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Imagine that you’ve played professionally in the NFL for years, taking opioids sometimes twice a day during game season to kill your chronic pain, anxiety, and stress. Suddenly you are tapped on the shoulder and told not to return to work in the morning. Imagine losing your career instantaneously, and with it your life’s expectations, goals, and the structure and daily routine you’ve been following for the past five years or more. Now, imagine what it feels like readjusting to life in the ‘real world’ following a career in the NFL – what do you do now? Where do you work? How do you treat the chronic pain, anxiety, and sometimes depression that come with an NFL career and a new reality? What if you suffer from other symptoms – symptoms that aren’t part of opioid addiction and the constant physical contact of an intense sport like professional football? You are cut off from the NFL and from other players by a tacit understanding that you are not to discuss your feelings, injuries, addictions, or life without the NFL in a way that might reflect negatively on the organization. After all, it gave you a lot while you were included in it. But is that loyalty and devotion worth keeping quiet about the problems that players and former players experience as a result of their involvement in the NFL?

You may have heard that Baltimore Ravens’ tackle Eugene Monroe asked the NFL to stop testing its players for marijuana consumption so they can avoid using powerful and addictive opioids for pain – and cannabis has long been used as a painkiller for players. As Monroe told the New York Times this month, “[w]e now know that [opioids] are not as safe as doctors thought, causing higher rates of addiction…and we have cannabis, which is far healthier, far less addictive, and quite frankly, can be better in managing pain.” Monroe is not the only NFL-associated football player to step forward in support of medical cannabis to manage a litany of symptoms, from possible Chronic Traumatic Encephalopathy (CTE) and chronic pain, to depression, anxiety, and stress.

I interviewed Nate Jackson and Jake Plummer, formerly of the Denver Broncos, the San Francisco 49ers, and the Arizona Cardinals, along with researchers Ryan Vandrey at Johns Hopkins’ School of Medicine and Marcel Bonn-Miller at the Department of Veterans Affairs (who are beginning the initial phases of scientific research on medical cannabis and NFL players this summer). Vandrey and Bonn-Miller’s work is the first of its kind: legalization and increasing knowledge about opioid medication risks and the dangers associated with professional football have led to a push for this type of research. CW Botanicals and the Realm of Caring are working together on the When the Bright Lights Fade campaign to bring awareness and funding to the cannabis and NFL player research studies of Vandrey and Bonn-Miller.

What is the When the Bright Lights Fade Campaign?

The When the Bright Lights Fade campaign was started by CW Botanicals (creators of the Charlotte’s Web strain) and the Realm of Caring (RoC), a Colorado Springs-based organization which aims to “improve lives through cannabis research, education, and advocacy.” RoC works with families and individuals across the globe, even offering financial assistance programs for those who can’t afford cannabinoid therapies on their own; over $32,000 was awarded in 2015, and over $60,000 is expected to be awarded this year. The first When the Bright Lights Fade campaign fundraiser, launched online in May, was supported by current and former NFL, NBA, MLB, boxing, and MMA athletes. The campaign successfully raised over $100,000 – the cost of the first 2 or 3 scientific studies being funded. Heather Jackson, RoC’s CEO, noted that Eugene Monroe alone donated $80,000 toward the studies. Jackson anticipates that there will be many future fundraisers for the campaign, especially if the results of the current studies are effective in showing that NFL “players who used cannabinoids during their career have better outcomes than those who did not.” The goal of both the RoC and CW Botanicals with the campaign is to raise awareness of the problems former and current football players face, to begin research on debilitating CTE and other illnesses’ symptoms, and to prevent brain damage in the first place.

In order to understand the studies themselves, we must first understand that CTE is a new disease, and one that can only be diagnosed post-mortem (after death). Part of what researchers and funders hope to achieve in the long game is a way to identify CTE and prevent it from developing in the brains of living athletes. These first few research studies, however, have much more modest goals: they are meant to specifically define the medications (illicit and licit) that NFL players and former NFL players use to make their lives, pain, and issues livable. The possibilities include alcohol, cannabis, opioids, street drugs, painkillers, and so on.

What are the NFL Players and Cannabis Studies About?

According to Jackson, cannabinoids are known anti-inflammatory, analgesic, anti-depressant, and neuroprotectant compounds which may help to slow or prevent CTE-associated symptoms in professional athletes. A neuroprotectant is a strategy, drug or chemical compound that can protect the Central Nervous System (CNS) from injury or degeneration after trauma, such as that sustained by professional athletes. Researchers are particularly interested in the neuroprotectant property of cannabis, as it might help to prevent CTE or other brain injuries or issues in athletes in future – before they happen.

