Therapeutic Use Exemptions
About Therapeutic Use Exemptions (TUEs)
There is a process that allows you to take a medication containing a banned substance if you need to for medical reasons. It's called a Therapeutic Use Exemption (TUE).
You may need to apply for a TUE if you get sick or injured and require medication, or if you have an ongoing medical condition that requires treatment, such as diabetes or asthma.
Getting a TUE may protect you from a sanction if a banned substance is found in your sample. An TUE is only granted if you will gain no unfair advantage by using the banned substance or method. It’s also important that your wellbeing is not put at further risk by using the medication.
In advance vs retroactive
Some athletes must apply for a TUE in advance (i.e. before using any banned medications or methods). Others may only apply retroactively (i.e. after a positive test).
To find out which applies to you:
- Read the information under 'In-advance or retroactive?'
- Check the 'When to apply in advance (infographic)'
- Check the 'In-advance criteria table (by sport)'
Ready to apply for a TUE?
In-advance or retroactive?
In advance TUEs
Some athletes must have a TUE before they take a banned substance. This includes:
- Athletes in the DFSNZ Registered Testing Pool or National Testing Pool;
- Athletes selected for New Zealand Olympic, Paralympic or Commonwealth Games teams;
- Athletes who have been registered, qualified, selected, named or contracted to compete in specific teams and/or national events listed in the 'In-advance criteria table (by sport)' - see below.
If you’re competing internationally, check with your Federation and be clear about your responsibilities around TUEs. You may have to apply for a TUE from your International Federation rather than from us. Find out more about this below under ‘International-level athletes’.
Not sure what level athlete you are? Email us at tue@drugfreesport.org.nz or contact your National Sport Organisation to check.
Retroactive TUEs
A retroactive TUE is one that's granted after an athlete has tested positive. Retroactive TUEs are available to those competing at levels that aren't listed in the 'In-advance criteria table (by sport)'. You'll need to meet the criteria and supply comprehensive medical documents before a TUE can be granted.
You may apply to us for a retroactive TUE if:
- You needed emergency or urgent treatment for a medical condition;
- There was insufficient time, opportunity or other exceptional circumstances that prevented you from submitting the TUE application, or having it evaluated, before getting tested;
- You weren't allowed or required to apply in advance for a TUE as per the anti-doping rules;
- You're a lower-level athlete who was tested but isn't under the jurisdiction of an International Federation or National Anti-Doping Organization;
- You tested positive after using a substance out-of-competition that was only prohibited in-competition (for example glucocorticoids).
In rare and exceptional circumstances (and notwithstanding any other provision in the International Standard for Therapeutic Use Exemptions) you may apply for and be granted retroactive approval for a therapeutic use of a prohibited substance or method, if considering the purpose of the Code, it would be manifestly unfair not to grant a retroactive TUE. This unique retroactive TUE will only be granted with the prior approval of WADA (and WADA may in its absolute discretion agree with or reject the Drug Free Sport New Zealand’s decision).
Important note: Using a banned substance or method without a TUE could result in an anti-doping sanction. Keep all your medical notes in case you need to apply for a retroactive TUE.
TUE basics
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- You tell your medical professional that you’re an athlete who could be drug tested and ask them to bear this in mind when prescribing medication.
- Check the status of any prescribed medication or method. Find out how at Medications and methods.
- If the substance or method is prohibited, ask your doctor if there are any alternatives that could be used.
- If there’s no alternative, you may need to apply for a TUE before you use the medication or method. Find out whether you need to apply in advance under 'When to apply in advance'. If it is an emergency, treatment may begin immediately.
- Download an application form. Your application must be completed in full by a medical practitioner, preferably the prescribing doctor, and all relevant supporting documentation attached. (Note that most applications require specialist support.)
- Submit your TUE application to us via email or it send your TUE to your International Federation if appropriate. You can also send it to us by post or fax. Check our contact details.
- Your application will be reviewed by the TUE Committee once it is received in full.
- You and your medical professional will be told whether the application has been accepted or rejected within 21 days. You will be told of any conditions, including the date of expiry and restrictions on the use of the medication.
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This table shows the levels of sports at which a TUE is required before an athlete takes a medication containing prohibited substances. If your sport and competition/level appear in the table, you need a TUE in advance from DFSNZ.
Sport National Level Athlete Criteria IF Athletics Athletes who enter in the senior category at the National Track and Field Championships World Athletics Basketball Athletes selected in the Breakers Squad
Athletes selected in the National Basketball League (men and women).
FIBA Canoeing Athletes who enter in the Open Age category at the Canoe Sprint National Championships ICF Cricket Men's Plunket Shield, 50 Over and T20 Competitions
Women’s One Day and T20 competitions
ICC Cycling Athletes who enter in the Elite category at National Championship events (includes road, track, mountain bike and BMX championships) UCI Football Athletes selected for the Wellington Phoenix Squad
Men’s National League Squad (10 teams who reach the Championship phase)
Women's National League Squad
FIFA Hockey National Hockey Championship – Tier 1 (men and women) FIH Netball ANZ Premiership World Netball Rowing Premier grade at the New Zealand National Rowing Championships World Rowing Rugby League NZ Warriors Squad and the Warriors Women Squad
Athletes who compete in the Premiership (tier 1) division of the National Rugby League Competition (men and women).
