The subtheme “Complexities of Trusting Medical Staff” explores how athletes navigate trust in team medical staff, particularly around cannabis. Trust varied widely and was shaped by personal relationships, team hierarchy, and fears that information would be passed up to management. 

Trust in trainers developed over time and grew with how much time athletes spent with them. Athletes reported stronger relationships and better communication with staff they saw daily, especially strength and conditioning coaches, and said these friendships made it easier to discuss sensitive topics such as cannabis. One athlete noted, “It’s just their [trainers’] willingness to hang around the guys. . . it’s just how much conversations you have about anything with them” (EA2). Another elaborated, “. . . You might even end up telling them. . . I’m having trouble sleeping because I’m going through this with my family. . . it’s almost like it’s therapy” (EA8). Some athletes described highly trusting relationships with particular trainers who were open‑minded and willing to learn. These trainers were seen as counsellors, from taping ankles daily, sharing handshakes, hearing complaints about coaches, and forming “very strong” relationships that felt different from other roles in the organization (EA3, EA9). This trust depended heavily on individual trainer characteristics, however. Athletes felt safer with trainers who held positive views on cannabis or used it themselves and were wary of those seen as judgmental. One athlete explained, “It depends on the trainer. . . I wouldn’t have said anything to some because anything you say goes straight back to coach. . . The other 2 I feel like I would have felt more comfortable. . . but I would have had to preface it with ‘Please keep this between us. . . I’m just asking for a ‘friend’ type of thing’” (EA3).  Athletes relied on teammates to signal which staff could be trusted. New players reported low initial trust after “hear[ing] stories” of trainers “ratting on other matters” and were warned to “steer clear” of certain staff (EA2). Because trainers and performance staff answered to upper management, athletes believed that questions about cannabis could quickly reach senior decision‑makers and threaten their careers, leading some to say they would “definitely not” ask team medical staff about cannabis because of potential repercussions (EA6, EA2).

Concerns extended to doctors and higher‑level personnel, whom athletes saw less frequently and perceived as more likely to judge or report them. Many preferred third‑party medical providers outside the team, who had no power over contracts or playing time, and described limited trust in internal staff, saying they “wouldn’t trust [them] a whole lot with conversations regarding cannabis use” or “wouldn’t tell a soul. . . I wouldn’t trust any of them” (EA7, EA10). One athlete described opening up to an outside professional because they feared team‑affiliated staff would tell the coach, who might think there was a problem and bench them (EA3).  When asked whether players would trust internal staff more than third‑party providers, athletes consistently said they would “trust somebody outside of [the team] more for sure” and “would never go to the trainer and/or the doctor [about cannabis]” (EA7). As a result, many avoided discussing cannabis with team medical staff altogether.

Athletes perceived younger staff as more receptive and knowledgeable about contemporary issues, including cannabis. One athlete felt able to “tell [a younger coach] anything” (EA1), while another believed it would be “very hard” for older personnel to accept cannabis but expected younger staff to be more open, especially if they had grown up with different cultural views (EA6). Some athletes mentioned staff who used cannabis themselves or were clearly aware of its role in athletes’ lives and open to learning more, suggesting that as organizational attitudes shift, these younger or more progressive staff could become key partners in future cannabis education and support (EA1, EA8, EA9).