WADA proposes Tramadol remains a monitored rather than a banned substance in 2015

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Although there is growing concern about the use of the powerful painkiller tramadol in cycling, the World Anti Doping Agency has confirmed to CyclingTips that it is not currently envisaged that the substance will be added to the prohibited list in 2015.

According to a WADA spokesperson the painkiller, which has been described by some professional riders as having performance enhancing capacities and which has been anecdotally linked to a number of crashes in races, could retain its current status as a monitored substance rather than being banned.

If so, it means that while WADA would test for it and note the extent of its use, that riders would not be prevented from using it.

The spokesman underlined that a final decision is yet to be made and that the months ahead will likely see debate on this issue.

“Tramadol was added to the monitoring programme back in 2012,” he told CyclingTips. “It has remained on our programme for 2014 and the latest is that it has been added to our draft monitoring programme for 2015. So we propose that it remains on our watch list, that it continues on the monitoring programme.

“That is open for consultation over the next few months until September. That programme would then be approved at our executive committee meeting, along with the prohibited list.”

Tramadol became a major topic of conversation in October 2012 when Taylor Phinney spoke at length to VeloNation.com on the use of the substance in the sport.

“You see so many late-race stupid crashes that I almost wouldn’t be surprised if some or most of those crashes are caused by people taking these hard-hitting painkillers at the end of races,” he told this writer, referring to tramadol and other similar substances.

“There is widespread use of finish bottles, which are just bottles of crushed up caffeine pills and painkillers. That stuff can make you pretty loopy, and that is why I have never tried it. I don’t even want to try it as I feel it dangerous.”

Aside from having risks of increasing crashes in the bunch, Phinney added that he felt the substances were also potentially a gateway to harder products. “I do think in a way that painkillers could either be a stepping stone to something bigger, or perhaps a step down for maybe an older pro who has had a sketchy past, who has got used to racing with something and has to have something,” he said then.

“From there, there is a whole argument about things like cortisone; people can invent a knee injury and get a TUE for that substance. Using that would definitely enhance your performance.

“If it was up to me, I would say if you need cortisone, you shouldn’t be racing. You should get that injury fixed and then you can come back, but you are not racing any more in the meantime.

“It is the same thing with painkillers or something like Sudafed. If you wake up with a fever and you need to take some sort of painkillers to be racing, then you probably shouldn’t be racing in the first place and your team doctor should be worried about your health and send you home.”

The debate about such grey area products has continued since then. More recently former US Postal Service, Discovery Channel and Team Sky pro Michael Barry admitted using banned substances for much of his career. He said that he was racing clean in his latter years but, while competing with Team Sky, said that he and others used tramadol.

He accepts now that even if it didn’t break rules, that it was dangerous. He is also clear about the performance benefits, likening it to using prohibited substances such as EPO.

“Tramadol is something different from an over-the-counter analgesic,” he wrote in his book, Shadows on the Road. “It is a controlled opioid that is potentially addictive and has a long list of adverse effects.

“When I crashed and broke ribs on the second day of the Tour de France, I took tramadol to alleviate the pain. The drug made me feel slightly euphoric. It made my legs feel painless. I could push harder than normal. It was as performance enhancing as any banned drug I had taken, but with a major difference: it was legal.”

Responding to Barry, Team Sky didn’t address whether or not the substance was used by its riders during the period specified. Instead, it simply denied it was in use at this point in time.

WADA deliberations: Why is it not banned?

WADA has a clear guideline as to when products should be banned; the agency states that if a substance satisfies two out of three criteria, then it should be blacklisted.

“A substance or method may be placed on the Prohibited List if it meets two of the following three criteria: it has the potential to be performance enhancing; can be detrimental to the health of an athlete; and it is contrary to the spirit of sport,” said the spokesman.

Listening to Phinney and Barry, both riders’ statements about the substance would appear to give grounds for debate. They are clear about the performance benefits and also about the potential for danger.

In addition to that, Phinney raised questions about whether or not such substances aligned with the spirit of sport.

“Another issue is taking something for an improvement, getting into that mentality. You have to ask why are you taking a painkiller?,” he stated. “You are doing that to mask effects that riding a bike is going to have on your body…essentially, you are taking a painkiller to enhance your performance.

“But the whole reason we get into sport in the first place is to test our bodies, to test our limits. If you are taking something that is going to boost your performance, that is not exactly being true to yourself, not exactly being true to your sport.”

Asked this week what the next step was in the process, the WADA spokesman told CyclingTips that there is some room for debate in the months ahead.

“At the moment it is proposed as being on the [monitored] list for next year. There is the potential for these things to change, depending on the opinion which comes back. But that is what we have proposed and then that gets confirmed in September’s meeting.

He said that he wasn’t in a position to give a personal opinion about why it would be on a monitored list rather than banned.

“All I can comment on is for something to be on our prohibited list, a substance or method, it needs to cover two of our three criteria. If it is not considered that it does tick two of those boxes, it is not added to the list as something which is going to become prohibited.

“I can only say that it obviously to date hasn’t ticked two of those boxes that are required.”

Xenon and carbon monoxide:

A different substance which does appear to have ticked those boxes is the gas xenon, which came to prominence during the recent Winter Olympics in Sochi. Believed to artificially increase the level of EPO in the body, the spokesman has confirmed that it looks set to be blocked from next year.

“Xenon has been added to the draft 2015 Prohibited List,” he said. “The draft List is open for consultation and for comments from stakeholders between now and the Executive Committee meeting in September, at which time it will be discussed once again and approved.”

Another substance – or, rather, method – which is rumoured to have been used by some within cycling to try to drive up red blood cell levels is carbon monoxide. At this point in time, there are no plans to block it.

“WADA is alert to the possible use of carbon monoxide. The alleged practice was reviewed recently by the List Committee, who are conscious of its potential dangerous effects,” he said. “It does not consider this approach to be blood manipulation and does not recognise it as a banned method.”

Back to tramadol, the substance which Phinney and Barry expressed concerns about. WADA is yet to make a final decision, but at this point in time it appears more likely than not that it won’t be prohibited in 2015.

“The status quo is what is proposed,” the spokesman confirmed, before stating that nothing is set in stone. “These things can change, and that is the whole point of this consultation period that it allows people to discuss it, to debate it openly and then depending on how that goes, a decision is taken in September.”

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