As some of the most influential people in athletes’ lives, coaches can play a powerful role in keeping sport clean by helping athletes understand and act upon their anti-doping responsibilities. These Coach’s Advantage videos cover the latest anti-doping information.
As a coach or other athlete support person, you play one of the most vital roles in an athlete’s life. Your knowledge and influence can help athletes make critical choices that will shape their future and reputation. By taking this course, you will become more prepared for and informed about anti-doping processes and policies, as well as how you can support athlete rights and responsibilities. This online education tutorial should take less than 45 minutes and covers information critical to your success as an athlete support person to clean athletes, including categories of prohibited substances and methods, how to apply for a Therapeutic Use Exemption, the process for collecting urine and blood samples, and the results management process. We will provide you with some helpful resources throughout. Equipped with this information, we want you to feel confident and prepared to uphold the anti-doping rules, promote clean sport, and support your athletes with their anti-doping responsibilities and through their doping control experiences with USADA.
As you learn about the anti-doping process in this tutorial, keep in mind that USADA is a signatory to the World Anti-Doping Code, or the Code. The Code and a number of international standards help ensure athletes around the world follow the same rules and are held to the same standards. The Code requires coaches and other athlete support personnel to: be knowledgeable about and comply with all anti-doping policies and rules; cooperate with the athlete testing program; use their influence on athlete values and behavior to foster anti-doping attitudes; disclose any anti-doping rule violations or ADRVs they have received within the past 10 years to USADA and their International Federation; cooperate in any ADRV investigation; and not use or possess any prohibited substance or method without valid justification.
Our hope is that by the end of this course you:
[Welcome to the Coach’s Advantage. I’m Trevon Jennifer, two-time Paralympian in wheelchair basketball and USADA TrueSport Ambassador. Being knowledgeable about, compliant with, and supportive of clean sport is not only a requirement set out by the World Anti-Doping Agency, or WADA, but also necessary to ensure sport is safe, fair, and clean. As the coach of an elite athlete, we understand that your time is extremely valuable and limited, and we would not ask you to give it lightly. But we also understand the impact of your words and actions on athletes can be life changing. In fact, research shows that your influence carries more weight than any other person in an athlete’s life. It is for this reason that you are critical to the mission of clean sport. You can support your athlete and their clean sport journey by doing three simple things:
Number one: Be an anti-doping resource to athletes.
Number two: Have athletes check to see if their medications are allowed in sport.
And number three: As required, have athletes file Whereabouts and updates in a timely fashion.
USADA created this resource to provide you with the educational tools you'll need to be an anti-doping resource to athletes, so thank you for your time and dedication to learning the material and supporting clean sport.]
The WADA Prohibited List is one of the most important parts of the global anti-doping movement. The List identifies substances and methods prohibited in sport and is reviewed and updated annually by WADA. A substance or method is included on the WADA Prohibited List if it meets at least two of the following three criteria:
By the conclusion of this section, you will be able to help athletes:
[The most common question USADA receives from an athlete is “Can I use this medication or substance in my sport?” In order to answer this question, the World Anti-Doping Agency, or WADA, established a Prohibited List that requires athletes around the world to follow the same rules regarding substances and methods prohibited in sport. The only exception is if an athlete has applied for and been granted an approved Therapeutic Use Exemption, or a TUE, which we will discuss later in this section.
Any athlete member of a National Governing Body, or NGB, is subject to testing. As athletes subject to testing, they are responsible for what goes into their body. It is important that athletes research substances before they use them because they never know when they will be tested. Before any substance enters an athlete’s body through their mouth, eyes, nose, ears, or even through their skin via topical use or injection, know that they are held strictly liable, which means they are responsible for what’s in their system, regardless of their intent.
Each year in early October, WADA releases a revised Prohibited List to allow time to educate all stakeholders on the changes that take effect January 1st of the following year. Broken down into categories, the Prohibited List identifies which substances and methods are prohibited at all times, in-competition only, or in some cases, only in particular sports.
As the name suggests, in-competition testing is generally conducted during or following an event. The standard definition for “in-competition” is the period commencing at 11:59 p.m. on the day before the competition in which the athlete is scheduled to participate through the end of the competition and the sample collection process related to the competition.
On the other hand, out-of-competition testing is defined as testing at all other times, such as at an athlete’s home or training location.
