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Treatment with CBD – Your Gateway to the Science of Cannabidiol

Positive drug test after taking CBD?

A positive drug test can be a disaster for people who have to undergo drug tests regularly. These people include professional athletes, who might justifiably worry about getting a positive drug test after taking CBD.

Both elite and recreational athletes can put enormous strain on their bodies during competition and training. This strain results in wear and tear injuries, inflammation, gastrointestinal problems, musculoskeletal pain, and even performance-related anxiety. It is understandable that many consider using the widely available CBD products that offer to provide “natural” relief for these problems. In addition, many consider CBD to be an excellent alternative to pharmaceutical medicines.

However, there may be significant risks to using CBD by inadvertently violating anti-doping regulations.

What are the regulations on CBD and cannabis?

Under World Anti-Doping Agency (WADA) regulations, cannabis (or specifically cannabinoid use) is a banned substance for sportspeople. The specific wording is:

“[Prohibited in-competition] All natural and synthetic cannabinoids are prohibited, e.g., in cannabis (hashish, marijuana) and cannabis products. Natural and synthetic tetrahydrocannabinols (THCs). Synthetic cannabinoids that mimic the effects of THC. Except: Cannabidiol.”

WADA, 2020

Positive drug test after CBD consumption

WADA has set the urinary threshold of 150 nanograms per milliliter (ng/mL) for THC. This limit aims to reduce the risk that a professional athlete test positive due to casual CBD use outside of competition.

When users consume cannabis, the body breaks down the psychoactive Delta-9 tetrahydrocannabinol (THC) into carboxy-THC. The body then stores this substance for several days (or even weeks for heavy users). As such, it is a suitable metabolite for identifying cannabis use, via a blood or urine test.

Positive tests for all other cannabinoids are an “adverse analytical finding” or failed test except for CBD. Cannabidiol is no longer on the banned substances list since 2018. Unfortunately, professional athletes using CBD still must remain very vigilant. The reason is that full spectrum CBD products can still contain a range of banned cannabinoids that may potentially lead to an unintentional violation of WADA’s in-competition anti-doping rules.

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The risks of a positive drug test after taking CBD

A recent German/US research study aimed to identify the potential risks for CBD using professional athletes. The researchers assessed 16 potential cannabinoids in human “spot-check” urine samples of habitual CBD users. For this, they analyzed urine samples following the single-use of 15 CBD products available commercially.

The enormous growth and routine use of CBD worldwide places professional athletes at increasing risk of unintended exposure to cannabinoids. Even when they use only permissible CBD products, they can potentially risk their reputation or career. A number of studies have identified THC and other cannabinoids in commercial products, including recent German tests on mostly CBD oils. The study found that 25% of the tested CBD products had detectable THC.

The detected cannabinoids

As one would expect (but it may not necessarily be the case), CBD was present in all the tested products that had CBD label claim. However, urine concentrations were very variable despite similar levels of CBD label claims. For example, products labeled as containing 50 mg CBD yielded between 28 to 746 ng/mL CBD in the urine.

The most extreme variation was from a full-spectrum product containing 44 mg CBD which produced a urine concentration of 4485 ng/mL CBD. Such wide-ranging results could be down to individual metabolic differences. Previous research, however, suggests that it is more probably inaccurate product labeling or content declaration, or some bioavailability enhancing formulation.

The scientists detected a number of different cannabinoids in the urine samples: Cannabigerol (CBG), Cannabinol (CBN), Cannabichromene (CBC), Cannabidivarin (CBDV), Cannabigerolic acid (CBGA), Δ9-Tetrahydrocannabinol acid (THC), Cannabidiolic acid (CBDA), and Carboxy-THC (THC-COOH).

How much CBD will trigger a positive drug test?

The most common cannabinoids (excluding CBD) were CBG, in concentrations up to 800 ng/mL, and CBDV (up to 95 ng/mL). Of major concern was that in 53% (8 out of 15) of the individuals tested, their urine contained CBG 8 hours after consumption. In addition, CBDV appeared in 80% (12 out of 15) of the samples. Both these metabolites would cause a failed drug test if collected as an “in-competition” sample. In three samples, CBDV, CGB, and CBC appeared up to 32 hours after consumption.

The “spot-check” samples of habitual CBD users in this study showed large variations in the presence of cannabinoids. Those that were taking CBD to reduce pain or insomnia tended to have a broad range of cannabinoids present in their urine, including CBG (up to 154 ng/mL), CBDV (up to 47 ng/mL), CBN, CBC, and CBDVA. Once again, the level of cannabinoids that the tests detected could present a “substantial risk” for a professional athlete of breaking the WADA anti-doping regulations. This risk would even be present for those using legal CBD products.

Future testing changes?

WADA is continuing to review its regulations on cannabinoids. It is possible that as tests become more refined, they may include a broader range of cannabinoid metabolites and more refined testing.

From a professional athlete’s perspective, the availability of CBD may be an attractive alternative to “harsher” pharmaceutical treatments. This is particularly the case when considering the long-term management of chronic pain, for example. However, caution is necessary.

At present, the availability of CBD in the marketplace and its suggested use are racing ahead of the science and regulations that monitor its safety and quality. It is therefore completely on the professional athlete’s shoulders to understand what they are taking. In addition, it is also the athlete’s responsibility to ensure the CBD product is from a reputable manufacturer and has undergone a rigorous quality control and assurance process. As we have noted, not doing so risks taking unsuspected active compounds that may cause a career-damaging, positive anti-doping test.

References

Mareck U, Fusshöller G, Geyer H, Huestis MA, Scheiff AB, Thevis M. Preliminary data on the potential for unintentional anti-doping rule violations by permitted CBD use. Drug Test Anal. 2020 Oct 30. doi: 10.1002/dta.2959. Epub ahead of print. PMID: 33125823.

World Anti-Doping Agency. What is prohibited: Cannabinoids. [Accessed 11/21/2020]

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