Sport Integrity Australia CEO warns athletes using ADHD medications

Sport Integrity Australia CEO Dr Sarah Benson has expressed concerns about the number of Australian athletes using medication for Attention Deficit Hyperactivity Disorder (ADHD) without a formal diagnosis or without the medication having been prescribed to them.

The use of ADHD medication without a formal diagnosis or an appropriate prescription can have serious anti-doping consequences for athletes, particularly where the substances are prohibited in competition and require a Therapeutic Use Exemption (TUE) for legitimate use in sport.

Many athletes with ADHD rely on stimulant medications such as methylphenidate (for example, Ritalin and Concerta) or dexamphetamine-based treatments (for example, Adderall and Vyvanse).

These substances are listed on the World Anti-Doping Agency’s Prohibited List (S6 Stimulants) due to their potential performance-enhancing effects.

Generally, athletes can use ADHD medication in sport if they have a medical diagnosis and it is part of a legitimate medical treatment.

In recent cases, athletes sought retroactive TUEs following their positive test. However, if an athlete does not have a formal diagnosis prior to using the medication, and/or the medication was not prescribed to them, a retroactive TUE cannot be approved and the athlete can face sanctions

In Australia, TUEs are managed and approved by the Australian Sports Drug Medical Advisory Committee (ASDMAC).
 

SIA's CEO Dr Sarah Benson said ADHD shouldn’t be a barrier to participation or performance, but there are protocols to follow for athletes competing at a high level before competing.

“I continue to see a significant number of inadvertent Anti-Doping Rule Violations (ADRV)s relating to the use of ADHD medication by high level Australian athletes come across my desk,” Dr Benson said.

Many of these athletes have legitimate reasons for taking ADHD medication to support their health and wellbeing.

– Dr Sarah Benson PSM, CEO of Sport Integrity Australia

“However, since these medications could be abused by athletes for performance improvement reasons, the tough reality is that they are banned under the World Anti-Doping Code if the athlete does not have a formal diagnosis.

“Under the Code, this is true even if they establish their diagnosis after the positive test, and they face a ban of one to four years.

“These are not the sort of cases I want to see, and I want to ensure that SIA is doing everything it can to help athletes and prevent these sorts of cases happening in the first place.”

SIA’s CEO Dr Sarah Benson said this warning also applies to the athlete’s support staff and family members. Everyone has a responsibility to support athletes with ADHD to follow the necessary processes.

“It is imperative that athletes and their support staff fully understand their responsibilities when it comes to the use of ADHD medication and TUEs,” Dr Benson said.

SIA has resources available to athletes and their support staff to guide them through the TUE process. This includes the TUE checker on the SIA App and website, and the TUE elearning course. Advice is also provided by SIA relating to if, and when, an athlete needs to obtain a TUE.

SIA acknowledges that there has been changes to the way ADHD can be diagnosed and prescribed in Australia, with specialised general practitioners now able to do so in some states.

The TUE process still applies in this case and TUE application requirements are the same.