The Prohibited List explained

What are non-approved substances?

Non-approved substances are substances that do not address any of the sections of the prohibited list and currently have no approval by any government regulatory health authority for human therapeutic use. 

What are the risks of non-approved substances?

Non-approved substances have been linked to:

• Contamination
• Safety is unknown

Because non-approved substances have not been approved by a regulatory body the effectiveness, safety, risk and harm for human therapeutic use is unknown.

Where are non-approved substances encountered?

Non-approved substances are commonly encounter during a pre-clinical trial, found as designer drugs, discontinued drugs and veterinary pharmaceutical that have not been approved for human use. 

Common example includes:

• Experimental peptides such as BPC-157 sold as a supplement.

What are Anabolic Agents?

Anabolic Androgenic Steroids

A group of synthetic drugs that are similar to the male sex hormone testosterone. They regulate the development and maintenance of male characteristics having a tissue building and masculinising effect.

Other Anabolic Agents

Anabolic agents that have similar characteristics to anabolic androgenic steroids however influence other systems such as the heart and central nervous system e.g. Clenbuterol. This class include Selective Androgen Receptor Modulators (SARMs).

SARMs are experimental medicines claiming to build muscle mass and bone density without the side effects of steroids. They are not only banned in sport, but many have not undergone clinical trials and have not been deemed fit for human consumption.

What are the risks of Anabolic agent use?

Anabolic agent use has been linked to:

• Thickening and enlargement heart
• Arteriosclerosis (hardening of arteries)
• Heart attack & stroke
• Liver disease & cancer
• Acne
• Kidney or prostate cancer
• Fluid retention
• Depression, aggression & psychosis

In men:

• Gynaecomastia (breast enlargement)
• Suppressed spermatogenesis (reduced sperm count)
• Testicular atrophy
• Erectile dysfunction
• Hair loss
• Prostate problems

In women:

• Facial hair growth
• Deeper voice
• Change in facial features
• Disturbances to menstrual cycle
• Decreased breast size

Where are Anabolic agents encountered?

In Australia anabolic agents can only be legally used by an individual if a doctor has provided them a prescription for a legitimate medical condition. They may be prescribed to assist people with cancer, AIDS, anaemia or hormonal problems like delayed puberty in males or men with testicular disease or pituitary failure.

Anabolic Agents cannot be manufactured, imported, used or held in someone’s possession without a prescription or medical practitioner licence.

The ability to buy SARMs online or the presence of online advertising, does not negate the fact they are illegal in Australia without a valid prescription, licence or authority to possess. Buying SARMs online, or products containing SARMs, could result in hefty fines and/or jail time. For athletes, purchasing SARMs can also result in a lengthy ban for sport for the anti-doping rule violations of possession or trafficking.

Common examples include:

Prescribed medicines:

• Testosterone: e.g. Testim- testosterone gel used to treat primary hypogonadism
• Metenolone: e.g. Nibal Injection- used to treat anaemia due to bone marrow failure
• Oxandrolone: e.g. Oxandrin- used to promote weight gain after excessive weight loss from surgery or illness.

Other products:

• SARMs
  • Andarine
  • Ligandrol  
  • Ostarine

What are Peptide Hormones, Growth Factors, Related substances and Mimetics?

There are 3 categories of substances in this class.

Erythropoietins (EPO) and Agents affecting Erythropoiesis

Erythropoietin (EPO) is a hormone produced by the kidney and released into the blood when a reduction in oxygen is detected. It stimulates the formation of new red blood cells from blood stem cells in the bone marrow (erythropoiesis).

Peptide hormones & their releasing factors

Peptide hormones consist of small chain amino acids which circulate in the blood & bind to receptors on specific organs and tissues. They enable or disable biological pathways coordinating development, growth and reproduction. Eg. Luteinizing hormone (LH) stimulates reproductive system.

Releasing factors stimulate the body to produce and release specific hormones eg pituitary gland secrete LH when detects presence LH-releasing factor in blood.

