Blog: The pain of opioids

17 December 2018

Three Australians die from opioid use every day and 150 are hospitalised because of opioid harm, according to the Australian Institute of Health and Welfare report released last month.

In the decade to 2016, the report also found that the rate of opioid deaths and hospitalisations because of opioid poisoning increased by 62 and 25 per cent respectively.

Pharmaceutical opioids are a class of drugs with one primary legitimate use – to reduce pain.

As such, for the athlete recovering from injury, prescription opioids may have an important part to play in the treatment and rehabilitation process.

However, there are rules governing their use in sport.

Under WADA guidelines, some opioids are prohibited and categorised as S7 (Narcotics) class substances. They include (among others) pharmaceutical opioids such as Oxycodone, Buprenorphine, Fentanyl (and its derivatives), Morphine and Methadone, but also illegal opioids such as heroin.

Thus, unless a Therapeutic Use Exemption (TUE) has been granted, opioids listed on WADA’s Prohibited List are banned ‘in-competition’. While the definition of in-competition varies between sports and competitive schedules, in most instances it refers to the period commencing 12 hours before a competition up to the end of the competition and any sample collection process.

The detection of S7 class substances is relatively rare in Anti-Doping testing. Internationally in 2017, Narcotics composed 2% of positive results and were detected in 0.06% of in-competition samples.  

ASADA is also aware of anecdotal reports and allegations of opioid misuse in the athlete community.

While Australia has seen a concerning increase in the misuse and abuse of opioid-based substances within the general community, based on current data, the extent of opioid misuse within the Australian athlete population is unclear.