Some examples of substances prohibited at all times are:
All methods are prohibited at all times. Some examples of prohibited methods include:
There are certain substances that are prohibited only in-competition, such as:
It is also important to understand that there are substances prohibited in particular sports. For example, beta-blockers used to control heart rate are prohibited in sports such as shooting, archery, and golf, because they could enhance aim in these sports.
Athletes and support personnel can find information about the prohibited status of specific medications by using a trusted resource called Global Drug Reference Online, known as Global DRO. Athletes and support personnel utilizing this resource will be able to identify if brand name medications or active ingredients are prohibited in competition, at all times, or in specific sports, and if they are subject to conditions of use. There are some substances that are identified as conditional, which means that daily use limits exist for these substances. The absorption and excretion of substances can depend on an individual’s metabolism, body fat, and even age; because of the multitude of factors, USADA is unable to predict threshold information and clearance times of substances.
Know that if athletes are taking any medication, they should check the status by using Global Drug Reference Online at GlobalDRO.com. If they cannot find a result for their search term on GlobalDRO.com, that does NOT mean that it is permitted in sport and additional investigation must be undertaken, including contacting USADA. As a coach or athlete support person, you should stress to your athletes the importance of regularly checking the status of their medications. Even if something was approved in the past, its formulation may have changed, or one of its ingredients may have been added to the Prohibited List. GlobalDRO.com does not contain information on, or applicable to, dietary supplements, but we’ll talk more about those in another section.
Remember, it isn’t enough for athletes to ask peers or a team doctor about what is prohibited. In all circumstances, an athlete must do their own due diligence, as they are personally responsible for what’s in their body at all times. If an athlete still has questions after their GlobalDRO.com search, contact USADA’s Drug Reference Team at 719-785-2000, option 2, or email drugreference@USADA.org
There may be times in an athlete’s career when they need to take a medication. Whether they are visiting their physician or selecting an over-the-counter cold medication at a local drug store, it is very important that an athlete know if the substances going into their body are prohibited in sport. Remember, a doctor’s prescription alone does not give an athlete permission to use a prohibited substance or method under the anti-doping rules.
If, after checking a substance at GlolbalDRO.com, an athlete finds that the medication is prohibited and they have a legitimate medical need to take it, the athlete should apply for a Therapeutic Use Exemption, or TUE. Having a TUE allows an athlete to meet their medical needs while still following the anti-doping rules.
To apply for a TUE, an athlete must submit the appropriate TUE application form along with supporting medical documentation, such as lab results, a current letter from a specialist, clinical background, and/or a diagnosis, in advance of the intended use of the prohibited substance or method. USADA makes best efforts to process TUE applications as quickly as possible; however, it can take up to 21 days to process, therefore USADA recommends an athlete submit a TUE application at least 30 days in advance. All TUE applications are evaluated in accordance with the WADA International Standards for TUEs, or ISTUE, and are reviewed by an independent TUE Committee. The most common reason for a delay in processing TUE applications is insufficient supporting documentation. The TUE Committee needs enough medical documentation to come to the same clinical diagnosis and treatment plan as the prescribing physician, without ever seeing the athlete in person.
If an athlete’s TUE is approved, they will receive a certificate with an expiration date. The athlete should inform USADA immediately if their medical condition changes or if the dose or frequency of the medication changes.
A TUE may be granted for medications and methods if the use meets certain criteria, including the following:
In the case a medical emergency that requires the administration of a prohibited substance or method, the athlete’s health and well-being should remain the top priority. Critical medical treatment should not be withheld. Once the emergency is over, the athlete should contact USADA as soon as possible to determine if a retroactive TUE application is necessary.
Every medical decision should be made in consultation with an athlete’s physician, who should be a knowledgeable advocate and assist them in their goal to compete clean. However, it is the athlete’s responsibility to make their doctor aware of their status as an elite athlete. USADA cannot provide medical advice but stands ready to answer questions from the athlete and their physician regarding the Prohibited List and the TUE process.
Remember, the use of a prohibited substance or method in sport without a TUE, even if medically justified, can result in an anti-doping rule violation. Strict liability applies, so if an athlete uses a prohibited substance without prior approval, the athlete will be held responsible. For more information about TUEs and the application process, visit USADA.org/tue.
