The World Anti-Doping Agency (WADA) is pleased to publish the List of prohibited substances and methods 2022 (the List), Summary of the main changes and explanatory notes for 2022And the Monitoring program 2022. The 2022 List was approved by the WADA Executive Committee at its meeting of September 14, 2021 and will come into force on 1er January 2022.
The List is one of eight International Standards that all signatories du World Anti-Doping Code (the Code) must respect. It lists substances and methods prohibited in and out of competition, as well as substances prohibited in certain sports.
"Each year, WADA conducts an extensive consultation process on the Prohibited List, involving some of the foremost experts in science and medicine in the world," said WADA Director General Olivier Niggli . This consultation is an opportunity for WADA to analyze the most recent trends and scientific research to ensure that any new or existing substance or method likely to meet the criteria justifying an addition to the List is examined so as to protect the health of athletes and to maintain a fair environment for all. "
“As in previous years, we encourage athletes, their entourage and all partners to familiarize themselves with the Summary of the main modifications to avoid the inadvertent use of substances and methods prohibited in sport in 2022. We ask in particular to all anti-doping organizations worldwide to kindly transmit the List and its associated documents to athletes, their entourage and other relevant partners within their jurisdiction in order to draw their attention to the important changes made to the use of salbutamol and glucocorticoids in 2022. "
Main changes
As indicated in the Summary of the main changes and explanatory notes for 2022, the main changes are as follows:
- S9. Glucocorticoids
The draft 2021 List which was reviewed by the WADA Executive Committee at its September 2020 meeting proposed to ban all routes of administration of glucocorticoids by competitive injection. The Executive Committee approved this change but asked WADA management to set the entry into force of the ban at 1er January 2022 only, in order to give stakeholders enough time to learn about and adapt to this change.
Therefore, all routes of administration of glucocorticoids by injection will now be prohibited in competition. Routes of administration by injection include intravenous, intramuscular, periarticular, intraarticular, peritendinous, intratendinous, epidural, intrathecal, intrabursal, intralesional (eg, intracheloid), intradermal, and subcutaneous.
It is important to specify that the oral administration of glucocorticoids, which remains prohibited in competition, includes in particular the oromucosal, buccal, gingival and sublingual routes. The other routes of administration (including by inhalation or by topical routes: dental-intracanal, cutaneous, intranasal, ophthalmological and perianal) are not prohibited when they comply with the maximum doses and therapeutic indications authorized by the manufacturer.
It is strongly recommended that athletes comply with the minimum elimination periods, i.e. from the time of administration until the start of the competition period. These elimination periods, detailed in the Summary of main changes and explanatory notes, are based on use that respects the maximum doses established by the manufacturer.
If a legitimate health problem justifies the use of a glucocorticoid, the athlete can request a therapeutic use authorization (TUE). In the event of an in-competition Adverse Analytical Finding, the Athlete may request a retroactive TUE as provided in the applicable rules.
For more information on WADA's approach to glucocorticoid administration routes and elimination times, please refer to Summary of main changes and explanatory notes.
- S3. Beta-2 Agonists - Doses of salbutamol
For salbutamol, the daily dose spacing is reduced from 800 micrograms per 12 hours to 600 micrograms per 8 hours from the time of taking any dose. The goal is to reduce the risk of an abnormal analytical finding after taking a high dose. The total allowable daily dose is maintained at 1600 micrograms per 24 hours. A TUE should be obtained for doses exceeding these limits.
For details on the permitted dosage of salbutamol, please see the Summary of main changes and explanatory notes.
- S0. Substances not approved
For the first time, a substance has been added by name, by way of example, in section S0 (Unapproved substances) of the List. This substance, BPC-157, is an experimental peptide sold as a supplement. It was added to the 2022 List following a recent reassessment.
Annual List Revision Process
Each year, WADA conducts a review process for the List, which begins with an initial meeting in January and concludes with the publication of the List no later than 1er October. This is an important consultation exercise that includes collection by the WADA Prohibited List expert advisory group information such as the most recent scientific and medical studies, trends and intelligence obtained from law enforcement and the pharmaceutical industry. This is followed by sending a Preliminary List to stakeholders, reviewing and taking into account the comments received, revising the preliminary version, and then reviewing it by the Agency's Health, Medicine and Research Committee. This committee then makes its recommendations to the WADA Executive Committee, which approves the List at its September meeting.
For a substance or method to be added to the List, it must meet at least two of the following three criteria:
- It has the potential to improve or actually improve athletic performance.
- It presents a proven or potential risk for the health of the athlete.
- It is contrary to sportsmanship.
The List is published three months before its entry into force, so that athletes, their entourage and other stakeholders can familiarize themselves with the changes. Athletes are responsible for prohibited substances present in their body and for the use of prohibited methods. Members of athletes' entourage can also be prosecuted for anti-doping rule violations if their complicity is established. Therefore, when an athlete or a member of his entourage has a doubt about a substance or a method, it is crucial that he contacts his anti-doping organization (his international federation or his national anti-doping organization) to obtain advices.
The TUE program
Athletes who have a legitimate medical reason to use a prohibited substance or method on the List may apply for a TUE to determine if they meet the criteria set out in the International Standard for Therapeutic Use Authorization (ISAUT). The TUE program is rigorous and an integral part of elite sport. It is very widely accepted by athletes, doctors and other stakeholders.
TUE guidelines, including new rules for glucocorticoids
To assist physicians and athletes, WADA will shortly update and publish on its website the following guidelines on the management of TUEs to incorporate the new rules associated with glucocorticoids.
- Background document on glucocorticoids and TUEs (expected mid-October 2021)
- Checklists of various health conditions justifying the use of glucocorticoids (expected in early November 2021)
- TUE guidelines for physicians to help TUE committees assess TUE applications for the administration of glucocorticoids to treat different health conditions (expected in early November 2021 )
Learning resources
In addition to the above guidelines, WADA has provided or will provide various educational resources as part of its Support program for signatories for the implementation of the Code (CISP), accessible on the Anti-Doping Education and Learning Platform (ADEL) of the Agency. These resources include:
- a CISP Checklist - Implementation of the Revised List (available now);
- an information sheet on glucocorticoids for athletes and athlete support staff (scheduled for October);
- a glucocorticoid information sheet for healthcare professionals (expected in the coming weeks);
- a guide for athletes and athlete support staff relating to the 2022 List (planned for around 1er January 2022).
Upcoming webinar
To help partners better understand and implement the 2022 List, WADA will host a webinar in November 2021. As part of this webinar, the WADA Prohibited List expert advisory group will introduce participants to the main changes to the 2022 Schedule. Over the next few weeks, WADA will communicate the details of this webinar.
Languages and formats
La 2022 Prohibited List, Summary of Changes and Explanatory Notes for 2022And the Monitoring program 2022, can be downloaded from the WADA website, in versions English et French. The Spanish version will follow in the coming weeks.
Partners wishing to translate the list into other languages are requested to indicate their interest at info@wada-ama.org. WADA will provide them with the necessary files and, once the translation is complete, it will be posted on the Agency's website.
The List in digital version for mobile devices will be accessible on 1er January 2022.
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