Should high school athletes use CBD oil? It's complicated

What if there was a miracle drug?

What if sleepless nights, spent tossing and turning in chronic pain with no cure or treatment, could be eliminated?

And what if a high school athlete with nagging but treatable pain chose to try this alleged wonder drug? 

That's what some are calling CBD oil.

I have a family member in her late 50s who suffers from lupus and debilitating fibromyalgia, a medical condition characterized by chronic widespread pain and a heightened pain response to pressure.

Recently, she began using cannabidiol, also referred to as CBD oil, found in hemp and marijuana.

She takes daily doses of several drops orally, and declares she is nearly pain-free now. She often says this with a tear in her eyes.

CBD oil was approved in June by the U.S. Food and Drug Administration to treat two rare forms of epilepsy and currently is legal in Indiana.

"Though CBD is extracted from marijuana sativa plants, it does not produce the high typically associated with marijuana because it does not contain the psychoactive ingredient THC," according to a story in USA Today announcing the FDA's decision. Many believe CBD oil is an all-natural alternative to over-the-counter remedies in relieving chronic pain and anxiety without the high.

The Indiana Legislature clarified state law earlier this year allowing retailers to sell only CBD products that comply with new state testing and packaging requirements, including certification that the product is derived from industrial hemp and not marijuana.

My question to IHSAA Commissioner Bobby Cox was this: CBD oil doesn't make you faster or stronger, but if prep athletes begin using it for a sore shoulder, back or knee so they can perform at 100 percent, is it cheating?

"First and foremost, student-athletes should be under the care of their physician and that physician should be prescribing treatments that are legal and have the best interests of the student's health in mind," Cox said.

"I don't know if there's nearly enough research that would suggest these treatments, long term, have any ill effect on a student. That's a decision doctors have to make in concert with the parents."

There is endless literature on the Internet listing the benefits, legality, side effects and risks of CBD oil.

But according to an article on WebMD, "there is simply too little evidence to make a firm conclusion" about how effective CBD oil is at treating conditions other than the two rare forms of epilepsy.

"As long as these things are legal, within state law and prescribed by a physician, then we as an association and even the schools need to leave that up to the student-athlete's doctor and their parents," Cox said.

"Everybody's got their own opinion about their own morality and ethics. I've got a lot more things to worry about than whether this particular application is something that we need to tackle."

Cox said the IHSAA follows the lead of the Commission On Sports Medicine, a branch of the Indiana State Medical Association, and if its health care professionals show a concern over CBD oil, Cox said his organization would address it.

Here's the problem: Medical experts feel uncomfortable talking about CBD oil until more research is done on its long-term effects, if any.

Dr. Stephen Simons works for St. Joseph Health Systems in Mishawaka and serves as an adviser for the IHSAA. I left him and the company's marketing department countless voice mails and emails, requesting an interview, but hit a wall and never got a response.

Finally, I asked the IHSAA for help and was later informed Simons "isn't comfortable being interviewed due to the topic and who he represents."

IHSAA Assistant Commissioner Robert Faulkens then put me in touch with Dr. Dan Kraft, a sports medicine doctor at Witham Hospital in Lebanon, Indiana.

"(CBD oil) is so new, we in medicine don't have a good understanding of if it's effective, should it be used and are there side effects, especially in sports," Kraft said.

"It's alleged to be a pain-reliever and a neural-protective. That's what people are saying. The problem is, we don't have research yet to show that."

Cox told me neither the IHSAA nor any member school he is aware of currently has a policy regarding CBD.

"It's always my concern what adults take and how that same substance affects young athletes whose brains are still maturing," Kraft added. "We don't know until research is done."

Ash Rahmany is a sports nutritionist and dietary consultant for Vyto's Pharmacy in Highland, which he says is the only local pharmacy authorized to sell CBD oil.

It ranges in price from $50 to $500, depending on the dosage, and is available in drops, salve, capsules, lotion, candies, powder, gummies, vaping and CBD water.

One application lasts about 24 hours, according to Rahmany, but shouldn't be taken by anyone who is an organ recipient or on a blood thinner.

"It helps in many different ways but the majority of customers who come to me use it for chronic pain, insomnia and neuropathy," he said. "I'd say 35 percent of people come in because of chronic pain."

The 1995 Munster grad has been an amateur body builder for 20 years and uses CBD oil for his sore shoulders.

"Body builders take CBD oil for the relaxation of it," Rahmany said. "After workouts when the muscles are tight and broken down, CBD helps relax the muscles, takes the soreness out and helps you recover faster with the amino acids that are in it."

Rahmany said he hasn't had any high school student-athletes purchase CBD oil, but his 13-year-old son Braden used it for intense pain after breaking his thumb this summer.

"Because of the pain, he wasn't able to sleep. I gave him CBD oil and an hour later, he just relaxed and fell sound asleep," Rahmany said.

Kraft said he's opposed to children using it.

"I would not recommend it, again, because we don't have the research to know what the long-term effects are," Kraft said.

Some researchers have suggested that using CBD on a consistent basis may help prevent chronic traumatic encephalopathy or CTE in football players.

"Evidence shows CBD is neuroprotective. I would have each individual take a capsule an hour or two before they play or practice. It’s better than nothing,” said Lester Grinspoon, a professor emeritus at Harvard, in an interview with the Washington Post in late 2016.

According to a May 2016 story on the FOX Sports website, former NFL quarterback Jake Plummer felt so good after taking prescribed CBD oil for a year that he considered coming out of retirement to play for the Denver Broncos at age 41. Plummer had not played for the Broncos since 2006.

I still wonder about the prep athlete who has pain but decides to mask it, temporarily, with CBD oil.

"As an example, let's say you're the quarterback and the shoulder's hurt," Cox said. "Your shoulder doesn't hurt if there's not something wrong. But if he takes something to mask that pain and goes out and performs, the chances are pretty good you're going to do more damage.

"When you come off that ingredient, now you may have permanent damage. You won the battle but lost the war. That's why a doctor needs to be involved."

But they're still learning, too.

"We just don't know enough to talk about it," Kraft said.

This isn't about Friday night, Cox told me, it's about Friday nights 20 years from now.


Source: NWI Times