The supplement industry and the Cannabinoid, or CBD, markets are not regulated in the same way as medications, which means any given product – even common vitamins and natural salves – does not need pre-market approval for safety or efficacy before being sold, and therefore, can present a risk for athletes. While there are ways to reduce this risk, please know that USADA does not recommend or approve the use of any supplement or CBD product.
By the conclusion of this section, you will be able to:
[Wonder why the sugary, colorful, kid-appealing cereals are located on the lower shelves in the grocery store? So that kids can see and grab the product easier- a result of intentional placement by cereal companies. Ever notice the sponsored advertisements on your devices are based on previous searches you’ve performed? A strategic marketing ploy implemented by companies. Many supplement companies are no different. They rely heavily on being able to target individuals they believe would “benefit” from using their supplement product. You have probably seen the transformative before and after pictures. You may even know someone who has seen personal results. But at what cost?
We understand that athletes put their body through rigorous training and that they want the best nutrition and products to help fuel their performance. However, unlike prescription drugs, the dietary supplement and CBD industries are not required to comply with good manufacturing practices or undergo quality control testing. Dietary supplements and CBD products are not evaluated or approved by the FDA before they are sold. It is also important to realize that contaminated products make it to store shelves on a regular basis. Intentional or accidental ingestion of contaminated substances can be harmful to both an athlete’s health and career, which is why experts suggest a food-first approach for nourishment and recovery rather than relying on dietary supplements.
Be aware of the following facts regarding the dietary supplement industry:
Help athletes recognize ways to reduce their risk of testing positive or experiencing an adverse health effect from supplements by paying attention to red flags, such as:
To minimize risks associated with taking dietary supplements, USADA recommends that an athlete adopt a food-first approach to nutrition. We recognize that navigating healthy options can be challenging, so we have created a Supplement Guide and a Nutrition Guide; links to these resources will be provided at the end of the tutorial.
If an athlete chooses to use supplements despite the known risks, USADA recommends that athletes use only dietary supplements that have been certified by a third-party program that tests for substances prohibited in sport. Third-party certification should also include an audit of the manufacturing process, an evaluation of the product’s quality, and an evaluation of labeling to ensure it is accurate and compliant with regulations.
USADA currently recognizes NSF Certified for Sport® as the certification program best suited for athletes to reduce the risk from supplements. Using an NSF Certified for Sport® product significantly reduces, but does not necessarily eliminate, the chance for testing positive and being sanctioned. Under the rules, if an athlete tests positive and establishes the source as a contaminated NSF Certified for Sport® product, the athlete could receive a reduced sanction, but there likely would still be a consequence.
NSF Certified for Sport® products are recognized by the Certified for Sport label and should be verified by checking on the NSF Certified for Sport® website or the mobile application.
As always, it is important for athletes to review SupplementConnect.org for red flag warnings, reference the High-Risk List for products that USADA has found to contain prohibited substances, and search the prohibited status of supplement ingredients on GlobalDRO.com.
Cannabidiol, or CBD, is a non-psychoactive cannabinoid, widely marketed to athletes for claimed effects such as decreased anxiety, anti-inflammatory properties, relief of pain, and for post-exercise recovery. It is the only cannabinoid permitted in sport. Consumers’ interest in CBD has increased considerably since 2015 and is still accelerating. Preclinical studies suggest that CBD could be useful to athletes; however, almost no clinical data are available on CBD in the context of exercise, which makes its use in this context unscientific and premature. The safety of the long-term use of CBD is understudied and there are indications of some adverse effects, including liver toxicity and negative impact on male fertility.
Similar to dietary supplements, CBD products are regulated and monitored by the FDA differently than medications. It’s important to realize that while CBD products may claim to be “THC free,” they may still contain prohibited cannabinoids, such as the psychoactive cannabinoid THC, which is prohibited in-competition.
When choosing to use a substance out-of-competition that is prohibited only in-competition, athletes should be aware that a complete washout of those substances and their metabolites cannot be easily predicted. For example, Cannabinoids are known to accumulate in body fat, increasing the time they are excreted into the urine.
Remember, before any substance enters an athlete’s mouth, eyes, nose, ears, and even through the skin via topical use or an injection, know that they are strictly liable for those substances.
