List of drugs banned by the World Anti-Doping Agency

Last updated

The International Standard for the Prohibited List is the standard published by the World Anti-Doping Agency (WADA) that lists substances prohibited in competitive sport. [1] [2] It is updated at least once per year as required by the World Anti-Doping Code. [3] [4] The adoption of the first World Anti-Doping Code (the Code) occurred at the 2nd World Conference on Doping in Sport in March 2003 in Copenhagen, Denmark. It was there that WADA assumed the responsibility of maintaining, updating, and publishing the List of Prohibited Substances and Methods (the List) in sport. The List is to be updated and published by WADA at least annually. [5] WADA specifies that the List generally includes any substance that meets any two of the following criteria: it enhances sport performance, it represents a health risk to the athlete, it violates the spirit of sport (as defined in the WADA Code). [3]

Contents

Substances and techniques that are prohibited by WADA fall into the following categories: [2] S0 non-approved substances; S1 anabolic agents; S2 peptide hormones, growth factors, related substances, and mimetics ; S3 beta-2 agonists; S4 hormone and metabolic modulators; S5 diuretics and masking agents; prohibited methods (M1 blood doping, M2 manipulation of samples, M3 gene doping); S6 stimulants; S7 narcotics; S8 cannabinoids; S9 glucocorticoids; P1 beta-blockers.

Blood doping

Blood doping is the injection of red blood cells, related blood products that contain red blood cells, or artificial oxygen containers. This is done by extracting and storing one's own blood prior to an athletic competition, well in advance of the competition so that the body can replenish its natural levels of red blood cells, and subsequently injecting the stored blood immediately before competition. The resulting unnatural level of red blood cells improves oxygen transport and athletic endurance; thus, it is prohibited in most events. It is often used in extreme sports like cycling, snowboarding, and skiing where endurance is highly valued. The most famous example of this type of doping is Lance Armstrong's performance in the Tour de France. [6]

Banned anabolic agents

Banned anabolic agents are, for the purpose of WADA, either anabolic steroids, which activate testosterone and epitestosterone receptors, thereby improving muscle strength and endurance, or "other anabolic agents". Andro, DHEA, stanozolol, testosterone, and nandrolone, or derivates (see below) are banned anabolic steroids. Other banned anabolic agents include clenbuterol, tibolone, zeranol, zilpaterol, and selective androgen receptor modulators. [7] While a few of the banned drugs are endogenous, that is they are normally produced in the human body, most of the banned drug are exogenous drugs chemically produced. These types of drugs were used extensively in Major League Baseball in the 1990s and early 2000s. [8]

Exogenous anabolic androgenic steroids

This is the complete list of exogenous (non-natural) androgenic agents banned as of January 1, 2012:

Drugs with similar structures and biological activity are also banned because new designer drugs of this sort are always being developed in order to beat the drug tests.

Caffeine, a stimulant known to improve performance, is currently not on the banned list. It was listed until 2004, with a maximum allowed level of 12 micrograms per millilitre urine. [9]

Endogenous anabolic androgenic steroids

The following substances, ordinarily produced naturally in the body, are prohibited when administered from outside the body.

Metabolites and isomers

Metabolites and isomers of endogenous anabolic androgenic steroids, including:

Other anabolic agents

Certain peptide hormones increase bulk, strength, and oxygen-carrying red blood cells. [7] :3

Erythropoiesis-stimulating agents such as erythropoietin (EPO), darbepoetin (dEPO), hypoxia-inducible factor (HIF) stabilizers, methoxy polyethylene glycol-epoetin beta (CERA) and peginesatide (Hematide); growth hormone (hGH), insulin-like growth factors (IGF-1, etc.), fibroblast growth factors (FGFs), hepatocyte growth factors (HGF), mechano growth factors (MGFs), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), human chorionic gonadotropin (hcG, banned in men only), somatotrophin (growth hormone), insulins and corticotrophins, corticosteroid mimics, and their releasing factor, are banned.

Also banned are any other growth factor affecting muscle, tendon or ligament protein synthesis/degradation, vascularization, energy utilization, regenerative capacity or fiber type switching, and other substances with similar chemical structure and/or biological effects.

Beta-2 agonists

All beta-2 agonists and their D- and L-isomers, are banned. However, formoterol, salbutamol, salmeterol, and terbutaline may be used with a "therapeutic use exemption", only in the inhaled form. [7] :4

Hormone and metabolic modulators

Hormone levels of a particular hormone, like testosterone, can be changed not only by administering it, but also by altering related hormones. For example, the estrogens estrone and estradiol are biosynthetically produced by the enzyme aromatase, respectively, from androstenedione and testosterone, which are both produced from 17α-hydroxyprogesterone. Thus, when the body senses low levels of estrogen, the precursor compounds 17α-hydroxyprogesterone, androstenedione, and testosterone are up-regulated. Likewise, interfering with a hormone's receptor leads to similar effects.

