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NFL, NFLPA hold forum on CBD use for pain management

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The Pain Management Committee of the NFL and the NFL Players Association held a fact-finding forum Tuesday with manufacturers of products that use CBD in sports medicine. The session was designed to give the medical experts on the committee an update from companies that produce and distribute CBD products about scientific research and evidence regarding the use of CBD products, and more information about which products are available, and how their use could benefit patients.

"The NFL-NFLPA Pain Management Committee is a jointly formed committee tasked with providing advice to the league and union regarding recent developments in the area of pain management for elite athletes," the league and the players' union said in a joint statement. "In furtherance of its duties, the Committee has been asked to brief the parties on the current state of pain management and alternative therapies, including cannabis, cannabinoids and CBD. The Committee invited manufacturers of CBD products to share their research today so the Committee may hear and consider the possible scientific evidence base for CBD use as a pain management alternative. This meeting was an educational and scientific exercise and does not impact the jointly administered Policy and Program on Substances of Abuse. We look forward to the continued cooperative work of the Joint Committee."

The NFL's current drug policy includes a ban on THC, a substance found in marijuana and some CBD products, which are both derived from cannabis plants. NFL players have long called for the league to allow the use of marijuana for pain management. The issue has become even more urgent as states continue to legalize the use of medical marijuana, and as the abuse of opioids originally prescribed for pain relief has become a national crisis.

The NFL maintains that there is not enough research and information on the use of CBD to treat acute and chronic pain, although today's session is a clear indication that the committee is continuing to look at the exploding use of CBD, and whether research will support anecdotal evidence that CBD products could help manage pain. With the next collective bargaining agreement being negotiated, the expectation is that a new agreement could include a different policy for marijuana.

The co-chairs of the committee recently sent to NFL teams two white papers that, in addition to suggesting alternatives to opioids for pain management, explain the committee's view of the current state of research on CBD products and marijuana use.

In the white paper sent to teams' medical staffs, the committee says, "CBD is a promising compound, but the extent of its use in the United States outpaces the level of evidence." It adds that small clinical studies have suggested that CBD may be effective for treating neuropathic pain, but it is difficult to know the purity and potency of many products, because they are purchased from unregulated sources. The white paper also says that multiple controlled trails show cannabis and two FDA-approved cannabinoids are effective in treating chronic pain and neuropathic pain, but those trials used small sample sizes and short follow-up periods, raising concerns about what can be extrapolated from the trials.

The paper concludes with this warning: "Of course, cannabis remains a banned substance under the NFL Policy for Substances of Abuse. In addition, the potential problems associated with cannabis, from acute impairment of driving, addiction, and exacerbation of psychiatric disorders such as depression and anxiety, make it a substance to approach with extreme caution."

Follow Judy Battista on Twitter @JudyBattista.

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