Navigating the NCAA Banned Substances List: A Guide for Student-Athletes

The NCAA's commitment to fair play and student-athlete well-being is reflected in its comprehensive drug-testing program. This program aims to deter the use of performance-enhancing drugs and safeguard the health of athletes. Understanding the NCAA's list of banned substances and the policies surrounding it is crucial for every student-athlete. This article provides a detailed overview of the NCAA banned substances list, medical exceptions, and important considerations for student-athletes.

Understanding the NCAA Banned Substances List

The NCAA prohibits drugs by class, encompassing any substance chemically or pharmacologically related to those classes. It is important to note that the NCAA list of banned-drug classes is subject to change by the NCAA Executive Committee. For the most up-to-date information, student-athletes should consult NCAA education services or visit www.ncaa.org/health-safety.

The NCAA banned drug classes align with the World Anti-Doping Agency’s list of prohibited classes, with the exception of the glucocorticoid and cannabinoid classes. The term "related compounds" includes substances that are included in the class by their pharmacological action and/or chemical structure. No substance belonging to the prohibited class may be used, regardless of whether it is specifically listed as an example.

Key Aspects of the NCAA Drug-Testing Program

The NCAA drug-testing program encompasses year-round testing for steroids, peptide hormones, and masking agents, as well as testing for stimulants and recreational drugs during championships. Member schools may also conduct their own drug-deterrence programs, testing for these substances.

The NCAA drug-testing program, along with clear policies and effective education, protects student-athletes who play by the rules by playing clean. The purpose of the drug-testing program is to deter student-athletes from using performance-enhancing drugs, and it impacts the eligibility of student-athletes who try to cheat by using banned substances.

The Role of Medical Exceptions

The NCAA recognizes that some banned substances are used for legitimate medical purposes. The NCAA allows exceptions to be made for those student-athletes with a demonstrated medical need to use certain banned substances.

There are two types of medical exceptions:

Medical Exception Pre-Approvals (MEPA): These must be submitted prior to athletics participation.
Medical Exceptions: These are submitted after a positive NCAA drug test.

For all other medical exceptions, a school should submit only after the student-athlete tests positive during an NCAA drug test.

Specific Medical Conditions and Exceptions

Anabolic Agents: The NCAA must approve the medically excepted use of an anabolic agent, hormone and metabolic modulator, peptide hormone, growth factors, related substances and mimetics before the student-athlete is allowed to participate in competition while using the banned substance. Anabolic agents generally refer to drugs that increase protein synthesis and tissue building, specifically muscle building and repair.
Testosterone Deficiency: Student-athletes competing in NCAA men’s sports must have an identifiable cause of testosterone deficiency. The student-athlete may be asked to have repeat testing with a certified and harmonized testosterone assay. Anti-estrogens such as clomiphene, anastrozole and letrozole stimulate the production of testosterone (specifically in humans with testicles). In general, treatment with clomiphene, letrozole and other anti-estrogens would not qualify for a MEPA in male student-athletes.
Growth Hormone Therapy: Student-athletes with growth-hormone deficiency due to an identifiable, irreversible cause of disease of the hypothalamus and/or pituitary might qualify for a MEPA for growth hormone therapy. The medical documentation may need to include evidence confirming the diagnosis (e.g., evaluation that conforms to most recent national guidelines for growth hormone deficiency). Similarly, those student-athletes that were given growth hormone therapy to treat short stature before the completion of puberty who seek a medical exception pre-approval will need to provide evidence (e.g., evaluations that conforms to most recent national guidelines) confirming the growth hormone deficiency.
Stimulants (e.g., ADHD Medication): Medical exceptions for substances in this drug class should be submitted following an NCAA positive drug test. Schools are required to provide written summary of comprehensive clinical evaluation, including original clinical notes of the diagnostic evaluation. The evaluation should include individual and family history, address any indication of mood disorders, substance use, anxiety disorders, and previous history of ADHD treatment and incorporate the DSM criteria to diagnose ADHD.

Student-athletes who are taking prescribed medications identified as stimulants (e.g. ADHD medication), beta-blockers, beta-2 agonists (asthma inhalers such as albuterol), diuretics, and narcotics (e.g. some pain medications) must provide specific documentation for each medication from the treating physician. This documentation includes a completed NCAA Medical Exceptions Reporting Form and supporting medical documentation. This documentation will be maintained in the Oxy sports medicine department and will be submitted to the NCAA in the event of a positive-drug test resulting from the use of these medications. Time is of the essence here, since the student-athlete will be withheld from competition until the documentation is submitted and the NCAA grants an exception.

The Risk of Nutritional/Dietary Supplements

Many nutritional/dietary supplements contain NCAA banned substances. Food and Drug Administration (FDA) does not strictly regulate the supplement industry; therefore purity and safety of nutritional dietary supplements cannot be guaranteed. Impure supplements may lead to a positive NCAA drug test. The use of supplements is at the student-athlete's own risk.

Read also: Crafting Your NCAA Profile

The NCAA does not endorse any dietary supplements; therefore, products markets as "NCAA compliant" have not been reviewed by the NCAA. There is no assurance of a product's purity, safety, or effectiveness. Manufacturers of dietary supplements are not required to obtain pre-market approval from the Federal Drug Administration (FDA). Therefore, there is no assurance of a product's purity, safety, or effectiveness. A dietary supplement may contain a banned substance, even if not listed, due to contamination or poor manufacturing practices.

Consequences of a Positive Drug Test

A positive drug test for some banned substances can results in suspension from competition for a minimum of 365 days and the loss of a year of remaining eligibility. Ultimately, student-athletes are responsible for everything they ingest.

Resources for Student-Athletes

The NCAA has partnered with Drug Free Sport AXIS, a free online resource for all NCAA student-athletes that provides up-to-date research on supplements and over-the-counter and prescription drugs and medications. Student-athletes can utilize the Medication Status Lookup and Dietary Supplement Inquiry features.

Institutional Responsibilities

NCAA legislation requires that schools provide drug education to all student-athletes. The athletics director or athletics director's designee shall disseminate the list of banned-drug classes to all student-athletes and educate them about products that might contain banned drugs. They should also be informed of the appropriate athletics department procedures for disseminating updates to the list. Furthermore, schools should discuss and review student-athlete use of prescribed and over the counter medications. Athletics department staff should provide guidance to student-athletes about supplement use, including a directive to have any product checked by appropriate athletics department staff before consuming.

Key Takeaways for Student-Athletes

Consult with Experts: A student-athlete should consult with their primary athletics health care provider (e.g., athletic trainer, team physician) about all medications and other products prior to use.
Supplements are Risky: Food and Drug Administration (FDA) does not review or approve nutritional/dietary supplements for safety or effectiveness. No. The NCAA does not approve the use of any specific nutritional/dietary supplement even if it is available over the counter. Student-athletes have tested positive and lost their eligibility using nutritional/dietary supplements and other products that contain banned substances.
There is no complete list: Note: This is neither a complete nor exhaustive list. Any substance chemically/pharmacologically related to these classes is also banned. The school and the student-athlete shall be held accountable for all substances within the banned-drug class regardless of whether they have been specifically identified. THERE IS NO COMPLETE LIST OF BANNED SUBSTANCES. Many nutritional/dietary supplements are contaminated with banned substances not listed on the label.
Stay Informed: The NCAA list of banned-drug classes is subject to change. Contact NCAA education services or www.ncaa.org/health-safety for the current list.

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