Banned cannabis and tramadol off the AMA until 2024

The List of Prohibited Substances and Methods of the World Anti-Doping Agency (AMA) 2023, which will enter into force tomorrow, January 1, maintains the use of cannabis prohibited in competition and leaves out the analgesic tramadol until its 2024 edition, despite being prohibited by organizations such as the International Cycling Union (UCI).

The list is one of eight mandatory international standards for all signatories to the World Anti-Doping Code, which determines prohibited substances and methods both in and out of competition and is updated annually by WADA, following a consultation process with experts in science and medicine from around the world.

As approved at the end of September by the WADA Executive Committee, the new list maintains the status of cannabis (THC), which is prohibited in competition because it meets the criteria for it, since its consumption poses a health risk. primarily neurological, and violates the spirit of the sport.

The AMA considers, however, that more clinical studies are necessary to rigorously determine the neuropsychological impact of THC and its improvement in performance, something that would require the participation of volunteers who actively consume it, with the difficulty that this would entail because in most of countries is illegal.

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Faced with this situation, WADA recommended that athletes from regions where cannabis use is legal refrain from consuming it for several days before the start of a competition.

The 2023 list will not include tramadol among the prohibited analgesics, although it will appear among them in the 2024 prescription.

WADA decided to postpone its presence to give the scientific community time to adjust procedures and ensure fairness for athletes. Also sports authorities to develop educational tools for athletes and medical and support staff to address the safe use of tramadol for clinical purposes within anti-doping.

Tramadol, a substance prohibited by the UCI and for which it annulled the results of the Colombian cyclist Nairo Quintana in the last Tour, has been in the monitoring program of the AMA, which has confirmed its significant use in the sport, the risks of its abuse, which have made it a controlled drug in many countries, and has also confirmed its potential to improve sports performance.

As novelties, the 2023 list includes “Voxelotor”, which helps hemoglobin in the uptake of oxygen, among the prohibited methods, manipulation of blood and supplements, since it alters the capacity of hemoglobin to release oxygen, thus increasing the arterial oxygen saturation.

According to the AMA, as a side effect, it increases serum erythropoietin, which has been shown to result in increased hemoglobin concentration in healthy individuals.

The chapter on diuretics and masking agents adds torasemide and clarifies that therapeutic use authorizations will not be required for topical ophthalmic administration of certain inhibitors (dorzolamide, brinzolamine) or for felypressin in dental anesthesia together with a threshold substance.

WADA leads an annual list review process, beginning with a meeting in January and concluding with the list’s publication on October 1, following an extensive consultation process.

This includes the gathering of information by the expert advisory group on the latest scientific and medical research, trends and information gathered from law enforcement and pharmaceutical companies, and the development and distribution of a draft list among the parties interested.

After consideration of their input and review by the Agency’s Health, Medicine and Research (HMR) Committee, the Agency makes its recommendations to the Executive Committee which ultimately approves the document.

Source: EFE