Aug 4, 2015
San Diego Union Tribune - Former SDSU and New Orleans Saints lineman Kyle Turley says marijuana is the only drug that has really helped him, and that it's safer than opioids
You’ve seen the ubiquitous prescription drug commercials on television.
A happy couple walks hand-in-hand along an isolated beach as the sun sets in the background. The drug name flashes across the screen. Cue a voiceover listing all the possible side effects – always in staccato speed because, well, the number of possible side effects is long enough that it would take a while to get through them all at regular pace.
Kyle Turley was watching one of those commercials earlier this year when he decided enough was enough. He was done with synthetic drugs.
A decade-long NFL career left the former San Diego State All-American offensive tackle with a multitude of health issues. Turley’s football injuries broke his body, but he’s also convinced that football did irreparable damage to his brain. He’s struggled with anxiety, headaches, depression and rage issues. In an interview with the Union-Tribune in 2013, he even admitted to having entertained suicide.
To help him deal with his ailments, Turley’s doctors have prescribed a multitude of painkillers, psych meds and muscle relaxants over the years.
Depakote. Wellbutrin. Zoloft. Flexeril. Percocet. Vicodin. Toradol. Vioxx.
You don’t need to know what each of these drugs is designed to do. The point is that dating back to when he blew out his knee at SDSU in 1996, Turley has been on them all at some point, often in different prescribed combinations, over a period that spans almost 20 years.
The sports world appears to be waiting to see what happens politically in regard to marijuana, with the movement to legalize it gaining steam in the United States. 23 states have now legalized marijuana in some form, with four of those (Alaska, Washington, Oregon and Colorado) allowing for outright recreational use for adults aged 21 and older.
The drug is still illegal in all the major pro sports leagues and very restricted at the NCAA level.
Experts in the field of pain medicine agree that everything is coming to a head.
“We have 100 million Americans in chronic pain. We don’t have good, strong and safe therapies. We have a crisis with pain and opioids in this country,” said Dr. Lynn Webster, a past president of the American Academy of Pain Medicine. “We need to find better treatments for athletes and non-athletes, and cannabinoids may by one way
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Cannabis has been used as a recreational drug for decades, yet because there’s such a stigma attached, it’s difficult to determine when athletes started taking marijuana for pain or stress management.
One of the earliest known instances of a high profile pro athlete being busted for the drug was in 1993, when Boston Celtics center Robert Parish – then the oldest player in the NBA at age 39 – was charged with marijuana possession after a drug-sniffing dog detected it in a FedEx package addressed to him. Parish later told the Boston Globe that he used marijuana to relax after games and that he quit smoking in 1995.
A 1997 New York Times story estimated that “60 to 70 percent” of NBA players smoked marijuana, though this pre-dated the medicinal marijuana wave of the 2000s, and it appears that marijuana was used mostly as a recreational drug.
Around the turn of the decade, evidence suggests more athletes started using marijuana more to help manage pain from injuries, especially in the NFL. Running back Jamal Anderson, who played for the Atlanta Falcons from 1994 to 2001 recently told Bleacher Report that during his career about “40 to 50 percent of the league” used marijuana
. San Diegan Ricky Williams, who played for the Saints, Dolphins and Ravens from 1999 to 2011, has also publicly talked about using marijuana during his career to help control pain and stress.
The focus on the issue sharpens when you consider that the NFL currently faces a lawsuit filed in May by a group of former players who allege that all 32 teams liberally dispensed large quantities of painkillers to injured players in a “conspiracy” to keep them on the field without fully educating them on the risks these medications present.
Anderson, Williams, Turley and former Denver Broncos tight end Nate Jackson are now part of a growing number of former players who believe that marijuana is a safer way to help athletes deal with pain.
“It’s natural for football players to lean toward marijuana to deal with the violence and trauma of the game,” said Jackson, 36, who played for the Broncos from 2003-08, and who estimates that up to half his team might have used marijuana. “Teams will prescribe you bottles and injections that are really bad for you. Cannabis was what my teammates and I preferred.
