The use of medications could lead to a rider inadvertently doping – that is, accidentally committing an Anti-doping Rule Violation. Medications that are used in everyday life may contain prohibited substances. This includes medications prescribed by a GP and those bought over a counter at a pharmacy or ‘off the shelf’ from a supermarket. Examples include some cold and flu remedies and some asthma inhalers.
Global Drug Reference Online
Before a rider takes any medication they should make sure it does not contain any prohibited substances. UK Anti-Doping, and its equivalents in the USA and Canada, have developed an online tool to support riders to check the status of their medication. This is called Global Drug Reference Online (Global DRO) and can be found here. Global DRO is based on the current WADA Prohibited List, and provides users with information about the status of medications and their ingredients (that is, whether they are prohibited or not). Global DRO is ‘mobile-enabled’ making it even easier for riders to check the contents of medications before purchase and use.
It is a rider’s sole responsibility to be sure that they are not using a medication that is prohibited, so they should always check using Global DRO before use, even if a doctor or any other support personnel has claimed to have checked it. However, it is a good idea for any support personnel regularly prescribing or recommending medication to a rider to be familiar with Global DRO too.
How to use Global DRO
Users are first asked to select their country.
Users must then click “Drug Search”
Users must read and accept the terms and conditions.
Users must then specify their user type, sport and nation of purchase and then enter a product name or an individual ingredient. It is essential that users carefully check the spelling of the brand, product and ingredient names that are generated.
The user can then view the status of that brand or ingredient during the in- and out-of-competition periods. The overall status and the status of individual active ingredients are listed as either prohibited or not prohibited (see below example Salbutamol search).
See below example of Lemsip Cold and Flu search.
Global DRO will confirm whether the medication searched for is either prohibited, not prohibited or conditional. This information is separated in to both its in-competition and out-of-competition timeframes and riders need to be aware of when these are applicable. Further information is available on the Prohibited List section.
If a medication check returns a conditional status then riders should consult the further information at the bottom of the search and take appropriate action to ensure they do not take another medication listed which if also detected in a urine sample may lead to an Anti-doping Rule Violation.
What should a rider do if the required medication is prohibited?
If a medication is declared as ‘prohibited’ the rider should first seek a suitable permitted alternative by consulting with their GP or reputable Pharmacist. If there is no suitable alternative, and its use is necessary, riders should check if they require a Therapeutic Use Exemption.
The prohibited status of some substances is dependent upon the route by which it is administered. This is because how a substance is administered (known as the route of administration), affects how much of it is available to the body, and thus, the potential performance enhancing effects. Typically, substances administered by a systemic route (oral, or intravenous injection for example) will have possible targets throughout the body, whereas a topical application (such as eye drops or skin cream) normally has a localised target and is not likely to affect anywhere other than the region applied. Users should be careful to ensure they are reading the correct route. If the route of administration is defined as ‘independent’ this means the prohibited status is not affected by how the substance is administered.
Alternative names (known as ‘synonyms’) for individual active ingredients are also listed on the results page, as well as the Prohibited List category of any prohibited ingredients.
Riders should print the results page, record the 11-digit search reference or email their search to themselves each time they check the status of their medication. The reference number is a record that the search was performed and could provide evidence supporting the rider in a possible doping case.
Are there any risks around checking medication?
Users must understand that Global DRO provides information on licensed medicines and their ingredients only. Global DRO does not contain information that applies to sport, dietary or herbal supplements. Even if a component of a supplement is listed as permitted, the use of any supplement that includes the ingredient is at the rider’s own risk. See the Supplements section of the Insight Zone for further information.
Riders must check the status of their medication regularly and ideally every time they use it. The Prohibited List is updated at least annually and the ingredients within a medication may also change over time, which may affect the status of a medication. Users should bear in mind there could be a delay in Global DRO being updated after the ingredients of a medication have changed, adding to the importance of keeping records of search references.
Users can check Global DRO for medications sold in the United Kingdom, Canada, and the United States only. Global DRO searches need to specify one of those countries, as a medication may be produced using different ingredients in different countries. In the event that a rider needs to use medication purchased elsewhere, they should use reputable pharmacists only. Riders should also beware of counterfeit products. If the rider is confident the medication is from a reputable source, Global DRO can be used to search each individual ingredient of medication purchased abroad, but the rider does so at their own risk.
UK Anti-Doping does everything possible to ensure Global DRO provides up-to-date information. If an ingredient or brand is not listed, that does not mean that it is permitted. If a user cannot find a medication on Global DRO they should contact UK Anti-Doping via Global DRO’s feedback function.
As the Prohibited List can change at any time riders should check the status of their medications on Global DRO before each time they use them.
Riders should make their GP aware that they may be subject to Doping Control testing and that if they take a prohibited substance that appears in a sample they may be subject to an Anti-doping Rule Violation. Riders should also make their GP aware of using Global DRO when providing a prescription in order to consult the Prohibited List.
For further information visit www.ukad.org.uk