RLIF Rugby Union Super Rugby Pacific (men)
Bunnings Cup squad (men)
Super Rugby Aupiki (women)
World Rugby Snow Sports TAPS Athletes FIS Swimming Open Age category at the NZ Open Championships World Aquatics Triathlon Elite (standard distance) category at the National Triathlon Championships World Triathlon Weightlifting Athletes who have qualified at A Grade and above and have entered WNZ Junior/Senior National Championships IWF -
A TUE granted by DFSNZ is only valid at the national level. If you are, or become, an international-level athlete, or compete at Major Games, that TUE will not be valid unless it is recognised by the relevant International Federation (IF) or Major Event Organization (MEO). It is your responsibility to check if your DFSNZ TUE is automatically recognised by your IF or MEO.
You may also need to apply directly to your IF depending on their definition of an international-level athlete. You can find the definition on the relevant IF’s website.
We can help you find out where to apply and how to present your DFSNZ TUE to an IF or MEO for recognition. Please contact tue@drugfreesport.org.nz.
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If you have a serious accident or you require emergency medical treatment, don’t hesitate. Your health always comes first and you should get whatever medical help you need immediately.
Do advise all medical staff that you’re an athlete who could be drug tested and ask them to check whether all medications are prohibited in sport. And if you do require a prohibited substance or method for the sake of your health, make a TUE application immediately after treatment. This is known as a retroactive TUE.
More TUE information
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All of the four following criteria must be met (for more details, please refer to the WADA International Standard for Therapeutic Use Exemptions (ISTUE) Article 4.2):
- The athlete has a clear diagnosed medical condition, which requires treatment using a prohibited substance or method;
- The therapeutic use of the substance will not, on the balance of probabilities, produce significant enhancement of performance beyond the athlete’s normal state of health;
- The prohibited substance or method is an indicated treatment for the medical condition, and there is no reasonable permitted therapeutic alternative;
- The necessity to use that substance or method is not the consequence of the prior use (without a TUE), of a substance or method which was prohibited at the time of use.
Your medical practitioner will need to provide information in support of your TUE application. This includes:
- Comprehensive medical evidence to justify the use of the treatment, preferably from a specialist;
- Confirmation that permitted alternative medications have been tried where possible.
The medical evidence you need to supply is dependent on your condition. WADA offer guidance for many common medical conditions. Before you make your application, please read the relevant WADA TUE checklist.
If your medication or condition is not listed, please ask your doctor to review WADA's Medical information to support the decisions of TUECs.
When we receive all the information we require, we generally process applications within five working days. Without all the information required, your application will be delayed. Please check all evidence has been included before you send your TUE application.
If granted, a TUE will only be valid for the specific medication and for a certain time period. Make sure you understand the restrictions that apply.
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Each TUE has a specific duration, at the end of which it expires automatically. Should you need to continue to use the prohibited substance or method, it is your responsibility to submit a new application for a TUE with updated medical information ahead of the expiry date, so that there is sufficient time for a decision to be made prior to the expiry of the current TUE.
Important note: The presence (following sample collection), use, possession or administration of the prohibited substance or method shall be consistent with the terms of your TUE which are present on your certificate. Therefore, if you require a materially different dosage, frequency, route or duration of administration, you should contact DFSNZ as you may be required to apply for a new TUE. Some substances and dosages, e.g. insulin, are often modified during treatment and these possible fluctuations should be mentioned by the treating physician in the TUE application and would usually be accepted by the ADO TUEC.
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If a TUE application is declined, you will receive a written explanation of the reasons for that decision. If you need help to understand why the decision was made, feel free to contact us. Sometimes, the application may be missing a critical piece of information, diagnostic test, laboratory results, signature etc. If this is the case, we’ll request the information and you will be able to reapply.
If you are a National Level or Recreational Level athlete, you may appeal DFSNZ's decision to the Sports Tribunal of New Zealand. For guidance on this process and the required documentation, please visit the Sports Tribunal website.
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If your International Federation does not recognise your DFSNZ TUE, you and DFSNZ have 21 days to refer the matter to WADA for review after notification of the non-recognition. You should send the same information that you submitted to DFSNZ, and on which their TUEC based their decision, via a secure online method or by registered mail to:
WADA Medical Department
World Anti-Doping Agency
Stock Exchange Tower
800 Place Victoria (Suite 1700)
P.O. Box 120
Montreal (Quebec) H4Z 1B7
CanadaThe email address to enquire and/or send the request for review is medical@wada-ama.org.
Pending WADA’s decision, DFSNZ’s TUE remains valid for national-level competition and out-of-competition testing only. If the matter is not referred to WADA for review, DFSNZ determines whether the original TUE granted to you should remain valid for national-level competition and out-of-competition testing.
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All the information contained in a TUE application including the supporting medical information and any other information related to the evaluation of your TUE request is kept strictly confidential and treated in accordance with the Athlete’s Declaration contained in the Drug Free Sport New Zealand's TUE Application Form. All members of the TUEC and any other authorized recipients of your TUE request and related information (as described in the Athlete’s Declaration) are subject to a professional or contractual confidentiality obligation.
Please review the terms of the Athlete’s Declaration carefully. In particular, note that should you wish to revoke the right of the Drug Free Sport New Zealand's TUEC to obtain the information related to your TUE request in accordance with the Athlete’s Declaration, your TUE application will be deemed withdrawn without approval being granted.
Your TUE request-related information will be retained by Drug Free Sport New Zealand and any other authorized recipients for no longer than necessary for the purposes stated in the Athlete’s Declaration, in accordance with the International Standard for the Protection of Privacy and Personal Information.