title: Prevalence and correlates of cannabis use among athletes-A systematic review.
abstract: Despite scientific evidence that marijuana impairs performance and mental health, there is evidence that some athletes are at higher risk for use. This review aims to identify possible risk factors associated with marijuana use in athletes.
  
  
  
  A search was conducted in the PubMed database with the keywords: (marijuana OR cannabis OR tetrahydrocannabinol OR delta-9-tetrahydrocannabinol OR THC) AND (sports OR sport OR athlete OR athletes). We retrieved 186 studies. After applying the inclusion/exclusion criteria, 15 studies remained for review.
  
  
  
  The review revealed a number of potential risk factors for marijuana use among adult athletes, including being male, Caucasian, using sport performance-enhancing drugs, using marijuana to enhance recreation or non-sport performance, and practicing specific types of sports including skeleton, bobsleding, and ice hockey. Contrary to use patterns in the general population, among athletes marijuana appears to take the place of tobacco as the second most widely used drug, after alcohol. Many elite athletes denied the use of marijuana, which suggests that toxicological testing is an important tool for identifying users, because it is more accurate than self-report. Geography appears important, as in areas of high consumption, prevalence among athletes appears to be greater as well.
  
  
  
  Contrary to the image that athletes do not use psychoactive drugs, this review suggests that a number of athletic subgroups are at increased risk for marijuana use. Surprisingly, a common rationale for use appears to be to enhance sports performance. As in the general population, experimentation starts early-in pre-adolescence-at an age that prevention and guidance programs could have positive influences. (Am J Addict 2016;25:518-528).
authors.affiliation: Departament of Neuroscience, Medical School, Fundação do ABC, Santo André, São Paulo, Brazil.
authors.forename: Maria Beatriz
authors.initials: MB
authors.lastname: Brisola-Santos
authors.affiliation: Departament of Neuroscience, Medical School, Fundação do ABC, Santo André, São Paulo, Brazil.
authors.forename: João Guilherme de Mello E
authors.initials: JG
authors.lastname: Gallinaro
authors.affiliation: Departament of Neuroscience, Medical School, Fundação do ABC, Santo André, São Paulo, Brazil.
authors.forename: Felipe
authors.initials: F
authors.lastname: Gil
authors.affiliation: Departament of Neuroscience, Medical School, Fundação do ABC, Santo André, São Paulo, Brazil.|ABC Center for Mental Health Studies, Santo André, São Paulo, Brazil.|Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Sampaio-Junior
authors.affiliation: Departament of Neuroscience, Medical School, Fundação do ABC, Santo André, São Paulo, Brazil.|Interdisciplinary Group for Studies on Alcohol and Drugs (GREA), Department and Institute of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Matheus Cheibub David
authors.initials: MC
authors.lastname: Marin
authors.affiliation: Departament of Neuroscience, Medical School, Fundação do ABC, Santo André, São Paulo, Brazil.|Interdisciplinary Group for Studies on Alcohol and Drugs (GREA), Department and Institute of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Arthur Guerra
authors.initials: AG
authors.lastname: de Andrade
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Kimber Paschall
authors.initials: KP
authors.lastname: Richter
authors.affiliation: Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine, Stanford, California.
authors.forename: Ira David
authors.initials: ID
authors.lastname: Glick
authors.affiliation: Departament of Neuroscience, Medical School, Fundação do ABC, Santo André, São Paulo, Brazil.|Interdisciplinary Group for Studies on Alcohol and Drugs (GREA), Department and Institute of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Danilo Antonio
authors.initials: DA
authors.lastname: Baltieri
authors.affiliation: Departament of Neuroscience, Medical School, Fundação do ABC, Santo André, São Paulo, Brazil. jmcmaia2@gmail.com.|ABC Center for Mental Health Studies, Santo André, São Paulo, Brazil. jmcmaia2@gmail.com.|Interdisciplinary Group for Studies on Alcohol and Drugs (GREA), Department and Institute of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil. jmcmaia2@gmail.com.|Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas. jmcmaia2@gmail.com.
authors.forename: João Mauricio
authors.initials: JM
authors.lastname: Castaldelli-Maia
mesh_terms: D056352:Athletes / Q000523:psychology* / Q000706:statistics & numerical data; D014943:Global Health; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D000074609:Marijuana Use / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors