A therapeutic use exemption (TUE), also known as a temporary use exemption, is a term created in 1991 and refers to an official medical document. The document gives an athlete permission to take a medication listed on the
World Anti-Doping Agency’s (WADA) Prohibited List, normally prohibited because its use would be considered a
performance enhancing drug
Performance-enhancing substances, also known as performance-enhancing drugs (PEDs), are substances that are used to improve any form of activity performance in humans. A well-known example of cheating in sports involves doping in sport, where bann ...
. In 2017, the ''Australian and New Zealand Sports Law Journal'' referred to the abuse of TUEs as “The Legal Dope”.
An example of a TUE is the
World Anti-Doping Agency
The World Anti-Doping Agency (WADA; french: Agence mondiale antidopage, AMA) is a foundation initiated by the International Olympic Committee based in Canada to promote, coordinate, and monitor the fight against drugs in sports. The agency's key ...
's exemption for
testosterone replacement therapy
Androgen replacement therapy (ART), often referred to as testosterone replacement therapy (TRT) or hormone replacement therapy (HRT), is a form of hormone therapy in which androgens, often testosterone, are supplemented or replaced exogenously ...
. The average for a normal functioning male is a 1:1 ratio, but WADA allows up to a 4:1 ratio without testing positive for elevated testosterone.
Mixed martial arts
Mixed martial arts (MMA), sometimes referred to as cage fighting, no holds barred (NHB), and ultimate fighting, and originally referred to as Vale Tudo is a full-contact combat sport based on striking, grappling and ground fighting, inc ...
do not have as stringent anti-doping regulations as most other sports. The
''Journal of Legal Medicine'' quotes Dr. Johnny Benjamin, a medical journalist, as stating that in regards to TUEs in mixed martial arts, “TRT is far too easily abused”.
In 2016, Russian cyberespionage group
Fancy Bear disclosed information about TUEs granted to more than 100 Olympic athletes from over 20 countries, raising concerns over the misuse of TUEs for cheating, including
Bradley Wiggins
Sir Bradley Marc Wiggins, CBE (born 28 April 1980) is a British former professional road and track racing cyclist, who competed professionally between 2001 and 2016. He began his cycling career on the track, but later made the transition to r ...
using the
corticosteroid triamcinolone acetonide
Triamcinolone acetonide, sold under the brand name Kenalog among others, is a synthetic corticosteroid medication used topically to treat various skin conditions, to relieve the discomfort of mouth sores, and by injection into joints to trea ...
in 2011, 2012, and 2013.
In a recent study, 51% of professional athletes interviewed believed that athletes within their sport had received an unnecessary TUE, and another study reported 40% of professional athletes interviewed distrusted the TUE system.
Abuse of TUEs happens for more than just steroids.
Adderall
Adderall and Mydayis are trade names for a combination drug called mixed amphetamine salts containing four salts of amphetamine. The mixture is composed of equal parts racemic amphetamine and dextroamphetamine, which produces a (3:1) ratio ...
pills were permitted by
Major League Baseball
Major League Baseball (MLB) is a professional baseball organization and the oldest major professional sports league in the world. MLB is composed of 30 total teams, divided equally between the National League (NL) and the American League (AL), ...
and 85% of players used them as performance enhancing drugs until 2006. In that year, the organization banned “greenies” but started granting TUEs for the substance. In eight years, the percentage of MLB players with TUEs for Adderall increased from 3 percent to 14 percent, prompting concerns that the substance is again being abused as a performance enhancing drug.
In addition to steroids,
insulin is a concern for cheating with TUEs. As the Cycling Independent Reform Commission’s 2015 report to the president states, “One team doctor stated that he believed the TUE system had been regularly abused, particularly as previously mentioned, in the area of corticoids. Today there appears to be concern among riders about the way in which TUEs are used for corticoids and insulin in particular, and the extent to which they are being abused”.
[Cycling Independent Reform Commission, Report to the President of the Cycliste Internationale, 2015]
Sports
Sport pertains to any form of competitive physical activity or game that aims to use, maintain, or improve physical ability and skills while providing enjoyment to participants and, in some cases, entertainment to spectators. Sports can, ...
Drugs in sport
References
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