Growth factors and GF modulators

Growth factors are a group of secreted proteins that stimulate the growth of specific tissues. Unlike hormones which are produced by glandular tissue, growth factors can be produced by many different tissue types. For example, Insulin-like Growth Factor-1 (IGF-1), and its analogues.

What are the risks of Peptide Hormones, Growth Factors, Related substances and Mimetics?

The use of Peptide Hormones, Growth Factors, Related substances and Mimetics have been linked to:

• Increased risk of bleeding
• Shortness of breath
• Swelling of arms and legs
• Thrombosis
• Thick blood which can cause heart attack
• Gynaecomastis
• Increased risk of cancer
• Acromegaly
• Increased risk heart disease and diabetes
• Cushings syndrome

Where are Peptide Hormones, Growth Factors, Related substances and Mimetics encountered?

Peptide Hormones, Growth Factors, Related substances and Mimetics are found in prescription medications used to treat anaemia, cancer, AIDS, fertility issues, pituitary deficiencies, and therapeutic treatment for growth.

Prescribed medicines:

• Epoetin: injection used to treat anaemia
• Zoladex: injection used to treat breast and prostate cancer
• Decapeptyl: injection used to treat endometriosis

Peptide hormones should only be used as prescribed by a doctor and should not be purchased in dietary supplements.

Other products:

Synthetic peptides, such as Sermorelin and Ipamorelin, are often found in products marketed as assistants for anti-aging, muscle building and fat loss.

What are Beta-2 Agonists?

Beta-2 Agonists are a group of medication which mimic epinephrine and norepinephrine attaching to B2 receptors in muscles found in lungs, digestive tract, uterus and some blood vessels. This causes a chemical response which facilitates smooth muscle relaxation for example bronchodilation of the airways.

What are the risks of Beta-2 Agonists?

The use Beta-2 Agonists has been linked to:

• Tachycardia
• Headache
• Excessive sweating
• Dizziness
• Tremors
• Anxiety
• Rash
• Chest pain
• Muscle cramps

Where are Beta-2 Agonists encountered?

Prescription medication

Beta-2 Agoinsts are regularly prescribed to treat asthma, chronic obstructive pulmonary disease (COPD) & Hyperkalemia. For example:

• Ventolin - Inhaler short acting bronchodilator used for asthma
• Salmeterol- Inhaler used for COPD
• Albuterol - Prescription medication used for asthma and COPD however often misused in an attempt to increase fat loss.

Other products

Higenamine is often found in supplements. It may be present under many botanical names.

What are hormone and metabolic modulators?

Hormone and metabolic modulators contain synthetic compounds that act to modulated hormonal pathways, they modify the effects of hormones to slow down or accelerate enzyme reactions.

There are five categories of hormone and metabolic modulators:

1. Aromatase inhibitors
2. Selective Estrogen Receptor Modulators (SERMS)
3. Anti-estrogenic substances
4. Agents modulating myostatin function
5. Metabolic modulators

These hormone and metabolic modulators are generally used to interfere with the function of hormones.

What are the risks of hormone and metabolic modulators?

The use of hormones and metabolic modulators has been linked to:

• Cardiac problems
• Pain and weakness in joints
• Difficulties breathing
• Sweating/hot flushes
• Blurry vision
• Skin rashes
• Dizziness

As the use of hormone and metabolic modulators interferes with the normal functioning nature of hormones, the endocrine system that controls these hormones is significantly impacted. This interferes can therefore increases the risk of severe illnesses.

Where are hormone and metabolic modulators encountered?

Hormone and metabolic modulators are found in prescription medications to treat hormone conditions such as menopause, osteoporosis and diabetes. They may also be found in supplements.

Common examples include:

Prescribed medicines:

• Anastrozole (Arimidex) in a tablet form to treat early breast cancer.
• Raloxifene in a tablet form to prevent osteoporosis.
• Fulvestrant in a solution injection to treat postmenopausal.

Other products:

• Supplements claiming to stimulate muscle growth.

What are diuretics and masking agents?

