There are two ways to obtain medicine: the physician writes a prescription or purchases directly from the pharmacy. As a n athlete, you must obtain a physician’s prescription every time to obtain medicine and tell the physician that you are an athlete and must follow the anti-doping regulations. The physician must make sure that the medicine he prescribes does not contain any prohibited substances; if the physician is in doubt, this website can assist in consulting any questions about prohibited substances.
If the medicine you use does not require a physician’s prescription (also called commercial medicine), it is best to present the prohibited list to the pharmacist for reference before purchasing. Some brands provide similar products (non-drowsy, quick relief, extra, and long-lasting), but the formula is different. It may contain prohibited substances, while the other does not.
If it is necessary to use such medicine, please contact the International Federation or National Federation or the Chinese Taipei Anti-Doping Agency to inquire about therapeutic use exemption eligibility and operating procedures.
Before submitting an application, it is better to ask your physician to consider alternative treatments that do not contain prohibited substances or methods. If there are other alternative treatments, the application for therapeutic use exemption may be returned, and the entire procedure will delay your recovery period.
In the event of acute and life-threatening illnesses requiring immediate treatment with medicine containing prohibited substances, you and your physician must apply for a therapeutic use exemption certificate after treatment. However, such cases are sporadic, so in critical situations, a certificate of therapeutic use exemption will still be issued after careful review.
The same brand in commercial medicine has a different name in a foreign country, and the substances contained in them are different by their regulations.
Maybe the medicine bought in a specific country does not contain prohibited substances, but in other countries might have. However, when buying medicine abroad, it is better to ask the team doctor first and contact the local national anti-doping organization or us. If there is no other option, you may bring the prohibited list to the pharmacy to ask the pharmacist about the medicine contain the prohibited substance or not.
In addition, carry some medicines (painkiller, antipyretics, allergy medication, cold medicine, stomach medicines, dermatological) that you are familiar with and may be used in your luggage to avoid the above situation. Before bringing those into other countries or returning to the country, it is best to check whether the entry clearance regulations allow you to bring these medicines and ensure that you do not bring prohibited substances into the destination country.
It is similar to the use of nutritional supplements. Some countries will use natural medical products, but the quality control of herbal medicines and other alternative medical products is sometimes not as strict as medicine controlled; therefore, inaccurate labeling, poor production, and pollution may all be affected, and prohibited substances will occur the body unknowingly. The concentration of active substances contained in natural medical products is usually deficient. However, the product label does not specify the chemical substances contained, only the original substance listed (the extracted from plant or animal), so it is difficult to determine whether the products contain prohibited substances or now.
In addition, athletes must be very cautious when using medicine produced by ancestral or social and cultural traditions. Remember, according to the principle of strict liability, athletes are responsible for themselves regardless of how or why prohibited substances enter the athlete’s body.
According to the strict liability implemented by the current anti-doping regulation, as an athlete, you must be responsible for any substance that enters your body, whether it is recommended by others, prescribed by a physician, or provided by others that are fully responsible. If an athlete’s testing results are positive, he/she will be disqualified and may be penalized or suspended.
Many countries’ governments do not have clear laws and regulations to restrict the production of nutritional supplements; it also means the ingredients contained in the product may be different labeling from the outer packaging or outer box. It may contain the prohibited substances in anti-doping regulation which did not specify. According to study reports, up to 20% of products sold on the market for athletes contain substances that may cause testing positive. Moreover, many positive cases are related to nutritional supplements.
According to strict liability regulations, athletes are responsible for any substances detected in their bodies. No matter how the substances enter the body, their sanctions may be disqualification or suspension.
If athletes think they need to take in nutrients, they should first consult a sports nutritionist, sports physician, or other qualified sports science professional, to ensure that their daily diet can supplement the nutrients they need. If experts think you need to use nutritional products, these people should be appropriate for maintaining your nutritional needs and health issues, making full use of their professional knowledge, and accepting strict liability principles.
In 2003, the International Olympics Nutrition Working Group also stated its stance on the use of nutritional supplements by athletes: “Athletes should be more cautious when using nutritional supplements. Nutritional products containing nutrients can supplement the lack of dietary intake or partial eating habits. However, the effect of taking sufficient nutrition is short-term. The use of nutrition cannot supplement the partial eclipse and the lack of diet. Athletes who want to use nutrition and sports food should consider their utility, cost, and risk of affecting health and performance, and potential risk of the positive testing result.”
