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Therapeutic Use Exemptions (TUE)

Athletes may at times need to use a prohibited medication to treat a legitimate medical condition. A Therapeutic Use Exemption (TUE) is an exemption that allows an athlete to use, for therapeutic purposes only, an otherwise prohibited substance or method (of administering a substance) which may be present during competition. If an athlete is tested, any substances that an athlete may be taking must be declared in testing paperwork, in addition to any TUE that the athlete has.

Visit here for more information: www.asada.gov.au/substances/therapeutic_use_exemptions.html

New TUE guidelines from 1 January 2015 – www.asdmac.gov.au/TUE.html

To understand whether you require a TUE and what type of TUE you require please follow the steps below:

1. Are you taking a medication or using a method that is on the WADA prohibited list? (To check on your medication or method, search using Global DRO to check your substances www.globaldro.com/AU/search and/or on WADA’s Prohibited List, by clicking here). If yes then…

2. What is your level of competition?

International-level athletes – (defined as: a member of an International Federation (IF) testing pool and/or competing at an International sporting event as defined by the IF for that sport).

You should; for a ‘first-time’ TUE, apply directly to your IF. If you already have a national level (ASDMAC) TUE, check with your IF (or ASDMAC) to see if it will be recognised by the IF. ASDMAC can assist you in your application to your International Federation if required.

National-level athletes – (defined as: a member of an ASADA testing pool, competing at open-age ‘national events’ or competing in a sport under an ASADA contract or anti-doping arrangement).

You should apply for an in-advance TUE to ASDMAC (i.e. obtain the TUE prior to Using the substance or method in question).

All other athletes – (defined as: not being an ‘International’ level or ‘National’ level athlete (as above), e.g. junior national, state, club, youth or masters). You are not required to apply for an in-advance TUE (for certain medications – see below), so you can therefore apply for a TUE via the Planned Retroactive TUE process outlined below.

TYPES OF Therapeutic Use Exemptions (TUEs)

In-advance TUE

A TUE that is applied for prior to commencing the medication or competing in sport using the medication. This has been the standard approach for applying for TUEs in the past but now only applies to National and International level Athletes.

Planned Retroactive TUEs

This is a new process from 1st January 2015. All athletes below International and/or National level should apply for a Planned Retroactive TUE if

1) The Prohibited Substance the athlete is taking is on the following list
i) Inhaled B2 agonists – Terbutaline (not required for salbutamol, formoterol and salmeterol)
ii) Aromatase inhibitors used in the treatment of breast and ovarian cancer e.g. anastrazole
iii) SERMs used in the treatment of breast cancer e.g. tamoxifen, raloxifene
iv) Insulin for the treatment of diabetes
v) Diuretics for the treatment of cardiovascular disease including hypertension
vi) Intravenous infusions for the treatment of acute dehydration- usually due to acute gastroenteritis
vii) Stimulants – methylphenidate, dexamphetamine, modafinil- for the treatment of ADHD or sleep disorders
viii) Narcotics – in the treatment of acute or chronic pain e.g. morphine
ix) Glucocorticoids – prednisolone, cortisone in the treatment of acute inflammatory illness such as asthma, inflammatory bowel disease or inflammatory arthritis
x) Beta-blockers for the treatment of cardiovascular disease

If the prohibited substance is not included in the list above then the athlete MUST apply for an in-advance TUE regardless of their level of competition.

AND

2) After and only if the athlete is subjected to Doping Control (within 21 days of receiving notification by ASADA of an Adverse Analytical Finding (i.e. a positive doping control test)

Please note that if you are using a Prohibited Substance or Method for an acute or chronic medical condition and you are eligible for a planned retroactive TUE you should keep a medical file prepared in case an application is necessary.

Other Retroactive TUEs

Other than the planned retroactive TUE outlined above, any athlete may also be granted a retroactive approval for his/her Therapeutic Use of a Prohibited Substance or Prohibited Method (i.e., a retroactive TUE) if they did not have an in-advance TUE and one of the following situations occurred:
a. Emergency treatment or treatment of an acute medical condition was necessary; or
b. Due to other exceptional circumstances, there was insufficient time or opportunity for the Athlete to submit, or for the TUEC to consider, an application for the TUE prior to Sample collection; or
c. It is agreed, by WADA and by the Anti-Doping Organisation to whom the application for a retroactive TUE is or would be made, that fairness requires the granting of a retroactive TUE.