Risks of Taking Medications
By Sean Burke
Last week I wrote about the potential risks of accidentally ingesting banned substances when using what appears to be a completely legal supplement. You may think that you’ll never have to deal with USADA, but the reality is that the potential for amateur athletes to be testing is growing every day. They are already testing Gran Fondo Riders in NY. Colorado and Florida already have plans to test racers in 2013, and there is talk of instituting amateur testing in Southern California. So this week I’d like to go talk hat to do when you are legitimately taking a medication that is on the ban list.
Basically the idea is that the substances on the list either confer an unfair advantage, or that they could potentially harm the athlete But what about over the counter medications, drugs you are taking for a legitimate medical reasons and even medications that are prescribed to you by your physician? They can still get you into trouble.
In 1999 skeleton slider Zach Lund began taking the anti baldness medication finasteride, and it was perfectly within the rules. Lund was tested many times over the years, and each time he was tested, he disclosed his use of the medication. Then in 2005, unbeknownst to Lund, finasteride was put on the banned list. It was added not because it gives a competitive advantage, but because WADA claims finasteride can be used to mask other more sinister drugs. Even though Lund had been using the medication for years, even though he disclosed his use, and even though he got no competitive advantage; he was kicked off the national team and missed the 2006 Winter Olympics. As of this writing, finasteride is longer on the banned list. So while Lund eventually went with a clean shaven pate, he could now choose to take finasteride without consequence.
The reality is that something as simple as an over the counter cold medicine could be on the banned list, and some medications are banned during competition but not out of competition. You can see why understanding exactly what is allowed and what isn’t can be difficult. Take Nyquil for example: Nyquil Cold and Flu, and Nyquil Cough are just fine, and won’t get you into any trouble. But Nyquil D, Nyquil Cold , and Nyquil Hot Therapy Powder all contain small amounts of peudoephedrine, an “ in competition” banned substance. So you can take any of these without penalty if you aren’t racing for several days. So Nyquil Cold and Flu is fine any time, but Nyquil Cold can get you into big trouble on race day. You can see how easy it can be to get ourself in trouble. The best way to make sure you don’t test positive is to avoid taking any OTC medications, but that may not be realistic. The best way to check to see if your medication contains a banned substance is to check the Gobal Drug Reference Online(DRO). The DRO allows you to search medications by country and by sport, and puts drugs into essentially three different classifications. These classifications may be different for in competition vs out of competition ( as in the Nyquil example above). These classifications are:
- Not Prohibited
- Conditionally Prohibited (for example: certain levels are not allowed)
Before you take any OTC medication, you should check the DRO and know the USADA status of any medication you are taking. You may still be able to take a medication containing a banned substance without fear of penalties, but you’ll need to get a Therapeutic Use Exemption(TUE). A therapeutic Use exemption
What about medications that are prescribed by your doctor for a legitimate medical condition? You should check the DRO for those medications as well. If you are subjected to a drug test and a banned substance is found in your system, a doctor’s prescription is not enough to get you off the hook. You may still be able to take a medication containing a banned substance without fear of penalties, but you’ll need to get a Therapeutic Use Exemption(TUE). A therapeutic Use Exemption is essentially pre approval to use an otherwise banned substance because of a legitimate medical use. Examples are situations such as: insulin for Type 1 diabetics, some asthma medications, and some use of corticosteroids. A physician’s prescription alone is not enough. An athlete must have a TUE, and a Dr’s prescription is no guarantee that TUE will be approved. It may not be difficult to get an anti-aging Dr to prescribe banned medications such as testosterone. Those Androgel commercials that seem ubiquitous on television are constantly pushing the stuff, and its easy to see how a masters athlete may be tempted visit his doctor and ask to try it out. USADA will, in some circumstances, give a TUE for testosterone. But the level of documentation and the conditions present for a testosterone TUE to be approved are for more stringent that what many physicians require to give out a prescription. A slightly below average testosterone level or a testosterone level that falls with age is not going to be enough to get a TUE for the stuff. Back in 2003, journalist and avid cyclist Stuart Stevens got a Dr to prescribe him testosterone, growth hormone, and even EPO. While Stevens didn’t apply for a TUE for any of these, I’m certain that not a single one would have been approved.
Bottom line is that drug testing is now a concern for amateur athletes as well as professionals. When you sign up for a racing license you agree to be subject to testing, and amateur testing is becoming more common every day. Even the cleanest athlete out there is going to have some minor anxiety when going through the testing process. The banned list is large and sometimes confusing, and the possibility of innocently ingesting a banned substance is real. Being conservative with supplement choices, and being educated about common medications goes long way towards staying safe. But the best practice is probably to minimize your intake of supplements as well as medications whenever possible.
Sean Burke is the head coach for Crank Cycling in San Diego CA. Is there a training or coaching related question that you would like to see addressed in Cycling Illustrated? Contact Sean via his website, or Post your suggestions on the Cycling Illustrated Facebook page and tag Sean M Burke.