By Dr. Jeff G. Konin
Just one month ago (February 25, 2022) the Committee on Competitive Safeguards and Medical Aspects of Sports (CSMAS), a component of the National Collegiate Athletic Association (NCAA), announced a major change in its cannabinoid testing policies. Most specifically the committee increased the threshold for a positive THC test and recommended a reconfiguration of the penalty structure for those student athletes that test positive under the new guidelines.
The CSMAS announced the new threshold for a positive THC test would be set at 150 nanograms per milliliter. This is a significant increase from the previous level of 35 ng/ml. This does, however, align the NCAA testing levels for THC equal to that of the World Anti-Doping Agency (WADA) which currently uses 150 ng/ml as a threshold. These changes will take place immediately and also apply to past THC tests from the fall of 2021 with retroactive penalties removed for those who tests over 35ng/ml but less than 150 ng/ml. In addition, the CSMAS stated that future changes could be reviewed and approved in an effort to respond accordingly to future WADA changes.
In addition to the threshold level being adjusted, a notable pivot will take place in how a positive THC test is being managed. Prior to this change, a positive test was treated from a punitive perspective. That is, on the first time recorded positive test a penalty equivalent to 50% of a playing season suspension was handed down to a student athlete. The NCAA has acknowledged that a more educational and wellness intervention approach better suits the needs of the individual, and this will be handled at the institutional level with programs in place to meet the needs of the overall health and well-being of the student athlete. This approach is also consistent with the recommendations of a select group of sports medicine professionals from major colleges and universities and feedback received from NCAA membership school surveys conducted this past fall.
The stakeholder recommendations agreed to the lack of evidence of cannabis as a performance enhancing drug but also took note to the importance factual education amidst a changing cultural shift that has seen greater acceptance overall toward cannabis in this country. As a result, an emphasis on education, health and wellness, and open communication will likely become part of adjusted campus cultures. Under the proposed new structure, penalties of loss of eligibility will only be implemented if a repeat offender is not compliant with a university-led education and management plan.
It is important to note that 2 important items of relevance remain following this announcement. First, cannabis was not removed from the NCAA’s banned substance list and therefore remains an illegal substance for student-athletes to use. The ruling change merely raised the threshold that equates to a positive test. No endorsement of cannabis is being made, and testing will still occur. Furthermore schools may want to establish their own internal policies whereby they adhere to a the same or different threshold levels and address cannabis use as it not only relates to a positive test of greater than 150ng/ml. For example, a school may decide that those testing at 100ng/ml are of a concern in that trending behaviors may want to be addressed. And while cannabis has not been shown to be a performance enhancer in sports, it may very well be a performance inhibitor if taken in inappropriate dosages at the wrong times.
The second important item to discuss is that no mention was made of any of the other cannabinoids aside from THC. This is of great interest in that while all cannabinoids are banned, only THC is tested for. Therefore, mixed signals are now being sent to student athletes. In the past, word on the street was that some were nervous about using any forms of CBD for example in fear of having a positive drug test show up. Now, with the threshold levels being raised so high, this fear may be alleviated and lead to a greater use of CBD. In the very near future, this will need to be addressed for clarity purposes.
For now, many will appreciate the modern decision-making of the NCAA committee to better align with societal and cultural shifts, as well as the scientific evidence to support the transitions that are occurring. The NCAA should be commended for acting in a timely and relevant manner to its member’s input.
Dr. Jeff G. Konin is a Clinical Professor in the Department of Athletic Training in the Nicole Wertheim College of Nursing and Health Sciences at Florida International University (FIU) where he directs the Global Initiative for Cannabinoid Research and Education. To learn more about FIU’s cannabinoid research and education initiative you can visit their website at go.fiu.edu/GlobalCannabis. Views represented in this column do not reflect that of Florida International University and are solely attributed to Dr. Jeff G. Konin.
