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).[6]
Substances and techniques that are prohibited by WADA fall into the following categories: androgens, blood doping, peptide hormones, stimulants, diuretics, narcotics, and cannabinoids.
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.[7]
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 maximal 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.
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.
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.
Diuretics
The following diuretics, and chemicals with similar structure or biological activity are banned:
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:
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.[10]
In cannabis (hashish, marijuana) and cannabis products
Synthetic cannabinoids that mimic the effects of THC
Natural and synthetic tetrahydrocannabinols (THCs)
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 and requires a therapeutic use exemption. Topical uses of glucocorticoids does not require an exemption.
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:
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".[11][12] 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).[13]