Because of these natural hormone-hormone interdependent biosynthetic pathways and hormone-receptor interactions, all aromatase inhibitors, including anastrozole, letrozole, aminoglutethimide, exemestane, formestane, and testolactone are banned. Selective estrogen receptor modulators, including raloxifene, tamoxifen and toremifene are banned. Clomiphene, cyclofenil, fulvestrant, and all other anti-estrogenic substances are banned. Myostatin inhibitors are banned. Metabolic modulators including peroxisome proliferator-activated receptor delta (PPARδ) agonists (e.g., GW 1516), PPARδ-AMP-activated protein kinase (AMPK) axis agonists (e.g. AICAR) are also banned. Meldonium was banned on 1 January 2016, which was often used during the Russian doping scandal. [7] :4

Diuretics and masking agents

Diuretics, which increase the production of urine, and masking agents, chemical compounds which interfere with drug tests, are banned for two reasons. First, by decreasing water retention and thus decreasing an athlete's weight, an important consideration in many speed sports (e.g. track and field, speed skating), they increase the speed of an athlete. Secondly, increased urine production depletes the concentration of both the banned drugs and their metabolites, making their detection more difficult. Masking agents, on the other hand, work by making drug tests ineffective, leading to false-negative results. Desmopressin, plasma expanders (such as glycerol; intravenous administration of albumin, dextran, hydroxyethyl starch and mannitol), probenecid, and other substances with similar biological effects are also banned. Local application of felypressin in dental anesthesia is not prohibited. [7] :5

Diuretics

The following diuretics, and chemicals with similar structure or biological activity are banned:

Stimulants

Stimulants directly affect the central nervous system, increasing blood flow and heart rate. These drugs primarily help athletes in complex team sports like basketball and association football as well as choreographed sports like figure skating and artistic gymnastics. Stimulants that are banned in competition only include amphetamines, beta-2 agonists, ephedrine, pseudoephedrine, fencamfamine, cocaine, methamphetamines, mesocarb, and other substances with similar chemical structures and biological effects, including the following: [7] :6

Narcotics

Narcotic analgesics decrease the painful sensations of serious injuries, potentially allowing athletes to continue training for competition after an injury. While some painkillers are allowed, including codeine, the following are banned in competition only: [7] :7

Natural and synthetic cannabinoids

The following are banned for in-competition use only, with the exception of cannabidiol (CBD) which is not banned for any use. [2] In 2013, the level of THC metabolite allowed was changed from 15 ng/mL to 150 ng/mL so as to only detect in-competition use. [11] [7] :7

Glucocorticoids

Glucocorticoids are a class of corticosteroids that affect the metabolism of carbohydrates, fat, and proteins, and regulate glycogen and blood pressure levels. They possess pronounced anti-inflammatory activity and cause alteration of connective tissue in response to injuries. The anti-inflammatory and connective tissue effects of glucocorticoids might mask injuries, leading to more serious injuries to athletes. Because of this and metabolic regulation effects, the administration of any glucocorticoid orally, rectally, intravenously, or intramuscularly is prohibited in competition only and requires a therapeutic use exemption. Topical uses of glucocorticoids does not require an exemption. [7] :7

Beta blockers

Beta blockers are prohibited during competition in a number of sports; out of competition, they are prohibited only in archery and shooting. The prohibited beta blockers include: [7] :8

Therapeutic use exemptions

Therapeutic use exemption (TUE) is a term used by WADA and the United States Anti-Doping Agency to denote banned substances that athletes may be "required to take to treat an illness or condition". [12] [13] These exemptions are regulated by the International Standard for Therapeutic Use Exemptions (ISTUE). The detection of such substances in samples is labelled by WADA as an "adverse analytical finding" (AAF), which is distinct from "anti-doping rules violations" (ADRV). [14]

Methods

Prohibited methods include manipulation of blood components (e.g. autologous red blood cell transfer, "blood doping"), manipulation of samples, and gene doping. These are prohibited at all times. [7] :5

