Suek’s medical expert Pekka Rauhala explains what kind of drug tramadol, which has been on Wada’s list of prohibited substances, is.
The painkiller Tramadol will be on Wada’s list of prohibited substances from the beginning of next year. PDO
As of January 1, 2024, Tramadol is on the World Anti-Doping Agency WADA’s list of prohibited substances. The drug has been on the watch list since 2012.
Suek’s (Ethical Center for Finnish Sports) medical expert Pekka Rauhalan I think Wada’s solution is correct.
– Tramadol belongs to opioids – and opioids have been banned for a long time. Exceptions to these have been tramadol and codeine, which are classified as a weaker substance, but yes, tramadol is a proper opioid and therefore belongs to the list of prohibited substances.
Although tramadol is primarily intended for pain relief, it also removes the feeling of fatigue that comes with longer duration performances. Because of this, the use of tramadol has been prohibited in cycling since 2019.
– But then, for example, it has treated injuries in team sports, and it has not been about improving performance, Rauhala says.
According to Wada’s report, the use of tramadol has increased significantly in recent years in cycling, rugby and football, among others.
Caution period
Although tramadol is banned from the beginning of next year in connection with competitive events, it can still be used during the training season.
– It’s only useful during the competition, Rauhala reminds.
Wada will later announce a withdrawal period for the use of tramadol, i.e. how many days before the competition the use of the drug must be stopped.
– I bet we’re talking about a few days, but this is just my own assessment, Rauhala emphasizes and continues.
– The caution period depends on what is set as the threshold value, i.e. what concentration in the sample must be exceeded in order for it to be considered to affect competition performance.
Instead of codeine?
When the use of tramadol is prohibited, another painkiller may take its place.
– Codeine will probably be used in the future when tramadol is banned. Codeine is an opioid like tramadol, but not as hard, Rauhala says.
Codeine is still on the list of permitted substances. In Finland, it is available in combination products. If, for example, paracetamol is not effective enough, there is also a paracetamol-codeine combination product available.
The combination in question is used daily by 5.5 per thousand Finns, i.e. there are on average about 5 people out of 1,000 people who have the medication in question.
A common medicine
Tramadol, which also ended up on the list of prohibited substances, is a common painkiller in Finland.
– If the usual anti-inflammatory drugs do not have sufficient effect, tramadol is one step ahead. It is a prescription product on the market, Rauhala knows.
Tramadol should only be used for temporary pain, for example after surgery.
– Even though tramadol is a weak opioid, it also becomes addictive. If you use it for a longer time, stopping use can cause withdrawal symptoms, warns Rauhala.
Tramadol is used daily by three per thousand Finns, that is, there are on average three people out of 1,000 people who have the medication in question.
For comparison, for example, the anti-inflammatory painkiller Burana is used daily by five percent of Finns, or an average of 50/1000 people.