Major League Baseball’s approach to substance use is governed by the Joint Drug Prevention and Treatment Program, negotiated between MLB and the MLB Players Association. This agreement outlines rules on performance-enhancing drugs (PEDs), “drugs of abuse,” testing procedures, and player discipline. It is updated periodically and remains the central framework for how MLB handles substance-related issues.

Performance-Enhancing Drugs: Zero Tolerance

PEDs such as anabolic steroids, testosterone, human growth hormone (HGH), certain stimulants, and masking agents are strictly prohibited. MLB maintains one of the toughest anti-doping systems in U.S. sports.

Current penalties include:

  • 80 games for a first positive PED test
  • 162 games for a second
  • A permanent suspension for a third, with the possibility of reinstatement

Players suspended for PEDs are also barred from postseason play in the same season. Recent bans—including 80-game suspensions for violations involving hCG or exogenous testosterone—show that MLB continues to enforce this policy aggressively.

Drugs of Abuse and Opioids: A Treatment-First Model

Before 2019, MLB treated “drugs of abuse” mostly as disciplinary matters. After the opioid-related death of Angels pitcher Tyler Skaggs, MLB and the MLBPA revamped the system.

Under today’s rules:

  • Samples are tested for opioids, fentanyl, cocaine, and synthetic THC.
  • A first positive triggers mandatory evaluation and a personalized treatment plan, not automatic suspension.
  • Discipline applies only if a player refuses treatment, violates the plan, or is involved in serious misconduct such as distribution.

This shift follows public health guidance and recognizes substance misuse as a medical issue while still allowing MLB to protect competitive fairness and player safety.

Marijuana: Removed From the Banned List

In December 2019, MLB became one of the first major U.S. leagues to remove marijuana from its “drugs of abuse” list. Natural cannabinoids—including THC and CBD—are no longer prohibited substances under the Joint Drug Program.

However, this does not mean unlimited freedom:

  • Players may use marijuana legally, similar to alcohol.
  • They may still be disciplined for unlawful possession, distribution, DUI, or other conduct violating team or league standards.
  • A positive THC test alone does not lead to suspension.

For minor leaguers, MLB has also eliminated suspensions for marijuana use, replacing them with evaluation and treatment if necessary.

CBD and Cannabis-Derived Products

CBD products are permitted, but MLB warns players to be cautious. Some over-the-counter products contain synthetic THC or other banned substances, which could still trigger discipline. MLB encourages players to consult team medical staff before using any supplement.

Other Related Rules

MLB’s substance policies interact with broader conduct standards:

  • Tobacco: Smokeless tobacco use is restricted, especially for younger players and in public settings.
  • Alcohol: Permitted, but misuse can lead to discipline, especially when tied to off-field misconduct.
  • Domestic Violence, Sexual Assault, and Child Abuse Policy: The Commissioner can place players on administrative leave and issue suspensions for off-field behavior, even without criminal charges. Substance use can factor into these investigations.
What It Means Today

The modern MLB substance-use framework reflects two priorities: protecting the integrity of the game and supporting player health.

  • PEDs receive the harshest penalties because they threaten competitive fairness.
  • Opioids and drugs of abuse receive a health-oriented, treatment-first response.
  • Marijuana is no longer banned, but marijuana-related misconduct still carries consequences.
  • CBD is allowed, with caution about mislabeled products.

For players and fans, MLB’s approach offers a clearer understanding: the league has embraced a modern, health-focused model — while keeping the toughest restrictions in place where performance and safety are most at risk.

Read how Ryan Tucker went from MLB prospect to cannabis advocate here.