Boxing and Medication

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Boxing and Medication

How to box and to undergo medical treatment at the same time?

Athletes, like all others, may have illnesses or conditions that require them to take particular medications.  Due to the sportive environment in which the boxer is taking part, this medication may be considered as having a doping effect and to fall under the WADA Prohibited List of Substances. In order to box, the athlete must first obtain the authorization (Therapeutic Use Exemption-TUE) to take the needed medicine.
TUEs have been implemented to allow athletes to box and to utilize prohibited substances at the same time. The use - In or Out-of-Competition - of those drugs apply to different rules and procedures.   

        What are the criteria for granting a TUE?

The criteria are:
- The athlete would experience significant health problems without taking the prohibited substance or method;
- The therapeutic use of the substance would produce no additional enhancement of performance other than that which might be anticipated by a return to   a state of normal health following the treatment of a legitimate medical condition; and  
- There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method.

The TUE will be taken into consideration if the substance is detected in the athlete's sample, and it will protect the athlete from sanctions if the medical justification is confirmed. International competing athletes who need to apply for a TUE should request information about the TUE application process to AIBA through their National Federation.

Athletes included by AIBA in its Registered Testing Pool and other Athletes participating in any International Event must obtain a TUE from AIBA (regardless of whether the Athlete previously has received a TUE at the national level). The application for a TUE must be made as soon as possible (in the case of an Athlete in the Registered Testing Pool, this would be when he/she is first notified of his/her inclusion in the pool) and in any event (save in emergency situations) no later than 21 days before the Athlete’s participation in the Event.  

Athletes not in AIBA’s Registered Testing Pool who inhale Glucocorticosteroids and/or formoterol, salbutamol, salmeterol or terbutaline to treat asthma or one of its clinical variants do not need a TUE in advance of participating in an International Event unless so specified by AIBA. 

What major changes does the revised ISTUE include? (no ATUE anymore)

Generally speaking, the feedback received indicated that the principles and the philosophy of TUEs are well accepted and considered as useful. The only revisions requested concerned the Abbreviated TUE process (as opposed to Standard TUEs), due to the administrative workload it generates for ADOs. This concerns a limited number of identified substances. The revised ISTUE addresses these concerns by eliminating the concept of the Abbreviated TUE.

Asthma (inhaled Beta-2 agonists and inhaled Glucocorticosteroids)

The revised ISTUE, which takes into consideration stakeholder feedback and current medical perspectives such as the International Olympic Committee Consensus on Asthma issued in February 2008 (calling for strict control of use of controls of these drugs by athletes) is based on the premise that for the process to be manageable while at the same time deterrent enough for elite athletes, different requirements can be requested of athletes depending on their level (international or national level). All athletes needing to use inhaled Beta-2 agonists and inhaled Glucorticosteroids for asthma must have a medical file and must declare these substances in ADAMS and on the doping control form.

For international-level athletes:
Athletes part of an international registered testing pool (IRTP) need an approved Standard TUE for asthma prior to using the substance. For athletes who are no part of an IRTP but are taking part in an international event, it is at the discretion of the IF either to deliver a TUE prior to the event or to provide a retroactive TUE in case of an adverse analytical finding (AAF). The granting of a retroactive TUE has to comply with the criteria set forth in the revised ISTUE.

For national-level athletes:
- It is at the discretion of the NADO either to approve the TUE or to provide a retroactive TUE in case of an AAF. In any case, all athletes may request a TUE if they wish to do so.

Non-Inhaled, Non-Systemic Glucocorticosteroids (GCS) 
In the case of non-inhaled, non-systemic GCS, the athlete must provide a minimum declaration that includes the diagnosis, the substance taken, and contact information of the medical doctor who administered the treatment. It is at the discretion of the ADO to ask for more than this minimum declaration. For topical use of GCS, neither a TUE nor a declaration is requested.

How to apply for an exemption?

An exemption will be granted only in strict accordance with the AIBA and WADA criteria. First of all, boxers must obtain the official form from AIBA Anti-Doping Department and on this website.

To simplify and accelerate the whole exemption process, the AIBA Anti-Doping Department and AIBA Media & Communications Department work in common to update regularly the anti-doping section on AIBA's website and to give all the necessary forms directly on-line.

The application for a TUE must include a comprehensive medical history and the results of all examinations, laboratory investigations and imaging studies relevant to the application. Only when it has been fully completed, the form has to be sent to AIBA Headquarters in Lausanne (Switzerland). 

Q&A on tue for athletes 

What happens if I am granted a TUE?
TUEs are granted for a specific medication with a defined dosage. They are also granted for a specific period of time and do expire. The athlete needs to comply with all the treatment conditions outlined in the TUE Application. Once a TUE has been granted by an IF or a NADO, it will inform WADA, who will then have the opportunity to review this decision. If the decision does not conform to the International Standard for TUEs, WADA may reverse it and deny the TUE.

What can I do if WADA reverses the original decision granting me a TUE?
You or your granting authority can appeal to the Court of Arbitration for Sport (CAS) for a final decision.

What should I do if I am notified for doping control while using a prohibited substance under a granted TUE?
When filling out the doping control form, make sure that you declare the substance or medication being used and that you specify that a TUE has been granted. If you have easy access to a copy of the TUE Approval form, it is preferable but not mandatory that you show it to the doping control official.

What will happen if the prohibited substance is detected during the analysis?

What will happen if the prohibited substance is detected during the analysis?

When the doping control authority receives the report from the laboratory, an initial review will take place to verify that the TUE is still in effect and that the results of the analysis are consistent with the TUE granted (nature of substance, route of administration, dose, time frame of administration, etc.). If the review proves satisfactory, the result of your test will be recorded as negative.
The revised ISTUE entered into force on January 1, 2009, at the same time as the revised Code and the revised AIBA Anti-Doping Rules.