Therapeutic Use Exemptions and Declarations of Use

If you have a documented medical condition that requires the use of a Prohibited Substance or a Prohibited Method, you must request a Therapeutic Use Exemption (“TUE”) from USADA or your International Federation (“IF”, for most professional runners IAAF). TUE information is available Please check the website as specific requirements can change.

To determine if you need a TUE, first research the medication on the Global Drug Reference Online (“Global DRO”) available through the USADA website or at Here you can enter the name of the medication and the site will tell you whether it is currently prohibited in-competition and out-of-competition.

Second, there are different TUE requirements for “Level 1 Athletes” and “Level 2 Athletes.” Athletes included in the USADA RTP are Level 1 Athletes. International Level Athletes (also Level 1 Athletes) are those designated by the IAAF as within IAAF’s Registered Testing Pool (“IAAF RTP”). USADA will assist International Level Athletes with forwarding TUE applications, but you have to request USADA’s assistance at least 21 days in advance of your use of the medication. Once you determine your competition level, you can determine the specific TUE requirements for that substance.

If you are beginning to feel confused and overwhelmed, this is normal and expected. There is a lot to understand regarding TUEs and it is not something to undertake lightly. If you take a medication for a medical condition, consult your resources. Consult USADA’s website listed above or email USADA  with questions. Call the USADA hotline at 1-800-233-03893 (in the USA) or 011-719-785-2020 (outside the USA). The hotline is available Monday through Friday, 8am to 4pm (MST; 10am to 6pm eastern). Ask your coach or agent for assistance, or call an advisor who can help you with the process. Again, it is your responsibility to get a TUE if you need one. The fact that you could have obtained a TUE prior to testing positive is not a defense.

If you need the medication, seek a TUE immediately. If you wait, it may be too late.

Anti-Doping Violations

In the event that you test positive for a Prohibited Substance, you will need assistance with any defense you may decide to undertake. You should consult with your coach, agent, advisor, the USOC Athlete Ombudsmen, or a lawyer with experience in anti-doping matters before proceeding.

USOC Athlete Ombudsman
John Ruger is the United States Olympic Committee (“USOC”) Athlete Ombudsman. The USOC's Athlete Ombudsman provides independent advice to athletes at no cost about the applicable provisions of the Ted Stevens Olympic Amateur Sports Act and the constitution and bylaws of the USOC, national governing bodies, Paralympic sports organizations, international sports federations, the International Olympic Committee, the International Paralympic Committee, and the Pan-American Sports Organization, and with respect to the resolution of any dispute involving the opportunity of an amateur athlete to participate in the Olympic Games, the Paralympic Games, the Pan-American Games, world championship competition or other protected competition as defined in the constitution and bylaws of the USOC. For more information go to

Among other helpful information, the USOC Athlete Ombudsman’s includes a list of attorneys who have represented athletes in Olympic-related disputes. This list is provided as a courtesy by USOC and does not constitute a stamp of approval.