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 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