To be Concerned: Tramadol Will Be Classified as Doping

Publication of the 2024 WADA Prohibited List. Source: WADA.

Jakarta, 29 September 2023

On September 28th, 2023 the World Anti-Doping Agency (WADA) publishes the 2024 List of Prohibited Substances and Methods (List), which was approved by WADA’s Executive Committee (ExCo) during its meeting on 22 September 2023 and enters into force on 1 January 2024.

On his statement, WADA Director General Olivier Niggli said: “We encourage athletes, their entourage and all stakeholders to acquaint themselves with the Summary of Major Modifications to avoid inadvertent use of substances and methods that are prohibited in sport for 2024. In particular, we kindly ask all Anti-Doping Organizations around the world to share the List and its related documents with athletes, their entourage and other relevant stakeholders under their jurisdiction.”

All Major Modifications for 2024 are outlined in the 2024 Summary of Major Modifications and Explanatory Notes, including the following particular information regarding tramadol.

For the historical stage of decision-making process, on 23 September 2022, the ExCo endorsed the recommendation by WADA’s List Expert Advisory Group to prohibit the narcotic tramadol in competition, effective 1 January 2024. 

The delay in implementation was to provide an additional year to allow enough time for stakeholders to learn and adapt to this change.

Tramadol has been on WADA’s Monitoring Program and data gathered through that program have indicated significant use in sports. Tramadol abuse, with its risk of physical dependence, opiate use disorder and overdoses, is of concern worldwide and has led to it being a controlled drug in many countries. Research studies funded by WADA, as referenced in the Explanatory Note, have also confirmed the potential for tramadol to enhance sports performance.

As in information, tramadol is a pain medication used to treat moderate to severe pain that is not being relieved by other types of pain medicines such as after the surgery. This form of pain medication is not for use on an as-needed basis for pain.

Tramadol is available only on prescription. Tramadol is a synthetic opioid and acts in the brain of the central nervous system to reduce the amount of pain somebody feels. If somebody has long term pain, this pain medication may also be prescribed if weaker painkillers no longer work.

Taking quotation of a news released by USADA few years ago, stating a real story of an elite athlete, points out that tramadol is the go-to painkiller for many athletes, despite its reputation of abuse. Speaking from experience, he explains that athletes feel perceptible pain relief by taking tramadol – a potent painkiller – before, during, and after intense workouts or competitions – all without risking a positive test. Unlike other narcotics, such as oxycodone and morphine, athletes know they can use tramadol whenever the pain hits and still remain compliant with anti-doping rules.

He started taking tramadol when his doctor prescribed it to him as pain relief from chronic pancreatitis, but soon realized that he could both train and competition better while taking the drug. “Using tramadol can feel as good as getting a blood transfusion for athletes,” he says. “You can pop a pill 18 hours into a 24-hour endurance race and it’s an immediate boost that helps you power through the end.” Fortified by recollections of his doctor saying that tramadol-dependency wasn’t something he’d encountered, he started getting tramadol through other competition when his prescription ran out, wanting the pain relief and believing that he wouldn’t get addicted.

But before long, his days were consumed by watching the clock, counting down the minutes between doses. His addiction was obvious – and disturbing – to both himself and those around him. His dependency destroyed a relationship, and it made him wonder how anyone could simultaneously be an addict and an elite athlete who cares about their body.

Trying to break the addiction, he would avoid taking the drug, only to be overcome by the debilitating symptoms of withdrawal, from nausea to cold sweats.

This cycle of need and regret was interspersed with a number of overdoses that left him disoriented, bleeding, and desperate for rehabilitation.

Because of that, IADO strongly reminds all athletes, athlete support personnel and their national federations to be aware of the new List of Prohibited Substances and Methods released by WADA, entering into force on 1 January 2024.  Compared to the 2023 list, the only difference is on the prohibition of use of tramadol, which has actually been sounded since September 22nd, 2022, it is however that other prohibited ones should be underlined, because once any athlete used to take such substance, he / she would be classified as to violate the anti-doping regulation, in particular the World Anti- Doping Code on certain period.

Jakarta, 29 September 2023.

Chairman of IADO,
Gatot S. Dewa Broto

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top