The World Anti-Doping Agency moved to ban the opioid painkiller tramadol in competition from 2024 onward during the meeting of the Executive Committee in Sydney this week.
Tramadol is already prohibited in competition under UCI anti-doping rules, a provision that caught out Nairo Quintana (Arkéa-Samsic) in testing during the 2022 Tour de France.
Quintana is contesting the dried blood spot analysis that turned up traces of the addictive painkiller, which has had a history of abuse in professional cycling.
The Court of Arbitration for Sport registered Quintana’s appeal on September 1 but has not yet published a date for the Colombian’s hearing.
Under UCI rules, Quintana faces the disqualification of his Tour de France results and a 5,000 CHF fine for “the presence of tramadol and its two main metabolites” in samples taken after two summit finishes on stage 7 and stage 11 of the Tour at La Planche des Belles Filles and the Col de Granon, respectively.
Quintana’s points for his sixth place overall in the Tour de France are also at stake as Arkéa-Samsic fight to make the sporting criteria of being in the top 18 teams in the 2020-2022 rankings for the 2023 UCI WorldTour.
But from 2024 onward, the stakes for tramadol positives will be much higher, with athletes facing multi-year bans. WADA delayed adding the opioid to its Prohibited List for 2023 to provide “broad communication and education of athletes, their entourage and medical personnel”, according to the WADA press release.
“It will also give time to the scientific community to adjust the exact procedural details so that fairness can be ensured for athletes.”
Tramadol will not be banned out-of-competition but the drug can reportedly show up in urine tests up to four days after the last use, while blood tests are thought to detect the drug only within 24 hours of its last use.
The ban comes after almost ten years of lobbying by the MPCC, which has long asserted that riders were abusing the painkiller to dull the effects of muscle fatigue and boost performance.
The UCI began testing for tramadol in 2019 after several public admissions to abuse of the drug.
In 2012, former Team Sky rider Jonathan Tiernan-Locke alleged that tramadol was offered ‘freely’ around the Great Britain national team. “It just didn’t sit well with me,” he said. “I thought, ‘I’m not in any pain’, why would I want a painkiller?'”
Team Sky told Cyclingnews that the painkiller had been prescribed ‘minimally’ in 2013. Then, in 2014 former Team Sky rider Michael Barry told The Times that he had used the drug and it “made me feel euphoric, but it’s also hard to focus. It kills the pain in your legs, and you can push really hard.”
In 2018, Lieuwe Westra highlighted the use of substances that are technically allowed but abused for performance-enhancement. “People say: ‘why do you use tramadol? […] The answer is simple: because it is allowed and because you will perform better. And if I do not, someone else will. That’s what a cyclist thinks.”
WADA had the drug on its Monitoring Program for nearly a decade, gathering evidence of its use in sports, and funding research that supported the performance-enhancing qualities of tramadol.
In the meeting, the ExCo officially endorsed keeping the ban on cannabis, despite delta-9-tetrahydrocannabinol (THC) being legalized in many regions.
THC is prohibited in competition only with a urinary threshold of 150 ng/mL. “This threshold was increased in 2013 from 15 ng/mL. As such, the high level of cannabis required to trigger an Adverse Analytical Finding in competition today would be consistent with a significantly impaired athlete or a frequent user,” WADA wrote.
“Further, the inclusion of the ‘Substance of Abuse’ provision in the Code from 2021 significantly reduced the length of suspension from a potential two (or even four) years previously to as low as one month today for athletes who can establish that the THC use occurred out of competition and was unrelated to sport performance.”
“WADA plans to continue research in this area in relation with THC’s potential performance-enhancing effects, its impact on the health of athletes and also in relation to perceptions of cannabis from athletes, experts and others around the world,” WADA Director General Olivier Niggli said.