Summary
WADA has increased the level for reporting of cannabis in athletes from 15ng/mL to 150ng/mL. This change is now in place. It is likely to significantly lower the amount of positive findings for cannabis world-wide, and may be seen as a 'middle-ground' between those who want cannabis off the Prohibited List, and those who believe it should stay.
In this eBulletin, we discuss the WADA decision and possible implications for sport in Australia.
The new threshold
The World Anti-Doping Agency (WADA) announced on 16 May 2013, that the threshold level for the reporting of cannabis had been increased, effective 11 May 2013.
Previously, the threshold limit set by WADA for the reporting of cannabis was 15 ng/mL. In a WADA-backed paper published in 2011 (Cannabis in Sport - Anti-Doping Perspective) WADA observed that one reason that the threshold of 15ng/mL was used was because it differentiated 'passive smokers' from reaching a level where they may test positive. WADA also noted in their paper that in certain circumstance and for certain sports, cannabis can act as a performance aid.
WADA has now increased the threshold level to 150 ng/mL, and the decision limit to 175ng/mL. The decision was made by the Executive Committee of WADA following consideration of a number of submissions received by stakeholders during its review of the World Anti-Doping Code.
It is not known whether this new level was selected because studies have shown at levels below 150ng/mL there is no performance aid. One study discussed in the WADA Paper found that cannabis concentrations of more than 150 ng/mL were present in individuals who smoked cannabis 12 days per month for a number of years. Given that athletes who reach and maintain elite levels of sport where they are more likely to face testing, are less likely to be such frequent users of cannabis, the new threshold is less likely to detect the recreational/occasional user. In fact, the WADA study itself observed that athletes who are occasional users of cannabis and who abstain seven days prior to a competition are unlikely to return a positive cannabinoid result.
The new threshold level for cannabis came into effect on 11 May 2013. WADA has advised that the new threshold:
- will apply to all samples received and analysed from 11 May 2013 forward; and
- to any cases currently in the "results management phase" if the reported concentration is less than 150 ng/mL.
The immediate impact of this change is that if any sport is currently processing a cannabis case where the reported level was less than 150ng/mL, they are advised by WADA to cease progression of the matter. An athlete in such a situation will have a decent claim for their matter to be determined under the new, more favourable, rules.
Increasing the "bar" for a positive cannabis test will lower the number of cannabis findings. In our experience, cannabis findings range from those who "only just" test positive with readings in the 20 - 40 ng/mL range, to those who test positive at levels exceeding 400ng/mL and more. Anecdotally, some tests have exceeded 1000ng/mL.
WADA's statistics show that cannabis was one of the most reported prohibited substances between 2003 to 2009. Since 2011, in the USA, UK and Canada, 36 athletes have been sanctioned for the presence of cannabis. In New Zealand, six athletes have been disciplined in the past three years for returning positive samples for cannabis.
In Australia, cannabis accounted for 25% of ASADA's reported matters in 2011/2012 (six findings), and 18% in 2010/2011 (eight findings). There is no indication as to what percentage of these findings were above 150ng/mL, and it will be interesting to compare the numbers moving forward to determine just how much of an effect the change has had.
Sporting organisations should be aware that the change is for in-competition testing performed by ASADA or another accredited anti-doping organisation. It does not apply to illicit drug testing that sports may conduct on their own. Sports that believe they have a particular problem with cannabis are still able to implement illicit drug testing as a means to counter that concern.
On the face of it, WADA appears to have moved to balance the interests of those who believe cannabis should be removed from the list of banned substances altogether, with those who believe it should remain prohibited.
By increasing the level from 15ng/mL to 150ng/mL, there will be less recreational users detected, which should appease the critics of cannabis being on the list, but the substance as a whole remains prohibited, which should go some way to appeasing the supporters. Given that the new WADA Code has provisions for dealing with "drugs of abuse", including counselling and support in lieu of sanctions, this should further help ensure that those who continue to test positive to cannabis at the higher levels receive the support that they need.
Freeing ASADA from handling low-level cannabis cases will mean that more resources can be available to combat what some consider the serious doping agents: steroids, hormones and other "non-specified" substances. This is particularly timely in Australia; given the recent release of the 2011-2012 Australian Crime Commission Illicit Drug, which reported an increase in the use of such substances.