Diuretics are classified as a substance that has the ability to dilute urine and therefore potentially impair or mask banned substance that would otherwise be found in athletes. Diuretics are medicines that increase the amount of urine produced. Urination is a method of removing excess salt and water from the body. Diuretics are commonly used to treat condition that have fluid retention and reduces blood pressure.

What are the risks of diuretic use?

Diuretics use has been linked to:

• Increased urination
• Increased sodium loss
• Affects blood potassium levels
• Dizziness
• Dehydration
• Muscle cramps
• Joint disorders (gout)
• Increased blood sugar

The use of diuretics affects the levels of electrolytes in your system and can create an imbalance which leads to severe health problems. The interaction of diuretics with certain medical conditions such as diabetes is not safe.

Where are diuretics and masking agents encountered?

Diuretics are prescribed medications. There are three main types of diuretics:

1. Thiazide
2. Loop
3. Potassium-sparing.

Diuretics can also be purchased as an over-the-counter medication and found in supplements in a less potent form.

Common examples include:

Prescribed medicines:

• Furosemide in tablet form to treat oedema
• Spironolactone in tablet form to treat hypertension

Other products:

• Water pills or water weight loss supplements

What are stimulants?

Stimulants are a class of drugs that accelerate the function of the central nervous system. They stimulate the sympathetic nervous system which causes an increase in body temperature, heart rate, blood pressure and affects respiratory rate. They also suppress sensations of hunger, thirst and fatigue which when combined with sharp rises in body temperature result in an increased risk of dehydration, complete exhaustion and death.

What are the risks of stimulant use?

Stimulant use has been linked to:

• Heart palpitations and heart attack
• Stroke
• Tremor
• Anxiety and Depression
• Seizures
• Heat exhaustion
• Shortness of breath and Respiratory paralysis
• Aggression
• Sleep disturbances

Stimulants are highly addictive and there is association with increased risk of heart attack and organ damage with increased use.

Stimulant use in conjunction with exercise is a significant risk factor of illness or death.

Where are stimulants encountered?

Stimulants can be prescribed medication, used to treat a number of disorders such as attention deficit hyperactivity disorder (ADHD). They can also be found in some over the counter medications. Additionally, stimulants are used as a recreational/illicit drug.

Common examples include:

Medicines:

• Medication prescribed for ADHD (e.g. Ritalin®)
• Over the counter cold and flu medicine containing Pseudoephedrine (e.g. Sudafed Sinus and pain relief tablets)

Illicit drugs:

• Cocaine
• MDMA / "ecstasy”

What are Narcotics?

Narcotics refer to opium derivatives, they originate from the opium poppy. Narcotics have been used to treat severe pain management, anaesthesia, sedations and cough suppression. Narcotics work by binding to certain receptors in the brain that tells the nerves to slow down the transmission of pain signals.

What are the risks of narcotics use?

Narcotics use has been linked to:

• Drowsiness
• Impaired judgement
• Slow reflexes
• Constipation
• Nausea
• Slowed heart rate
• Metal depression
• Rush or itching
• Agitation
• Breathing irregularities

Narcotics are highly addictive and cause abnormal chemical changes in the brain, dependence can become a real problem. If narcotics are taken for a longer period of time due to the nature of the drug your body can build up a tolerance therefore requiring larger amounts for the same effect.  Narcotics can be dangerous if taken with alcohol and other drug classes.

Where are narcotics encountered?

Narcotics are available via prescription medication, prescribed by a doctor for a medical purpose such as serve pain management that has not responded to other medications. Additionally, narcotics are substances of abuse used illegally. 

Common examples include:

Prescribed medicines:

• Fentanyl in the form of a patch to treat pain associated with cancer.
• Morphine in the form of an injectable solution as short-term management of severe pain.
• Oxycodone in the form of oral tablets for severe pain management.

Illicit drugs:

• Diamorphine (Heroin).

What are Cannabinoids?

Cannabinoids are drugs that share the active agent found in Cannabis (Marijuana). Cannabinoids are any chemical substance that bind to the cannabinoid receptors in the brain and body. They have similar effect to that produced by the Cannabis Sativa Plant.

What are the risks of Cannabinoid use?

