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Pain Medications: Prohibited v. Permitted

Pain medications are something that most people, and many athletes, may need to use at some point. Whether it’s after surgery, or just a difficult workout, pain medications of various strengths and routes of administration are often prescribed or purchased over-the-counter. Athletes, however, have to be mindful of what products are allowed in sport.

Under the World Anti-Doping Agency (WADA) Prohibited List, there are some pain medications prohibited in-competition and some medications that are permitted. To determine if your medications are prohibited or permitted, search the brand name or ingredients on Global DRO. The list below provides some examples of prohibited and permitted pain medications, but remember, this list is NOT all inclusive and there may be substances that are prohibited that are not named here.

For more examples of prohibited pain relievers and opioids, review the WADA Prohibited List. You can also check out USADA’s Wallet Card for more examples of permitted pain relievers.

Permitted

By Mouth

  • Acetaminophen
  • (Tylenol)
  • Ibuprofen
  • (Advil, Motrin)
  • Naproxen
  • (Aleve, Anaprox)
  • Excedrin
  • Fioricet
  • Imitrex
  • Lortab
  • Midol Complete
  • Norco
  • Vicodin


Topical Creams/Patches

  • Bengay
  • (camphor, menthol, salicylates)
  • Lidocaine
  • (Lidoderm)
  • Hot/icy patches

 

Local Injections/trigger point treatment

  • Dry-needle
  • Cortisone/corticosteroid into a joint
  • Saline

Prohibited In-Competition

Buprenorphine

  • (Belbuca, Buprenex, Butrans, Probuphine, Sublocade, Suboxone, Zubsolv)

 

Fentanyl

  • (Actiq, Duragesic, Fentora, Ionsys, Lazanda, Sublimaze, Subsys) and its derivatives like sufentanil or remifentanil

 

Hydromorphone

  • (Dialudid, Exalgo)

 

Methadone

  • (Dolophine, Methadose)

 

Morphine

  • (Arymo ER, Avinza, Kadian, MorphaBond ER, MS Contin, MSIR)

 

Oxycodone

  • (Endocet, Oxaydo, Oxycontin, Percocet, Primlev Roxicodone, Xtampza ER)

 

Oxymorphone

  • (Opana)

 

Pentazocine

  • (Talwin)

Cannabinoids

The following cannabinoids are prohibited in-competition:

  • Natural cannabinoids, including cannabis, hashish and marijuana
  • Synthetic cannabinoids, including Δ9-tetrahydrocannabinol (THC) and other cannabimimetics

 

Cannabidiol, including CBD oil, is now permitted. However, cannabidiol extracted from cannabis plants may contain varying concentrations of THC, which remains a prohibited substance. More information on CBD is available here: Cannabidiol in 2018.

 

The WADA Monitoring Program

The following pain medications are currently permitted, but are also included on the WADA 2018 Monitoring List, which is used to identify performance-enhancing substances and trends of substance abuse in sport:

  • Codeine
  • Hydrocodone
  • Tramadol
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