Ryan Vandrey, Ph.D., is the Associate Professor of Psychiatry and Behavioral Sciences at the Johns Hopkins School of Medicine in Baltimore, Maryland. Vandrey’s main research consists of studies on the human behavioral pharmacology of cannabis, nicotine and tobacco, and he is partnering with Marcel Bonn-Miller of the U.S. Department of Veterans Affairs on the When the Bright Lights Fade campaign studies. Vandrey and Bonn-Miller stressed that the cannabis studies are observational, meaning they will not distribute cannabis to any of the former or current NFL players who volunteer for the study. The volunteers will be given a questionnaire about their cannabis, opioid, alcohol and other licit and illicit drug use, as well as their memories, moods, and anxieties. Current NFL players will be followed over the course of the coming season to determine which players function better than others, and what medications those players are ingesting. Essentially, the players’ medication and self-medication will be measured, along with their functioning in comparison to players who do not ingest particular substances. Of those that do use cannabis and opioids, the researchers will determine what types of products they are using, whether they are prescription medications or illicit “street” products.

If the findings of the study show that those who self-medicate with cannabis indicate improved functioning or reduction of negative health symptoms (such as increased memory, better moods, and less anxiety), both Vandrey and Bonn-Miller hope to continue cannabis-related athletic studies in the future, to further evaluate the scientific case for the use of cannabinoids in athletic medicine. The study will be recruiting current and former NFL football players, and Bonn-Miller estimates that the initial studies will be complete in December of 2016 or January of 2017. Vandrey noted in the interview that cannabidiol (CBD), one compound found in the cannabis plant, is one of many possible candidates being researched that may provide relief for NFL players, former players, and other athletes.

Following the initial two studies, Vandrey and Bonn-Miller should have a more defined hypothesis about the effects of cannabis, or specific types of cannabis-derived products, on sports-related injuries to base future studies on.

What is CTE and How is it Diagnosed?

Chronic Traumatic Encephalopathy, or CTE, is a newly-discovered progressive degenerative brain disease which was originally believed to be a boxer’s disease called dementia pugilistica  or “punch-drunk syndrome.” CTE affects people who suffer numerous repeated blows to the head, concussions, or trauma to the brain due to sports injuries or daily sports practice, games, and competition. Concussions are cumulative, meaning that many concussions are believed to be more damaging than a single bad concussion. As Nate Jackson described it, it’s not the big hits on the field that cause CTE, it’s the repeated damage to the brain that is sustained day after day on the football field during games and practices.

CTE is not limited to athletes, either; anyone in a line of work who suffers blows to the head on occasion may develop the disease, including military personnel. CTE develops following brain damage or traumatic cranium impacts over a period of years. Over time, a CTE patient may lose brain mass as the brain slowly deteriorates – although some areas may actually become enlarged as a result, as well. The accumulation of defective tau protein may also occur in CTE patients’ neurons, resulting in neurological interference in the brain. These proteins generally stabilize the nerve cells in the brain, but their degeneration is believed to be connected to Alzheimer’s and CTE symptoms. In other words, you don’t want your tau proteins to degenerate, and it may be better if they don’t build up at all. Cannabis may have the exact neuroprotectant properties that professional athletes and military personnel need to prevent the build-up of tau proteins and the degeneration of their brains. A cannabinoid study conducted in Canada has shown that cannabinoids actually stimulated the growth of neurons in newborn rats, while significantly reducing anxiety and depressive behavior. It makes perfect sense, then, that cannabis could be used to prevent the symptoms of many degenerative brain diseases.

How Can Cannabis Research Help Football Players and Other Athletes?

In a nutshell: we have to start somewhere. With mental diseases like Alzheimer’s, CTE, and depression becoming more prevalent than ever all over the world, we need to find a way to prevent the degeneration of the brain. Cannabis has always provided people with treatment for pain, but its applications for mental illnesses have just begun to be studied. For some, cannabis has been consumed for depression, PTSD, and addiction recovery reasons for years, but the science is not there, yet. Decades of prohibition around medical and scientific research into the properties of cannabis, along with widespread demonization of the plant in societies, has resulted in the loss of vast amounts of research and information that we now have the chance to catch up on.

Studies like that of Bonn-Miller and Vandrey, current PTSD studies, and the pressure being put upon the U.S. federal government to change cannabis scheduling are all in the works today. Tomorrow, the use of different, more potent strains in scientific and disease research may allow the prevention and more effective treatment of debilitating and fatal diseases like Alzheimer’s, CTE, and PTSD. It is our job to support this research, keep ourselves and others informed about our options, and to demand that the federal government allow this research in the future – cannabis may protect our children, our families, our friends, or other loved ones from the painful mental diseases which cripple 1.5 million Americans today.

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