When MMA fighter Elias Theodorou steps into the cage on Saturday, he isn’t just looking to fight his opponent, Bryan Baker — he’s also fighting for medical cannabis rights.

Although this fight will mark Theodorou’s second professional fight with a therapeutic use exemption for medical cannabis, it will be his first fight since gaining an exemption from a state athletic commission inside the United States.

The fight, hosted and promoted by the Colorado Combat Club, comes after Theodorou — whose pro record is 18 wins, 3 losses — received the exemption from the Colorado Combative Sports Commission in May.

Since cannabis rules vary by state and by different sports governing organizations — such as state athletic commissions, the UFC and the United States Anti-Doping Agency (USADA) — athletes seeking a medical exemption for it face many challenges.

Theodorou was diagnosed with bilateral neuropathy, a result of damage to the nerves located outside of the brain and spinal cord. He uses cannabis to mitigate the “pain and discomfort” he feels regularly. But he says the UFC denied him an exemption during his time as a fighter with them.

“They kept on telling me to take more prescription drugs, when my doctor and I knew that cannabis was right for me,” said Theodorou, a middleweight who has been undefeated in two fights since leaving the UFC in 2019. “They were telling me to take antidepressants and opioids, all while ironically or sadly having a campaign about the opioid crisis.”

Elias Theodorou of Canada kicks Daniel Kelly of Australia in their middleweight bout during the UFC Fight Night event on November 19, 2017 in Sydney, Australia.

Josh Hedges/Zuffa LLC via Getty Images

In January the UFC announced it was changing its policy to allow marijuana for in-competition athletes unless there was evidence that they did so “for performance-enhancing purposes.” USADA CEO Travis T. Tygart said in a statement that its UFC program “is not bound by the World Anti-Doping Code,” which lists THC, a key component of cannabis, as a prohibited substance. But he added, “It’s also important to note that state athletic commissions have marijuana rules of their own that may prohibit use.”

Last year, Theodorou became the first professional athlete in North America publicly known to receive a therapeutic use exemption for medical cannabis, granted by the British Columbia Athletic Commission in Canada. But he is far from the only one calling for changes to policies on its use.

“There’s been certain athletes that have been persecuted for their medicine, but also penalized as well, taking away any type of win, whether it’s in mixed martial arts, or obviously the Olympics,” Theodorou said. “And that comes from an outdated mindset, in regards to looking at cannabis as a drug.”

The U.S. Drug Enforcement Administration lists cannabis as a Schedule I drug, putting it in the same category as cocaine and heroin, and defining it as having no currently accepted medical use and a high potential for abuse. This categorization has stayed the same even as 36 states, Washington, D.C., and three U.S. territories now allow for the medical use of cannabis products.

Although USADA operates as a private nonprofit company, the largest portion of its revenue in 2020 came from government funds through the Office of National Drug Control Policy.

Theodorou says classifying cannabis as a Schedule I drug has made it harder for athletes like him to push for medical exemptions.

“It was like a non-go for the ability to get cannabis recognized as a medicine. And, you know, that process was many years,” he said.

“You can crush a handful of Percocet before a fight, and no one will give you any question,” he added. “But if you happen to smoke a joint a week or two before you can get penalized for it.”

The impact of these regulations was thrust into the spotlight last summer when star U.S. sprinter Sha’Carri Richardson’s positive test for cannabis resulted in her being disqualified from competing at the Tokyo Olympic Games. Richardson said she used cannabis to help her cope with the recent death of her biological mother, and noted that it was legal under state law.


Sha’Carri Richardson excluded from Olympics

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The decision to suspend Richardson sparked widespread public debate and questions about the handling of professional athletes’ use of cannabis. With THC included on the prohibited substance list of the World Anti-Doping Agency, pressure grew on the organization to consider whether these regulations are outdated and need change, as society’s views towards cannabis use have changed.

The agency later decided to review the status of cannabis as a banned substance, after receiving requests from “a number of stakeholders.” Besides the review being conducted in 2022 by WADA’s Prohibited List Expert Advisory Group, not much is known about how the process will work. WADA did not offer anyone for comment when CBS News asked about the review.

Some experts say medical authorization of cannabis in professional sports is overdue.

Dr. Craig Antell, a physician focused in sports-related injuries who has a medical cannabis practice, attributes the slow move in changes to anti-doping policies in the government and sports organizations to a lack of education about THC and CBD, and cultural stigmas of cannabis — rooted in historical discrimination.

“The NHL, the NFL, all of these organizations know there’s alternatives, they’re just hesitant to take that step, and they need to,” said Antell, who has worked in physical medicine and rehabilitation for more than 20 years.

Antell believes medical professionals need to be “more receptive to alternatives” for pain management, like medical cannabis, that are not mainstream yet.

Although CBD, another component of cannabis, is not on WADA’s prohibited substances list — which many national and international sports organizations subscribe to — Antell says CBD has to have enough THC to activate its medicinal properties. The federal limit for THC in CBD products is 0.3%, which Antell says is not enough to provide the medicinal benefits often described.

“One milligram of THC to 20 or 40 of CBD, that’s likely enough to turn on that endocannabinoid system to get rid of the pain,” said Antell, explaining how his practice balances CBD and THC to meet each patient’s needs.

“You’ll never get any cognitive effect off that all, so you’ll be able to work all day, you’ll be functional.”

As Theodorou continues to train for his upcoming fight, he says he’s already “very proud” of what he’s accomplished in advocating for medical cannabis.

“I look to make history once again, not only for myself but all athletes, and look to get my hand raised again, inside the cage and out,” said Theodorou.

-Christopher Brito contributed reporting.