"We've prescribed it minimally" says team doctor
Team Sky has given its backing to the MPCC’s (Movement for Credible Cycling) call for the pain killer Tramadol to be added to WADA’s list of prohibited substances.
Earlier this month Garmin-Sharp’s chief medical officer Prentice Steffen told Cyclingnews that the substance was being abused within the peloton.
The potentially addictive opioid remains on WADA’s Monitoring List, meaning that it could be banned in the future, while the anti-doping agency confirmed in a private letter to the MPCC earlier this year that “the number of samples containing Tramadol is significant and the very large majority of them originate from cyclists.”
Team Sky, who are not a member of the MPCC, has backed a call for the substance to be regulated through the TUE system but added that as a team it has prescribed Tramadol throughout the season, but only in what it calls "appropriate scenarios".
Allan Farrell, a full-time doctor with Team Sky since 2012, told Cyclingnews that Tramadol is, “an effective pain killer when it’s used in the clinically appropriate scenario. Certainly in our team we would have used it in the past but only when justified.”
“We would have prescribed it, very minimally but sometimes if someone had an injury that justified pain killing medication.”
Farrell pointed to the side-effects as one of the major issues with the drug. He also called for WADA to add Tramadol to their prohibited list in order to safeguard against potential abuse.
“There are side effects with the medication that are under reported. For me it’s not just about it being banned as a performance enhancing drug, it’s more an issue over rider safety. People react differently to different medication but some of the side effects can include nausea and dizziness so all of those issues, if they were to effect someone, could lead to other problems and potentially pose a danger.”
One high profile WorldTour rider, who did not want to be named told Cyclingnews that “some teams won’t give it out while some do. Some riders are out there training on it though.” There have also been rumours of riders using Tramadol in conjunction with caffeine in order to counter the effects of drowsiness.
“That very anecdotal,” Farrell told Cyclingnews.
“In terms of the evidence, there’s real evidence in the US that people taking Tramadol have an increased chance of a road accident so it stands to reason that if you have that sort evidence, and in an environment such as cycling, I’d be happy to see it banned. Then it could be used if necessary through the TUE system but putting it on the prohibited list would ensure that it wasn’t used in an inappropriate way.”
“With regards to it’s use, and I’ve seen that Prentice Steffen had called for the ban of its use, well that’s something that I’d be happy to see on the WADA prohibited list, both in and out of competition.”
Farrell confirmed that Team Sky has used Tramadol in the past and would do in the future if the situation called for it but stated that the team would not use the drug in a training scenario.
“We would never have used it in training. It’s only a medication that we would have used very minimally and in a supervised environment. I just can’t believe people would use it in a training environment.”
“It’s definitely something that we would have as medication within the team but it would only be something that we’d use in the appropriate scenario.”
Asked if Team Sky used Tramadol during this year’s Tour de France, Farrell said that he could not disclose the medical histories of his riders but he would say that, “if we used it for an injury it would have always been with the riders’ health and safety paramount. Any time we used it, it would have been with the best clinical guidelines and thinking of the riders’ safety."
“I can’t say who it would have been used with but we would have used it throughout the year for any moderate to severe injury if pain warranted it. It’s certainly something that we would have used in the past but very minimally. It’s something that we’d want to use in the future in order to provide adequate pain relief. But again, we would be very happy to see it on a list so that it was more regulated.”
Tramadol certainly is not in the leagues of blood doping or EPO in terms of performance boosting, but it has been used within the peloton for a number of years. One rider who raced throughout most of the 2000s told Cyclingnews that they had used the drug to help with inflammations and injury.
Farrell believes that riders prescribed Tramadol in the future via a TUE should not be in competition. Such a move would put Tramadol within the same bracket at cortico-steroids with riders in MPCC teams expected not to race for an eight-day window after taking the substance.
“If you need to apply for a TUE medication used as a pain killer, the reality is that someone should be removed from competition. I don’t think there should be a scenario where someone should compete with such a strong pain killer,” he said.
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