If you're taking medication for ADHD, you're not alone. According to the National Institutes of Health, approximately 4.4% of U.S. adults have ADHD. Medications such as Adderall (amphetamine and dextroamphetamine) and Ritalin (methylphenidate) help millions of people around the world manage their condition. As an elite athlete, it is vital that you understand how your need for medication will affect your ability to compete in the sport you love.
Understanding Therapeutic Use Exemptions
A Therapeutic Use Exemption (TUE) is required whenever an athlete needs to use a medication that contains a substance or requires an administration method that is on the List of Prohibited Substances and Methods. Obtaining a TUE establishes that an athlete is using the medication or administration method to maintain their health instead of to achieve a competitive advantage.
All of the stimulant medications that are used as the first-line treatment for ADHD are included on the World Anti-Doping Agency (WADA) Prohibited List. When people who don't have ADHD take stimulants, they can feel hyperactive or laser-focused. However, the same medication helps people with ADHD rein in their distractibility and hyperactivity.
There are two general types of TUEs: prospective TUEs and retroactive TUEs. Under the rules, athletes are required to obtain prospective TUEs before they use any type of prohibited substance for medical purposes. This means, typically, an athlete taking ADHD medication would seek to obtain a prospective TUE as soon as they have a diagnosis requiring the use of a banned substance. With proper documentation, a TUE for ADHD medication can be granted for up to four years at a time.
In very limited circumstances, an athlete may obtain a retroactive TUE after they have tested positive for a banned substance, which would negate their positive test. Thus, it is imperative an athlete try to secure a prospective TUE for their ADHD medication to minimize the risk of ever committing an anti-doping rule violation since retroactive TUEs are difficult to obtain.
If you need a TUE for your ADHD medication, you must have a diagnosis from a physician who specializes in the treatment of ADHD (preferably a psychiatrist) and has evaluated your condition using the DSM-5 criteria for ADHD. Your application must include objective medical information that demonstrates your developmental history, level of impairment, and any applicable observations that can be used to justify a DSM-5 diagnosis of ADHD. Information from multiple sources, including standardized behavior rating scales and documentation of changing treatment efforts, is recommended.
Although there is no reason to be ashamed of or feel embarrassed by an ADHD diagnosis, the process of obtaining a TUE is confidential to protect an athlete's privacy.
Different Organizations Have Different Guidelines for Athletes Seeking a TUE
The exact process you must follow to obtain a TUE will depend on the rules of your sport. For example:
- USA Track & Field (USATF) requires athletes to submit paperwork at least 30 days ahead of the competition in order to have their TUE approved.
- In Canada, although U Sports applies the WADA Prohibited List in accordance with the rules of the Canadian Anti-Doping Program (CADP), student-athletes are not required to complete formal paperwork for a TUE and instead, undergo a medical review once they receive an adverse analytical finding to validate and permit the use of prescribed medications for therapeutic reasons.
- The NCAA is not a WADA Code signatory, so it conducts its own in-house anti-doping program. A school may request a medical exception following a student-athlete's positive test for ADHD medication from the NCAA.
If you plan to compete on an international basis, remember that a TUE from a national anti-doping organization such as the U.S. Anti-Doping Agency (USADA) only applies to competitions within the country's borders. To compete internationally while taking your ADHD medication, you'll need to obtain approval from your sport's international federation, such as the Fédération Internationale de Football Association (FIFA).
Are You an Athlete in Need of a Therapeutic Use Exemption for Your ADHD Medication?
If you're an athlete who needs a Therapeutic Use Exemption to begin treatment or wishes to apply for a retroactive TUE to wipe out a pending anti-doping violation, it is critical to speak with our anti-doping attorneys as soon as possible. Attorneys Paul Greene and Matthew Kaiser have extensive experience navigating complex anti-doping regulations and will advocate for your interests throughout the process of obtaining a TUE. Contact us online or call us directly at +1-207-747-5899 to schedule a consultation.