Anti-Doping: Therapeautic Use Exemptions

I can't find a reference to this on this forum so I thought I'd start a new thread on it.

Does anyone on this forum have any knowledge of this matter, in particular the granting of Therapeutic Use Exemptions (TUE) for the use of certain prohibited drugs which are prescribed to treat a particular illness?

The drug in question is Sotalol (Sotacor) which is banned for archers both in and out of competition unless a TUE has been issued. Sotalol is a beta blocker and is prescribed in the following cases:

Beta-blockers are used to treat high blood pressure (hypertension), congestive heart failure (CHF), abnormal heart rhythms (arrhythmias), and chest pain (angina). Beta-blockers are sometimes used in heart attack patients to prevent future heart attacks.

As may be obvious, people for whom this medication is prescribed are not terribly well and their cardiologists would not normally countenance their patients not taking this particular drug.

Does anyone know of an archer who has heart problems who takes this drug and has been issued a TUE for its use. If so, would you also happen to know if the person who has been granted the TUE, has been limited by the issuing authority, in regard to what level of competition they may participate in?

If you do know of people who are under certain restrictions in their TUE, does anyone know if there are circumstance whereby an archer who has to take this medication can be granted exemption to participate in International level competitions and if so, what those circumstances are?

Has anyone with a heart condition for which this medication has been prescribed, ever been issued a limited TUE which they have then appealed to the World Anti-Doping Agency (WADA) to have the limitation lifted and if so with what result?

Any information on this matter would be greatly appreciated.

[Furface]

The person to ask about this, and anything TUE or drug related, is Gary Carr at the GNAS Office - pucoordinator@gnas.org

[Jumile]

Definitely ask GNAS about it. They must have access to medical people with the answers to these things.

However, the Sports Drug Information Database (formerly "UK Sport DID") says that there are sport-specific exceptions for SOTALOL HYDROCHLORIDE, and goes on to say that TUE's "may be granted for medically justified reasons". I'd say a doctor's written diagnosis of a health condition coupled with you competing is a medically justified reason.

[Andyakashrek]

I take several drugs including Tramadol, a safer version of morphine, Beta blockers and anti migraine drugs and I asked about competing whilst taking these drugs and was told, can't remember who by....one of the side effects of Tramadol, "dont worry about TUE's as you dont shoot big tournaments". It may have been the GNAS office but I can't be sure.
Thing is I can't shoot without my drugs because I shake and the medicine stops the shakes. Even so I overdose myself so I can shoot and then spend several days getting back to normal. But it's worth it.
There must be lots of archers on the line taking certain medications but do not have TUE's. Has anyone been tested?

[Andyakashrek]

Just searched the drug database link above and found Tramadol, and the anti migraine treatments that I take are not prohibited but inderal, a beta blocker is.
That means I can get relaxed, happy and shake free, and be OK but I have to let my blood pressure go sky high. At least the Tramadol will stop me worrying about it .

[Barndoor]

Originally Posted by Andyakashrek

"dont worry about TUE's as you dont shoot big tournaments". It may have been the GNAS office but I can't be sure.

I know someone who had a very similar, quick and very friendly (good luck in your first Rose etc) reply from the GNAS office.

[Furface]

Yes, it is very (very very) unlikely that anyone will be tested outside top competition, and then only top level archers. However, it is still theoretically possible, as it is really only resourcing stopping it. My view (I take, amongst other things, a diuretic which is banned) is that i wanted to find out the status of the various medications in my cocktail just in case, but not to apply for a TUE.

Thanks for the information so far. Much appreciated.

However, I have a particular problem. I take Sotacor as a precribed drug for my heart condition plus a large number of other drugs, which, thankfully, are not on the Prohibited list.

I have already submitted a TUE to our granting organisation, The Australian Sports Drug Medical Advisory Committee (ASDMAC) and have been granted a TUE by them which limits me to Club shoots only.

When I asked why I could not be cleared for higher level competition I was fobbed off with the comment that "to get approval for higher level competition would require a lot of time, information and expense" !!

I'm now in the process of doing up a written statement seeking clarification of this issue from the Australian Sports Anti-Doping Authority (ASADA) as well as WADA and FITA. I get the feeling I am being politely screwed for some reason.

Archery Australia's position is that I require a TUE simply to shoot at normal club competitions, which surprised the hell out of me.

Firstly, I find it hard to believe that I need a TUE for Club Competition and secondly I find it hard to believe the implication that getting a TUE for higher level competition for a clinically prescribed drug to treat a serious medical condition is not possible. Hence my query to you knowledgeable folks.

I'm pretty bloody angry at this whole business and am sorely tempted to package up all of my archery gear and send it to ASDMAC with a request for reimbursement of the large sums of money I have invested in this sport for apparently no good reason.

[LineCutter]

I was curious - I recalled a quote about some huge percentage of shooters in one of the Olympics having beta blockers for "medical reasons". Can't find that one, but did turn up this:

For example, there is evidence that at the 1984 Olympics, at least some team doctors were involved in blatantly exploiting a loophole in the doping regulations.
Although beta-blockers were not at that time banned by the IOC, team doctors had to fill in declarations for all athletes using beta-blockers and state the doses used. If competitors produced a doctor's certificate stating that they needed the drugs for health reasons, they would not be disqualified if drug checks proved positive.

However, when urine specimens were screened there were several positives in the modern pentathlon contest. To the amazement of officials, team managers came forward with doctors' certificates covering whole teams.

I can empathise with your frustration.



I guess that they are saying that that benefit of defending your (potential) winning of a major tournament would be instantly reversed many fold by the discovery that you were using performance enhancing drugs (notwithstanding the medical need for them).



Maybe we need to consider 2 levels of competition, drug free & anything goes.

Maybe the IOC, FITA and WADA need to understand that people who take this because it is prescribed for their condition aren't all that well and that not taking the stuff is usually life threatening.

In any event, my point is that if ASDMAC issued the TUE to me for club competition only, what are the criteria for issuing a TUE for higher level comps? I cannot believe that there are not other people like me in this sport who haven't been given a clearance to compete at a higher level than Club shoots.

As for me, I'm a 67 year old TPI war veteran with terminal heart disease and on my good days feel sick as a dog from the side effects of all of the medicines I take. I suppose I should feel flattered that Archery Australia is terrified of letting me loose in open competition agianst all of the fully fit 20 year olds in case I wipe the flooor with the lot of them. What a bloody farce!

Thanks for your thoughts, anyway