THERAPEUTIC USE EXEMPTION
To compete at a high level while taking beta blockers you’ll need to apply for a therapeutic use exemption (TUE).
In the UK, UK Anti-Doping (UKAD) is responsible for creating an environment for confidence in clean sport, and part of its remit is the granting of TUEs.
UKAD also defines at what level of competition a TUE is required, known collectively as the UKAD National TUE Pool: British Shooting World Class Programmes (Olympic and Paralympic) British Shooting National Academy Programmes (Olympic and Paralympic) British Shooting Talent Academy Programmes (Olympic and Paralympic) Athletes competing at ISSF and/or WSPS Major International Events (World Cups, World Championships and European Championships).
Other organisers may also choose to adopt WADA standards in their rules, terms and conditions. For example, the rules for the CPSA Championships stipulate that competitors must ‘refrain from the use of banned substances that contravenes the rules of WADA and UKAD’. Always check the small print.
Applying for a TUE can be done by following the instructions on UKAD’s website. You will need to provide your medical history and a clinical justification from the prescribing doctor:
• The prohibited substance or method in question is needed to treat a diagnosed medical condition supported by relevant clinical evidence.
• The therapeutic use of the prohibited substance or prohibited method will not produce any additional enhancement of performance beyond what might be anticipated by a return to the athlete’s normal state of health following the treatment of the medical condition.
• The prohibited substance or prohibited method is an indicated treatment for the medical condition, and there is no reasonable permitted therapeutic alternative.
• The necessity for the use of the prohibited substance or prohibited method is not a consequence, wholly or in part, of the prior use (without a TUE) of a substance or method that was prohibited at the time of such use.
The second and third criteria are troublesome for competitors with arrythmias and other conditions that don’t react positively to alternative treatments.
Nick Wojek, UKAD’s head of science and medicine, says: “The TUE process is there to enable athletes who have legitimate medical conditions to continue competing. But this is impossible to uphold when a prescription drug gives an individual an advantage. If an athlete in this position has real ambition to progress, I urge them to contact UKAD early for advice because it is very difficult to obtain a TUE for a beta blocker. A panel of three doctors reviews each application objectively, but the second criteria states that a substance can only return the competitor to a normal state of health, it cannot provide any performance enhancement, which is an obstacle when assessing beta blocker applications.
“So it is extremely rare that TUEs are approved for beta blocker use.”