Some athletes are required to be in a USADA Testing Pool. These athletes are required to provide personal information, referred to as Whereabouts. Providing Whereabouts for no-notice testing is an effective means to deter doping across sports and allows DCOs to locate an athlete for testing at any time.
By the conclusion of this section, you will be able to:
[An important part of USADA’s testing program is the ability to test athletes without advance notice in an out-of-competition setting. To maximize testing resources and minimize the burden on athletes, USADA has created a Registered Testing Pool (RTP) and a Clean Athlete Program (CAP). Athletes in the RTP and CAP are subject to different Whereabouts requirements and compliance criteria that can be found in USADA’s Whereabouts policy. Whereabouts information, including dates, times, and locations, is data submitted to USADA by an athlete and allows the athlete to be located for out-of-competition testing. Athletes in both the RTP and CAP are subject to testing 365 days a year and there are no “off-seasons” or cutoff periods during which testing does not occur.
Athletes will be notified if they are included in the USADA RTP or CAP and are required to submit Whereabouts information. As outlined in the World Anti-Doping Code, the International Standards for Testing & Investigations, and the United States Olympic and Paralympic Committee National Anti-Doping Policy, elite athletes who have been identified and notified that they are part of the USADA RTP or CAP are responsible for keeping USADA informed of their Whereabouts. Athletes who have not been notified of their responsibility to submit Whereabouts information are not required to submit any Whereabouts information to USADA, although they can still be tested out-of-competition by USADA.
Both the USADA RTP and CAP require the submission of Whereabouts information by specific deadlines. Deadlines for RTP filing are: March 15, June 15, September 15, and December 15. Athletes in CAP must file and update a Whereabouts summary twice per year on June 15 and December 15.
For a CAP athlete, failure to provide accurate Whereabouts can result in them being moved into the RTP. For RTP athletes, failure to provide accurate or complete Whereabouts can result in a Whereabouts Failure. All Whereabouts Failures issued by USADA will be shared via email with the athlete and a secondary contact chosen by the athlete. Any combination of three Whereabouts Failures that are declared by USADA, WADA, or an IF, within a 12-month period could result in an anti-doping rule violation and a minimum one-year sanction. As a coach, you can support your athletes by encouraging them to accurately file, and then update, their Whereabouts, especially when their schedule has changed.
For more information about the testing programs or Whereabouts requirements, please visit www.usada.org/new-whereabouts-program
If your athletes want to be the best at something, they dedicate long hours and hard work to their craft, but that is not always enough. Whether they are receiving suggestions on their form from coaches, nutritional alterations from the team dietitian, or modifications on personal habits from their teammates, they value the input from those who have their best interests in mind. The testing and results management component of anti-doping is also a form of evaluation on an athlete’s performance. Your athletes compete clean; therefore, their results are clean. If an athlete doesn’t compete clean, there are specific processes and consequences in place under the USADA Protocol and World Anti-Doping Code.
When it comes to the drug testing process, protecting athletes and the integrity of the sample are two of USADA’s top priorities. We work hard to maintain the most strategic testing plan and ensure that the testing processes are completed in a professional manner and adhere to all requirements under the Code and International Standards of Testing and Investigations. USADA also ensures that the results management process is rigorous and as fair as possible for all athletes.
In this section, we will share the details of the testing and results management processes to ensure you are prepared to help your athletes feel confident and protected throughout USADA’s anti-doping practices.
By the conclusion of this section, you will be able to
[Coaches and support personnel can support their athlete during the collection process by asking questions or acting as a representative for the athlete. Watch this sample collection video to learn more about the steps of the sample collection process to see how you can help your athlete.
USADA is committed to making sport safe, fair, and authentic at all levels of competition through independent and comprehensive anti-doping programs. One key component of a successful anti-doping program is strategic drug testing in accordance with the World Anti-Doping Code. USADA’s gold standard testing program utilizes in-competition testing and out-of-competition testing, which can occur at any time and any location. Athletes selected for testing may be required to provide urine, blood, or both. This applies to U.S. Olympic and Paralympic athletes, international and master's level athletes, and junior athletes.
When a doping control officer, or DCO, notifies athletes that they have been selected for testing, the DCO must show the athlete their credential. If the DCO is not the same gender as the athlete, they will be accompanied by a chaperone of the athlete’s gender who can supervise the provision of the sample. The athlete is then required to produce identification and stay within direct view of the DCO or chaperone until the test is concluded.
