World Anti Doping Agency (WADA) - 2011 Prohibited List.

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2011 Prohibited List
Explanatory Notes on the 2011 Prohibited List

Introduction :
Members of the Anti-Doping Community should be aware that careful consideration has been given to all of the thoughtful comments that have been provided in response to the distribution of the draft 2011 List. It will be recognized that not all suggestions have been accepted or incorporated into the 2011 List but, as is explained below, modifications to the draft have been made possible because of the contributions and submissions of many of our colleagues.

S0 NON-APPROVED SUBSTANCES AND METHODS
This section has been added in order to address the issue of the abuse of substances that are currently in an experimental phase of development or that are not or no longer permitted for human use.

S1 ANABOLIC AGENTS
This section has been modified in a minor way to standardize the spelling for certain substances.

S2 PEPTIDE HORMONES, GROWTH FACTORS AND RELATED SUBSTANCES
S2.1: This section has been modified to include the international non-proprietary name of Hematide – “peginesatide”. In order to reflect the growing number of substances developed to stimulate erythropoiesis, hypoxia-inducible factor (HIF)-stabilizers have been added as an example of this class of products.
S2.3: Questions relating to the use of insulins and other associated substances will be the focus of further review by the List Expert Group in 2011.
S2.6: Platelet-derived preparations have been removed from the List after consideration of the lack of any current evidence concerning the use of these methods for purposes of performance enhancement notwithstanding that these preparations contain growth factors Despite the presence of some growth factors, current studies on PRP do not demonstrate any potential for performance enhancement beyond a potential therapeutic effect. Note that individual growth factors are still prohibited when given separately as purified substances as described in S.2.5

S3 BETA-2-AGONISTS
The WADA List Expert Group made changes to S3 (beta-2-agonists) in response to the concerns expressed by members of the Sport Community. References to the “Declaration of Use” have been removed. Concerns continue to exist about the performance-enhancing effects of beta-2-agonists when taken in large quantities. The List prohibits the administration of all beta-2-agonists except salbutamol (maximum 1600 micrograms over 24 hours) and salmeterol when taken by inhalation in accordance with the recommended therapeutic regime. Urinary thresholds continue to apply to the management of salbutamol; work is ongoing to develop thresholds for other beta-2-agonists.

The issue of beta-2-agonists will continue to be the focus of WADA’s research activity in order to ensure that the administration of large doses of these substances is prevented and prohibited, but that the appropriate care and treatment of asthmatic athletes is facilitated. Ongoing surveillance of the use of these medications will continue as a priority; it is to be anticipated that there will be further changes in the way in which these substances are addressed in the future.

S5 DIURETICS AND OTHER MASKING AGENTS.
• The prohibition of glycerol is not intended to prevent the ingestion of this substance which is commonly found in a variety of foodstuffs and toiletries. Such use will not cause a competitor to test positive for this Prohibited Substance.

• “Desmopressin” has been added as an example of a masking agent.
• The last paragraph of section S5 has been revised to more clearly explain the consequences of detecting an exogenous threshold substance at a sub-threshold concentration in the presence of a diuretic or other masking agent. Even when a Therapeutic Use Exemption (TUE) exists for the masking agent, the detection of the exogenous threshold substance at any level will be reported as an Adverse Analytical Finding by the laboratory and therefore a TUE is also required for the threshold substance when applicable.

M1 ENHANCEMENT OF OXYGEN TRANSFER
Minor changes have been made to the wording of this section to ensure consistency of style and structure.

M2 CHEMICAL AND PHYSICAL MANIPULATION
M2.2: Attention is drawn to the fact that medical information is provided on the WADA Web site (http://www.wada-ama.org/Documents/Science_Medicine/Medical_info_to_support_TUECs/WADA_Medical_info_IV_infusions_v.2.2_March2010_EN.pdf) to support the decisions of TUECs regarding the use of intravenous infusions.
M2.3: The prohibition of “the sequential withdrawal, manipulation, and reinfusion of whole blood” is not intended to prevent plasmapheresis, a specialized form of blood donation, and similar processes which are often undertaken by civic-minded Athletes and do not involve the re-administration of whole blood; rather it specifically addresses the process in which an Athlete’s blood is removed, treated or manipulated, and then re-injected. Those undergoing hemodialysis, as part of the treatment of chronic kidney disease, will require a TUE for such procedures (and the substances that are often used to treat such disorders).

M3 GENE DOPING
Significant changes have occurred to the wording, and ordering, of this section for purposes of clarification.

S6 STIMULANTS
• The stimulant “methylhexaneamine” (which may be described, like many other substances, by other chemical names) is now included in the Prohibited List as a Specified Substance. This substance is now often marketed as a nutritional supplement and may frequently be referred to as “geranium oil” or “geranium root extract”.
• Minor changes have been made to the spelling of “levmetamfetamine”.

S8 CANNABINOIDS
There have been changes to this section to clarify that marijuana-like substances (cannabimimetics) are included in the List.

S9 GLUCOCORTICOSTEROIDS
The section remains unchanged from the 2010 List insofar as the prohibited routes of administration of glucocorticosteroids are concerned. Surveillance of the use of these substances continues and work is ongoing to develop threshold levels to assist in the detection and management of these substances. It is to be anticipated that there will be further changes in this section in the future. References to “Declarations of Use” and “Therapeutic Use Exemptions” have been removed.

P1 ALCOHOL
Changes have been made in response to requests by the Union Internationale de Pentathlon Moderne (UIPM); due to changes introduced in the format of the competition, alcohol is no longer prohibited in Modern Pentathlon for disciplines involving shooting.

P2 BETA-BLOCKERS
• For clarification purposes, Skeleton has been added by name to the list of Fédération Internationale de Bobsleigh et de Tobogganing (FIBT)-governed sports where beta-blockers are prohibited.
• At the request of the federation [Fédération Internationale de Gymnastique (FIG)] beta-blockers are no longer prohibited in gymnastics.
• At the request of the federation [World Darts Federation (WDF)] beta-blockers are now prohibited in the sport of darts.