Therapeutic Use Exemptions
What is a Therapeutic Use Exemption (TUE)?
Athletes may have illnesses or conditions that require them to take medications or undergo procedures. If the medication or method an athlete is required to use to treat such illness or condition is prohibited as per the World Anti-Doping Agency’s (WADA) Prohibited List , a TUE may give the athlete the authorization to use that substance or method.
Applications for TUEs are evaluated by a panel of physicians, the TUE Committee (TUEC).
A TUE granted by Sport Ireland is only valid for national-level Competition and Out-of-Competition Testing.
What Are the Criteria For Granting a TUE?
All of the four following criteria must be met (for more details, please refer to the WADA International Standard for Therapeutic Use Exemptions (ISTUE) Article 4.2):
- The athlete has a clear diagnosed medical condition, which requires treatment using a prohibited substance or method;
- The therapeutic use of the substance will not, on the balance of probabilities, produce significant enhancement of performance beyond the athlete’s normal state of health;
- The prohibited substance or method is an indicated treatment for the medical condition, and there is no reasonable permitted therapeutic alternative;
- The necessity to use that substance or method is not the consequence of the prior use (without a TUE), of a substance or method which was prohibited at the time of use.
Who should apply for a TUE? Where and when to apply?
Athletes who are subject to anti-doping rules would need a TUE to take a prohibited substance or use a prohibited method. You should verify with Sport Ireland, whom you need to apply to i.e. Sport Ireland or your International Federation, and whether you need a TUE in advance of competition or can apply retroactively.
First, check if the required medication or method you intend to take or use is prohibited as per the WADA Prohibited List.
Check your medications and/or method here
You have a responsibility to inform your physician(s) that you are an Athlete bound to anti-doping rules. You and your physician(s) should check the Prohibited List for whatever substance/method you are prescribed. If the substance/method is prohibited, discuss non-prohibited alternatives, if there are none, apply for a TUE. Remember athletes have the ultimate responsibility. Contact Sport Ireland if you are having difficulties.
Then, contact Sport Ireland to determine your competition level and TUE application requirements.
If you are a Registered Testing Pool (RTP) Athlete (the RTP is a list of elite athletes agreed upon by Sport Ireland and NGB’s – you will be notified in writing if you are included in the RTP) you must apply to Sport Ireland in advance, as soon as the need arises, unless there are emergency or exceptional circumstances.
For substances prohibited in-competition only, you should apply for a TUE at least 30 days before your next competition. Please refer to the section “How to apply to Sport Ireland for a TUE?” below.
If you are NOT on the “Registered Testing Pool” as defined above, you are entitled to apply for a retroactive TUE after being tested by Sport Ireland. If you are not on Sport Ireland’s Registered Testing Pool but are competing internationally, you may be required to apply for a TUE with your International Federation in advance of competing. Please contact the Anti-Doping Officer within your National Governing Body who can assist you with this process.
A TUE granted by Sport Ireland is only valid at the national level. If you are, or become, an International-Level Athlete, or compete at Major Games, that TUE will not be valid unless it is recognized by the relevant International Federation (IF) or Major Event Organization (MEO). It is your responsibility to check if your Sport Ireland TUE is automatically recognized by such IF or MEO.
Sport Ireland can assist you in the determination of your level and TUE application requirements, and, should the need occur, assist you in presenting your Sport Ireland TUE to an IF or MEO for recognition. Please contact email@example.com
Can I get a retroactive TUE?
You may only apply retroactively for a TUE to Sport Ireland if:
- You required emergency or urgent treatment of a medical condition.
- There was insufficient time, opportunity or other exceptional circumstances that prevented you from submitting the TUE application, or having it evaluated, before getting tested.
- As per the Irish Anti-Doping Rules you were not permitted or required to apply in advance for a TUE.
- You are a lower-level athlete who is not under the jurisdiction of an International Federation or National Anti-Doping Organization and were tested.
- You tested positive after using a substance Out-of-Competition that was only prohibited In-Competition (for example glucocorticoids).
In rare and exceptional circumstances and notwithstanding any other provision in the ISTUE, you may apply for and be granted retroactive approval for a therapeutic use of a prohibited substance or method, if considering the purpose of the Code, it would be manifestly unfair not to grant a retroactive TUE.
This unique retroactive TUE will only be granted with the prior approval of WADA (and WADA may in its absolute discretion agree with or reject Sport Ireland’s decision).
Using a prohibited substance or method without a TUE could result in an Anti-Doping Rule Violation.
In case an application for a retroactive TUE is necessary following sample collection, you are strongly advised to have a medical file prepared and ready to submit for evaluation.
How to apply for a TUE?
[Option 2 – through ADAMS or paper format / electronic TUE form]
Please access the electronic version of the Sport Ireland TUE Application Form here or at the footer of this webpage, and once completed and signed, send it together with the required medical file as a password protected document to firstname.lastname@example.org
Alternatively, athletes who have an ADAMS account may submit TUE applications to Sport Ireland via ADAMS, together with the required medical files.
