Therapeutic Use Exemptions (TUE) 06/2010

 

THERAPEUTIC USE EXEMPTIONS

 

What is a Therapeutic Use Exemption (TUE)?

“Athletes, like all others, may have illnesses or conditions that require them to take particular medications. If the medication an athlete is required to take to treat an illness or condition happens to fall under the World Anti-Doping Agency’s Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the authorization to take the needed medicine.”

- World Anti-Doping Agency

 

Athletes are not automatically granted authorization, and must submit a TUE application to the appropriate governing body. Go straight to the TUE forms and requirements.

 

Under what circumstances will a TUE application be approved?

A TUE application will only be considered by the CCES under the following circumstances:

•           the athlete would experience a significant impairment to health if the prohibited substance or method were to be withheld in the course of treating an acute or chronic medical condition;

•           the use of the prohibited substance or method would produce no additional enhancement of performance other than that which might be anticipated by a return to a state of normal health following the treatment of a legitimate medical condition; and

•           there are no reasonable therapeutic alternatives or other alternatives are ineffective.

 

Examples include:

•           Insulin for the treatment of Type 1 Diabetes Mellitus;

Beta-2 Agonist inhaler, such as terbutaline, for the treatment of asthma; (not Salmeterol and salbutamol); and

•           Methylphenidate for the treatment of ADD or ADHD.

 

How long is a TUE valid?

TUEs granted by the CCES are valid for the duration of the treatment as prescribed by the physician, up to a maximum of two years, or four years for inhaled asthma medications. It is the athlete’s responsibility to know when the TUE expires and to apply for renewal before this date if necessary.

 

Who should apply for a TUE?

All athletes who are subject to doping control must be aware of the TUE rules and requirements that apply to them. These rules and requirements will vary depending on the athlete’s level of competition and will determine when and to which organization an athlete must submit a TUE application.

 

APPLY FOR TUE THROUGH FITA – ADAMS SYSTEM

1)         Athletes in their International Federation’s (IFs) Registered Testing Pool (RTP) must ensure they comply with their IF’s TUE and Declaration of Use requirements.  You will have been notified by FITA if you are in the RTP.

 

IF-RTP athletes are required to submit a TUE application to FITA at the time the medication is prescribed by the physician (for medications prohibited in- and out-of-competition) or no less than 21 days prior to participating in an IF-sanctioned event (for medications prohibited in-competition only).

The International Events for which a TUE must be submitted to FITA (or the mutual recognition policy may apply – see the conditions on the link “Mutual recognition policy” below) are defined as being the events recorded in the FITA events calendar available on the FITA website in the section “Calendar”, with Grades 1, 2, 3 and World Ranking boxes ticked.  Canada has no events meeting these criteria in 2010.

 

The WADA online ADAMS system is mandatory for all types of Declarations or Applications for TUE’S as of 1 January 2010.

 

2)         Athletes who meet their IF’s criteria for an international athlete and/or compete in any major games event (e.g., Commonwealth Games, Pan Am Games, FISU Universiade) but are not included in the IF-RTP, must comply with the IF’s TUE and Declaration of Use requirements.  This would apply to archers who make the Canadian team competing at the Commonwealth Games or Pan-American Games.

 

The websites of most IFs include a definition of an international athlete in their anti-doping rules and publish a list of events that require an IF TUE approval.

 

See above for the process.  The WADA online ADAMS system is mandatory for all types of Declarations or Applications for TUE’S as of 1st January 2010.

APPLY THROUGH CANADIAN CENTRE FOR ETHICS IN SPORT

 

3)         These TUE rules and requirements apply only to athletes in the CCES Registered Testing Pool, either National (N-RTP) or General (G-RTP).

 

If at any time an athlete is added to the International Federation’s RTP or meets the IF’s criteria for an international athlete, it is the athlete’s responsibility to ensure that he or she first meets any additional TUE or Declaration of Use requirements imposed by the IF.

 

N-RTP and G-RTP athletes must submit TUE applications to the CCES at the time the medication is prescribed by the physician (for medications prohibited in- and out-of-competition) or no less than 21 days prior to participating in an event (for medications prohibited in-competition only).

 

The TUE application requirements for asthma medications (inhaled Beta-2 Agonists) are much more stringent than in the past. Applications must be accompanied by a medical file that objectively supports an athlete’s diagnosis and prescription.  SEE ADVISORY RE: ASTHMA MEDICATION AND COUGH/COLD MEDICATION (Pseudoephedrine).

 

When prohibited substances are administered under emergency conditions, athletes should submit a TUE application to the CCES for retroactive approval.

 

For application forms, requirements, and criteria, go to: TUE Forms and Requirements.

 

When selected for doping control, athletes must declare:

•           All prescribed medications (e.g., asthma medications and glucocorticosteroids); and

•           All non-prescribed medications and supplements taken in the last ten (10) days.

 

 

4)         These TUE rules and requirements apply uniquely to Canadian domestic athletes.

If at any time an athlete is added to the CCES Registered Testing Pool, the International Federation’s Registered Testing Pool, or meets their IF’s criteria for an international-level athlete, it is the athlete’s responsibility to ensure that he or she meets any additional TUE or Declaration of Use requirements imposed by CCES or the IF.

 

Domestic athletes may submit TUE applications to the CCES for retroactive approval, and are not required to submit applications prior to participating in events. Should an athlete be selected for a doping control test, the CCES may request that a TUE application be submitted based on the findings of that doping control test.

 

TUE applications must be accompanied by a medical file that objectively supports an athlete’s diagnosis and prescription. Any athlete who uses a prohibited medication(s) is advised to maintain a medical file that will support a TUE application should it be requested.

 

For application forms, requirements, and criteria, go to: TUE Forms and Requirements on the CCES website.

