I was diagnosed with severe asthma when I was but two years old, something of a rarity in 1962 but much more commonplace today. So I have a great deal of empathy for competitive athletes who try to excel at the highest levels of their sport despite the debilitating effects of this disease. For myself, today I have only 62% lung function and I feel that loss of ability each and every day.
For competitive athletes with asthma it is particularly important to pay attention to the World Anti-Doping Agency and the current 2018 Prohibited List for drugs that are, and are not, permitted for use by an athlete both in- and out-of competition.
The drug Salbutamol is routinely prescribed to asthma patients for help in opening bronchial passages during bouts of asthma – my own prescription for Teva-Salbutamol is a 100mcg dosage with DIN 02326450. For competitive athletes, Salbutamol is a prohibited, Beta-2 Agonist both in- and out-of competition. However, Salbutamol is permitted as a therapeutic drug when used with prescribed, reasonable dosages. The 2018 WADA Prohibited List uses the following language for exceptions for Salbutamol and similar drugs:
Except:
- Inhaled salbutamol: maximum 1600 micrograms over 24 hours in divided doses not to exceed 800 micrograms over 12 hours starting from any dose;
- Inhaled formoterol: maximum delivered dose of 54 micrograms over 24 hours;/li>
- Inhaled salmeterol: maximum 200 micrograms over 24 hours.
The presence in urine of salbutamol in excess of 1000 ng/mL or formoterol in excess of 40 ng/mL is not consistent with therapeutic use of the substance and will be considered as an Adverse Analytical Finding (AAF) unless the Athlete proves, through a controlled pharmacokinetic study, that the abnormal result was the consequence of a therapeutic dose (by inhalation) up to the maximum dose indicated above.
Often co-prescribed by physicians for asthma is a glucocorticoid (a man-made steroid) to reduce inflammation. These have a variety of brand names but a typical one used in Canada is Flovent HFA, whose specific drug is fluticasone propionate. My own Flovent prescription is for a dose of 125mcg with DIN 02244292. For competitive athletes, oral administration of fluticasone is specifically prohibited by WADA in-competition.
Finally, another common affliction for asthma-sufferers is eczema. Hydro-cortisone is the commonly-prescribed drug for eczema, though very mild concentrations of hydro-cortisone are available over-the-counter. Fortunately for eczema sufferers, while hydro-cortisone is a glucocorticoid, and thus a banned substance, topical application of hydro-cortisone is not specifically banned in the 2018 Prohibited List.
Athletes who are taking any of these or similar medications should consider asking the Canadian Center for Ethics in Sport (CCES) if a Therapeutic Use Exemption (TUE) is required and to get that paperwork in place before the start of the competitive curling season.
Note as well that many over-the-counter cold medications, particularly nasal decongestants, are also prohibited by WADA in-competition. Athletes are solely responsible for their adherence to the WADA Prohibited list and should check with their coach, pharmacist, or with the CCES prior to taking any medications. Currently, save for the Olympic Games, drug testing in the sport of curling is rare but athletes must make the effort to ensure that all competition is drug-free and so avoid catastrophic disappointments.