UPDATED: NOVEMBER 19, 2023
The World Anti-Doping Agency (WADA) recently released the 2024 WADA Prohibited List, which will go into effect on January 1, 2024. For 2024, WADA only made a few significant changes, all of which USADA has been advocating for and supports. As usual, WADA also made clarifications to the List to help athletes and their support teams better identify and understand prohibited substances and methods.
WADA’s Summary of Major Modifications and Explanatory Notes is available and we’ve explained the major changes, as well as some of the minor clarifications, below.
MAJOR CHANGES
1. Tramadol will be PROHIBITED IN-COMPETITION
As of January 1, 2024, tramadol is prohibited in-competition* in the class of S7. Narcotics. Data has indicated significant use of tramadol in sports and research studies funded by WADA have confirmed the potential for tramadol to enhance physical performance, in addition to its potential to adversely affect athlete health due to its opioid properties. In 2023, WADA issued a notification that tramadol would be prohibited in 2024, and as you may have noticed, Global DRO also included a notification in the search results for tramadol throughout 2023 to ensure athletes were informed of this upcoming change. You can also reference this fact sheet from WADA for more information.
Going forward, you need to:
- Understand that using tramadol in-competition, or close to competition, puts you at risk of a positive anti-doping test.
- Tell your medical professional that you’re an athlete and subject to drug testing. If they prescribe tramadol, ask if an alternative (and not prohibited) medication is possible.
- Check competition and International Federation rules to understand when the in-competition period starts and when your use of tramadol may occur in relation to that time period.
- If you still need to use tramadol, prepare a comprehensive medical file containing all your medical notes in case you need to apply for a Therapeutic Use Exemption (TUE).
2. Donation of blood plasma via plasmapheresis will be PERMITTED
Plasma donation by plasmapheresis** performed in a registered collection center is now permitted and does not require a TUE as of January 1, 2024. Previously, plasmapheresis was prohibited under M1. Manipulation of Blood and Blood Components because blood components are removed and then reintroduced to the circulatory system. However, donation by athletes of plasma or plasma components by plasmapheresis by an official registered blood donation facility is no longer prohibited, allowing athletes to donate for humanitarian or other personal reasons. Athletes can donate whole blood, or donate plasma by plasmapheresis without requiring a TUE. It’s best practice to keep records, including the dates and locations, of your donations in case any medical records are requested.
3. New washout period for rectal glucocorticoids
WADA has now included washout times for glucocorticoids administered by the rectal route. The washout period for all glucocorticoids by the rectal route is three days, except for triamcinolone (diacetate or acetonide), which requires 10 days. If prescribed use occurs within the washout period before a competition, then athletes are advised to retain all medical records in case a TUE is necessary. More information on glucocorticoids and TUEs is available here.
MINOR CLARIFICATIONS
S0. Non-Approved Substances
This category is for substances that are not approved for therapeutic use anywhere in the world that don’t fit into any other substance classification on the Prohibited List, and that have the potential to enhance performance. In 2024, WADA has added a few new substances, including 2,4-Dinitrophenol (DNP), an extremely dangerous compound often marketed for weight loss, and the troponin activators Reldesemtiv and Tirasemtiv. Troponin activators are being investigated to improve muscle function, such as in the treatment of spinal muscular atrophy and amyotrophic lateral sclerosis.S1. Anabolic Agents
In this category, a few examples were added to the Prohibited List, including trestolone and dimethandrolone. These substances have been on Global DRO for years as substances prohibited at all times. This List update does not change the status of these compounds, but merely adds more examples.S2. Peptide Hormones
WADA has reworded this section to clarify that testosterone-stimulating peptides (previously Gonadotrophin-Releasing Hormone (GnRH) agonist analogs) are prohibited in males, including buserelin, deslorelin, goserelin, histrelin, leuprorelin, nafarelin, and triptorelin. Users of Global DRO will find this information in the Conditions and Warnings section of the search results page for these substances. Histrelin and kisspeptin were both added as examples to the Prohibited List as well. Tetracosactide (ACTH 1-24) was added as an example, as it is the first 24 amino acid portion of natural corticotrophin (ACTH) and possesses the full biological activity of the natural hormone. Capromorelin and ibutamoren (MK-677) were added as examples of a growth hormone secretagogue (GHS), which are mimetics of the natural hormone, ghrelin, stimulating the production of growth hormone and, in turn, insulin-like growth factor 1 (IGF-1).S4. Hormone and Metabolic Modulators
This section was updated to include Rev-Erb-ɑ agonists and SR9011 was added as an example. Another important example added to this section is MOTS-c, more formally known as “Mitochondrial open reading frame of the 12S rRNA-c.” MOTS-c is heavily marketed by wellness and anti-aging clinics and on social media as a weight loss peptide, even though it is an experimental peptide not approved for human therapeutic use.S5. Diuretics and Masking Agents
Conivaptan and mozavaptan were added as further examples of vaptan drugs.S6. Stimulants
Beta-methylphenethylamine (BMPEA) was added as an example to the Prohibited List. This stimulant is not a legitimate medication or dietary ingredient, but it can be found unlawfully in dietary supplements. Visit Supplement Connect to read more about the risks of dietary supplements.Monitoring Program
Substances in the Monitoring Program are not prohibited. The WADA laboratories analyze for the substances in the program to evaluate patterns of use, but athletes will not incur an anti-doping violation for using substances in the Monitoring Program.
For 2024, tapentadol and dihydrocodeine were added to monitor patterns of use in-competition, and semaglutide (GLP-1 analog) was added to examine prevalence of use in sport.
About the WADA Prohibited List
USADA is a signatory to the World Anti-Doping Code established by WADA, which means that USADA upholds and enforces WADA rules that govern sport around the world.
The WADA Prohibited List is among those rules, and identifies (by categories) which substances and methods are prohibited in-competition, out-of-competition, and in some cases, by specific sport. WADA conducts an annual review of the List and identifies if substances and methods should be added or removed, as well as if any categories and conditions should be modified or clarified. More information about how the List is updated is available here.
While USADA has a team available to help answer your specific questions (contact info below), we also urge you to use GlobalDRO.com to search the prohibited status of your medications and ingredients.
More questions?
For questions about specific products, substances, and methods, contact USADA’s Drug Reference Line at drugreference@USADA.org or call (719) 785-2000, option 2.
*In-competition refers to the period commencing at 11:59 pm on the day before a competition in which the athlete is scheduled to compete through the end of such competition and the sample collection process related to such competition. WADA may approve alternative definitions for particular sports.
**Plasmapheresis is a therapeutic intervention that involves extracorporeal removal, return, or exchange of blood plasma or components. The underlying mechanism of this procedure is accomplished by either centrifugation or filtration using semipermeable membranes.
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