 

THERAPEUTIC USE EXEMPTIONS

 

What is a Therapeutic Use Exemption (TUE)?

“Athletes, like all others, may have illnesses or conditions that require them to take particular medications. If the medication an athlete is required to take to treat an illness or condition happens to fall under the World Anti-Doping Agency’s Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the authorization to take the needed medicine.”

- World Anti-Doping Agency

 

Athletes are not automatically granted authorization, and must submit a TUE application to the appropriate governing body. Go straight to the TUE forms and requirements.

 

Under what circumstances will a TUE application be approved?

A TUE application will only be considered by the CCES under the following circumstances:

•           the athlete would experience a significant impairment to health if the prohibited substance or method were to be withheld in the course of treating an acute or chronic medical condition;

•           the use of the prohibited substance or method would produce no additional enhancement of performance other than that which might be anticipated by a return to a state of normal health following the treatment of a legitimate medical condition; and

•           there are no reasonable therapeutic alternatives or other alternatives are ineffective.

 

Examples include:

•           Insulin for the treatment of Type 1 Diabetes Mellitus;

Beta-2 Agonist inhaler, such as terbutaline, for the treatment of asthma; (not Salmeterol and salbutamol); and

•           Methylphenidate for the treatment of ADD or ADHD.

 

How long is a TUE valid?

TUEs granted by the CCES are valid for the duration of the treatment as prescribed by the physician, up to a maximum of two years, or four years for inhaled asthma medications. It is the athlete’s responsibility to know when the TUE expires and to apply for renewal before this date if necessary.

 

Who should apply for a TUE?

All athletes who are subject to doping control must be aware of the TUE rules and requirements that apply to them. These rules and requirements will vary depending on the athlete’s level of competition and will determine when and to which organization an athlete must submit a TUE application.

 

APPLY FOR TUE THROUGH FITA – ADAMS SYSTEM

1)         Athletes in their International Federation’s (IFs) Registered Testing Pool (RTP) must ensure they comply with their IF’s TUE and Declaration of Use requirements.  You will have been notified by FITA if you are in the RTP.

 

IF-RTP athletes are required to submit a TUE application to FITA at the time the medication is prescribed by the physician (for medications prohibited in- and out-of-competition) or no less than 21 days prior to participating in an IF-sanctioned event (for medications prohibited in-competition only).

The International Events for which a TUE must be submitted to FITA (or the mutual recognition policy may apply – see the conditions on the link “Mutual recognition policy” below) are defined as being the events recorded in the FITA events calendar available on the FITA website in the section “Calendar”, with Grades 1, 2, 3 and World Ranking boxes ticked.  Canada has no events meeting these criteria in 2010.

 

The WADA online ADAMS system is mandatory for all types of Declarations or Applications for TUE’S as of 1 January 2010.

 

2)         Athletes who meet their IF’s criteria for an international athlete and/or compete in any major games event (e.g., Commonwealth Games, Pan Am Games, FISU Universiade) but are not included in the IF-RTP, must comply with the IF’s TUE and Declaration of Use requirements.  This would apply to archers who make the Canadian team competing at the Commonwealth Games or Pan-American Games.

 

The websites of most IFs include a definition of an international athlete in their anti-doping rules and publish a list of events that require an IF TUE approval.

 

See above for the process.  The WADA online ADAMS system is mandatory for all types of Declarations or Applications for TUE’S as of 1st January 2010.

APPLY THROUGH CANADIAN CENTRE FOR ETHICS IN SPORT

 

3)         These TUE rules and requirements apply only to athletes in the CCES Registered Testing Pool, either National (N-RTP) or General (G-RTP).

 

If at any time an athlete is added to the International Federation’s RTP or meets the IF’s criteria for an international athlete, it is the athlete’s responsibility to ensure that he or she first meets any additional TUE or Declaration of Use requirements imposed by the IF.

 

N-RTP and G-RTP athletes must submit TUE applications to the CCES at the time the medication is prescribed by the physician (for medications prohibited in- and out-of-competition) or no less than 21 days prior to participating in an event (for medications prohibited in-competition only).

 

The TUE application requirements for asthma medications (inhaled Beta-2 Agonists) are much more stringent than in the past. Applications must be accompanied by a medical file that objectively supports an athlete’s diagnosis and prescription.  SEE ADVISORY RE: ASTHMA MEDICATION AND COUGH/COLD MEDICATION (Pseudoephedrine).

 

When prohibited substances are administered under emergency conditions, athletes should submit a TUE application to the CCES for retroactive approval.

 

For application forms, requirements, and criteria, go to: TUE Forms and Requirements.

 

When selected for doping control, athletes must declare:

•           All prescribed medications (e.g., asthma medications and glucocorticosteroids); and

•           All non-prescribed medications and supplements taken in the last ten (10) days.

 

 

4)         These TUE rules and requirements apply uniquely to Canadian domestic athletes.

If at any time an athlete is added to the CCES Registered Testing Pool, the International Federation’s Registered Testing Pool, or meets their IF’s criteria for an international-level athlete, it is the athlete’s responsibility to ensure that he or she meets any additional TUE or Declaration of Use requirements imposed by CCES or the IF.

 

Domestic athletes may submit TUE applications to the CCES for retroactive approval, and are not required to submit applications prior to participating in events. Should an athlete be selected for a doping control test, the CCES may request that a TUE application be submitted based on the findings of that doping control test.

 

TUE applications must be accompanied by a medical file that objectively supports an athlete’s diagnosis and prescription. Any athlete who uses a prohibited medication(s) is advised to maintain a medical file that will support a TUE application should it be requested.

 

For application forms, requirements, and criteria, go to: TUE Forms and Requirements on the CCES website.

 

 

 Therapeutic Use Exemption Flow Diagram