Agency calls on athletes, entourage
and all stakeholders to note major modification concerning tramadol that is to
take effect in 2024.
The World Anti-Doping Agency (WADA)
wishes to remind athletes and all other stakeholders that the 2023 List of Prohibited Substances and Methods (List) entered into force on 1 January.
The 2023 List was approved by WADA’s Executive Committee (ExCo) during its
meeting on 23 September 2022 and was first published on 29 September 2022.
The List is one of the eight International Standards that are mandatory for all Signatories of the World Anti-Doping Code (Code). It designates what substances and methods are
prohibited both in- and out-of-competition and which substances are banned in
Major modifications for 2023
All Major Modifications for 2023 are
outlined in the 2023 Summary of Major Modifications and Explanatory Notes.
Major modification concerning tramadol for 2024
It should be noted that, also on 23
September, the ExCo endorsed the recommendation by WADA’s List Expert Advisory Group to prohibit the narcotic tramadol in competition, effective 1 January
The delay in implementation is to
provide an additional year for broad communication and education of athletes,
their entourage and medical personnel so that there is a better understanding
of the practical implementation of tramadol prohibition in competition.
It will also give time to the
scientific community to adjust the exact procedural details so that fairness
can be ensured for athletes. In addition, it gives sports authorities time to
develop educational tools for athletes, and for medical and support personnel
to address the safe use of tramadol for clinical purposes within anti-doping.
Tramadol has been on WADA’s Monitoring Program and data gathered through that program have indicated
significant use in sports. Tramadol abuse, with its dose-dependent risks of
physical dependence, opiate addiction and overdoses in the general population,
is of concern and has led to it being a controlled drug in many countries.
Research studies funded by WADA, as referenced in the Explanatory Note have
also confirmed the potential for tramadol to enhance sports performance.
Annual List review process
WADA leads an annual revision process concerning the List,
beginning with an initial meeting in January and concluding with the publication
of the List by 1 October. This is an extensive consultation process that
includes WADA’s List Expert Advisory Group gathering information including the
latest scientific and medical research, trends, and intelligence gathered from
law enforcement and pharmaceutical companies; circulating a draft List among
stakeholders; and, taking their submissions into consideration to revise the
draft, followed by review by the Agency’s Health, Medical and Research (HMR)Committee.
The HMR Committee then makes its
recommendations to WADA’s ExCo, which approves the List during its September
For a substance or method to be
added to the List, it must be determined that it meets at least two of the
following three criteria:
1. It has the potential to
enhance or enhances sport performance
2. It represents an actual or
potential health risk to the athletes
3. It violates the spirit of sport
The List is released three months
ahead of it taking effect so that athletes, their entourage and other
stakeholders can acquaint themselves with any modifications.
Ultimately, athletes are responsible
for prohibited substances found in their body and prohibited methods found to
have been used. Athlete entourage are also liable for Anti-Doping Rule
Violations if determined to be complicit. Consequently, if there is any doubt
as to the status of a substance or method, it is important that they contact
their respective Anti-Doping Organizations (International Federation or
National Anti-Doping Organisation) for advice.
The Therapeutic Use Exemption Program
It should be noted that for athletes
who have a legitimate medical reason for using a prohibited substance or method
that is on the List, they can apply for a Therapeutic Use Exemption (TUE) to
determine whether they meet the criteria outlined in the International Standardfor Therapeutic Use Exemptions (ISTUE). The TUE Program is a rigorous and
necessary part of elite sport which has overwhelming acceptance from athletes,
physicians and anti-doping stakeholders.
In addition to the documents linked
above, WADA has provided, or will provide, a number of educational resources as
part of its Code Implementation Support Program (CISP), which can be accessed
on the Agency’s Anti-Doping Education and Learning Platform (ADEL). These
A CISP Checklist – Implementing Revised List (available now)
Athlete and Athlete Support Personnel (ASP) Factsheet on tramadol
Medical Professionals Factsheet on tramadol (available now)
Athlete and ASP Guide to the 2023 List (to be available in January 2023)
WADA will look to develop additional
educational activities, such as webinars, to support ADOs in their efforts to
educate their target populations about the change regarding tramadol.
Languages and formats
The 2023 Prohibited List; the 2023
Summary of Modifications and Explanatory Notes; and the 2023 Monitoring Program
are available for download on WADA’s website in English, French and Spanish.
The List is also available in Catalan, Croatian, Danish, German and Greek.
Stakeholders wishing to translate the
List into other languages are kindly asked to signal their interest to
email@example.com. WADA will then provide the necessary files and, once the
translation is finalized, will make the translated List available on the
The List’s mobile-friendly digital
edition can be accessed here.