On Wednesday, 17 August 2022 Nairo Quintana became the first professional cyclist to be sanctioned for using the opioid painkiller tramadol in competition.
The case is unique in that the UCI rules, in force since March 2019, exceed those of the World Anti-Doping Agency in banning Tramadol.
Tramadol use falls under the UCI’s medical regulations, rather than its anti-doping programme, so positive tests are not treated as anti-doping rule violations.
Quintana has been stripped of his results from the Tour de France, where he tested positive, but has not been suspended, although he could be if he tests positive again in the future.
The case is a novelty in professional cycling, leading to question marks and confusion, so Cyclingnews sets out all you need to know about tramadol – from its effects and its associations with performance enhancement, to the ban and what the UCI rules actually mean.
What is tramadol?
The prescription drug has been on the market since the 1970s but has only come into widespread use since the 1990s.
It is in the class of opioids, a group of drugs that also includes powerful painkillers like morphine and oxycontin but was marketed for managing pain without the highs imparted by those drugs.
Tramadol is effective in managing low to moderate pain but it still comes with undesirable side effects that include dizziness and drowsiness, nausea and, in higher doses, respiratory issues.
Does tramadol enhance performance?
WADA added Tramadol to its Monitored List in 2012. The list typically comprises grey-area drugs or substances that might improve sporting performance. Caffeine, nicotine and the common decongestant phenylephrine are some of the other substances on this list.
There is a theory – voiced by numerous former professional riders – that the painkiller can enable a rider to push past the pain barrier and dig deeper into their physical reserves.
“It kills the pain in your legs, and you can push really hard,” said former Team Sky rider Michael Barry, while Lieuwe Westra admitted tramadol was part of his use of legal methods to optimise his athletic performance.
Performance-enhancement is not the only factor associated with tramadol; there are also health concerns. The potential for drowsiness has been highlighted as a possible cause of crashes and injuries, while it is also feared that use could lead to addiction.
What is pro cycling’s history with tramadol?
The widespread use of the drug came into the public sphere after USADA…
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