Today cannabis became legal across Canada for recreational use. For years before it has also been legal for medicinal purposes. Despite changing attitudes and laws cannabis remains a banned substance in competition by many State and Provincial Athletic Commissions. The World Anti Doping Agency removed alcohol and CBD from their prohibited list in 2018. THC, however, remains banned in-competition by WADA. In other words, if you fight drunk it is not an anti-doping violation in many jurisdictions but being sober and having trace amounts of detectable THC can be.
Athletic Commissions use varying and sometimes arbitrary thresholds when measuring what constitutes ‘in competition’ cannabis use. What is ok in one jurisdiction is not in another. A legitimate medicinal user of cannabis can be stone-cold sober in competition yet still test positive given these thresholds. It is arguable, as I discussed in this 2013 article, that a Therapeutic Use Exemption (TUE) can be given for cannabis but to date I am not aware of this occurring. UFC fighter Elias Theodorou is looking to change this. The #13 ranked middleweight has just published an open letter challenging the current landscape and asking for the combat sports anti-doping landscape to be recalibrated to take into account the legitimate needs of medicinal cannabis users. Below is Theodorou’s letter in full –
MY NEXT FIGHT: The STIGMA of MEDICAL CANNABIS FOR ATHLETES
As Canada goes through this truly historic moment of legalisation (October 17th, 2018), ending decades of prohibition, there is a common misconception that every Canadian has been given equal access to cannabis, enacted via the Canada Cannabis Act. Furthermore, medical cannabis has already been in use for a number of years, as prescribed by one’s doctor, via the Access to Cannabis for Medical Purposes Regulations (ACMPR), and thus has been a part of our fundamental healthcare rights as Canadian citizens.
However, even with Canada’s legalization of cannabis nationwide, and its previous medical exemptions, it remains “illegal” for medical use in-competition for all Canadian athletes, like myself, which is something I am determined to change. My next UFC fight is on December eighth, in Toronto, ON, against Eryk Anders, at UFC 231. He’s an incredibly tough opponent, no doubt; however, my biggest fight is not against one man, but instead transcends sport — it is against the stigma attached to medical cannabis.
USADA/WADA (United States Anti-Doping Agency/World Anti-Doping Agency) currently classifies cannabis as a PED (performance-enhancing drug), while studies have shown it to be anything but. It is, however, a much better alternative to treating my chronic injuries and condition, as well for pain management and recovery, as diagnosed and prescribed by my doctor. More specifically, due to my bilateral neuropathic pain (in my wrists and elbows), I am currently at a competitive disadvantage, when compared to other professional athletes. Medical cannabis, as prescribed by my doctor, has proven an effective treatment, allowing me to perform at the same base level of others in my sport, effectively evening the playing field.
Over the last 17 months, I’ve been working with USADA to become the first professional athlete ever to receive a TUE (therapeutic use exemption) for medical cannabis, in-competition. This has included multiple submissions over many months and having been forced to exhaust all first-line medications, such as Lyrica, Gabapentin and other pharmaceutical meds, like opioid-based painkillers, which did not work for me as either a patient or athlete, failing to treat my condition and causing debilitating side-effects.
Lyrica, for example, caused constant constipation and an upset stomach, hindering my ability to train, due to the tremendous pain and discomfort. It also made me put on weight, which created enormous mental stress, as I have to make 185-lbs. to compete in the UFC’s middleweight division. When I went off Lyrica, my stomach issues cleared quickly and I lost the very uncomfortable 12 lbs. I had gained on the medication. For high-level athletes like myself, the need to be ready on fight night begins months beforehand. Each and every physical and mental side-effect from any medication is a serious roadblock to my success.
While other athletes with similar conditions can simply opt for painkillers, I don’t have that medical option, as they either do not work for me or cause even worse side-effects. For instance, it would be perfectly legal for any of my future opponents to medicate with Vicodin while in-competition, while I would receive a substantial penalty for using medically prescribed cannabis.
At this point in my TUE application, USADA has acknowledged the legitimacy of my medical ailment, has not been difficult to work with and has even been helpful throughout the process. However, it is still very much an on-going one, unfortunately. The goal of modern medicine is for a doctor or medical practitioner to prescribe the best treatment for a patient. In this case, my doctor has already diagnosed and prescribed the most effective medication for my condition. However, with USADA erroneously still classifying cannabis as a prohibited substance, they’ve required me to exhaust all other first-line medicines in my TUE pursuit, which I have done, even though we’ve already proven, medically, what is effective in my treatment, as diagnosed by my doctor, and medical cannabis healthcare provider, Solace Health Network.
If you are confused by the process so far or taken aback by the bureaucracy, don’t worry: I have been as well. It would be nearly impossible for any one person or athlete to tackle such uncharted territory on their own. Thankfully, I have not been fighting this historic battle alone. Over the past eight months, my cannabis healthcare provider, Solace Health Network, and the VP of Clinical Affairs, Sabrina Ramkellawan, have empowered me, both as a patient and athlete, assisting with the process, my submissions and subsequent resubmissions, including my next one. It has been reassuring to have a team behind me as I’ve been gearing up for this public announcement, especially with all the unknowns moving forward, for myself, Canada and Canadian athletes.
I recognize that being the first professional athlete to apply for a medical cannabis TUE would not be an easy, or quick, journey, and that changing USADA’s current classification would require a great deal of work on my, my doctor and the Solace Health Network’s behalf, which we’ve been more than willing to put in. Over the past 17 months of constant communication, I’ve quietly been submitting and resubmitting my TUE, all the while my condition has worsened and I have been unable to treat it effectively. Now, in conjunction with Canada’s historic legislation, I feel more comfortable, and even obligated, to no longer hide in the shadows of prohibition and an outdated approach to medicine.
Throughout my TUE application process, I have been concerned with what the professional organization I compete for — the Ultimate Fighting Championship (UFC) — would think of, and how they would react to, my current medical condition, application and desire to go public in this pursuit. It was a great relief when I reached out months ago to the UFC and VP of Athlete Development, Jeff Novitzky (the former top FDA agent, famous for busting Lance Armstrong), who not only “support my ongoing process,” but also are “committed to continue helping along the way.” Many other athletes in professional sports have not been so lucky and would fear suspension or worse if they went public in a similar fashion. It is an honour to compete for an organization open to allowing me to freely, and without repercussions, make my voice heard, as both a patient and athlete.
In coming forward, my hope is not only to gain a TUE for myself, but also to establish a roadmap for other Canadian athletes that may wish to exercise their now Canadian right to choose, following their doctor’s diagnosis, to use medical cannabis, as prescribed.
I have always believed in, and remain 100-percent committed to, a clean sport. I have never failed any type of drug test that’s been administered to me, in-competition or out of, and have gladly followed all the rules, regulations and directives. However, I feel at this moment that the still on-going process of acquiring a medical cannabis TUE via USADA is not keeping pace with either myself, the rights of Canadian athletes, or our current events.
I am writing this letter in hopes of bringing this subject out of the shadows, to shed light upon the current, unwarranted stigma surrounding medical cannabis, which must be challenged and changed. Therefore, my biggest fight is not against the man standing across from me in the Octagon, on December eighth, but rather against the current stigma associated with medical cannabis, and my right as a Canadian to medically employ it.
As I once again get ready to resubmit my TUE application to USADA, from this day forward, Wednesday, October 17th, this is a fight that transcends myself and sport, but one I am determined to win.