The majority of nutraceutical manufacturers claim the effectiveness of their products, but credible scientists have not confirmed these, and manufacturers rarely inform consumers about potential negative benefits. The nutraceutical’s manufacturing industry is a profit-making business. Athletes should receive proper assistance and identify whether this is a marketing strategy or factual information. If an athlete decides to use nutraceuticals, it is best to choose the products of a company that has established a great reputation and uses excellent manufacturing operations, such as a significant international pharmaceutical factory. The athlete can contact the manufacturer for more information or even ask his physicians to help.
- Nutraceuticals advertised as having the effect of “strengthening muscle” or “burning fat” usually contain prohibited substances such as anabolic agents or stimulants.
- The words “herbal” and “natural” do not mean that this product is necessarily “safe.”
- Prohibited substances that may be contained in nutritional supplements include:
- Dehydroepiandrosterone (“DHEA”)
- Androstenedione/diol (and variants, including “19” and “nor”)
- Amphetamines (and “street drugs” such as ecstasy)
- Pure vitamins and minerals are not prohibited, but athletes should choose well-known brands and avoid mixing them with other substances.
- The black market or unlabeled products should pay more attention and not use unknown items, even if coaches or athletes provide them.
- When purchasing nutraceuticals through the internet, athletes should avoid the company that only lists the post office box without a company address or only contact information such as only an email address.
P.S: Even if the athletes follow the recommendations and precautions above, there is no guarantee that nutraceuticals will not be positive in the testing result.
Therapeutic Use Exemption
Athletes can get sick just like ordinary people or need to take medicine due to their physical condition. If the substances are prohibited, then the therapeutic use exemption certificate allows athletes have the right to use the required medicine.
The standards include:
- If prohibited substances or methods cannot be used for treatment, athletes’ health will be seriously affected.
- The therapeutic substance does not improve competition results, and there are no other reasonable treatment alternatives to replace it.
If you are an international athlete or an athlete who has signed up to participate in an international competition, you should apply to the international federation where you belong. The international federation is responsible for accepting, reviewing, and issuing the therapeutic use exemption certificate. As for the national-level athletes who belong to the Registered Testing Pool (RTP) should apply to their National Anti-Doping Organization. Athletes are not allowed to apply for exemption for therapeutic purposes from more than one organization but competent authority according to the standard in the preceding paragraph and the athlete’s status. Athletes cannot submit to the World Anti-Doping Agency.
The procedure for athletes to apply for an exemption for therapeutic purposes is quite simple. Each athlete should:
- Contact your international federation where you belong to obtain the therapeutic use exemption application form or download the domestic therapeutic use exemption application form here.
- Ask your physician to fill in the form, provide the required certification documents, then send it to the International Federation or the National Anti-Doping Control Agency (choose the appropriate organization depending on the athlete’s status). Athletes must keep in mind that according to the standard operating guidelines, applications for therapeutic use exemption should be submitted at least 30 days before participating in the competition.
The therapeutic use exemption certificate is issued for specific medicine and dosages and has a certain validity period. Once the International Federation or the National Anti-Doping Agency issue therapeutic use exemption, it will notify the World Anti-Doping Agency (WADA). WADA may review this decision. Once found inconsistent with the international standards of therapeutic use exemption, it may overturn and reject the therapeutic use exemption certificate.
You or the authority responsible for issuing the certificate may appeal to the Court of Arbitration for Sport (CAS), and the decision is final.
Recommended to show the therapeutic use exemption certificate to the testing inspector and fill out the anti-doping testing record sheet to make sure that you have explained the “used substances or medicine, the therapeutic use exemption that has been issued.”
When receiving the report from the testing laboratory, the prohibition testing authority will check whether the therapeutic use exemption is still valid and whether the analysis results meet the approved therapeutic use exemption content (the nature of the substance, the route of administration, the dosage, and the time of administration.) Conduct a preliminary review. If verified matches, your test result recorded is negative.
Athletes concerned about confidentiality should know that all therapeutic use exemption application information and athletes’ medical records will be treated confidentially. All therapeutic use exemption committees must sign a confidentiality agreement; if other scientific experts need to consult for a specific case, the athlete’s name will not show in the circulated documents.
Check the relevant regulations on the World Anti-Doping Agency website on www.wada-ama.org, or contact the International Federation to which you belong.