High-performance sport, marijuana, and cannabimimetics.

The prohibition on use of cannabinoids in sporting competitions has been widely debated and continues to be a contentious issue. Information continues to accumulate on the adverse health effects of smoked marijuana and the decrement of performance caused by the use of cannabinoids. The objective of this article is to provide an overview of cannabinoids and cannabimimetics that directly or indirectly impact sport, the rules of sport, and performance of the athlete. This article reviews some of the history of marijuana in Olympic and Collegiate sport, summarizes the guidelines by which a substance is added to the World Anti-Doping Agency Prohibited List, and updates information on the pharmacologic effects of cannabinoids and their mechanism of action. The recently marketed cannabimimetics Spice and K2 are included in the discussion as they activate the same receptors as are activated by THC. The article also provides a view as to why the World Anti-Doping Agency prohibits cannabinoid or cannabimimetic use incompetition and should continue to do so.