See also

Footnotes

  1. "International Standards". wada-ama.org. 14 November 2013. Retrieved 25 July 2021.
  2. 1 2 3 "Prohibited List 2021" (PDF). World Anti-Doping Agency. Retrieved 25 July 2021.
  3. 1 2 "The Prohibited List". wada-ama.org. 14 November 2013. Retrieved 25 July 2021.
  4. "World Anti-Doping Code" (PDF). World Anti-Doping Agency. Retrieved 25 July 2021.
  5. Mazzoni, Irene; Barroso, Osquel; Rabin, Olivier (2011). "The List of Prohibited Substances and Methods in Sport: Structure and Review Process by the World Anti-Doping Agency". Journal of Analytical Toxicology. pp. 608–612. doi:10.1093/anatox/35.9.608. PMID   22080899 . Retrieved 1 May 2022.
  6. "Lance Armstrong's doping was all for nothing". 30 June 2017.
  7. 1 2 3 4 5 6 7 8 9 10 11 "World Anti-Doping Code: International Standard Prohibited List 2017" (PDF). January 2017.
  8. "Baseball's most notorious steroid users".
  9. "Athletes' caffeine use reignites scientific debate". www.abc.net.au. 2008-08-02. Retrieved 2021-08-21.
  10. 1 2 Pluim BM, de Hon O, Staal JB, Limpens J, Kuipers H, Overbeek SE, Zwinderman AH, Scholten RJ (January 2011). "β₂-Agonists and physical performance: a systematic review and meta-analysis of randomized controlled trials". Sports Medicine. 41 (1): 39–57. doi:10.2165/11537540-000000000-00000. PMID   21142283. S2CID   189906919.
  11. Kim, Victoria (May 20, 2013). "Olympics Relax Regulation of Pot". The Fix. Retrieved July 26, 2021.
  12. "Therapeutic Use Exemptions". WADA. 20 May 2014. Retrieved 13 September 2016.
  13. "Therapeutic Use Exemptions (TUEs)". USADA. Retrieved 13 September 2016.
  14. "ADO Testing Statistics". WADA. December 2014. Archived from the original on 3 January 2018. Retrieved 13 September 2016.

Related Research Articles

<span class="mw-page-title-main">Tetrahydrogestrinone</span> Synthetic and orally active anabolic–androgenic steroid (AAS)

Tetrahydrogestrinone (THG), known by the nickname The Clear, is a synthetic and orally active anabolic–androgenic steroid (AAS) which was never marketed for medical use. It was developed by Patrick Arnold and was used by a number of high-profile athletes such as Barry Bonds and Dwain Chambers.

<span class="mw-page-title-main">Androstenedione</span> Endogenous weak androgen

Androstenedione, or 4-androstenedione, also known as androst-4-ene-3,17-dione, is an endogenous weak androgen steroid hormone and intermediate in the biosynthesis of estrone and of testosterone from dehydroepiandrosterone (DHEA). It is closely related to androstenediol (androst-5-ene-3β,17β-diol).

<span class="mw-page-title-main">Stanozolol</span> Discontinued steroid for heart treatment

Stanozolol, sold under many brand names, is a synthetic androgen and anabolic steroid (AAS) medication derived from dihydrotestosterone (DHT). It is used to treat hereditary angioedema. It was developed by American pharmaceutical company Winthrop Laboratories in 1962, and has been approved by the U.S. Food and Drug Administration for human use, though it is no longer marketed in the USA. It is also used in veterinary medicine. Stanozolol has mostly been discontinued, and remains available in only a few countries. It is given by mouth in humans or by injection into muscle in animals.

<span class="mw-page-title-main">Metenolone</span> Chemical compound

Metenolone, or methenolone, is an androgen and anabolic steroid (AAS) which is used in the form of esters such as metenolone acetate and metenolone enanthate. Metenolone esters are used mainly in the treatment of anemia due to bone marrow failure. Metenolone acetate is taken by mouth, while metenolone enanthate is given by injection into muscle.

<span class="mw-page-title-main">Trenbolone acetate</span> Chemical compound

Trenbolone acetate, sold under brand names such as Finajet and Finaplix among others, is an androgen and anabolic steroid (AAS) medication used in veterinary medicine, specifically to increase the profitability of livestock by promoting muscle growth in cattle. It is given by injection into muscle.

Performance-enhancing substances (PESs), also known as performance-enhancing drugs (PEDs), are substances that are used to improve any form of activity performance in humans.

<span class="mw-page-title-main">Drostanolone propionate</span> Chemical compound

Drostanolone propionate, or dromostanolone propionate, sold under the brand names Drolban, Masteril, and Masteron among others, is an androgen and anabolic steroid (AAS) medication which was used to treat breast cancer in women but is now no longer marketed. It is given by injection into muscle.

<span class="mw-page-title-main">Mestanolone</span> Chemical compound

Mestanolone, also known as methylandrostanolone and sold under the brand names Androstalone and Ermalone among others, is an androgen and anabolic steroid (AAS) medication which is mostly no longer used. It is still available for use in Japan however. It is taken by mouth.

<span class="mw-page-title-main">Selective androgen receptor modulator</span> Class of pharmaceutical drugs

Selective androgen receptor modulators (SARMs) are a class of drugs that selectively activate the androgen receptor in specific tissues, promoting muscle and bone growth while having less effect on male reproductive tissues like the prostate gland.

