Therapeutic Use Exemption (TUE's)

[abc987]

I see no reason why medical confidentiality (an important principle which we all take for granted) should be removed for athletes.
Athletes have to declare their medical conditions and justify their TUE requests in confidence to qualified professionals. Can anyone proposing that TUEs be publicised explain exactly what we would gain by broadcasting this personal medical information to everyone else? Will the collective expertise of millions of unqualified internet experts introduce new rigour to the administration of the TUE system?

I have no problem with the suggestion that we take a long, hard look at the TUE system now (and in the future) to ensure that it is not abused for performance gains, but that needs to be done by qualified experts in the anti-doping organisations.

 

[thehog]

I see no reason why medical confidentiality (an important principle which we all take for granted) should be removed for athletes.
Athletes have to declare their medical conditions and justify their TUE requests in confidence to qualified professionals. Can anyone proposing that TUEs be publicised explain exactly what we would gain by broadcasting this personal medical information to everyone else? Will the collective expertise of millions of unqualified internet experts introduce new rigour to the administration of the TUE system?

I have no problem with the suggestion that we take a long, hard look at the TUE system now (and in the future) to ensure that it is not abused for performance gains, but that needs to be done by qualified experts in the anti-doping organisations.

No one is advocating for release of all TUEs, however the system is broken. The UCI even with its own CiRC report citing the problems has refused to tackle the cortisone issue.

Similarly to the NSA to get the truth out, there has to be some collateral damage. Wiggins is the unfortunate recipient of that damage but when you have him and his team telling the world that they don't like needles, that they are taboo and in France you can buy it over the counter then he really doesn't have the ability to point fingers at privacy. He lied thinking no one would ever find out and they did via a hack.

 

[King Boonen]

No one is advocating for release of all TUEs...

Really? Reading over the last couple of pages it seems like some people are.

 

[abc987]

No one is advocating for release of all TUEs... [but]...there has to be some collateral damage.

So what are you advocating, exactly?

 

[sniper]

No one is advocating for release of all TUEs...

Really? Reading over the last couple of pages it seems like some people are.

I don't want to talk for thehog, but I think his disclaimer is important: the system is broken.
In other words, if the system wasn't broken, people wouldn't be advocating for the release of TUEs.
In the current broken system, I personally think elite athletes have a duty to release if not all TUEs, then at least all the TUEs they use in competition.

 

[thehog]

No one is advocating for release of all TUEs... [but]...there has to be some collateral damage.

So what are you advocating, exactly?

Oversight, there is none. Wiggins's TUEs in isolation may appear innocuous, however in the grand scheme of his race calendar you can see he was abusing the system for his own gain. Retrospective action in this case would be a large deterrent.

Proper and well audited systems would have a 4-eyes or secondary review system by an independent auditor at random to ensure the system is not willfully gamed like Sky have done in this case.

The system is broken because it's 'in house', it allows for nepotism and favouritism. The Froome TUE showed that. The TUE procedure is for therapy not to legally gain drugs that enhance performance or allow you to compete when you should be resting.

It's very simple.

 

[MatParker117]

No one is advocating for release of all TUEs... [but]...there has to be some collateral damage.

So what are you advocating, exactly?

Oversight, there is none. Wiggins's TUEs in isolation may appear innocuous, however in the grand scheme of his race calendar you can see he was abusing the system for his own gain. Retrospective action in this case would be a large deterrent.

Proper and well audited systems would have a 4-eyes or secondary review system by an independent auditor at random to ensure the system is not willfully gamed like Sky have done in this case.

The system is broken because it's 'in house', it allows for nepotism and favouritism. The Froome TUE showed that. The TUE procedure is for therapy not to legally gain drugs that enhance performance or allow you to compete when you should be resting.

It's very simple.

This went through committee which considers the following criteria:

TUE applications need to meet all of the following criteria before a TUE will be granted:

• The rider would experience significant health problems without taking the prohibited substance or method

• The therapeutic use of the substance would not produce enhancement of performance

• There is no reasonable therapeutic alternative

• Use of the prohibited substance or method is not needed because of previous doping.

The following evidence is needed to support a TUE application:

• Medical history

• An accurate diagnosis. For chronic conditions, up-to-date review letters that confirm treatment monitoring should be provided.

• Alternatives have been considered or trialled.

What stake do those doctors have in helping riders dope?

 

[Benotti69]

No one is advocating for release of all TUEs... [but]...there has to be some collateral damage.

So what are you advocating, exactly?

Oversight, there is none. Wiggins's TUEs in isolation may appear innocuous, however in the grand scheme of his race calendar you can see he was abusing the system for his own gain. Retrospective action in this case would be a large deterrent.

Proper and well audited systems would have a 4-eyes or secondary review system by an independent auditor at random to ensure the system is not willfully gamed like Sky have done in this case.