Athletes are required to report immediately to an out-of-competition location or to the in-competition doping control station, unless the DCO approves a valid reason for delay such as cooling down, attending a medal ceremony, fulfilling a media commitment, or receiving medical attention.
Athletes do have the right to have a representative present.
For urine samples, minor athletes are also encouraged to have a third-party present in the toilet area where they can monitor the DCO or chaperone during the provision of the sample. Athletes with disabilities have the right to request necessary modifications to the testing process.
All athletes are asked to provide a sample of at least 90 milliliters of urine under the direct observation of a DCO or witnessing chaperone. If 90 mL are not immediately available, athletes will store the partial sample in a secure vault and use another collection cup to secure the remaining sample when ready.
After staying in view of the chaperone and then providing a full sample, athletes will be offered a choice of sealed sample collection equipment that contain two security bottles marked A and B. They should inspect the equipment prior to use and the DCO should instruct the athlete to ensure that the alpha numeric code on the bottles match and correspond to the barcode on the outside of the box. This is critical since the athlete’s name will not appear on the documentation sent to the lab to ensure anonymity.
Athletes will then divide their sample between the A and B sample bottles, secure the bottles, and seal them for shipping. Athletes are to maintain direct observation and control of their sample until it’s sealed.
A sample collection session may include a blood collection. Some USADA DCOs will be licensed or certified phlebotomists, but if they are not, a certified and/or licensed phlebotomist, called a blood collection officer, or BCO, will perform the blood draw. Athletes are asked to stay seated for a period of time before blood is drawn. Less than two tablespoons of blood is needed for testing, which should not affect athletic performance. Complications from a blood draw are rare but can include fainting, dizziness, bruising at the puncture site (or hematoma), nerve injury, and arterial puncture or laceration. Site reactions such as bruising or swelling can be minimized by applying pressure to the collection site for at least five minutes, avoiding strenuous exercise for at least thirty minutes, and keeping the bandage on for at least two hours. If you have ever experienced complications from a past blood draw, please bring them to the attention of the USADA DCO before the blood draw begins.
After securing the sample, the DCO will review the doping control official record or DCOR with an athlete, at which time they will declare their use of any medications, supplements, or treatments, before signing the DCOR. Athletes are encouraged to discuss any concerns with a DCO and to provide feedback to USADA.
Once the sample is collected, the DCO will then securely ship the sample to a WADA-accredited laboratory to be analyzed.
USADA also uses the sample for the Athlete Biological Passport, or ABP. This resource is used to fight against prohibited drugs in sport and promote clean competition. USADA utilizes the ABP as an important tool for the long-term monitoring of an athlete’s biological data in both blood and urine, as well as the monitoring of potential markers that indicate doping.
The final step is to receive the results from the tested sample. The results are sent to USADA and USADA will then provide notification of the test results to the athlete via email. The results letter will also be available through the athlete’s online account. In general, athletes will receive their test results in six to eight weeks.
Most athletes never have to worry about the results of their test because they are competing clean and following the rules. However, if an athlete does test positive or is charged with an anti-doping rule violation, there is a full and fair legal process available to the athlete prior to a sanction being announced.
If the sample comes back as negative, there were no traces of prohibited substances or methods present.
If the sample comes back as positive, there was an Adverse Analytical Finding. When the athlete’s ”A” sample has returned a positive result and the athlete requests that their “B” sample be tested, the athlete will have the opportunity to be present for the ”B” sample opening. If the “B” sample confirms the Adverse Analytical Finding, the athlete can choose to accept the resulting sanction or if desired, the athlete can request an independent arbitration hearing where the case will be heard, and a decision rendered.
If you have questions while navigating the results management process, the USOPC employs an Athlete Ombuds who provides free information to athletes concerning their rights. The USOPC Athlete Ombuds can be reached by calling (719)-866-5000 or by email at firstname.lastname@example.org.
USADA’s testing is based on intentional planning and the evaluation of many factors. However, no athlete should ever know when or where they will be asked to provide a sample.
How are athletes selected for testing?
