Unnecessary doping allegations to youth due to asthma medicines

The Finnish Anti-doping Agency FINADA published its last year’s doping test statistics last week. FINADA performed 3,020 doping tests in Finland and abroad last year. The results were positive in eight cases. The topicality of the subject brought up an important consideration for doctors treating athletes: the use of asthma medicines.

Over the last few years it has become apparent that several young athletes unknowingly use prohibited asthma medicines. This has led to individual doping violations. The doping violations are presumed to be related to amended doping substance listings and permit practices, which has led to the misconception that all asthma medicines are allowed. It is true that a significant amount of asthma medicines have been dropped out of the prohibited substance list since 2011, but there are still several medicines that require an exemption permit.

Asthma is a very common illness among athletes. The risk for asthma is elevated especially for endurance athletes, such as skiers, swimmers and long-distance runners, as the continuous extreme strain on the lungs irritates the mucous membranes. Environmental factors, such as cold air, pollen and impurities also act as irritants, and may cause bronchial inflammation and functional changes.

The medication has been started for many asthmatic athletes in early childhood, and there is no need to alter the medication if the illness stays in balance. As the junior athlete becomes older and doping matters topical, prevailing doping regulations and the potential need for exemption permits should be observed. Often in real life, the junior athlete has visited the same doctor or attended the follow-up of the same pediatric polyclinic the whole time, which means that the illness has been treated, but the doping regulations have been overlooked. The situation is very unfortunate if the asthma medicine is on the list of prohibited substances (terbutaline), or the violation is not noticed until a doping test is performed. It is unfortunate also because the medicine can virtually always be replaced by a corresponding product that is not prohibited.

Sports doctors meet asthmatic athletes daily. They also regularly come across situations where the athlete uses a prohibited asthma medicine unknowingly. The situation is so common that it has been a good practice to check the asthma medication of every athlete, even if the doctor’s visit doesn’t have anything to do with asthma.

Doping is a crime in all its injustice, even though it still isn’t punishable by Finnish laws. No athlete wants to violate doping regulations unknowingly. It is the obligation of the doctor treating the athlete to make sure that the athlete doesn’t commit doping violations by using prohibited substances. Equally, the athlete and the sports club should make sure that drugs with or without prescription do not contain prohibited substances. Athletes of all ages should keep in mind that the medication has to be permissible or a permit has to be applied from the anti-doping officials.