The system is broken because it's 'in house', it allows for nepotism and favouritism. The Froome TUE showed that. The TUE procedure is for therapy not to legally gain drugs that enhance performance or allow you to compete when you should be resting.

It's very simple.

This went through committee which considers the following criteria:

TUE applications need to meet all of the following criteria before a TUE will be granted:

• The rider would experience significant health problems without taking the prohibited substance or method

• The therapeutic use of the substance would not produce enhancement of performance

• There is no reasonable therapeutic alternative

• Use of the prohibited substance or method is not needed because of previous doping.

The following evidence is needed to support a TUE application:

• Medical history

• An accurate diagnosis. For chronic conditions, up-to-date review letters that confirm treatment monitoring should be provided.

• Alternatives have been considered or trialled.

What stake do those doctors have in helping riders dope?

what commitee? It was Zorzoli a good friend of Geert Leinders who approves TUEs. There was no committee.

 

[thehog]

No one is advocating for release of all TUEs... [but]...there has to be some collateral damage.

So what are you advocating, exactly?

Oversight, there is none. Wiggins's TUEs in isolation may appear innocuous, however in the grand scheme of his race calendar you can see he was abusing the system for his own gain. Retrospective action in this case would be a large deterrent.

Proper and well audited systems would have a 4-eyes or secondary review system by an independent auditor at random to ensure the system is not willfully gamed like Sky have done in this case.

The system is broken because it's 'in house', it allows for nepotism and favouritism. The Froome TUE showed that. The TUE procedure is for therapy not to legally gain drugs that enhance performance or allow you to compete when you should be resting.

It's very simple.

This went through committee which considers the following criteria:

TUE applications need to meet all of the following criteria before a TUE will be granted:

• The rider would experience significant health problems without taking the prohibited substance or method

• The therapeutic use of the substance would not produce enhancement of performance

• There is no reasonable therapeutic alternative

• Use of the prohibited substance or method is not needed because of previous doping.

The following evidence is needed to support a TUE application:

• Medical history

• An accurate diagnosis. For chronic conditions, up-to-date review letters that confirm treatment monitoring should be provided.

• Alternatives have been considered or trialled.

What stake do those doctors have in helping riders dope?

what commitee? It was Zorzoli a good friend of Geert Leinders who approves TUEs. There was no committee.

Exactly. Tucker also makes a 3 good points in today's CN article:

As well as treating allergies the substance is also known to stimulate fat burning or lipolysis, and therefore increases power. According to several riders who have taken it, it also subdues feelings of fatigue with almost immediate effects. One former user, Joerg Jaksche, has also told Cyclingnews that he believes it could provide around half the benefit of taking a blood bag or using EPO.

The timing of the application for the second set of TUEs has also raised eyebrows within the cycling community, with two leading experts and one of Wiggins’ previous team doctors, Prentice Steffen, questioning the necessity of needing the steroid in the build-up to major races. The TUEs were applied for and administered by Team Sky just days before Wiggins’ Grand Tour challenges at the Tour in 2011, 2012 and the Giro d’Italia in 2013. He went on to win the Tour in 2012, but crashed out of the 2011 Tour and abandoned in Italy.

Ross Tucker, Professor of Exercise Physiology at the University of the Free State in Bloemfontain, laid out three general and hypothetical scenarios relating to the Triamcinolone.

“There are three options here,” Tucker told Cyclingnews.

“Firstly, that the condition is real and has to be treated that way. The second is that the condition is there but the treatment, by using such a strong drug that has potentially sporting performance enhancing benefits, is opportunistic. The third is that the condition doesn’t exist at all and it’s just outright cheating.

“And by opportunistic, I mean that they're going beyond simply normalising an existing condition and into gaining an advantage from that condition.”

http://www.cyclingnews.com/features/pursuit-of-tour-de-france-glory-costs-team-sky-their-idealism/

 

[sniper]

We now have two clear cases where UCI favored riders by means of the TUE system.

1. Froome.

2. Wiggins.

Cookson needs to step down.

 

[python]

http://www.cyclingnews.com/features/pursuit-of-tour-de-france-glory-costs-team-sky-their-idealism/

without a question, this is the best article written by dan benson i ever read.

quite frankly, i was not his fan both as a journalist and his role in managing the forum...but i will say this, if he keeps up the excellent work as an investigative journo our sport needs so badly, i am willing to turn around 180. no crap.

 

[Rollthedice]

Somebody needs to start asking one-man committee Zorzoli some questions, he should be available since he was relived of duties.

 

[TheMight]

No one is advocating for release of all TUEs... [but]...there has to be some collateral damage.

So what are you advocating, exactly?