There are a variety of reasons why an athlete might be selected for testing, including, but not limited to:
One of the ways you can support your athletes when they are selected for doping control is to be an advocate for them throughout the process. As a support person, you should be knowledgeable about their rights and responsibilities. Here are just a few:
**NOTE: As defined by the Code: “Evading Sample collection; or refusing or failing to submit to Sample collection without compelling justification after notification by a duly authorized Person”, is an anti-doping rule violation.
As a coach or support person, it is particularly important to understand the rules regarding anti-doping rule violations, or ADRVs, and that athletes are not the only individuals who may be held accountable for an ADRV. In this section, we are going to elaborate on ADRVs and sanctions.
Under the Code, anyone who is found to have intentionally committed an ADRV could receive a sanction ranging from four years, up to a lifetime period of ineligibility. When facing a sanction, there is the possibility that an athlete can avoid or reduce their period of ineligibility if the athlete can demonstrate that the violation was unintentional or that he or she was not at fault or significant fault.
For example, per the 2021 World Anti-Doping Code, if an athlete can establish that the use of a substance of abuse was out-of-competition and unrelated to sport performance, then the use will not be considered “intentional” for purposes of the four-year period of ineligibility, but rather ineligibility is a flat three months with no need to further analyze the degree of fault.
If an athlete, or someone you know, is struggling with addiction or substance abuse, please reach out to the National Helpline by clicking here or calling the confidential Substance Abuse and Mental Health Services Administration (SAMHSA) national helpline at 1-800-662-HELP (4357).
If a sanction is issued, it is understood that there was a violation of the World Anti-Doping Code, the athlete’s International Federation rules, and/or the United States Olympic & Paralympic Anti-Doping Policy. There are many potential repercussions from a sanction, including:
By the conclusion of this section, you will be able to:
[There are set rules, laws, and expectations for most aspects of everyday living. Commonly, when those rules are broken, there are consequences. Speeding on the highway results in a speeding ticket. Not brushing your teeth, results in a cavity. Taking shortcuts in sport results in an Anti-Doping Rule Violation or ADRV. Under the World Anti-Doping Code, there is a very clear list of 11 ADRVs:
Your knowledge and assistance are vital to helping us to keep your sport clean which is why you can safely and confidentially provide doping tips to our play clean tip center. Also, remember under the 2021 Code, any discouragement or retaliation against those who report doping to authorities could result in an anti-doping rule violation, making it safer than ever for athletes to report doping. To report tips, please email playclean@USADA.org or call 1-877-752-9253. You can also use the shortcode USADA, or 87232 to text tips. With this system, your information including your phone number will remain anonymous to USADA.
Remember, USADA can perform a test on any athlete, even if they are foreign but present in the United States. Your hard work means a great deal to your team, the country standing behind you, and your career. USADA supports you and your fellow clean athletes. More information on the Play Clean Tip Center can be found at the conclusion of this course in the resource guide.
You have just completed the Coach’s Advantage tutorial. As you know, paying attention to this annual education can make all the difference and we thank you for your time. We hope you feel more confident about USADA’s processes and supported by our mission to protect clean athletes. If you have any questions, please feel free to connect with USADA through Athlete Express by phone at 1-866-601-2632 or by email at athleteexpress@USADA.org. We want to encourage you and your athletes to be vocal in the anti-doping movement.
[Well, I hope you found the Coach's Advantage Tutorial to be useful and informative, and that you'll use the knowledge and tools provided to help your athletes achieve their goals the right and clean way.
Your athletes are under tremendous pressure to succeed, and some of them may feel overwhelmed by the rules and regulations. You can help by encouraging all athletes and competitors to stay aware, active, and vigilant in striving for a clean competitive environment.
At the end of the day, remind them that, win or lose, it is only by competing clean that they honor their country, their sport, their support personnel, and their legacy as athletes.]
Coach’s Advantage Resource Guide
Throughout the 2023 Coach’s Advantage tutorial, helpful information and resources were shared. USADA wants you to feel knowledgeable of your rights and responsibilities and has compiled a resource guide with information critical to your success as a coach or support person. If you have any questions after viewing the tutorial or this resource, please connect with USADA through Athlete Express by phone at 1-866-601-2632, or by email at athleteexpress@USADA.org.
2023 Athlete’s Advantage Tutorial Topics
Substances of Abuse and Mental Health
U.S. Anti-Doping Agency
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