There are situations in which athletes need to take a prohibited substance or use a prohibited method, as specified by the Prohibited List, for health reasons. The anti-doping rules therefore stipulate therapeutic use exemptions, or TUE for short.
To which organization and at which time a TUE application must be submitted, depends on the assignment to the TUE pool and participation in international competitions, or the definition of International-Level Athletes.
TUE Wizard
The TUE Wizard asks the relevant questions and helps to ascertain if, when, and to whom a TUE application should be submitted.
Prospective TUE
A prospective TUE means that an exemption must be obtained prior to the start of treatment to ensure that the athlete in question is protected against an anti-doping rule violation by the corresponding therapy. TUE pool athletes and international-level athletes require a prospective TUE.
TUE Pool
The term TUE Pool athlete is synonymous with National-Level Athlete.
The following athletes are part of the TUE Pool of Swiss Sport Integrity:
All holders of a Swiss Olympic Card Elite, Bronze, Silver or Gold
All players in whereabouts pools for teams (I-III)
International-Level Athletes
International Sports Federations define who is considered an International-Level Athlete and therefore also requires a TUE in advance. Each International Sports Federation has its own definition, which is based, for example, on the world rankings, license or participation in certain international competitions.
Help with the definitions of International-Level Athletes
International-level Athletes submit their TUE application to the relevant International Sports Federation. For athletes who are both in the TUE pool and meet the International-level Athlete definition, the regulations of the International Sports Federation take precedence, and the application must be submitted to the International Sports Federation.
International-Level Athletes also require a prospective TUE at national level (e.g. participation in national or regional competitions). This must also be observed if no international competitions are to be competed in for a longer period of time. Further information on this can also be found in the help section on the definitions of International-Level Athletes.
Major Event Organizers
In addition, organizers of international multi-sport events require prospective TUEs for participation in their competitions. These include the following competitions (not exhaustive):
- Olympic Games
- Paralympic Games
- Youth Olympic Games (YOG)
- European Youth Olympics Festival (EYOF)
- European Games
- Universiade
Retroactive TUE
Lower-Level Athletes
Athletes who neither belong to the TUE pool nor are considered International-Level Athletes do not have to be in possession of a valid TUE before the start of therapy. These athletes have the option of applying for a TUE retroactively, i.e. after the start of therapy and after a possible doping test.
The medical examination must be established before the start of therapy and documented by the physician. In addition, the progression of the illness and therapy follow up must be documented carefully. For a retroactive TUE application, this comprehensive medical documentation must be submitted.
A basic requirement for the approval of a TUE is that no reasonable, permitted therapeutic alternative can be used. First and foremost, this should be clarified with the treating physician.
Exceptions for TUE Pool Athletes and International-Level Athletes
In a few exceptional situations, TUE Pool Athletes and International-Level Athletes can submit a retroactive TUE application, i.e. after the start of therapy.
Use of glucocorticoids or narcotics out-of-competition
For medically prescribed therapies that are only prohibited “in competition” and whose use is discontinued before this period, a retroactive TUE application can be submitted after the therapy and after a possible positive doping test. This procedure applies to out-of-competition treatment with glucocorticoids and narcotics. It is generally not recommended to pause stimulants for the treatment of ADHD on competition days in order to submit a TUE application on the basis of this exception.
Medical Emergencies
In the event of a medical emergency, health comes first. Emergency therapies should be administered immediately, even if this involves using prohibited substances or methods according to the Prohibited List. Any necessary TUE application should be submitted as soon as the health situation allows. TUE pool athletes and International-Level Athletes submit an emergency TUE application on their own initiative and independently of any doping control.
Support and Contact
If you have any questions, please do not hesitate to contact us. If you are unclear about the necessity of a TUE application or about the responsibility for evaluating a TUE application, Swiss Sport Integrity will be happy to help you.