Oversight, there is none. Wiggins's TUEs in isolation may appear innocuous, however in the grand scheme of his race calendar you can see he was abusing the system for his own gain. Retrospective action in this case would be a large deterrent.

Can this sport actually have oversight? There were people that were forecasting this when Cookson took over at UCI. He's British, British cycling is enjoying popularity spike, Sky will cheat. They/we can't even follow the protocols and procedures to report test results. I guess it's all perspective, the house had smoke billowing out of the windows the entire time Lance was winning, I don't know how anybody could have been surprised when he confessed, there were just tons of little lies and inconsistencies.. Sky is looking very similar right now, maybe they aren't as aggressive with it but they clearly aren't leaving any marginal gains on the table.

Proper and well audited systems would have a 4-eyes or secondary review system by an independent auditor at random to ensure the system is not willfully gamed like Sky have done in this case.

The system is broken because it's 'in house', it allows for nepotism and favouritism. The Froome TUE showed that. The TUE procedure is for therapy not to legally gain drugs that enhance performance or allow you to compete when you should be resting.

It's very simple.

I think it is that simple. If you need a TUE, then you don't compete, you should rest and heal. For a lot of these things there are also multiple treatment options.

If you need a TUE as a matter of course, say to treat ADHD or some emotional issues or something, then maybe you should move over to the paraolympics or something else. Or perhaps work to find some remedies that aren't abused for performance enhancement. Especially if privacy is a concern.

What would be an interesting data point is how many riders have sought treatment for issues and chose to not use the performance enhancing variety. Just as a general health of the sport issue.

 

[sniper]

Re:

http://www.cyclingnews.com/features/pursuit-of-tour-de-france-glory-costs-team-sky-their-idealism/

without a question, this is the best article written by dan benson i ever read.

quite frankly, i was not his fan both as a journalist and his role in managing the forum...but i will say this, if he keeps up the excellent work as an investigative journo our sport needs so badly, i am willing to turn around 180. no crap.

agreed, it's really good and probably one of his better pieces.
Kudos.

At the risk of nitpicking:
I do have a problem with the title, as it implies Sky started out with genuine clean cycling idealism, something for which there is preciously little evidence.
I also have to point out the incorrectness of formulations such as
"they did not break any rules" and "it must be stressed that Wiggins, Froome and Team Sky stayed on the right side of legality". He needs to specify that that is the case wrt the TUEs. We don't know if they've ever broken any other rules.

Somebody needs to start asking one-man committee Zorzoli some questions, he should be available since he was relived of duties.

+1

 

[Irondan]

Re:

http://www.cyclingnews.com/features/pursuit-of-tour-de-france-glory-costs-team-sky-their-idealism/

without a question, this is the best article written by dan benson i ever read.

quite frankly, i was not his fan both as a journalist and his role in managing the forum...but i will say this, if he keeps up the excellent work as an investigative journo our sport needs so badly, i am willing to turn around 180. no crap.

Agreed, Dan Benson really hit the mark with this piece...

He's getting close to some real truths about TUE's, I hope he keeps digging.

 

[Rollthedice]

Re: Re:

http://www.cyclingnews.com/features/pursuit-of-tour-de-france-glory-costs-team-sky-their-idealism/

without a question, this is the best article written by dan benson i ever read.

quite frankly, i was not his fan both as a journalist and his role in managing the forum...but i will say this, if he keeps up the excellent work as an investigative journo our sport needs so badly, i am willing to turn around 180. no crap.

Agreed, Dan Benson really hit the mark with this piece...

He's getting close to some real truths about TUE's, I hope he keeps digging.

He needs to check with Freeman, Peters, Leinders the doctors, then with the body who approves these TUEs, Zorzoli, Cookson. I don't buy the fact that Zorzoli can't smell from a thousand miles that Wiggo's Tues are for enhancing performance. Leinders was buddies with Zorzoli as testified by the Chicken. Why is Zorzoli approving these things, with Froome we know breaking the rules? Is he a Team Sky fan or was financially rewarded? Fancy bears started it, now we need some real journos to find out the rotten truth behind Sky. Wiggo needs to be cornered, he might spill the beans.

 

[DirtyWorks]

No one is advocating for release of all TUEs... [but]...there has to be some collateral damage.

So what are you advocating, exactly?

I advocate for quarterly, aggregate reporting of TUEs and the drugs prescribed. No names. This way there is some way to get a sense of the frequency of the use/abuse by sport.

If an athlete is clean, reporting 99% of TUEs down to the individual would be no problem. So, I don't really get the wailing about privacy.

 

[Nick C.]

Re:

^^i suggest, being fully in sync with your sentiment, that is, 'make this embarrassing or personal issue known to potentially every single person on the planet', you should ALSO be concerned with the paralympic athletes for whom, as inferred above,the personal embarrassment is imposed by the international sporting rules.

people should be treated equally regardless of what ailment they were born with....right ?