“It was a supplement/recovery for me. (Opioids or marijuana), it was never a dilemma. It was a physical reaction to substances that I assessed after trying both and realizing that marijuana was better for my mind and body. I don’t like taking pills. They make me feel slow, sluggish and heavy.”
The violent nature of professional football almost ensures a continuous litany of injuries throughout the season. In 2014 alone, 365 NFL players found themselves on the reserve/injured list. Injuries are acknowledged as part of the profession, an occupational hazard, if you will.
In Jackson’s six-year NFL career, for instance, he broke his fingers, broke a rib, separated both his shoulders, broke his tibia, tore the medial collateral ligament in his knee and tore his hamstring off the bone twice. He used marijuana after practices and games for relief from his injuries.
The NFL only tests for marijuana between April and August, so it’s not difficult for players who use cannabis to work around that and stay under the radar while ensuring they pass the drug screening.
Turley also used marijuana regularly when he played in the NFL because he said it helped him deal with some of his health issues – anxiety, sleeplessness and depression among them. Now, he’s returned to marijuana as a way to manage his ailments in his post-NFL life.
Since weaning himself off all prescription drugs three months ago and transitioning solely to medicinal marijuana, Turley has noticed a “night and day difference in his psyche.” He no longer suffers from low testosterone, his libido is back, and his anxiety issues have improved.
“I don’t have as bad depression any more, that’s getting better. The cognitive impairment seems to be getting a little bit better. Life is more manageable, I have more energy and feel more alive,” Turley said. “I don’t think about killing myself any more. Suicidal thoughts and tendencies were part of my daily living.
“At the end of the day, I was losing hope with the synthetic drugs and now I feel better. It’s giving me hope again, helping with depression and anxiety.”
More research could prove valuable for athletes looking for answers outside established medical practices that they have come to distrust – especially NFL players who have in the last five years become much more aware of how concussions and head trauma sustained during their football careers can cause long term brain damage or chronic traumatic encephalopathy (CTE) – the progressive, degenerative brain disease that results from multiple sub-concussive blows to the head.
Turley has been diagnosed with early onset dementia, and has had his brain scanned for damage. Scans yielded a “big blurred area that doctors are concerned about,” Turley said.
Put together the results of the scans, his memory issues, depression and anxiety problems, and Turley believes he has CTE. Turley also thinks marijuana might be helping his brain to heal.
Yet, for all his praises of marijuana, even Turley admits that in terms of its properties as a medicine, it’s still very much an untested commodity. While he has no medical or scientific credentials, he is passionate about the subject and is anxious to learn more.
“There’s no real science behind this yet,” Turley said. “I’m really looking forward to expanding on my experience with it now that it’s giving me relief.
“If I have to take something, I’d rather take something that grows from the ground and has medicinal properties than something that the government grows or I have to get from Walgreens.”
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The cannabis plant has several hundred chemical compounds, but two of the main chemicals are THC (tetrahydrocannabinol) and CBD (cannabidiol).
THC is the principal psychoactive compound – the chemical that produces a high, but has also been found to have analgesic, anti-spasm, anti-nausea and appetite stimulating properties. CBD might help with seizures, anxiety, psychosis management and management of diseases in which inflammation is an important element.
It’s difficult for scientists to do extensive research on marijuana in the United States because its status as a Schedule 1 drug – it’s deemed to have a high potential for abuse and has no medical purpose – means the federal government regulates its dispensation for use in all scientific studies, and this is often a long, tedious process.
But several uses of cannabis have been established in recent years. In 2012, British researchers at the University of Reading found that a chemical in the cannabis plant helped to suppress epileptic seizures with no side effects. Last fall, researchers from St. George’s University of London also discovered that cannabinoids can help to treat brain cancer.
“Cannabis can help with neuropathic pain – a kind of burning, tingling hyper-sensitivity type of pain,” said Dr. Igor Grant, the head of the Center for Medicinal Cannabis Research at UCSD. “We see this with some diseases like HIV and certain kinds of injuries to the nervous system. This type of pain does not respond to typical pain medication such as Ibuprofen or opioids.”
