Therapeutic Use Exemptions for Performance Enhancing Drugs

I’ve previously discussed known loopholes for testosterone use in drug testing programs. And of course, the fact that growth hormone use is undetectable via drug testing urinalysis makes it an easy and attractive drug for the athlete seeking performance enhancement.

Just as problematic is the loophole of “therapeutic use exemptions” (TUE) for performance-enhancing drugs on the banned substance list. In many cases, an athlete can use performance enhancing drugs (even steroids) with impugnity if they are granted a TUE for a medically documented condition.

The therapeutic use loophole is not widely publicized by WADA and other drug testing organizations because it does not contribute to the appearance of an effective drug testing program and a “clean sport.”

In the 2006 Tour de France, it was reported that 60 percent of the 105 riders subject to testing had therapuetic use exemptions. This meant that even if they tested positive for a banned substance, they were not penalized. Pat McQuaid, of the International Cycling Union (UCI) was quoted as saying:

We follow the WADA rules and the WADA rules allow guys to have (the certificates) for certain things… It’s not particular to cycling.

TUEs for anabolic steroids, beta-2 adrenergic agonists (e.g. clenbuterol, salbutamol), and corticosteroids were granted by the UCI.

Now just imagine how problematic the TUE loophole could be in Major League Baseball whose drug testing procedures are much more lenient that those of WADA (World Anti-Doping Association).

According to the Mitchell Report, Rob Manfred from the Commissioner’s Office maintained that no therapeutic use exemptions were issued to MLB players for growth hormone (GH). (If use of GH is not detectable, it is clearly not necessary for a doped athlete to obtain a TUE.)

But when Senator Mitchell’s office asked for the total number of therapeutic use exemptions granted to players, the Commissioner’s Office and Player’s Association refused to answer:

I asked for the number of therapeutic use exemptions granted each year for performance enhancing substances (without identifying the players involved) because therapeutic use exemptions have been a significant loophole in some drug testing programs. The Commissioner’s Office and the Players Association declined to provide that information on the ground that it is considered confidential under the joint program.

Is it possible that several MLB players could have TUEs for anabolic steroids, especially those athletes over 40 who could “legitimately” qualify for testosterone replacement therapy? Or using “greenies” with TUE due to adult-onset attention deficit disorder?

About the author

Millard

MESO-Rx | Website

Millard writes about anabolic steroids and performance enhancing drugs and their use and impact in sport and society. He discusses the medical and non-medical uses of anabolic-androgenic steroids while advocating a harm reduction approach to steroid education.