Therapeutic Use Exemption: Rule 11 in prevention of doping

Doctor's Corner with DR JOSEPH KABUNGO
THE 11th rule in the prevention of doping is that of a Therapeutic Use Exemption (TUE).

There are some drugs, which are sold over the counter in many drug stores and pharmacies across the country that are not permitted for routine use in sport.
They are found on the list of prohibited drugs by the World Anti-Doping Agency (WADA).
Medicines are used for different problems ranging from infectious diseases to the non-infectious diseases like asthma, diabetes, osteoarthritis and many other conditions.
Sport has found itself at the centre regarding use of medicines for the treatment of various injuries.
However the use of medicines in young and fit adults, who participate in controlled sport, has to be given special consideration.
Controlled sport in this sense implies that, the sport is being played under the strict rules without doping either during competition or not.
To discuss this issue, I will use football in illustrating when it is allowed for some of the prohibited drugs to be used in sport. This is an important consideration in the effective prevention of doping.
In football, there is normally a lot of apprehension when players know or just hear that a particular match will involve doping control.
It is not only the players who get concerned but also the medical team, especially if they have prescribed something, which they are not sure of.
It is normal to see anxious players confiding in their doctor about the medicines they might be taking which was not prescribed by a doctor.
This makes it important for all involved in sport to be conversant with the list of prohibited substances as given by the WADA.
Medical doctors who are conversant with the WADA list of the prohibited substances in sport need to be constantly explaining dangers associated with taking medicines by sports men and women without legitimate medical conditions.
The worst nightmare for any player is to fail a dope test and get banned.
Failing a dope test can be as a result of taking drugs with the view of enhancing performance and at times.
It is the lack of knowledge regarding the use of medicines without medical justification.
The other issue concerning food supplements which are becoming popular among sportsmen and women has to be addressed especially with the risk of being contaminated with the prohibited substances.
Some prohibited drugs can be used for treating legitimate medical conditions in sportsmen and women.
However this is not a mere verbal assurance by a player or doctor that they are using the drugs for a certain condition without following the required procedure.
For a player to be allowed to use a prohibited drug, it must be proved beyond any reasonable doubt that there is no other substitute for the drug in question and withholding such medication will put a player’s health at risk.
It must also conform to a standard that the drug is only for therapeutic purposes and will not result in performance enhancement in a player.
Any player who suffers from chronic medical conditions such as asthma can apply for a TUE if they will be participating in a controlled match or competition.
However a player cannot apply for a TUE, a day before a game.
A standard TUE has to be applied for 21 days before competition.
This is to enable the regulatory body or TUE committee to go through the case thoroughly and make sure that such a drug is purely for the said medical condition.
At times an emergency TUE can be applied for if the condition being treated in a player was not anticipated and the application is made below the standard 21 days.
A TUE is a passport to allow players who are taking drugs found on the prohibited list for purely legitimate medical conditions.
This will enable players to participate in a competitive match and also adequately treat their respective medical condition.
It is important for all the doctors in sport to be familiar with the process of obtaining a TUE in good time.
Doctors have to familiarise themselves with the updated list of Prohibited drugs from WADA so that they do not put players at risk of failing a dope test.
It must be appreciated that a TUE is specifically reserved for players who suffer from acute or chronic disease or physical symptoms and signs following injury and need a specific disease or injury specific medication.
A TUE is only with respect to the drugs which are found on the WADA prohibited list of drugs.
Players are encouraged to seek medical attention for any problem to avoid the risk of failing a dope test.
Doping is cheating and this has no place in modern football.
For questions and comments write to Dr Kabungo Joseph
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