The rapid expansion of cannabis legalization across the United States has created a complicated landscape for NCAA athletes, particularly those competing on the national stage during March Madness. With recreational cannabis now legal in most tournament host states and medical cannabis permitted in many others, players are navigating a web of federal regulations, university rules, and NCAA drug-testing protocols that often conflict with local law. The result is a patchwork of policies that continues to shape athlete behavior, preparation, and off-court awareness.

Under NCAA rules, cannabis remains included on the association’s banned drug list. Although the NCAA’s Committee on Competitive Safeguards and Medical Aspects of Sports voted to recommend removing cannabinoids from the list, formal adoption has not yet occurred. Until such a change is officially implemented, athletes competing in March Madness remain subject to the existing framework: cannabis use can still trigger penalties regardless of state legalization. The threshold for a positive test was raised significantly in 2022 to 150 nanograms per milliliter of THC metabolites, aligning more closely with professional leagues, but it remains enforceable during championship events.

This creates a paradox for players traveling through tournament sites such as Las Vegas, Denver, or Boston—cities where adult-use cannabis products are widely available and openly marketed. While legal for the general public, these products remain off-limits for student-athletes under NCAA policy. Athletic departments and compliance officers often hold mandatory briefings ahead of March Madness to remind players that local legalization does not grant them permission to consume. For many programs, education has become as important as enforcement.

Medical cannabis adds another layer of complexity. Even in states with established medical marijuana systems, the NCAA does not recognize medical cannabis as an acceptable exemption. Players managing chronic pain, anxiety, or recovery needs must rely on approved medications or therapies sanctioned by team medical staff. For athletes who come from states where medical cannabis is part of their routine health plan, adjusting during March Madness can be challenging.

The evolving legal landscape has also prompted renewed conversation among coaches and athletic directors about athlete wellness. As more research emerges around cannabis and pain management, sleep support, and reduced opioid reliance, some university leaders have urged the NCAA to shift toward a health-based rather than punitive approach. This mirrors broader national trends, where major professional leagues—including the NBA and NFL—have softened penalties and prioritized education.

Still, until national policies fully align with local laws, NCAA players must operate under strict guidelines. For March Madness competitors, the message remains consistent: legalization in host cities does not change the enforceable rules tied to eligibility. Awareness, communication, and compliance remain essential components of tournament preparation.

As conversations about cannabis reform continue, the intersection of legalization, athlete wellness, and national competition will remain an important topic—one likely to shape the future of college athletics long after the final buzzer sounds.