Exploring Medical Professionals' Perspectives on Cannabinoid Use in Professional and Elite-Level Contact Sports: A Qualitative Inquiry.

BACKGROUND

The legalization and growing use of cannabis in elite sport raise concerns about the preparedness of sports medical staff, who often lack formal cannabinoid education and face regulatory, ethical, and communication challenges.

HYPOTHESIS: Elite and professional contact sport medical staff have significant knowledge gaps, experience stigma, and face regulatory ambiguities that hinder open communication and athlete guidance on cannabis use.

STUDY

DESIGN

Qualitative, descriptive study using thematic analysis of semi-structured interviews.

LEVEL OF EVIDENCE: Level 4.

METHODS

Semi-structured interviews were conducted with 10 medical staff (physicians, athletic trainers, nutritionists, and mental health professionals) from elite sports leagues in North America and Australia including the NHL, NFL, and NCAA. Interviews explored knowledge, experiences, barriers, and communication regarding cannabis. Transcripts were inductively coded to identify themes.

RESULTS

Six themes emerged: (1) pervasive "knowledge gap," with most staff lacking formal cannabis education and relying on informal sources; (2) compliance challenges and regulatory uncertainty due to inconsistent policies; (3) stigma and fear limiting open dialogue; (4) shifting attitudes as societal norms evolve; (5) observed increase in athlete cannabis use and inquiries for recreational and therapeutic purposes, highlighting a knowledge-practice gap; and (6) trust and communication as prerequisites for honest discussion and safe guidance. These factors restrict access to informed, evidence-based advice.

CONCLUSION

Elite sport medical professionals face educational and regulatory barriers, compounded by stigma and inconsistent policies. Despite evolving attitudes, most lack knowledge and institutional support to advise athletes, underscoring the need for education, research, and clear guidelines.

CLINICAL RELEVANCE: Targeted cannabinoid education, destigmatization, and clearer league policies are essential to optimize athlete care and harm reduction as cannabis use grows in elite sport.