My basis on using caffeine as a bench mark was that it created less dependency than alcohol, was in between alcohol and street cannabis, and more importantly caffeine is regarded as a substance not prohibed by the International Olympic Committee.
So to be fair, I thought Iâ€™d look at all the criteria used by the Olympic authorities and compare them against Caffeine, Alcohol, and Cannabinoids. I have taken the criteria from the BBC and performed a brief literature search on the equivalent scientific terms associated with them.
Stimulants – Drugs that boost bodily functions, including heart rate and brain activity.
Caffeine: Caffeine has been shown by Silvio Buscerni to have no effect on the QT-Interval. It has been shown by D.M. Warburton that caffeine has the effect of improving cognitive functioning, in terms of attention, problem solving and delayed recall. Therefore, whilst caffeine may not have a positive or negative effect on heart rate it does have a positive effect on brain activity.
Alcohol: Alcohol has been shown by Karl-JÃ¼rgen BÃ¤r to increase the QT-interval after withdrawal, which has the oppostive effect to boosting heart rate. Alden Gross has found that sustained alcohol use has the effect of impairing cognition in later life.
Therefore alcohol can be seen to have a negative effect on heart rate when withdrawn from. It also has an eventual negative effect on cognition, so may not be suitable for long-term use by athletes.
Cannabinoids: Cannabis had been shown by Kimina Hanormand to have a negative effect on cognition when compared with non-use. According to GW Guy cannabis has a minimum effect on boosting QT-interval shortly after consumption, so has a minor performance reducing effect.
Therefore cannabis does not have the performace reducing effects of alcohol in terms of increasing QT-interval, it does have short-term performance reducing effects in terms of cognition, whereas this is only true of alcohol in the long-term.
Caffeine: According to TA Astotino caffeine has no effect on reducing perception of pain, so should therefore not be seen as a performance enhancing drug in this context.
Alcohol: According to SA Shah alcohol has a positive effect on reducing pain up-to a period of 9 months.
Cannabinoid: As previously stated, David Blake has shown that the cannabis-based medicine, Sativex has a positive effect as a pain-killer in people with rheumatoid arthritis.
Joy Goebel has found that the use of alcohol and other substances like cannabis for self-management of pain has little beneficial effects in veterans.
It is acknowledged by the IOC that alcohol and caffeine are diuretics. Also, I have found no studies assessing the diuretic properties of cannabinoids. So therefore I have not considered this in great detail.
Summary of Findings
Alcohol has the effect of reducing performance, as the withdrawal effects boost the QT-interval. Cannabis on the other hand has minimum impact on QT-interval, and caffeine none. Caffeine has the effect of increasing performance in brain activity, whereas cannabis reduces it in the short-term to long-term and alcohol in the long-term. Caffeine has little effect as a painkiller (narcotic) whereas alcohol and cannabis do. There seems to be little relevance in the use of drugs as diuretics other than their effectiveness at masking the use of banned substances.
Whilst cannabis has a greater immediate negative effect on brain activity than alcohol, the long-term outcomes are the same. Caffeine on the other hand has positive effects in brain activity. Also, withdrawal from alcohol has a greater negative effect on heart performance than cannabis. Therefore, if the IOB wishes to ban cannabis because of reduction in performance then it should also ban alcohol. If it is willing to ban other drugs which improve performance then it should also ban caffeine.
Alcohol has been shown to have painkilling advantages, just as cannabis has. Caffeine has no such properties, but it can boost concentration to overcome the attention focus on pain. Therefore if the IOB wants to ban cannabis then it should also ban alcohol.
I therefore conclude that in the long-term alcohol has the same harmful effects as short-term use of cannabis in terms of cognition. Also, alcohol has the same harmful effects on heart-rate on withdrawl as other QT-prolongers such as anti-psychotics, potentially leading to stroke and therefore reduced cognition.
While as an employer the immediate benefit of having a workforce who are able to self-medicate and still perform effectively using alcohol and caffeine instead of cannabis which has more immediate cognition-reducing effects, as a society we need to consider the externalities of alcohol on cognition in later life, and potentially after withdrawl. That is the costs to the NHS of dealing with elderly patients or stoke victims may be the same for those who consumed excessive alcohol leading to associated disorders as those who consumed cannabis.