Cannabis can also help with weight gain – “the idea of the munchies is really true. These are appetite stimulants,” Grant said – and control of nausea and vomiting, especially with cancer patients.”
From an athletic standpoint, the benefits of marijuana have not been extensively studied, but much of what is known comes from a 2011 scientific manuscript on cannabis in sport that was authored by Dr. Marilyn Huestis, the Chief of Chemistry and Drug Metabolism at the National Institute on Drug Abuse. Huestis is on the World Anti-Doping Agency’s Prohibited Drug Committee and she worked with WADA scientific officers Irene Mazzoni and Olivier Rabin on the review.
The investigators concluded that while additional research into the effects of cannabis on athletic performance is needed, the acknowledged benefits are as follows.
According to Huestis’ manuscript, cannabis:
• Induces relaxation and steadiness
• Relieves the stress of competition
• Improves sleep and recovery after an event
• Reduces anxiety and fear
• Increases risk taking, which could improve performance
• Increases appetite, which could help athletes gain weight if they’re trying to bulk up.
• Enhances sensory perception
• Decreases respiratory rate
• Increases heart rate
• Acts as an analgesic that can help athletes work through injuries and pain from training fatigue.
At the moment, there’s little to no research that shows marijuana helps the human brain heal from concussions.
UCSD’s Grant said some animal studies have been done on the subject, and “a little bit of human work.” He concedes that it’s “not an outlandish idea,” but also points out that it has not been established.
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Despite some of the espoused benefits, not everyone is on the pro-marijuana bandwagon.
Among a long list of college athletes who have recently been penalized for marijuana use is former Horizon High and current Oregon wide receiver Darren Carrington Jr., who in January was suspended for the Ducks’ national championship game against Ohio State after a positive test.
The list of NFL players who will serve marijuana-related suspensions this fall includes Cleveland wide receiver Josh Gordon, who has been banned for the entire season after a series of substance abuse infractions that included testing positive for marijuana.
According to NFL spokesman Greg Aiello, the league’s rationale for maintaining its ban on marijuana is based primarily on the fact that the league’s doctors believe there are other ways to alleviate pain, and the fact that marijuana use is still “a violation of federal law in virtually every state other than Washington and Colorado.”
The NFL also does not have any provisions in place to allow for medicinal marijuana use because “our understanding is that the conditions for which medical marijuana would be prescribed would normally mean that the individual is in no condition to play football,” Aiello said.
Former Cleveland Browns General Manager Phil Savage said that until marijuana becomes fully legalized in the United States, he can’t see the NFL taking the drug off its illegal substances list, and can’t imagine how the league would benefit from doing so.
“I get the sense society would have to draw the line first because of the integrity of the league and the idea of being role models. The NFL has tremendous influence in society,” said Savage, who is now the Executive Director of the Senior Bowl. “I think if the league did away with testing for marijuana and said, ‘it’s open season’ that sends the wrong message to youth, middle, high school and college football players, to say, ‘Hey it’s OK with us but not OK with the laws of your town’
“For the league to sustain itself, they have to grow the game at the grassroots level with middle and high school football. I would think the vast majority of parents out there would much prefer the league saying, ‘This is not right for us and for our organization.’ Parents are already fighting an uphill battle to keep kids away from alcohol abuse or drug abuse.”
It’s not just the American pro sports leagues that are holding marijuana at bay. Even though the U.S. Anti-Doping Agency and WADA have both set their marijuana testing threshold at higher than the NFL, at 150 nanograms per millimeter of urine (compared to the NFL’s 35 ng/ml and the 15ng/ml standard for most employment-based drugs tests nationally) cannabis remains prohibited from competition because some believe it has certain performance enhancing properties.
