Inside the Minds of Professional and Elite Athletes: A Qualitative Exploration of Perspectives on Cannabinoid Use in Contact Sports

BACKGROUND: As cannabis legalization expands and professional sports organizations reassess cannabinoid policies, elite contact sport athletes are increasingly exposed to cannabis use for therapeutic, recovery, and recreational purposes. Despite these shifts, limited evidence-based education and persistent stigma may hinder informed decision-making and athlete-clinician communication. HYPOTHESIS: Professional and elite-level contact sport athletes exhibit inconsistent knowledge and perspectives regarding cannabis use, shaped by stigma, inadequate education, and regulatory ambiguity. STUDY DESIGN: Qualitative descriptive study. LEVEL OF EVIDENCE: Level 4. METHODS: A total of 10 semi-structured interviews were conducted with current or former elite contact sport athletes from professional and collegiate leagues, including the National Hockey League, National Football League, National Basketball Association, American Hockey League, National Collegiate Athletic Association, and USports. Interviews explored athletes' knowledge, attitudes, and experiences related to cannabis and cannabinoid products in sport. Transcripts were analyzed using Braun and Clarke's 6-step thematic analysis framework to identify recurring patterns and themes. RESULTS: A total of 5 primary themes emerged: (1) athletes use cannabis; (2) insufficient education and lack of credible information sources; (3) persistent stigma and fear of judgment; (4) limited trust and communication with medical staff; and (5) inconsistency in laws, policies, and organizational responses. Athletes reported cannabis use for pain management, sleep, recovery, and mental health, typically with deliberate control over dosage, timing, and administration methods. Across interviews, participants emphasized the need for accessible, evidence-based education for both athletes and medical personnel. CONCLUSION: Elite contact sport athletes use cannabis intentionally for recreational, therapeutic, and recovery purposes but face systemic barriers related to misinformation, stigma, and inconsistent policy guidance. Enhancing athlete and clinician education and standardizing cannabis-related regulations across leagues may support safer, evidence-informed practices. CLINICAL RELEVANCE: This study identifies critical educational and policy gaps regarding cannabis in elite sport and underscores the need for multidisciplinary collaboration to guide responsible cannabinoid use among athletes.