Your TUE application must be submitted in a legible form using capital letters or typing.
The medical file must include:
- A comprehensive medical history, including documentation from the original diagnosing physician(s) (where possible),
- The results of all examinations, laboratory investigations and imaging studies relevant to the application.
Any costs incurred during the completion of a TUE application are solely the responsibility of the Athlete, including any required additional medical examinations, tests, imaging studies, etc.]
Any TUE application that is not complete or legible will not be dealt with and will be returned for completion and re-submission.
To assist you and your doctor in providing the correct medical documentation, we suggest consulting the WADA’s Checklists for TUE applications for guidance and support during the TUE application process, and Medical Information to Support the Decisions of TUECs for guidance on specific common medical conditions, treatments, substances, etc.
Keep a complete copy of the TUE application form and all medical information submitted in support of your application, and proof that it has been sent.
What happens at Major Events?
A Major Event Organization (MEO) requires athletes to apply for the recognition of their TUE if they wish to use a prohibited substance or method in connection with the Event.
If you have a TUE granted by Sport Ireland and you will be competing at a Major Event e.g., the Olympic Games, you should contact the MEO for information on their recognition process. The Anti-Doping Officer from your National Governing Body can assist you with this.
When will I receive a decision on my TUE application?
Sport Ireland’s TUEC must render a decision as soon as possible, and usually within 21 days from the date of receipt of the complete TUE application, including the required medical information.
What if I need to renew my TUE?
Each TUE has a specific duration, at the end of which it expires automatically. Should you need to continue to use the prohibited substance or method, it is your responsibility to submit a new application for a TUE with updated medical information ahead of the expiry date, so that there is sufficient time for a decision to be made prior to the expiry of the current TUE.
The presence (following sample collection), use, possession or administration of the prohibited substance or method shall be consistent with the terms of your TUE. Therefore, if you require a materially different dosage, frequency, route or duration of administration, you should contact Sport Ireland, as you may be required to apply for a new TUE. Some substances and dosages, e.g., insulin, are often modified during treatment and these possible fluctuations should be mentioned by the treating physician in the TUE application and would usually be accepted by the ADO TUEC.
What if my Sport Ireland TUE application is denied?
A decision to deny a TUE application includes a written explanation of the reason(s) for the denial. If it is not clear to you, please contact Sport Ireland to understand exactly why the TUE was denied. Sometimes, there may be a critical piece of information, diagnostic test, laboratory results missing, etc. In which case, you should re-apply to us.
The TUE Committee decision shall be the final decision of Sport Ireland and may be appealed in accordance with Article 13.4. of the Irish Anti-Doping Rules.
What if my Sport Ireland TUE is not recognized by my International Federation?
You or Sport Ireland have 21 days to refer the matter to WADA for review after notification of the non-recognition. You should send the same information that you submitted to Sport Ireland, and on which their TUEC based their decision, via a secure on-line method or by registered mail at:
WADA Medical Department
World Anti-Doping Agency
Stock Exchange Tower
800 Place Victoria (Suite 1700)
P.O. Box 120
Montreal (Quebec) H4Z 1B7
The email address to enquire and/or send the request for review is: email@example.com
Pending WADA’s decision, Sport Ireland’s TUE remains valid for national-level competition and out-of-competition testing only. If the matter is not referred to WADA for review, Sport Ireland must determine whether the original TUE that was granted should remain valid for national-level Competition and Out-of-Competition Testing.
Will my medical information be treated in a confidential manner?
All the information contained in a TUE application including the supporting medical information, and any other information related to the evaluation of your TUE request is kept strictly confidential and treated in accordance with the Sport Ireland TUE Application Form and in the Athlete’s Declaration contained in the ADAMS TUE process.
All members of the TUEC and any other authorized recipients of your TUE request and related information are subject to a professional or contractual confidentiality obligation.
Please review the terms of the Sport Ireland TUE Application Form and ADAMS Athlete’s Declaration carefully. In particular, note that should you wish to revoke the right of Sport Ireland’s TUEC to obtain the information related to your TUE request, your TUE application will be deemed withdrawn without approval being granted.
Your TUE request-related information will be retained by Sport Ireland and any other authorized recipients for no longer than necessary for the purposes stated in the Sport Ireland TUE Application Form and Athlete’s Declaration, in accordance with the International Standard for the Protection of Privacy and Personal Information.
For any further information and questions in relation to Sport Ireland’s personal information practices, please contact firstname.lastname@example.org
If you have a doubt as regards to which organization you should apply for a TUE, or as to the recognition process, or any other question concerning TUEs, please contact: email@example.com
Other Useful Links
WADA International Standard for Therapeutic Use Exemptions (ISTUE)
WADA Checklists for TUE Applications
WADA Guidelines for the 2021 International Standard for Therapeutic Use Exemptions (ISTUE)
WADA Anti-Doping Education and Learning (ADEL)
International Standard for the Protection of Privacy and Personal Information (ISPPPI).