Drugs Banned in Sport
The use of performance-enhancing substances or techniques to augment an athlete's ability to succeed in competitive sports is a pertinent and timely topic for athletes, coaches, and any involved health care provider. The use of these agents or methods, whether legal or illegal, can occur at all levels of sports - from high school and college student athletes, to international Olympic competitors, and even professional athlete celebrities. At the professional and Olympic level, each athlete is responsible for the drugs they consume and knowing if any substances are on the World Anti-Doping Code Prohibited List, which is published yearly by the World Anti-Doping Agency (WADA).
World Anti-Doping Code Prohibited List
The World Anti-Doping Code Prohibited List is an International Standard. The List groups substances and methods by those that are banned at all times (in and out of competition), those that are banned in-competition only, and those that are banned by a particular sport. If an athlete has a legitimate medical reason to use one of the banned agents, a Therapeutic Use Exemption (TUE) may be granted only after extensive review. This List was originally published in 1963 under the direction of the International Olympic Committee. As of 2004, the World Anti-Doping Agency is in charge of updating and publishing the List each year.
Athletic drug testing is done to detect banned substances or performance enhancing agents in competitive-level athletes. In the U.S, drug testing may occur in Olympic-level sports, National Collegiate Athletic Association sports (NCAA), and professional sports. The U.S. Anti-Doping Agency (USADA) is the national anti-doping organization for the Olympic movement in the United States. With the USADA, as noted in the WADA code, testing may occur in competition or out of competition and can occur at any time and at any location. Testing can result in disqualifications, sanctions, and stripping of medals and world titles.
Drugs such as
have been shown to impart significant performance enhancing effects. However, these substances can also be associated with dangerous and possibly life-threatening side effects. Athletes should avoid these performance-enhancing substances not only because they may compromise the privilege to compete, but also because they can be harmful or even fatal with long-term use.
Substances prohibited at all times
This means that the substance or method is prohibited In- and Out-of-Competition as defined in the Code.
- 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 Other Masking Agents
M1 – M2 – M3 Prohibited Methods
Prohibited methods (M1, M2, M3) are prohibited at all times (in- and out-of-competition). M1 addresses Manipulation of Blood and Blood Components and M2 addresses Chemical and Physical Manipulation. All prohibited methods in this class are non-Specified except methods in M2.2. which are Specified Methods (see definitions for non-Specified and Specified Methods below). Athletes or other involved parties should review these regulations on the 2022 Prohibited List for verification. M3 involves gene and cell doping and is listed below:
M3. Gene and Cell Doping
The following, with the potential to enhance sport performance, are prohibited:
- The use of nucleic acids or nucleic acid analogues that may alter genome sequences and/ or alter gene expression by any mechanism. This includes but is not limited to gene editing, gene silencing and gene transfer technologies.
- The use of normal or genetically modified cells.
Substances prohibited in-competition
Subject to a different period having been approved by WADA for a given sport, the In-Competition period shall in principle be the period commencing just before midnight (at 11:59 p.m.) on the day before a Competition in which the Athlete is scheduled to participate until the end of the Competition and the Sample collection process.
Substances prohibited in particular sports
Specified and Non-Specified Substances
As per Article 4.2.2 of the World Anti-Doping Code, "for purposes of the application of Article 10, all Prohibited Substances shall be Specified Substances except as identified on the Prohibited List. No Prohibited Method shall be a Specified Method unless it is specifically identified as a Specified Method on the Prohibited List". As per the comment to the article, "the Specified Substances and Methods identified in Article 4.2.2 should not in any way be considered less important or less dangerous than other doping substances or methods. Rather, they are simply substances and methods which are more likely to have been consumed or used by an Athlete for a purpose other than the enhancement of sport performance".
Substances of Abuse
Pursuant to Article 4.2.3 of the Code, Substances of Abuse are substances that are identified as such because they are frequently abused in society outside the context of sport. The following are designated Substances of Abuse: cocaine, diamorphine (heroin), methylenedioxymethamphetamine (MDMA/"ecstasy"), tetrahydrocannabinol (THC).
- World Anti-Doping Code. International Standard. Prohibited List 2022 (List effective Jan. 1, 2022)
- World Anti-Doping Agency. International Standards (Accessed Nov. 21, 2022)
- World Anti-Doping Agency. The Prohibited List. FAQs (Accessed Nov. 21, 2022)
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Last updated: November 21, 2022, by Leigh Anderson, PharmD.