use, but many athletes fear repercussions from disclosure to their medical staff.
- Closing the cannabis education gap through credible training, clearer policies, and reduced stigma is essential for better health conversations.
We’ve have already covered what athletes themselves say about cannabis, including why so many use it quietly for pain, sleep, and recovery without much help from the people paid to keep them healthy. Here’s the other side of that story, and it comes from the other side of the exam table.
A qualitative study published in Sports Health, partially funded by the NFL and NFLPA’s joint pain management committee, asked 10 medical professionals working in elite and professional sports what it’s actually like to field cannabis questions from athletes. The answer, in short: not great. Physicians, athletic trainers, nutrition professionals, and mental health specialists described a system that never prepared them for this conversation, even as it’s become unavoidable.
What the Study Actually Looked At
Researchers from the University of Saskatchewan and the University of Regina conducted semi-structured interviews with medical staff from leagues including the NHL, NFL, and NCAA. The sample included six men and four women, ages 25 to 55, all with at least six years of experience in their roles. Roughly half had personal experience with cannabis products, either therapeutic or recreational, and half had none at all.
This is a small, qualitative sample. The authors openly acknowledge that the study doesn’t represent every team doctor or athletic trainer in professional sports. But the patterns that emerged were consistent enough across interviews that the researchers felt confident naming them as recurring themes rather than isolated opinions.
Six major themes came out of the interviews: a persistent knowledge gap, confusion over compliance and league rules, stigma that discourages open conversation, shifting attitudes as laws and culture evolve, a noticeable uptick in athletes asking about cannabis for both recreational and therapeutic reasons, and the central role trust plays in whether any of these conversations happen at all.
The Knowledge Gap Nobody Trained Them For
The most consistent finding was simple: most of these professionals never received formal cannabis education. One staff member put it bluntly, saying the education they’d received “has been pretty much nothing.” Another, despite holding a master’s degree, said the topic was “never talked about” during their training.
That absence of formal training pushes people toward informal sources. Several interviewees said they turn to the internet or peers when a question comes up, with little confidence in what they find. One participant described struggling to find quality cannabis education and questioned whether they could trust online sources.
This tracks with research outside the sports world. A review cited in the study notes that nearly 90% of medical students report feeling unprepared to recommend cannabis therapies, a gap that clearly doesn’t disappear once those students become team physicians or athletic trainers. When a professional doesn’t have a reliable answer, athletes don’t stop asking the question. They just ask somewhere else, often a teammate or a quick search, where the information may be incomplete or wrong.
League Rules Are a Moving Target
Cannabis policy across professional sports has shifted fast, and staff are expected to keep up in real time. The NBA removed marijuana from its banned substances list in 2023. The NCAA followed with a similar vote in 2024 for Division I athletes. The NFL reformed its policy that same year, cutting fines and raising the allowable THC threshold. Meanwhile, the World Anti-Doping Agency still prohibits THC during competition, with a 150 nanogram per milliliter urinary threshold, a policy USADA’s own CEO has publicly called unfair.
That patchwork creates real anxiety for medical staff trying to give athletes a straight answer. One interviewee described sticking strictly to CBD conversations “because that way nobody could make a mistake,” which says a lot about how cautious this space has become. Another noted that compliance pressure sits above everything else: “I operate within the law. I don’t get close to the edges.”
Staff also pointed out an obvious double standard. Sports culture openly sponsors and celebrates alcohol, yet leagues still test athletes for cannabis, a stigma that alcohol has never faced. As one person said, “Every team is sponsored by alcohol, yet as soon as you mention cannabis it’s a big no, no.”
Stigma Still Shapes the Conversation
Even where cannabis is legal and policies have loosened, stigma hasn’t caught up. Staff described cannabis use as something that’s “not openly discussed, still pretty taboo,” even among professional peers who talk openly about alcohol. That silence has consequences. Athletes who fear judgment may avoid mentioning cannabis use to their own doctors entirely, which closes off a conversation that could otherwise catch a drug interaction or flag a safety concern early.
One interviewee described athletes as “petrified” to bring it up with their doctor, worried about what might happen if they did. That fear runs both directions. Some staff admitted they’re unsure how to respond if an athlete brings it up, which doesn’t exactly invite more openness.
The researchers note that younger, more research-minded staff tend to hold more open attitudes, often shaped by personal exposure to legal cannabis markets or direct observation of patient outcomes. That shift is happening, just unevenly.
Where the Evidence Actually Stands
It’s worth being direct about what the science does and doesn’t support right now. A systematic review in Sports Health analyzed 11 studies and found that roughly 23% of athletes reported using cannabis in the past year. However, the evidence on cannabis and athletic performance remains limited and generally low quality. So far, research has not shown that cannabis improves performance or recovery, so you should treat claims to the contrary skeptically until better studies emerge.
That evidence gap is part of why medical staff feel stuck. Several interviewees said they’d welcome a credible, expert-led course if one existed, with one saying they’d “definitely love to sign up” for real cannabinoid education tied to institutional credibility. Right now, that kind of resource mostly doesn’t exist in a standardized way across leagues.
Trust Is the Real Bottleneck
The study’s final theme ties everything together: none of this works without trust. Interviewees said it can take a full season or longer to build the kind of relationship where an athlete feels safe disclosing cannabis use. One staff member said knowing they wouldn’t be put on a drug test list made athletes more willing to talk openly.
That trust is fragile, especially when staff are directly employed by the same organization enforcing policy. One interviewee acknowledged the hesitation athletes feel, since “they don’t know where that information is going.” Until someone resolves the tension between confidentiality and institutional loyalty, people will likely keep a lot of relevant health information to themselves.
The researchers argue that closing the knowledge gap, clarifying policy, and reducing stigma all need to happen together. Education alone won’t fix a system where athletes still fear repercussions for asking an honest question.
Frequently Asked Questions
Mostly not. The Sports Health study found that medical staff across major leagues reported little to no formal cannabis education, relying instead on informal sources like peers or online searches.
Yes. Policies vary widely. The NBA and NCAA have removed marijuana from banned substances lists, the NFL raised its THC threshold in 2024, and WADA still prohibits THC during competition with a 150 ng/mL threshold.
Current evidence doesn’t support that claim. A systematic review found the overall quality of research is low, and available data does not show cannabis improves athletic performance.
Stigma and fear of repercussions are major factors, according to interviewed medical staff. Athletes often worry about confidentiality when their team or league employs their doctor directly.
Interviewees pointed to credible, expert-led cannabinoid education tied to a trusted institution, paired with clearer and more consistent league policies and reduced stigma around open conversation.
