Tramadol in sport will tackle multiple issues 

The World Anti-Doping Agency (WADA) has announced that Tramadol will be banned for in-competition use in sport from January 2024. Dr Lex Mauger, Reader in Sport and Exercise Sciences at the University of Kent, led research that was pivotal to WADA’s decision after the study provided compelling evidence that tramadol is a performance enhancing drug. 

Commenting on the ban, Dr Mauger says: ‘While there are several wider issues and concerns about the use of tramadol and despite cyclists identifying it as a doping agent, until recently the World Anti-Doping Agency have held off banning the drug in sport, primarily because there hasn’t been the evidence to show that it is performance enhancing. 

‘This study has provided compelling evidence to show that tramadol is a performance enhancing drug, which has led to this welcome move by WADA to ban it for in-competition use. Not only will it address the issue of athletes gaining a performance edge, but it also helps tackle the other concerns around taking tramadol during exercise and competition. 

‘Tramadol is a synthetic, centrally-acting and potent analgesic that displays opioid-like effects – it is a narcotic and is highly addictive. This significantly increases risk of overdose, depression, and suicide. There have been a number of high-profile athletes who have talked candidly about their battle with addiction to pain killers. 

‘Secondly, tramadol has a number of side effects including nausea, dizziness and vomiting and it can affect motor control. For those in sporting competitions, these side-effects can prove dangerous – for the athlete taking the drug as well as fellow competitors. If you’re a cyclist riding in a peloton at high speed and you have less control of your bike, there is a bigger chance of a crash that could injure you or other riders. If you’re a rugby player, and your co-ordination is impaired then the chances of making a badly timed or dangerous tackle and injuring someone is also higher.  

‘Finally, if tramadol is used to mask the pain from an actual injury there is a risk to the individual of making that injury significantly worse, and either prolonging the recovery time from that or risking permanent damage. Tramadol is such a strong pain killer that the question probably needs to be asked whether the athlete should be competing if they need tramadol to get through the pain. 

‘The lengthy delay in this ban taking effect reflects the complicated history of the drug and will enable athletes and athlete support personnel to prepare for the change, WADA-Accredited Laboratories to update their procedures, and sports authorities to develop educational tools.’ 

About the research:  

In a randomised controlled trial, the team showed that highly trained cyclists performed a 25-mile time trial on average 1.3% faster than a placebo condition – a highly meaningful improvement in a group of this standard. To put this improvement in context, in this group the 1.3% difference could change the make-up of the medalling positions, or take a rider from the bottom half of the rankings into the top half. This performance enhancing effect was seen in 80% of the participants, suggesting the effects are pervasive.