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 an illness or condition is prohibited as per the World Anti-
Doping Agency’s (WADA) Prohibited List , a TUE may give that athlete the authorization to use that substance or method while competing without invoking an anti-doping rule violation (ADRV) and applicable sanction.
Applications for TUEs are evaluated by a panel of physicians appointed by the TUE Committee (TUEC).
NADO TUEs are 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 the Bahamas Anti-Doping Commission to know to whom you need to apply and if you 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 or globaldro.com.
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 the Bahamas Anti-Doping Commission if you are having difficulties.
Then, contact the Bahamas Anti-Doping Commission to determine your competition level and TUE application requirements.
If it is determined that you are a National-Level Athlete, (on a National team, has broken a National record or a top performing athlete within your Sport) you must apply to the Bahamas Anti-Doping Commission 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 the Bahamas Anti-Doping Commission for a TUE?” below.
If your level is lower than the “National-Level” as defined above, (participates in a moderate level of competition) you are entitled to apply for a retroactive TUE after being tested by the Bahamas Anti-Doping Commission or any other Anti-Doping Organization (ADO).
A TUE granted by the Bahamas Anti-Doping Commission 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 the Bahamas Anti-Doping Commission’s TUE is automatically recognized by such IF or MEO.
The Bahamas Anti-Doping Commission can assist you in the determination of your level and TUE application requirements, and, should the need occur, assist you in presenting your Bahamas Anti-Doping Commission’s TUE to an IF or MEO for recognition. Please contact Petra Haven at 242-325-2633 or email@example.com
CAN I GET A RETROACTIVE TUE?
You may only apply retroactively for a TUE to the Bahamas Anti-Doping Commission 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 our anti-doping rules (the Bahamas Anti-Doping Commission) 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 the Bahamas Anti-Doping Commission’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 TO THE BAHAMAS ANTI-DOPING COMMISSION FOR A TUE?
The Bahamas Anti-Doping Commission encourages athletes to submit TUE applications via ADAMS, together with the required medical file. If you do not have an ADAMS account yet, please contact Petra Haven at 242-325-2633 or firstname.lastname@example.org to have it set up.
Otherwise, please download the Bahamas Anti-Doping Commission’s TUE Application Form , and once duly completed and signed, send it together with the required medical file to Petra Haven at 242-325-2633 or email@example.com
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.
Please note that in relation to costs incurred for the completion of TUE is solely at 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 TUE Physician Guidelines 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 the Bahamas Anti-Doping Commission 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.
WHEN WILL I RECEIVE A DECISION ON MY TUE APPLICATION?
The Bahamas Anti-Doping Commission’s TUEC’s 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 the Bahamas Anti-Doping Commission, 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 BAHAMAS ANTI-DOPING COMMISSION’S 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 the Bahamas Anti-Doping Commission 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. Otherwise, you may appeal the denial decision as follows:
By providing all information and documentation to the Bahamas Anti-Doping Commission’s Appeal Tribunal via the Bahamas Anti-Doping Commission’s Executive Director at firstname.lastname@example.org.
WHAT IF MY BAHAMAS ANTI-DOPING COMMISSION’S TUE IS NOT RECOGNIZED BY MY INTERNATIONAL FEDERATION?
You or the Bahamas Anti-Doping Commission 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 the Bahamas Anti-Doping Commission, 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 the Bahamas Anti-Doping Commission’s TUE remains valid for national-level competition and out-of-competition testing only. If the matter is not referred to WADA for review, the Bahamas Anti-Doping Commission 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?
Please review the terms of the Athlete’s Declaration carefully. In particular, note that should you wish to revoke the right of the Bahamas Anti-Doping Commission’s TUEC to obtain the information related to your TUE request in accordance with the Athlete’s Declaration, your TUE application will be deemed withdrawn without approval being granted.
Your TUE request-related information will be retained by the Bahamas Anti-Doping Commission and any other authorized recipients for no longer than necessary for the purposes stated in the Athlete’s Declaration, in accordance with the International Standard for the Protection of Privacy and Personal Information.
THE PURPOSE OF TUE
The Bahamas Anti-Doping Therapeutic Use Exemption Committee (BADTUEC)
- Receive and examine applications from national-level athletes for Therapeutic Use
- Exemption Certificates;
- Revoke Therapeutic Use Certificates;
- Perform any other functions that are conferred or imposed on it by the Act.
The Committee shall consist of six (6) duly qualified medical practitioners. Each appointment shall be evidenced by an instrument in writing, stating the period of office, which should not exceed three (3) years.
A Chairman of this Committee shall be appointed by the Commission.
Members may be eligible for re-appointment.
Where any member of the BADTUEC is connected with an athlete (having regard to their familial, business or other relationship) or has an interest in any national sporting organization or international sporting federation, such a member is excluded from considering any application for Therapeutic Use Exemption from that athlete or, as the case may be, any athlete who is a member or participant in a sporting event organized or sanctioned by the international sporting federation or national sporting organization in which he has an interest.
Dr. Kathryn de Souza
Dr. Kathryn de Souza is a Physiatrist (Doctor of Physical Medicine and Rehabilitation) with US board certification in both Physical Medicine and Rehabilitation as well as Sports Medicine. After graduating from Middlebury College, she attended New York Medical College, receiving her medical degree in 1992. She completed her medical training at Columbia Presbyterian Medical Center in New York, where she was Chief Resident. She currently works in private practice at Doctors Hospital West and is the Clinical Director for Rehabilitation Services at Doctors Hospital. Dr. de Souza is a competitive marathon runner and rows with the Nassau Rowing Club, where she serves as Vice President of the Board. She is also a board member of the Bahamas Humane Society. She has been the Chairperson of the Therapeutic Use Exemption Committee for the Bahamas Anti-Doping Commission since its inception.
THE TUE PROCESS
Complete TUE form via ADAMS after requesting from your relevant ADO.
BADC Office, 2nd Floor
Betty Kelly-Kenning Aquatic Centre
P. O. Box SPO-63814
New Providence, Bahamas
Print off the completed TUE form ADAMS and have your physician fill out relevant sections and sign where indicated. Ensure to gather all required documents (doctor's notes, diagnosis, medication listing)
Send completed form and required documents to your ADO for processing. Please be advised that ORIGINAL copies are required with signatures when submitting required supporting documents for your Therapeutic Use Exemption.
For athletes and doctors abroad submitting TUEs and required documents, please contact the office at 242-325-2633 or email firstname.lastname@example.org.
Once a TUE is requested, a panel of experts selected by the ADO reviews your request and will grant a TUE if;
- Your health will be significantly impaired if you do not take the substance.
- The substance does not enhance your performance beyond what brings you back to normal health.
- There are no alternative treatments available.
The ADO advises if you can take the medication or not. In the case of denied request, you will be informed of the reasons. You have the right to appeal the decision.
THE TUE FORM
To download TUE Form, please click here (PDF) or here (WORD doc)
Who do I contact/ where do I return my form?
BADC Office, 2nd Floor
Betty Kelly-Kenning Aquatic Centre
P. O. Box SPO-63814
New Providence, Bahamas
Telephone or Fax:
TUE tips during Doping Control.
- Declare the approved medication on your Doping Control Form.
- Specify that a TUE has been granted.
- Show a copy of the TUE approval/certificate to the doping control officer
For any further information and questions in relation to the Bahamas Anti-Doping Commission’s personal information practices, please contact Petra Haven at 242-823-2867 or email@example.com.
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: 242-326-2633 or firstname.lastname@example.org