Revista de Medicina Desportiva (English) November 2018 | Page 16

Rev. Medicina Desportiva informa, 2018; 9(6):14-15.
Prof. Doutora Maria João
Cascais
Presidente da Comissão
de atribuição da AUT
The Therapeutic Use
Exemption (TUE)
What is a TUE?
It is a Therapeutic Use Exemp-
tion with the aim to ask for
authorization to use a medica-
tion indicated in the Prohibited
List. The athlete has the right to
have the best available treat-
ment and, sometimes, because
of a disease or a surgery he
needs to take medications
included in the prohibited list.
The TUE allows the athlete to
overcome this situation accord-
ing the Norms of the World
Anti-Doping Agency (WADA), to
which all athletes have to comply.
The TUE commission verifies the
application and gives an answer as
soon as possible. Each member of
this commission has it is own medi-
cal specialty, which allows to clarity
any doubts related to the several
pathologies and their treatments.
This means the athletes can be
prescribed with medications that
include substances forbitten by
WADA?
Yes, but if there is an urgent treat-
ment, the medication can be given
on first instance and later it will
be asked for a retroactive TUE. The
classification of the situations that
allow a retroactive TUE are indi-
cated on WADA’s site and a version
for doctors can be consulted at the
ADOP’s site.
How does the doctor know that
the medication included in the
Prohibited List?
Every year, during October, a List of
Prohibited Substances and Methods
14 november 2018 www.revdesportiva.pt
is ratified by the National Anti-
Doping Agencies in every country.
In Portugal it is ADOP the entity
responsible for this process and
for the annual publication of the
actualized list in Diário da República
for the next year. This List is updated
annually, and it includes forbitten
medications to consume in all occa-
sions (in and out of competition) or
only during competition, and it also
includes the Monitoring Program of
non-forbitten substances, but their
consumption is monitored by the
anti-doping laboratories. Caffeine,
for example, is one of the monitored
substances. At ADOP’s site there is a
tool called Jogo Limpo (figure) where
is possible to check if a certain medi-
cation is included in the List.
But the athlete should indicate that
he or she is an athlete…
It is thought that the athlete informs
the doctor of his/her condition as
an athlete, but not all the athletes
are aware of this or they weren’t
correctly informed. The urban myths
are strong if the person is not well
educated. However, if the doctor
does a correct anamnesis during
the consultation, he will find out
that person is an athlete and will be
aware of some limitations for the
prescription. Regarding the emergent
treatment, he has the opportunity
to make a TUE after applying the
medication, but he should respect
the established and publicized rules.
It is reminded, however, that the
athlete is responsible for appearance
in the body of any forbitten drug or
its metabolites.
How can one apply? Where are the
forms?
The athlete must fill and sign the
application form (or the legal person
if he/she is a minor) and the doctor
that made the prescription for that
athlete has to sign it as well, but it
could be another or the accompany-
ing doctor. It is stretched that for
some medications only the respec-
tive specialized doctor can apply for
authorization of medication related
to his/her area of experience, and it is
also needed to send medical reports
about the disease. For example, con-
cerning the diuretics, a report with a
clinical history performed by a car-
diologist, or the so often application
for hyperactivity syndrome, where
there are rigid rules that indicate the
kind of doctor that can make such
prescription and application and the
type of report that should be sub-
mitted. It is useful and required to
indicate an e-mail address and the
telephone number of the doctor and
of the athlete must be legible, which
information is important to proceed
with the process and to avoid any
delay. The official form can be down-
loaded from the ADOP’s site.
After sending the application, can
the athlete start the treatment
right away?
Provided it isn’t an emergent treat-
ment or a pathology that compro-
mises the well-being of the athlete
so obviously, the athlete must wait
for an answer from ADOP, which will
be sent by e-mail and later the offi-
cial certificate will be mailed to the