Sport, médicaments et dopage : la pratique et le cadre législatif. Importance pour l'allergologue

The frenzied demand for greater performance from certain athletes, regardless of their age or level of performance, may lead them to use performance-enhancing substances. The campaign against the use of such substances is at present the responsibility of the World Anti-drug Agency. The WAA has compiled a list of such substances and methods that is brought up to date annually, and they are commonly banned in most countries and by international sports federations; the list is. Certain anti-allergy drugs used regularly by allergic and/or asthmatic individuals found on this list are considered to be performance-enhancing substances. Therefore, allergists should be aware of the list and must be very cautious when prescribing drugs to athletes. However, prohibiting the use of these certain anti-allergy drugs by athletes is obviously a handicap for those who need them. For this reason, governments have anticipated the possibility that some asthmatic and/or allergic patients will need to use certain medicines when there is strong medical justification. In this case, an “authorization for the use of drugs for therapeutic purposes” (AUT) is required. β2-agonists by inhalation (formoterol, salbutamol, salmeterol and terbutaline) and glucocorticoids by the oral route or by inhalation are the drugs mainly concerned by this regulation. Allergists should check the composition of medicines that they prescribe to athletes, have an up-to-date list of proscribed drugs, inform allergic athletes that one or more their medicines is proscribed and that the use of proscribed drugs requires a note, which must state that the use of particular medicines is necessary for the patient. The allergist should provide the patient with a certificate, using AUT guidelines, only for those substances that are authorized, basing this need on solid evidence, for example, pulmonary function test results. In case of doute, allergists should not hesitate to contact the local Antenne medicale de prevention et de lutte contre le dopage (Committee for the Prevention and Fight against Drug Use).