Medical Exceptions

 

MEDICAL EXCEPTIONS

 

The NCAA has instituted strict guidelines for eligibility under medical exceptions for banned substances, including stimulants used to treat ADHD/ ADD, medications for male-pattern baldness, peptide hormones (hGH), and anabolic steroids (testosterone) or any other medications banned* by the NCAA.  There are no medical exceptions for street drugs. 

The NCAA bans classes of drugs because they can harm student-athletes and can create an unfair advantage in competition.   Some legitimate medications contain NCAA banned substances, and student-athletes may need to use these medicines to support their academics and their general health.  The NCAA has a procedure to review and approve legitimate use of medications that contain NCAA banned substances through a medical exceptions procedure.  The  benefit  of  a  medical exception  procedure  is  that  in  most  cases  the  student-athlete’s  eligibility  remains  intact  during  the process.  Any student-athlete who tests positive will need to comply with this policy.

Procedures for Exceptions:

1. Alternative non-banned medications for the treatment of various conditions exist and should be considered before an exception is pursued.

2. In the event that the student-athlete and the physician (in coordination with sports-medicine staff at the student athlete's institution) agree that no appropriate alternative medication to the use of the banned substance is available, the decision may be made to continue the use of the medication. However, the use of an anabolic agent or peptide hormone must be approved by the NCAA before the student-athlete is allowed to participate in competition while taking these medications. The institution, through its director of athletics, may request an exception for use of an anabolic agent or peptide hormone by submitting to the NCAA medical documentation from the prescribing physician supporting the diagnosis and treatment. (contact mwilfert@ncaa.org)

3. The institution will maintain documentation that supports the use of medication in the student-athlete's Health Services medical record on campus. The documentation can be a letter or copies of medical notes from the prescribing physician that documents how the diagnosis was reached, and that the student-athlete has a medical history demonstrating the need for regular use of such a drug. The letter should contain information as to the diagnosis (including appropriate verification of the diagnosis), medical history and dosage information. A  simple  statement  from  the prescribing physician  that  he  or  she  is  treating  the  student-athlete  for  ADHD  with  said medication is not adequate documentation. 

The following form must be used when reporting the use of medications for the treatment of ADHD:

ADHD FORM

 

4. Unless requesting a review for the medical use of an anabolic agent or peptide hormone, a student-athlete's medical records or physicians' letters should not be sent to the NCAA unless requested by the NCAA.  Also, the use of any substance need not be reported to the drug-testing crew at the time of NCAA drug testing

Student-athletes must provide the Brown University Student Health Services with all documentation related to use of banned substances.  Brown University Department of Athletics, Sports Medicine and Health Services will not track or verify any information kept for this purpose. The sole responsibility for meeting this NCAA ruling rests with the student athlete and his or her physician.

Documentation can be faxed to the Brown Health Service at 401-863-7953, or mailed to:

Brown University Health Services
Andrew House

c/o: Jennifer Hosdhon

13 Brown Street
Providence, RI            02912

Student-athletes are responsible for notifying the Sports Medicine staff of any medications they are taking when they fill out the yearly online Athletics Health Questionnaire for intercollegiate athletics.The student athlete is responsible for updating the sports medicine staff during the school year if there are any changes in these medications.

Attention Deficit/Hyperactivity Disorder (ADHD) – is one of the most common neurobehavioral disorders of childhood and can persist through adolescence and into adulthood. ADHD is generally diagnosed in childhood, but sometimes not until college or later. The most common medications used to treat ADHD are methylphenidate (Ritalin) and amphetamine (Adderall), which are banned under the NCAA class of stimulants. In order for a medical exception to be granted for the use of these stimulant medications, the student-athlete must show that he or she has undergone standard assessment to identify ADHD. Frequently a student-athlete may find that the demands of college present difficult learning challenges. They may realize that some of their teammates are benefitting from the use of these medications, and figure they should ask their team physician or family doctor to prescribe the same for them. If they do not undergo a standard assessment to diagnose ADHD, they have not met the requirements for an NCAA medical exception. Most colleges provide these types of assessment through their student support services or counseling and testing centers. The student-athlete should either provide documentation of an earlier assessment, or undergo an assessment prior to using stimulant medication for ADHD. If the diagnosis is ADHD, the student-athlete may then pursue treatment with the team physician or family physician for a prescription for stimulant medication, and provide all documentation to the university health services to keep in the file in the event the student-athlete is selected for drug testing and tests positive. At that point, the athletics administrator will be instructed to provide the documentation for review by the medical panel, and if all is in order, the student-athlete's medical exception is granted.

Male-Pattern Baldness – Androgenic alopecia is a common form of hair loss in both men and women. In men, this condition is also known as male-pattern baldness. Hair is lost in a well-defined pattern, beginning above both temples. Over time, the hairline recedes to form a characteristic "M" shape. Hair also thins at the crown of the head, often progressing to partial or complete baldness. Non-banned medications are available to treat this condition. Finasteride (trade name Propecia), which is prescribed in some cases to treat male-pattern baldness, is a banned substance under the class of masking agents, as it interferes with the ability to identify steroid use. Before using finasteride, a student-athlete must exhaust other standard medications and document this effort. All documentation should be submitted to the student health services to maintain in their medical record. In the event a student-athlete tests positive for the use of finasteride, the institution will then submit the full record for a medical exception review.

Hypogonadism – Or testosterone deficiency, results either from a disorder of the testes (primary hypogonadism) or of the hypothalamus or pituitary glands (secondary hypogonadism). Causes of primary hypogonadism include Klinefelter's syndrome, undescended testicles and hemochromatosis. Secondary hypogonadism can be due to aging, increasing body mass index and/or type 2 diabetes mellitus. Treatment for hypogonadism may include testosterone medication. Testosterone falls under the banned drug class "anabolic agents". A student-athlete through the Director of Athletics must request approval to use medication with testosterone prior to participation while using this substance. A full medical documentation of the diagnosis, course of treatment and prescription history must be provided by the institution prior to allowing the student-athlete to compete on this medication. If a student-athlete tests positive for testosterone and has not obtained prior approval to use this substance, the case must go to appeal.

In all cases, if a student-athlete does not meet the criteria for a medical exception, the student-athlete may request an appeal hearing of the positive drug test. In this case, the student-athlete's eligibility will be suspended pending the outcome of the appeal.

Questions should be directed to the Brown University Athletic Training staff at 401-863-3851.

The NCAA website http://www.ncaa.org/wps/wcm/connect/public/NCAA/Health+and+Safety/Drug+Testing/Drug+Testing+Landing+Page  contains information regarding drug testing and medical exceptions.