“I think there’s a common misunderstanding in the athlete community suggesting it shouldn’t be on the prohibited list because it’s not performance enhancing, but we need to think more broadly about what performance enhancing means in the context of cannabinoids,” said Dr. Matt Fedoruk, Science Director at USADA. “You need to look at the drug and its effect on specific sports.”
For soccer goalkeepers, for instance, cannabis may improve their vision or reduce the speed at which the play is happening.
Cannabis can also improve the performance of athletes in sports that require greater concentration because it has been known to enhance focus.
Cannabis also has side effects, and it affects everyone differently.
“Marijuana is associated with suicidal thoughts in a subset of the population,” Webster said, adding that it can also trigger schizophrenia in individuals who are predisposed to that brain disorder.
In some people, it might induce risk-taking and decrease coordination, which can be dangerous in certain sports.
Also, the perception that marijuana is a non-habit forming drug is untrue, doctors say. It’s just not quite as habit-forming as some other recreational drugs out there.
“Cannabis produces mild physiological dependence,” Grant said. “If somebody is a heavy user and they suddenly stop using, in the days and weeks after they stop, they may get more irritable and feel more anxious. … It’s not a medically dangerous type of withdrawal.”
“About nine to 10 percent of people exposed to marijuana will develop physical dependence.”
There is also evidence that marijuana use can negatively affect brain development, particularly in adolescents.
“We have really good evidence that if (marijuana) is used before 16, it dramatically affects brain development,” said Huestis, who added that she’s also wary of full marijuana legalization because this could lead to an increase in traffic accidents involving people driving while high.
Then, there’s the act of smoking itself. While there are other means of ingesting marijuana, smoking it is still the most common. USADA’s Fedoruk said one area of concern in regard to marijuana and athletes is the link between smoking and pulmonary toxicity.
“If you’re an elite athlete, the last thing you want to be doing is to harm your cardiovascular outlet, so smoking is not something you want to be doing,” Fedoruk said.
Ultimately, the anti-marijuana legalization camp cites the drug’s effects on a person’s coordination, its addictive quality, and its linkage to mental illness as some of the biggest red flags.
“We know from research that when a person has a mental problem, marijuana can exacerbate that. Any time anyone is using any kind of a mind-altering substance, they can make bad decisions,” said Calvina Fay, Executive Director of the nonprofit Drug Free America Foundation.
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So does marijuana help or hurt people in the long run?
Turley argues for the former. The little green bud of marijuana that he holds between the thumb and index finger of his left hand is dwarfed by the quart-sized Ziploc bag he clutches in his right hand.
The bag is full of prescription pill bottles. It represents everything Turley weaned himself off this year.
“I’ve tried all the medicines in this freaking bag,” he says, shaking the Ziploc bag with all his pill bottles before holding up the bud of marijuana in his left hand. “Not one of them does what this does.”
“My charge is to take this away from the ‘pot head and reefer madness’ crowd and bring this to an arena where we can be educated about it,” Turley said. “I’m really interested in finding more answers in the plant that grows in the ground instead of the synthetic things that have really controlled my life for the last 15 years or more.”
Some scientists are on his side. They want marijuana to be declassified from the Schedule 1 drugs to open up the opportunity for more extensive research on its benefits.
It’s all about relativity. Opioids or marijuana: which is more dangerous for an athlete when it comes to pain management?
Former NFL players like Jackson and Turley who’ve been on both sides of the opioid/marijuana pain management spectrum say that marijuana is safer and has more upside because there’s a lot of promising research around it that is just barely scratching the surface.
If Turley were tasked with guiding the NFL on its marijuana policies, he says he would create a wellness center to further advance the research of marijuana in dealing with brain injuries. Jackson posits a similar initiative.
“I would lift the ban on marijuana or raise the threshold really high and not punish guys for it,” Jackson said. “And consider starting some clinical trials with former players, collecting data and doing some tests with CBDs and THCs and following up with studies that have been done in Israel on brain trauma and marijuana.
“We’ve talking about making football safer. If marijuana truly is a neuro-protectant, it would help these guys.”