On 23 September 2022, the World Anti-Doping Agency’s (WADA) Executive Committee approved the 2023 List of Prohibited Substances and Methods (“Prohibited List”). The Prohibited List will come into force on 1 January 2023.

Addition to the Prohibited List - Tramadol

The only addition to the Prohibited List has been the substance Tramadol, a powerful painkiller that has led to several cases of addiction.

Tramadol will be a prohibited substance in competition, but its prohibition will not be effective until 1 January 2024. This is to ensure that athletes receive the correct education on the use of the substance and that medical staff prepare for its safe use for clinical purposes, prior to its formal introduction.

This advance notice of more than 15 months is likely to be welcomed by athletes and stakeholders alike given the significant amount of time it provides for them to prepare for the change.  This may prevent a scenario similar to the Maria Sharapova case, where the athlete tested positive for Meldonium (a prohibited substance), after being tested on 26 January 2016. This was only 4 months after WADA published its 2016 prohibited list, in September 2015.

Notably, in the Sharapova case, the Panel at the Court of Arbitration for Sport noted that:

“anti-doping organizations should have to take reasonable steps to provide notice to athletes of significant changes to the Prohibited List, such as the addition of a substance, including its brand names”.

Indeed, this was one of the mitigating factors considered that resulted in a reduced period of ineligibility for Sharapova.  However, it is unlikely that athletes who do subsequently test positive for Tramadol after the 2024 Prohibited List takes effect will be treated with the same leniency, given the increased amount of notice by WADA of its inclusion in the List.

Why Tramadol?

            In short, WADA believes that the substance:

  1. poses a risk to athlete health;
  2. has the ability to enhance performance; and therefore
  3. is contrary to the “spirit of sport”

WADA has justified Tramadol’s inclusion in the Prohibited List on the basis that “the abuse, with its dose-dependent risks of physical dependence, opiate addiction and overdoses in the general population, is of concern and has led to it being a controlled drug in many countries”.

However, Tramadol addiction and overdose is not the only concern for WADA. WADA has also stated publicly that “Research studies funded by WADA have also confirmed the potential for tramadol to enhance sports performance”.

The research was conducted on a sample of Cyclists who undertook time trials. The study revealed that participants who were given the substance were “significantly faster” than the ones that had received a placebo.  According to the research, this advantage in speed could be enough to change the medalling positions of a championship.

Ultimately, preserving the integrity of competition and the “spirit of sport” is one of the fundamental tenants of the WADA Code.


Cannabis’ place on the Prohibited List has been subject to much debate over the years. In fact, many suspected that WADA would consider removing it from the next iteration of the Prohibited List, following the request of several sports stakeholders in countries such as United States and the Netherlands.

Like many other substances, WADA had been carrying out independent investigations on the effects of cannabis/Tetrahydrocannabinol (“THC”) since at least September 2021 to determine whether the substance warrants inclusion in the Prohibited List.  

Despite the public position of the Doping Authority Netherlands that, “Cannabinoids most likely have a negative impact on athletic performance”.  WADA has not removed the substance from the Prohibited List as it still considers that (a) it represents a health risk to the athlete and (b) violates the spirit of sport.

The independent investigations conducted by WADA’s Expert Advisory Group have identified several arguments and supporting evidence that shows that the use of Cannabis constitutes a health risk to the athlete.

It is important to also bear in mind that the threshold for the substance was increased in 2013 because “the high level of cannabis required to trigger an Adverse Analytical Finding in competition today would be consistent with a significantly impaired athlete or a frequent user”. This suggests that if an athlete tests positive for the substance, it is unlikely to be due to its sporadic use out of competition, but rather more regular and prolonged use.

Nevertheless, WADA has confirmed that investigations on this substance are not over and therefore its position on Cannabis might change in the future, leaving the door open for future changes to the Prohibited List.

The sports law team at Mills & Reeve has considerable experience in anti-doping matters, representing athletes at domestic and international federation tribunals and the Court of Arbitration for Sport.

Written by Rustam Sethna and Xabier Lopez Hervas

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Every piece of content we create is correct on the date it’s published but please don’t rely on it as legal advice. If you’d like to speak to us about your own legal requirements, please contact one of our expert lawyers.


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