Figures released by the World Anti-Doping Agency (WADA) under its 2017 Monitoring Program suggest that the use of opioid-based painkiller tramadol and glucocorticoids (corticosteroids used to treat inflammatory allergies) is prevalent in cycling. The figures (PDF below) relate to testing data for substances that are do not feature on the 2017 Prohibited List, but have been monitored in 2017 in order to detect potential patterns of misuse in sport.

The figures show that use of tramadol and glucocorticoids in cycling way outstrips their use in any other sport. Of 3,199 in-competition samples monitored in cycling, 121 tested positive for glucocorticoids in a concentration greater than 1ng/mL (3.8%); and of 479 out of competition samples, 21 (4.4%) tested positive for the same concentration. Of 12,554 cycling samples monitored for tramadol, 548 reported concentrations greater than 50 ng/mL (4.4%).

The prevalence of both substances in cycling is much higher than the prevalence of prohibited substances detected through anti-doping tests across sports, which in 2016 was 1.6%. An argument has developed between the movement for credible cycling (MPCC) and WADA about whether corticosteroids and tramadol should be prohibited in sport. 

WADA argues that the performance benefits of glucocorticoids are ‘very narrow indeed’, and tramadol is better regulated by physicians for therapeutic use as a legitimate painkiller. The MPCC argues that glucocorticoids do have a positive effect on performance. David Lappartient, President of the International Cycling Union (UCI), promised to ban both substances in cycling as part of his election campaign. 

All glucocorticoids are prohibited under section S9 of WADA’s Prohibited List ‘when administered by oral, intravenous, intramuscular, or rectal routes’. However, they are permitted in competition (IC) via other routes of administration, and out of competition (OOC). 

Tramadol, an opioid-based painkiller, currently does not feature on WADA’s Prohibited List, but was added to its Monitoring Programme in 2016. There have been claims that tramadol has been abused in cycling, and the International Olympic Committee (IOC) is understood to be investigating its use in sport. During 2015, two Australian rugby league players came close to death after overdosing on the painkiller.