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Pharmacological treatment of asthma-related issues in athletes
Published in John W. Dickinson, James H. Hull, Complete Guide to Respiratory Care in Athletes, 2020
A therapeutic use exemption (TUE) is: A means of getting approval to use a sabultamol inhalerA document that proves an athlete has asthmaNecessary for an athlete wishing to take inhaled steroidAllows an athlete to take as much inhaler as they wishNecessary for an athlete who is prescribed oral corticosteroid in competition.
Current Trends in Performance- and Image-Enhancing Substance Use Among Gym Goers, Exercisers, and Athletes
Published in Ornella Corazza, Andres Roman-Urrestarazu, Handbook of Novel Psychoactive Substances, 2018
Neha P. Ainsworth, Jake Shelley, Andrea Petróczi
A TUE is authorization granted to an athlete to continue using medically necessary substances which fall under the WADA prohibited list (www.wada-ama.org/en/what-we-do/science-medical/therapeutic-use-exemptions).
A case study in ‘gene enhancement’: gene transfer to raise the tolerance to pain – a legitimate mode of enhancement, or illegitimate doping?
Published in Silvia Camporesi, Mike McNamee, Bioethics, Genetics and Sport, 2018
Silvia Camporesi, Mike McNamee
How should we frame the request of an athlete seeking VEGF-gene transfer for the purposes of better coping with pain during a competition? In the first instance, his participation might look like a case of what we could call ‘physician-assisted doping’. As discussed in the previous chapter, the World Anti-Doping Agency (WADA) sets out three criteria to classify a product or process as ‘doping’ (WADA 2015). These pertain to (i) the (potential) performance-enhancing effects; (ii) the potential harm to health; (iii) the (potential) threat to the spirit of sport. Only two criteria need apply for a product or process to be prohibited. The anti-doping code recognises the rights of athletes to secure healthcare, and this right may supersede anti-doping regulations when (as we saw in the previous chapter) specific conditions apply. This does not, however, allow the patient-athlete carte blanche. Prior to utilising banned products or processes athletes on a registered testing pool (who are on notice that they may be randomly tested) must submit a Therapeutic Use Exemption (TUE) certificate signed by a relevant medical authority. Retrospective applications are typically frowned upon, but under particular conditions they may be acceptable.
Attitude and practice of substance misuse and dietary supplements to improve performance in sport
Published in Journal of Substance Use, 2019
There are a variety of medications and supplements which are commonly used in a sports medicine setting (Mazzeo, 2016). These are usually used to manage pain or in an effort to reduce inflammation (Motola et al., 2001; Savulescu, Foddy, & Clayton, 2004; Schenone et al., 2003). Moreover, elite athletes may be subject to drug testing. If an athlete requires one forbidden medication they can apply for a ‘Therapeutic Use Exemption’ (TUE). For these athletes, doctors can be very ‘dangerous’ people as the use of many communal medications can elect to a positive drug test. If the athletes, in competition or several cases used pharmaceuticals to improve performance, this banned use commonly is known as doping. By doping, athletes violate the World Anti-Doping Agency’s (WADA’s) regulation which forbids the use of pharmaceutical substances in competitive sports (Mazzeo, Monda et al., 2018). WADA’s World Anti-Doping Code includes drug lists and methods describing what is not acceptable – and what is – in a number of sports. In accordance with article 4.2.2 of the World Anti-doping Code, all Prohibited substances shall be considered as “Specified substances “Except substances in classes S1, S2, S4.4, S4.5, S6.A, and prohibited methods M1, M2 AND M3 (Table 1).
Treating exercise-associated low testosterone and its related symptoms
Published in The Physician and Sportsmedicine, 2018
David R. Hooper, Adam S. Tenforde, Anthony C. Hackney
The medical standard of care for treatment of hypogonadism in men typically revolves around the use of pharmaceutical agents to address low serum testosterone, either through exogenous testosterone or medications to stimulate the production of testosterone. Competitive athletes suffering from EHMC may not use pharmacological treatment per WADA regulations. Testosterone and gonadotropin stimulator agents fall into the WADA ‘List of Prohibited Substances and Methods’ (categories: S1 Anabolic agents; S2, Peptide hormones, growth factors related substances, and mimetics) which if used constitutes a doping violation by the athlete [69]. WADA does have a Therapeutic Use Exemption (TUE) option by which athletes can take banned drugs for medical reasons, but the scenario by which EMHC occurs as a consequence of exercise training does not fit into the circumstances by which WADA would grant a TUE to an athlete.
Natural Talent, Fair Equality of Opportunity, and Therapeutic Use Exemptions
Published in The American Journal of Bioethics, 2018
According to the “World Anti-Doping Code. International Standard. Therapeutic Use Exemptions” a TUE can be granted in the following circumstances: 4.1 An Athlete may be granted a TUE if (and only if) he/she can show that each of the following conditions is met:a. The Prohibited Substance or Prohibited Method in question is needed to treat an acute or chronic medical condition, such that the Athlete would experience a significant impairment to health if the Prohibited Substance or Prohibited Method were to be withheld.b. The Therapeutic Use of the Prohibited Substance or Prohibited Method is highly unlikely to produce any additional enhancement of performance beyond what might be anticipated by a return to the Athlete's normal state of health following the treatment of the acute or chronic medical condition.c. There is no reasonable Therapeutic alternative to the Use of the Prohibited Substance or Prohibited Method.d. The necessity for the Use of the Prohibited Substance or ProhibitedMethod is not a consequence, wholly or in part, of the prior Use (without a TUE) of a substance or method which was prohibited at the time of such Use.” (World Anti-Doping Agency 2015, 10, emphases in original)