What are the TUEs? – A controversal topic

Welcome everyone again, in this new post, we are going to talk in depth about the Therapeutic Use Exemptions (TUEs).

In previous posts we talked about a recent new, the assumption doping of Bradley Wiggins in 2012 and others irregularities in the Team Sky. This topic is controversal due to the supposed doping was produced for an excessive use of a substance considered as a TUE.

Image 1. Salbutamol (Ventolín) one of the TUE drugs more used nowadays. 

The TUEs are prohibited substances for WADA that can be used in exceptional chases for some athletes claiming theraupetic reasons previously. With the purpose of regulate this issue the WADA developed The International Standard for Use of Therapeutic Exemptions. In this mandatory International Standard is established the main conditions for achieve a TUE:

If an athlete have all these conditions and finally request a TUE, this application have to be assseded for the Therapeutic Use Exemption Committee (TUEC). As a last resort, is the WADA TUEC the panel in charge for review the TUE decisions of other Anti-Doping Organizations. You can download the template of TUE application form clikcing here.

According to the established in The International Standard for Use of Therapeutic Exemptions:

An Athlete who needs a TUE should apply as soon as possible. For substances prohibited In-Competition only, the Athlete should apply for a TUE at least 30 days before his/her next Competition, unless it is an emergency or exceptional situation. The Athlete should apply to his/her National Anti-Doping Organization, International Federation and/or a Major Event Organization (as applicable), using the TUE application form provided.

The form must be accompanied by:

a. a statement by an appropriately qualified physician, attesting to the need for the Athlete to Use the Prohibited Substance or Prohibited Method in question for Therapeutic reasons; and

b. a comprehensive medical history, including documentation from the original diagnosing physician(s) (where possible) and the results of all examinations, laboratory investigations and imaging studies relevant to the application.

Each TUE will have a specified duration, as decided by the TUEC, at the end of which the TUE will expire automatically. If the Athlete needs to continue to Use the Prohibited Substance or Prohibited Method after the expiry date, he/she must submit an application for a new TUE well in advance of that expiry date, so that there is sufficient time for a decision to be made on the application before the expiry date.

In the next drawing, we can see the process necessary for an non-international-level athlete for achieve a TUE.

Image 2. Process to get a TUE for an Non-International-Level Athlete.

In the chase, of international-level athlete or major events the process is longer and complicated, if

you are interested in know more about it you can read the whole information here.

Team Sky and Bradley Wiggins under suspicion - It is doping or not?

Some weeks ago, the Digital, Culture, Media and Sport (DCMS) select committee make public a report declaring that Team Sky and Bradley Wiggins would have used drugs allowed under anti-doping rules to enhance performance instead of just for medical need.

Concretaly, the report accuse Team Sky of had used the anty-inflammatory drug triamcionolone to prepare Bradley Wiggins for the 2012 Tour de France, that as all know, the britanian cyclist finally won.

Triamcionolone is a substance banned during competition under WADA rules, unless the athlete has a therapeutic use exemption (TUE),  but is permitted out of competition. 

According to the report, Bradley Wiggins would have taken this drug, the final day at 2011 Criterium du Dauphine. If this were true, Wiggins could be banned with two without compete and the loss of results achieved.

Apart from this drug, the report inform about the unclear use of other substances such a testosterone, salbutamol or fluimucil. Many of them drugs are consider as TUEs but Team Sky could have used it for enhance the performance of some his athletes, claiming a "medical use". On his behalf, Team Sky have strongly denied have used TUEs for anything other purpose that medical need.

At the moment, this issue is only a report without a reliable evidence, so that can not lead to any type of sanction, although is expected that UCI (Union Cycliste Internationale) open a investigation trying to clarify this matter in the following days.