Maybe I don't follow Paralympics enough, but wouldn't their condition be somewhat obvious to the naked eye? I don't think a one legged man is divulging a state secret by announcing same.

 

[Irondan]

Re: Re:

^^i suggest, being fully in sync with your sentiment, that is, 'make this embarrassing or personal issue known to potentially every single person on the planet', you should ALSO be concerned with the paralympic athletes for whom, as inferred above,the personal embarrassment is imposed by the international sporting rules.

people should be treated equally regardless of what ailment they were born with....right ?

Maybe I don't follow Paralympics enough, but wouldn't their condition be somewhat obvious to the naked eye? I don't think a one legged man is divulging a state secret by announcing same.

Not necessarily. Being "legally blind" is enough of a handicap to compete in the paralympics.

http://www.marketplace.org/2012/08/29/life/legally-blind-and-competing-paralympics

https://en.wikipedia.org/wiki/Paralympic_Games

 

[BYOP88]

If you need a TUE you shouldn't be racing IMO, after all the UCI set the bar with Franck Bouyer when they refused his TUE request and effectively stopped his career from June 2004 until January 2009.

 

[MatParker117]

Re: Re:

http://www.cyclingnews.com/features/pursuit-of-tour-de-france-glory-costs-team-sky-their-idealism/

without a question, this is the best article written by dan benson i ever read.

quite frankly, i was not his fan both as a journalist and his role in managing the forum...but i will say this, if he keeps up the excellent work as an investigative journo our sport needs so badly, i am willing to turn around 180. no crap.

Agreed, Dan Benson really hit the mark with this piece...

He's getting close to some real truths about TUE's, I hope he keeps digging.

He needs to check with Freeman, Peters, Leinders the doctors, then with the body who approves these TUEs, Zorzoli, Cookson. I don't buy the fact that Zorzoli can't smell from a thousand miles that Wiggo's Tues are for enhancing performance. Leinders was buddies with Zorzoli as testified by the Chicken. Why is Zorzoli approving these things, with Froome we know breaking the rules? Is he a Team Sky fan or was financially rewarded? Fancy bears started it, now we need some real journos to find out the rotten truth behind Sky. Wiggo needs to be cornered, he might spill the beans.

No doctor is going to say a damn word about this, they'd be struck off. Medical confidentiality is also a reason why Sky have been so quiet it opens them up to legal action without Bradley's permission and I doubt Wiggo gives a *** about the opinions of the few people who will remember this in a month, news cycle being what it is. His legacy is secure and I doubt he cares. Hell he doesn't deserve to have his private medical matters dragged out into the public eye.

 

[sniper]

Clean and fairplaying cyclists deserve it.

 

[BullsFan22]

Hajo Seppelt, the doping expert:


https://twitter.com/hajoseppelt/status/776476222238916608

 

[MatParker117]

Re:

He deserves it.
Clean cyclists deserve it.

So you'd advocate publishing people's private medical records on the slim chance that someone is doing something wrong? What's wrong with you?

 

[thehog]

Re: Re:

http://www.cyclingnews.com/features/pursuit-of-tour-de-france-glory-costs-team-sky-their-idealism/

without a question, this is the best article written by dan benson i ever read.

quite frankly, i was not his fan both as a journalist and his role in managing the forum...but i will say this, if he keeps up the excellent work as an investigative journo our sport needs so badly, i am willing to turn around 180. no crap.

Agreed, Dan Benson really hit the mark with this piece...

He's getting close to some real truths about TUE's, I hope he keeps digging.

He needs to check with Freeman, Peters, Leinders the doctors, then with the body who approves these TUEs, Zorzoli, Cookson. I don't buy the fact that Zorzoli can't smell from a thousand miles that Wiggo's Tues are for enhancing performance. Leinders was buddies with Zorzoli as testified by the Chicken. Why is Zorzoli approving these things, with Froome we know breaking the rules? Is he a Team Sky fan or was financially rewarded? Fancy bears started it, now we need some real journos to find out the rotten truth behind Sky. Wiggo needs to be cornered, he might spill the beans.

No doctor is going to say a damn word about this, they'd be struck off. Medical confidentiality is also a reason why Sky have been so quiet it opens them up to legal action without Bradley's permission and I doubt Wiggo gives a **** about the opinions of the few people who will remember this in a month, news cycle being what it is. His legacy is secure and I doubt he cares. Hell he doesn't deserve to have his private medical matters dragged out into the public eye.

But he does believe in calling someone an alcoholic or making sexist jokes a charity for abused children or putting Armitstead missed tests under the spotlight and calling those who question him wankers... apparently he also believes that needles are 'taboo', and something the French do.

I'm very sure he doesn't care.....