Concussions are a widespread injury in the National Football League (NFL), with 187 concussions reported in 2021 (injuries caused by an impact on the head, neck, or body that disrupts the brain’s function). Concussion symptoms may include headaches, sleep issues, balance problems, changes in memory functions, and other areas of dysfunction.
Sustaining another concussion while still recovering from a previous concussion can result in delayed recovery and, in some cases, a life-threatening condition called “Second Impact Syndrome”. A typical adult concussion patient can expect to see recovery within ten to fourteen (10 – 14) days, although recovery may be longer in some cases.
For an NFL player, taking two (2) weeks off is not an exciting prospect. Fourteen (14) days off could represent missing multiple games, and practices, and possibly losing a spot on the field. If symptoms continue past the fourteen (14) day mark, these career risks can be compounded, creating strong incentives for players to get back on the field. The focus on cannabinoids came on the heels of an announcement by Major League Baseball (MLB) that cannabis will no longer be on its list of banned substances and the NFL may be following suit soon.
Team owners have already approved a proposed collective bargaining agreement with players that would protect them from facing game suspension for testing positive for cannabis and will implement changes to testing protocols. One thing is certain doctors across the country are in agreement that NFL players are at increased risk for Chronic Traumatic Encephalopathy (CTE) after a seminal report on the topic was published in the Journal of the American Medical Association.
In the largest study of its kind and a collaborative effort between the US Department of Veteran Affairs and Boston University’s CTE Center, researchers examined the brains of deceased professional, semiprofessional, college, and high school football players. Of the 111 NFL player brains examined, 110 (99%) showed positive CTE pathology and the authors noted that accumulations of amyloid-β, α-synuclein, and TDP-43 were common in the brains of cases with severe CTE pathology.
Traumatic Brain Injury (TBI)
As former and current NFL players urge the league to allow cannabis to be used as a potential treatment for pain management and head trauma, research is getting a boost as major grants recently have been awarded to Harvard University’s Phytomedicines and Medical Cannabis Institute, as well as others.
Additionally, researchers from Pharmacology at Temple University’s Lewis Katz School of Medicine in Philadelphia, are leading a research lab exploring the effects of cannabis on pain in animal studies. Currently, research results in animal models of pain, stroke, and Traumatic Brain Injury (TBI) continue to excite us regarding the potential for Cannabidiol (CBD) to alleviate brain inflammation and related behavioral consequences such as pain and cognitive impairment.
Given these promising results and the relative safety of CBD, what is greatly needed now are trials in patients, including athletes, to determine how our laboratory results will translate to people. Mounting evidence from other animal studies suggests that CBD can act as a neuroprotective factor, thereby preventing damage to the brain.
Japanese researchers found that stroke damage was lessened in mice who were treated with CBD. Specifically, the authors hypothesized that the neuroprotective effect of cannabidiol may be related to increased blood flow through the serotonergic serotonin 5-hydroxytriptamine1A receptor. Despite cannabis’ increasing legality in the United States and its promising medical qualities, the NFL still prohibits its use.
However, in recent years, with bargaining by the NFL Players Association (NFLPA), the NFL has softened its stance on cannabis. The NFL has agreed to spend one million dollars ($1,000,000) to research cannabis as a pain-relieving medication. In February 2022, the NFL announced that they awarded their research budget to two (2) research labs:
- One lab is at the University of Regina in Canada, which is studying the use of cannabinoids not only for post-concussion treatment but also for concussion prevention. The research is attempting to determine the optimal form and dosage of CBD and THC to reduce pain and treat injuries.
- The other lab awarded funding is at the University of California San Diego, which is also assessing the therapeutic efficacy of THC and CBD, both used alone and in conjunction.
The NFL has also eased its testing protocol by reducing the testing frequency, raising the threshold of THC in a player’s system to constitute a positive test, and reducing the penalties for testing positive for cannabis use. Although cannabis and cannabinoids have promising medical value, there are potential downsides, and their use should be further researched. We’ll continue to follow emerging research showing that professional athletes who experience a concussion, acute pain, and chronic pain may benefit from cannabinoids.
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