The World Anti-Doping Agency (WADA) has published the 2022 List of Prohibited Substances and Methods (List); the 2022 Summary of Major Modifications and Explanatory Notes; and the 2022 Monitoring Programme.
The 2022 List was approved by WADA’s Executive Committee (ExCo) during its meeting on 14 September 2021 and comes into force on 1 January 2022.
The List is one of the eight International Standards that are mandatory for all Signatories of the World Anti-Doping Code (Code). It designates what substances and methods are prohibited both in- and out-of-competition and which substances are banned in particular sports.
As outlined in the 2022 Summary of Major Modifications and Explanatory Notes, the Major Modifications for 2022 include the following:
1. S9. Glucocorticoids
The draft 2021 List, which was considered by WADA’s ExCo during its September 2020 meeting, proposed prohibiting all injectable routes of administration of glucocorticoids in-competition. While this modification was approved, the ExCo asked WADA Management to implement the prohibition only as of 1 January 2022, to allow enough time for stakeholders to learn and adapt to this change.
Therefore, all injectable routes of administration will now be prohibited for glucocorticoids during the in-competition period. Examples of injectable routes of administration include: intravenous, intramuscular, periarticular, intra-articular, peritendinous, intratendinous, epidural, intrathecal, intrabursal, intralesional (e.g. intrakeloid), intradermal, and subcutaneous.
For clarification: oral administration of glucocorticoids, which remains prohibited in-competition, includes, in particular, oromucosal, buccal, gingival and sublingual routes.
Other routes of administration (including inhaled and topical: dental-intracanal, dermal, intranasal, ophthalmological and perianal) are not prohibited when used within the manufacturer’s licensed doses and therapeutic indications.
It is strongly recommended that athletes follow the minimum washout periods, expressed from the time of administration to the start of the in-competition period. These washout periods, which are highlighted in the Summary of Major Modifications and Explanatory Note, are based on the use of these medications according to the maximum manufacturer’s licensed doses.
If there is a legitimate medical need for the use of a glucocorticoid, the athlete may apply for a Therapeutic Use Exemption (TUE). In case of an AAF in-competition, the athlete may apply for a retroactive TUE as provided for in the applicable rules.
For further information regarding WADA’s approach to the routes of administration of glucocorticoids and washout periods, please refer to the Summary of Major Modifications and Explanatory Note.
2. S3. Beta-2 Agonists – Dosage of Salbutamol
Regarding salbutamol, the daily dosing time intervals are modified to 600 micrograms over eight hours starting from the time any dose is taken (previously 800 micrograms over 12 hours). This is to reduce the risk of any potential AAF arising after high doses are taken at once. The total permitted daily dose remains at 1,600 micrograms over 24 hours. A TUE should be sought for doses in excess of these limits.
For further information on the permitted dosage of salbutamol, please refer to the Summary of Major Modifications and Explanatory Note.
3. S0. Non-approved Substances
For the first time, a substance has been included by name as an example in section S0 (Non-approved Substances) of the List. This substance, BPC-157, is an experimental peptide sold as a supplement, and it has been included in the 2022 List following a recent re-evaluation of its status.
The 2022 Prohibited List; the 2022 Summary of Modifications and Explanatory Notes; and the 2022 Monitoring Program are available for download on WADA’s website in English and French with Spanish to follow in the coming weeks.
In order to further assist stakeholders in their understanding and implementation of the 2022 List, WADA will host a webinar in November 2021 where participants will be taken through the major modifications for 2022 by WADA’s List Expert Advisory Group. WADA will communicate more details in the coming weeks regarding its November webinar schedule.