In the world of sports medicine prescribing medication requires care, as drugs testing can take place at any time both in and out of competition. Even the most revered athletes can find themselves under scrutiny as was the case with marathon runner Paula Radcliffe in 2015.
It is essential to check the ingredients of any drugs you are prescribing or the consequences can be disastrous, particularly for a professional sports person. Many medications for common conditions such as Asthma or Hay fever may contain prohibited substances. For example, some paracetamol brands are prohibited because they contain anabolic agents.
With regular drug testing in sport it is well worth being cautious when prescribing and indeed being aware of what is being prescribed to clients by other medical carers such as GP’s.
The advice from the UK Anti-Doping is to check every single substance or medication before you prescribe it, even if it has been used before and is already widely used.
Co-prescribing and over-subscribing
It is also worth ensuring you know exactly what medications your patients are taking prior to prescribing any other drugs. Some medications might cause an adverse effect or even have fatal consequences when taken. For example, Opioids with Benzodiazepines where found to be prescribed together quite often, despite the directions that accompany the drugs with negative results as outlined in a recent article by IASP.
Co-prescribing can happen as a result of prescriptions being given by multiple doctors and consultants. Hence the advice to always check whether a client is already taking any medications prior to prescribing. The same can be said for over subscribing drugs which often happens in cases of pain relief. It is all too easy to prescribe a medicine especially as patients now typically expect to walk away with at least a prescription when visiting a doctor.
Always seek advice, particularly when it comes to medication in the sports world, if at all necessary.
Where to get advice
A good point of reference is the Global DRO which provides information about the prohibited status of specific substances under the rules of sport based on the World Anti-Doping Agency (WADA) guidelines. Global DRA checks the status of branded medications and individual active ingredients as well as providing every search with a unique reference for your records. Medicines can be searched across four countries UK, Canada, USA and Japan. Be aware, however, that the listing does not include dietary supplements.
A mobile-enhanced version of Global DRO is also now available enabling athletes to check their medicines while travelling. If you can’t find what you are looking for, check with the UK Anti-Doping directly.
Therapeutic Use Exemptions (TUEs)
It is possible for an athlete to use a specific medicine that is prohibited by applying for a Therapeutic Use Exemptions (TUEs). This should be applied for only if there are no other options available or suitable for use. The Therapeutic Use Exemption (TUE) process is a means by which a sports person can obtain approval to use a prescribed prohibited substance or method for the treatment of a legitimate medical condition. Contact should be made with their National Governing Body or UK Anti-Doping to see what kind of TUE can be applied for. Until a TUE is granted medicines should only be taken in an emergency situation, for example, allergic reaction, asthma attacks or onset of Bell’s Palsy.
Travelling Abroad and Taking Medicines
It is especially worth remembering to check medicines when working abroad as drugs may contain different substances in different countries. It’s a good idea to advise taking enough medication for the duration of a trip. Otherwise check the products before travelling and that the medication is permitted in the country of travel and can be taken through customs. The British Athletics Organisation has launched the Clean Sport App which will help you check prohibited medicines wherever you are.
Sports people are advised to careful when taking supplements too. Some supplements may contain prohibited ingredients. A good option is to review diet and nutrition to see how this can be adapted to ensure specific nutrients are taken in the diet.
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