Cannabinoid use has been linked to:

• Dry mouth
• Low blood pressure
• Altered hormone levels
• Altered senses
• Altered sense of time
• Mood changes
• Impaired motor skills
• Impaired memory
• Hallucinations
• Psychosis

Cannabinoids also have the added risk of side effects when they interact with other drugs. This interaction can have a sedative effect that can lead to severe complications.

Where are Cannabinoids encountered?

Most cannabinoid products are unregistered drugs. For the legal use of cannabinoids as a medical treatment, they are prescription medications only. They can be used to treat neuropathic pain, for example patients with Multiple Sclerosis (MS) and cancer. Additionally, cannabinoids are used as a recreational/illicit drug.

Common examples include:

Prescribed medicines:

• Sativex Oromucosal Spray to treat symptoms of Multiple Sclerosis.
• Epidyolex cannabidiol in oral liquid form to treat seizure symptoms.

Illicit drugs:

• Cannabis (Marijuana)

What about CBD?

Cannabidiol, or CBD, is specific cannabinoid which is not prohibited however CBD products are high risk to athletes. Scientifically, it is nearly impossible to extract only CBD from the cannabis plant. Therefore, athletes should assume that all CBD products contain other prohibited cannabinoids, including THC, CBN, CBG as well as CBD.

Other information on this website

Medicinal Cannabis in Sport

Can I get a TUE for cannabis/cannabinoids/THC/CBD?

What are glucocorticoids?

Glucocorticoids are a class of steroid hormones, that suppresses the inflammatory responses and therefore interacts with the immune system. Glucocorticoids as a medicine is usually synthetic compounds that have anti-inflammatory effect similar to natural glucocorticoids.

What are the risks of glucocorticoids?

Glucocorticoid use has been linked to:

• Suppressed calcium absorption
• Weight gain
• Water retention
• Mood Swings
• Muscle weakness
• High blood pressure
• Feeling nervous
• Blurred vision
• Sleep disturbances

Because glucocorticoids suppress the immune system, the risk of infections becomes greater and with long term use, the risk of muscle loss can result in Cushing’s Disease.

Where are glucocorticoids encountered?

Glucocorticoids can be prescribed medication, used to treat a number of autoimmune disorders such as rheumatoid arthritis, multiple sclerosis and allergies such as asthma. They can also be found in some over the counter medications to treat skin conditions such as eczema.

Common examples include:

Prescribed medicines:

• Cortisone: in the form of an injection into joints.
• Prednisone: in a tablet form to treat severe bronchial asthma
• Triamcinolone: in a cream form to treat skin conditions.

Over the counter medicines:

• Hydrocortisone: in a cream form to treat contact dermatitis (skin irritations).  

The status of Glucocorticoid use is impacted by the manner, or route of administration, in which a product is used. Athletes should seek specific advice about their personal use.

What is manipulation of blood and blood components?

Blood is a bodily fluid that is the pumped by the heart to circulate throughout the body to supply essential substances in order for the cells and organs to function. Blood doping is the method of introducing blood or red blood cells products into the circulatory system. This manipulation alters the natural capacity to transfer oxygen throughout the blood.

What are the risks of manipulating blood and blood components?

Manipulation of blood and blood components has been linked to:

• Heart problems
• High blood pressure
• Blood clots
• Infections
• Decrease platelets  
• Increased viscosity
• Damage to the kidney and liver

Changing the components of your blood can be life-threatening as this technique can lead to heart diseases, stroke and pulmonary embolism.

Where is the manipulation of blood and blood components encountered?

Manipulation of blood and blood components can be accomplished by blood transfusions or the administration of recombinant human erythropoietin (rEPO). Blood transfusions are commonly encountered after a major injury or surgery where a significant amount of blood is lost. 

Common examples include:

• Transferring blood via intravenous lines.  
• Autologous doing – the removal of red blood cells, stored at low temperatures and then transfused back into the body.
• Homologous doping- the addition of red blood cells from a donor.
• Plasma donation – due to the re-infusion of red blood cells during the plasma donation process this is prohibited

What is chemical and physical manipulation?

