Introduction
According to Health Direct, “Using drugs to improve performance in sport may lead to an athlete being banned and may also harm their health. Sporting authorities have banned many drugs and other substances, not just because they might give an athlete an unfair advantage but also because of the wider health risks.”
Drug use in sports is of concern because of:
- Implicit risks to the health of the athlete
- Ethical concerns about cheating by artificially enhancing athletic performance
The International Olympic Committee has prepared an Olympic Movement Anti-Doping Code. This specifies prohibited substances, and prohibited methods of doping
Health professionals must be aware of the need to avoid giving ‘banned’ medications and the need to provide written notification when restricted substances are necessary.
Doping is the application of chemical substances with the deliberate intention or effect of altering performance. Doping is cheating.
The 2010 Prohibited List World Anti-doping Code
Substances prohibited at all times (in- and out-of-competition)
- S1 Anabolic Androgenic Steroids (AAS): e.g. nandrolone; testosterone (exogenous and endogenous AAS); others such as clenbuterol
- S2 Peptide hormones, growth factors and related substances: e.g. erythropoietin (EPO); growth hormone
- S3 Beta-2 agonists: all beta-2 agonists (including both optical isomers where relevant) are prohibited except salbutamol (maximum 1600 micrograms over 24 hours) and salmeterol when taken by inhalation in accordance with the manufacturers’ recommended therapeutic regime.
- S4 Hormone antagonists and modulators
- S5 Diuretics and other masking agents
Substances and Methods Prohibited in-competition
- S6 Stimulants: e.g. amphetamine, adrenaline; ephedrine, psuedoephedrine (with some exceptions/thresholds)
- S7 Narcotics: e.g. buprenorphine, diamorphine methadone, morphine
- S8 Cannabinoids: Natural (e.g. cannabis, hashish, marijuana) or synthetic delta 9 tetrahydrocannabinol (THC) and are prohibited.
- S9 Glucocorticosteroids: all glucocorticosteroids are prohibited when administered by oral, intravenous, intramuscular or rectal routes
Note; some substances included in the 2010 Monitoring Program such as caffeine, phenylephrine, phenylpropanolamine, are not considered as Prohibited Substances.
Methods Prohibited at all times (in- and out-of-competition)
- M1 Enhancement of oxygen transfer: e.g. blood doping; blood or red blood cell products; haemoglobin-based blood substitutes
- M2 Chemical and physical manipulation: e.g. tampering with samples; urine substitution; sequential withdrawal, manipulation and reinfusion of whole blood
- M3 Gene doping
Substances Prohibited in particular sports
- P1. Alcohol: Alcohol (ethanol) is prohibited In-Competition only, in the certain sports, e.g. archery (FITA); motorcycling (FIM)
- P2 Beta-blockers: Beta-blockers are prohibited In-Competition only, in the certain sports, e.g. archery (FITA) (also prohibited out of competition); billiards and Snooker (WCBS); Shooting (ISSF, IPC) (also prohibited Out-of-Competition) wrestling (FILA).
Therapeutic Exemptions
- Athletes, like all others, may have illnesses or conditions that require them to take particular medications
- Difficulty when drugs prescribed for legitimate therapeutic purposes also possess performance enhancing properties.
- If the medication an athlete is required to take to treat an illness or condition happens to fall under the Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the authorization to take the needed medicine
The purpose of the International Standard for Therapeutic Use Exemptions (ISTUE) is to ensure that the process of granting TUEs is harmonized across sports and countries