<span class="mw-page-title-main">Anabolic steroid</span> Class of drugs

Anabolic steroids, also known as anabolic-androgenic steroids (AAS), are a class of drugs that are structurally related to testosterone, the main male sex hormone, and produce effects by binding to the androgen receptor (AR). Anabolic steroids have a number of medical uses, but are also used by athletes to increase muscle size, strength, and performance.

<span class="mw-page-title-main">Enobosarm</span> Investigational selective androgen receptor modulator

Enobosarm, also formerly known as ostarine and by the developmental code names GTx-024, MK-2866, and S-22, is a selective androgen receptor modulator (SARM) which is under development for the treatment of androgen receptor-positive breast cancer in women and for improvement of body composition in people taking GLP-1 receptor agonists like semaglutide. It was also under development for a variety of other indications, including treatment of cachexia, Duchenne muscular dystrophy, muscle atrophy or sarcopenia, and stress urinary incontinence, but development for all other uses has been discontinued. Enobosarm was evaluated for the treatment of muscle wasting related to cancer in late-stage clinical trials, and the drug improved lean body mass in these trials, but it was not effective in improving muscle strength. As a result, enobosarm was not approved and development for this use was terminated. Enobosarm is taken by mouth.

<span class="mw-page-title-main">Cyclofenil</span> Chemical compound

Cyclofenil, sold under the brand name Sexovid among others, is a selective estrogen receptor modulator (SERM) medication which is used as a gonadotropin stimulant or ovulation inducer and in menopausal hormone therapy in women. It is mostly no longer available. The medication is taken by mouth.

Since their discovery, anabolic steroids (AAS) have been widely used as performance-enhancing drugs to improve performance in sports, to improve one's physical appearance, as self-medication to recover from injury, and as an anti-aging aid. Use of anabolic steroids for purposes other than treating medical conditions is controversial and, in some cases, illegal. Major sports organizations have moved to ban the use of anabolic steroids. There is a wide range of health concerns for users. Legislation in many countries restricts and criminalizes AAS possession and trade.

<span class="mw-page-title-main">NCAA banned substances</span> Items prohibited to U.S. collegiate student-athletes

In the United States the National Collegiate Athletic Association (NCAA), has since the 1970s been patrolling the usage of illegal drugs and substances for student-athletes attending universities and colleges. In 1999, NCAA Drug Committee published a list containing substances banned for the usage to student-athletes. Year after year it is updated and given to those students participating in college sports. If any student is caught taking any of the substances, they are subjected to suspension or even banned from participating in NCAA sports and possibly attending the university.

Doping, or the use of restricted performance-enhancing drugs in the United States occurs in different sports, most notably in the sports of baseball and football.

<span class="mw-page-title-main">Trenbolone enanthate</span> Chemical compound

Trenbolone enanthate, known by the nickname Trenabol, is a synthetic and injected anabolic–androgenic steroid (AAS) and a derivative of nandrolone which was never marketed. It is the C17β enanthate ester and a long-acting prodrug of trenbolone. Trenbolone enanthate was never approved for medical or veterinary use but is used in scientific research and has been sold on the internet black market as a designer steroid for bodybuilders and athletes.

<span class="mw-page-title-main">Ligandrol</span> Chemical compound

LGD-4033, also known by the developmental code name VK5211 and by the black-market name Ligandrol, is a selective androgen receptor modulator (SARM) which is under development for the treatment of muscle atrophy in people with hip fracture. It was also under development for the treatment of cachexia, hypogonadism, and osteoporosis, but development for these indications was discontinued. LGD-4033 has been reported to dose-dependently improve lean body mass and muscle strength in preliminary clinical trials, but is still being developed and has not been approved for medical use. The drug is taken by mouth.

<span class="mw-page-title-main">Androstanolone</span> Androgenic and anabolic steroid medication

Androstanolone, or stanolone, also known as dihydrotestosterone (DHT) and sold under the brand name Andractim among others, is an androgen and anabolic steroid (AAS) medication and hormone which is used mainly in the treatment of low testosterone levels in men. It is also used to treat breast development and small penis in males. Compared to testosterone, androstanolone (DHT) is less likely to aromatize into estrogen, and therefore it shows less pronounced estrogenic side effects, such as gynecomastia and water retention. On the other hand, androstanolone (DHT) show more significant androgenic side effects, such as acne, hair loss and prostate enlargement.

The practice of doping in tennis involves the use of prohibited, performance-enhancing substances listed by the International Tennis Federation (ITF) and World Anti-Doping Agency (WADA). The practice is considered unsportsmanlike and unethical, with punishments for such offences ranging from official warnings to career bans, depending on the severity of the offence.

References