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UTMB bans painkillers to protect runners from self-medicating, following three positive tests in Chamonix

South China Morning Post logo South China Morning Post 25/9/2021 Mark Agnew mark.agnew@scmp.com
The Ultra Trail du Mont Blanc has banned painkillers and other substances not on WADA’s list. Photo: Laurent Salino/UTMB The Ultra Trail du Mont Blanc has banned painkillers and other substances not on WADA’s list. Photo: Laurent Salino/UTMB

The Ultra Trail du Mont Blanc (UTMB) has banned painkillers before or during their races to mitigate the dangers of self-medication, organisers announced on Thursday.

The organisation clarified their new policy at their UTMB's Quartz Event health programme following three positive tests at this year's UTMB last month.

Best known for its 170km race in Chamonix, that loops around Mont Blanc the UTMB is considered by many to be the pinnacle of the ultra racing calendar and has a start line packed with stars.

UTMB also now organises a World Series, with races across the globe. It is both a competition in its own right and a pathway for runners to qualify to run in Chamonix.

Pain is part of the game in ultra running but UTMB runners are no longer allowed NSAIDs. Photo: Franck Oddoux / UTMB © Provided by South China Morning Post Pain is part of the game in ultra running but UTMB runners are no longer allowed NSAIDs. Photo: Franck Oddoux / UTMB

The Quartz programme was set up in 2008 and is the UTMB's way to track runners' health. Other races can sign up to the service that provides various health checks, and also testing for elite athletes in the 30 days leading up to the race and on the day.

The new rules came in force earlier this year, but seem to have gone under the radar, hence the announcement. In fact, three people out of 30 who were tested at the UTMB in Chamonix in August, had Non-Steroidal Anti-Inflammatory Drugs (NSAID) in their samples, but were not given bans.

The UTMB cited these as their first offences, adding that a lack of knowledge as to the updated list of banned substances as a probable cause of their mistake. In the future, athletes will be banned.

NSAIDs are not banned by WADA but the use of pain killers is particularly prevalent in ultra running where aching body parts are very common over vast distances. Whether painkiller use is a form of doping has been a point of discussion over the years.

However, the inclusions of the painkillers in the banned substances list is not to do with competitive advantages, but for participants safety, Doctor Patrick Basset, the medical director of Dokever, the company that manages the medical teams at all UTMB events, said on the UTMB website.

Many of the drugs now banned by the UTMB are not banned by WADA. Photo: Shutterstock © Provided by South China Morning Post Many of the drugs now banned by the UTMB are not banned by WADA. Photo: Shutterstock

"This practice (self-medication), implemented in an inappropriate way, can be dangerous for one's health. As a study carried out on the UTMB runners showed, the most frequent type of self-medication seen is to treat two types of symptoms: osteo-articular pain and digestive problems," Basset said.

"As a consequent, the main medicines concerned are non steroidal anti-inflammatory (NSAID), anti-diarrhoea or anti-vomiting medicines."

"In the context of long lasting endurance effort, the taking of anti-inflammatories could be toxic for the kidneys and provoke rhabdomyolysis which is the destruction of the muscular cells complicating more, or less, severe renal insufficiency."

He said there acute renal insufficiency (kidney failure) is most often a result of five factors coming together at once: rhabdomyolysis (destruction of muscle cells), dehydration (Insufficient or unsuitable hydrate contributions), hypoxia (insufficient oxygen connected to altitude and effort), the taking of NSAIDs and hypotension (fall of blood pressure).

At least some of these factors can be common in high altitude mountain running.

"They (NSAIDs) can also be to the detriment of the progression of the athlete's performances in the long term," Basset added.

At Thursday's event, the UTMB clarified that runners agree not to take part in any of the races when using:

Within 60 days before the start of the competition and during the competition:

  • Intravenous iron infusion

Within seven days before the start of the competition and during the competition:

  • Intravenous iron infusion
  • Intravenous infusion
  • Gas inhalation

Substances subject to a Therapeutic Use Exemption (TUE) according to the World Anti-Doping Agency (WADA) Prohibited List:

  • All glucocorticoids regardless of the mode of administration Thyroid synthesis hormones except in case of partial or total removal of the thyroid or hypothyroidism of medical origin.
  • Within 24 hours before the start of the competition and during the competition: All beta-2-agonists (typically found in asthma inhalers) regardless of the mode of administration
  • All painkillers including Tramadol and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) regardless of the mode of administration
  • All substances included in the WADA Monitoring Programme

This article originally appeared on the South China Morning Post (www.scmp.com), the leading news media reporting on China and Asia.

Copyright (c) 2021. South China Morning Post Publishers Ltd. All rights reserved.

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