Chemical and physical manipulation involves:

1. Sample tampering:
   • Adulteration: Adding another liquid or agent to the urine sample in order to destroy a drug present or mask it from testing methodologies Substitution: Replacement of a urine specimen
2. Intravenous infusions and or injections of more than a total of 100ml per 12 hours, except for those legitimately received in the course of hospital treatments, surgical procedures or clinical diagnostic investigations.
   • Intravenous injection or infusion occurs when a substance is given directly into the vein through a needle. It could be delivered in a small volume with a simple syringe, or in a large volume through a specialized needle, tubing, and an IV bag.

What are the risks of chemical and physical manipulation?

Intravenous infusions and or injections:

• Infection
• Cellulitis
• Inflammation of the vein wall with associated thrombosis (clot)
• Bleeding
• Leakage of solution into the surrounding tissue
• Air embolism
• If inappropriate levels of electrolytes are administered there can be serious cardiac, muscular, and nervous system effects, even resulting in death.

Where is chemical and physical manipulation encountered?

Common examples include:

• Wellness clinics offering IV infusions for wellbeing, lifestyles or hangover recovery
• Vitamin IV drips

What is gene and cell doping?

Cells are the building blocks of life, responsible for all of life’s processes. A gene is a section of DNA within the genome that contains the information that gives humans their individual characteristics.

Gene doping refers to the process of modifying your genes, where genetic materials or substances are introduced into the body that changes the expression of genes. They alter the way the cells function within the human body. 

What are the risks of gene and cell doping?

Gene and cell doping has been linked to:

• Cancer
• Irreversible damage to functional systems
• Growth factors are compromised (cause tumour cells) 
• Infections from transfer methods
• Contaminated products introduced into the body
• Loss of normal functions (alterations)  

With the nature of altering your genetic makeup through gene and cell doping, once genetic modification has occurred the cells will continue to synthesise the substances throughout your lifetime. The changes are irreversible.

Where is gene and cell doping encountered?

Gene and cell doping can be accomplished by the use of nucleic acids that alter the genome’s sequence through gene editing, gene silencing and gene transfer. It can be encountered through genetically modified cells.

Common examples include:

• Gene therapy
• Manipulated DNA/RNA infected via viruses
• In Vivo
• Ex Vitro

What are Beta-Blockers?

Beta-Blockers are a group of drugs that act to block the effect of adrenaline. They reduce the speed and force of the hearts contractions and widen blood vessels, reducing blood pressure.

What are the risks of Beta-Blockers?

Beta-Blockers use has been linked to:

• Nausea
• Asthma attacks
• Erectile dysfunction
• Fatigue and dizziness
• Poor circulation
• Weight gain

If taken without prescription Beta-Blockers can have dangerous effects as they can cause severe changes in blood sugar and heart failure in some individuals. Using Beta blockers whilst performing strenuous exercise can also lead to an increase in risk as the heart is unable to accommodate the increased demand placed upon it.

Where are Beta-Blockers encountered?

Beta-blockers are found in prescription medications primarily those prescribed to treat heart conditions such as atrial fibrillation, high blood pressure and angina. However, they can be prescribed for other conditions such as glaucoma and anxiety.

Common examples include:

Prescribed medicines:

Used to treat angina, hypertension and treat and prevent heart attacks:

• Propanolol (e.g. Inderal)
• Metoprolol
• Atenolol (e.g. Tenormin)

Other uses:

• Timolol:  - eye drop used to treat Glaucoma

What sports are Beta-Blockers Prohibited in?

Beta Blockers are prohibited In-Competition only, in the following sports, and also prohibited Out-of-Competition where indicated (*).

• Archery (WA)*
• Automobile (FIA)
• Billiards (all disciplines) (WCBS)
• Darts (WDF)
• Golf (IGF)
• Shooting (ISSF, IPC)*
• Skiing/Snowboarding (FIS) in ski jumping, freestyle aerials/halfpipe and snowboard halfpipe/big air
• Underwater sports (CMAS) in all sub disciplines of freediving, spearfishing and target shooting