- What can I do to avoid a positive test from taking a medication?
- What if the only medication to treat my medical condition contains a prohibited substance?
- What if an emergency arises for which I do not have the time or ability to verify that the medication required is free of banned substances?
- If I get sick and my next competition is scheduled in two weeks from now, how long can it take for medications to be eliminated from my body?
- What should I do if I get sick while traveling in a foreign country?
- Should I worry about creams, eye drops and other medications which I do not need to swallow?
- What about homeopathic products and alternative medicine?
- What can happen to me if my test result is positive because I used medication without knowing that it contained a prohibited substance?
- Is there a list of medications that do not contain prohibited substances?
- What else is being done to help athletes avoid an inadvertent positive result from using the wrong medication?
There are two ways for you to obtain medication: either by prescription from your doctor or directly from the shelves of a drugstore or pharmacy.
Anytime you need a prescription, you must remind your doctor that you are an athlete and are subject to anti-doping regulations. Your doctor should ensure that the medication prescribed does not contain any banned substances. If your doctor is unable to determine this, then the decision should be taken in consultation with your National Anti-Doping Organization (NADO) or with a competent pharmacist.
If you need to take a medication that does not require a prescription (commonly referred to as "over-the-counter"), it is highly recommended that you consult your national NADO or that you show the Prohibited List to the pharmacist and ask for help before you decide on a product.
Another consideration when choosing the right medication, make sure that you take exactly the one that was recommended. Some brand names offer multiple variations of the same product (e.g., non-drowsy, fast-relief, extra-strength, longer-lasting) and with the formula being different for each, there is a real risk that one will contain a prohibited substance while another may not.
The current Prohibited List is always posted on this Web site. Generally, an updated version of the List is published every year in October and comes into effect January 1st of the following year.
The World Anti-Doping Code (Code) recognizes the right of athletes to the best possible treatment for any medical condition. If you are in need of medication, please contact your International Federation or NADO to find out more about the criteria and procedures to apply for a Therapeutic Use Exemption (TUE). More information on the TUE process can be found in the Science and Medicine section.
Before applying for a TUE, it is recommended that you consult your doctor to consider possible alternative treatments that do not involve the use of a prohibited substance or method. If such an alternative treatment exists, your TUE request will likely be denied and the whole process can only delay your recovery.
3. What if an emergency arises for which I do not have the time or ability to verify that the medication required is free of banned substances? Up
In exceptional circumstances, when an acute life-threatening medical condition requires immediate intervention involving the use of a medication containing a prohibited substance, you and your physician must apply for a TUE immediately after the treatment has been delivered.
However, it is expected that such cases will occur very rarely and TUEs will therefore be granted in emergency situations under close scrutiny.
4. If I get sick and my next competition is scheduled in two weeks from now, how long can it take for medications to be eliminated from my body? Up
The amount of time someone's body takes to get rid of all traces of a substance depends on the nature of the substance and quantity taken, the individual's metabolism, the administration method, and on a number of other factors such as quantity of liquids consumed, interaction with other ingredients in the same medication, or other substances ingested. In essence, there is no general rule and the delay can vary from a few hours to several months.
More importantly, since you are also subject to out-of-competition testing, the fact that you will not compete in the next two weeks does not preclude the possibility of being tested before then.
Medications are usually commercialized under different names in different countries, and even if they have the same brand names, they may have a different composition in order to respect each country's laws on availability of certain substances. In one country, one product may be safe to take from an anti-doping perspective, while in another country the product sold under the same name may contain a prohibited substance.
Before using medications purchased in a foreign country, it is best to consult your team doctor, try to contact the NADO in the country that you are visiting, or contact your own NADO to ask for advice on what to do. As a last resort, you can bring the Prohibited List to a pharmacy and consult the list of ingredients with the pharmacist to ensure that the product you intend to take does not contain prohibited substances.
One way to prevent such situation from occurring is to bring with you, as part of your "travel kit," small doses of medications from home that you know are safe to use and that you anticipate may be required during your stay abroad (e.g., pain and fever, allergy, common cold, stomach aches, skin infections, etc.). Before bringing any medication into a foreign country or bringing one back home from abroad, it is wise to check whether customs regulations would allow you to do so and ensure that you do not carry a substance that is illegal at your destination.
You certainly should. Prohibited substances come in different forms and shapes and they may enter your body in different ways: by contact with your skin (creams and ointments), by inhalation (if you breathe in the vapor or mist), by contact with a mucus membrane (eye or ear drops, suppository, etc.).
Any medication applied to your body will likely enter your system to act in the way that is intended (reduce inflammation, relieve pain, kill bacteria, etc), and will be present in your blood before eventually being eliminated by the kidneys and turn up in your urine.
As is the case for nutritional supplements, in some countries homeopathic products, herbal remedies and other alternative medicinal products are not subjected to the same quality control requirements as pharmaceutical products. Therefore improper labeling, poor manufacturing practices and contamination can cause prohibited substances to be present without the consumer knowing.
Homeopathic products are usually very low in concentration of active substances, however since the label usually does not specify ingredients by chemical substances but rather by origin (name of plant or animal it is extracted from), it is difficult for anyone to determine whether a prohibited substance may be present.
In addition, athletes have to be careful about any home remedies that have found their place in the family tradition or cultural lifestyle. Many such concoctions are derived from herbal products and some prohibited substances do originate from plants. Remember, under the strict liability principle, it does not matter how or why a prohibited substance entered an athlete's body. Athletes are responsible for everything that goes into their body.
8. What can happen to me if my test result is positive because I used medication without knowing that it contained a prohibited substance? Up
Under the overarching principle of strict liability in effect under anti-doping regulations, as an athlete, you are ultimately responsible for everything that goes into your body, whether it was recommended, prescribed, or even provided by someone else. If an athlete tests positive, the result is a disqualification, and possible sanction or suspension.
To maintain current information with respect to prohibited substances on all products manufactured by the pharmaceutical industry around the world would require tremendous resources that are not currently at WADA's disposal.
Several tools and publications exist for this purpose. Doctors and pharmacists in some countries have access to an index of pharmaceutical products clearly stating which medications are allowed or not in sports, updated every month or year.
Some NADOs also offer this type of advice, either in the form of a list of permitted medications for common ailments, a substance inquiry hotline or e-mail service, or a consultable database of medications and substances. Contact information for the NADO in your country is available in the Anti-Doping Community and Resources sections of this Web site.If your country does not have NADO listed on WADA's Web site, please consult your national sport federation, National Olympic Committee or a competent health professional in your country to find out what other resources are available.
10. What else is being done to help athletes avoid an inadvertent positive result from using the wrong medication? Up
WADA is looking at possible partnerships with pharmaceutical associations that publish indexes of pharmaceutical products so that physicians prescribing treatment have immediate reference in the index about a medication containing, or not, a substance prohibited under anti-doping regulations.
WADA is also investigating the possibility of a global drug reference database that would contain all pharmaceutical products sold throughout the world and their status with regard to the Prohibited List. Such database would enable athletes to have access to reliable information about the ingredients of any pharmaceutical product, no matter in what part of the world they require to purchase it.