The World Anti-Doping Agency (WADA) has published a redesigned List of Prohibited Substances and Methods for 2021.
WADA Executive Committee members approved the 2021 Prohibited List at their meeting last month.
It details the substances and methods prohibited both in- and out-of-competition under the World Anti-Doping Code.
Included is a table of contents which provides a non-exhaustive list of examples of medical conditions for which substances in the different classes may be prescribed.
There is also an introduction that defines some terms used in the list.
Headings have been included in each class, indicating which substances or methods are prohibited at all times or just in-competition, as well as which classes are specified and non-specified and, where applicable, the identification of the substances of abuse within a class.
The redesign also includes headings for the classes and sub-classes, with more clearly identified exceptions and notes within the categories, and a new index at the end of the document which lists the substances and methods mentioned in the list.
One of the main modifications concerns "substances of abuse".
WADA said that during their two-year review process for the 2021 version of the WADA Code, they received considerable stakeholder feedback related to substances of abuse where it was felt that the use of some substances included in the list was often unrelated to sport performance.
This led to Article 4.2.3 being added to the Code, and cocaine, diamorphine (heroin), methylenedioxymethamphetamine (MDMA/ecstasy) and tetrahydrocannabinol (THC) being identified as substances of abuse in the 2021 list.
Should an athlete demonstrate that the use of any of these four substances was used out-of-competition and unrelated to sport performance, the suspension imposed will now be three months.
The suspension may be reduced to one month if the athlete completes a drug rehabilitation programme.
WADA also highlighted a change of "Prohibited Method M2.2", related to chemical and physical manipulation.
The organisation say that it will now be possible to identify a prohibited method as "specified" under the newly introduced Article 4.2.2 in the 2021 WADA Code.
Intravenous infusions and/or injections of more than a total of 100ml per 12-hour period, except for those legitimately received in the course of hospital treatments, surgical procedures or clinical diagnostic investigations, have now been classified as "specified".
WADA say this means that an athlete may receive a reduced sanction if it can be proven that this method was not used for doping purposes.
A modification concerning glucocorticoids will come into force from January 2022.
WADA said it had approved prohibiting all injectable routes of administration of glucocorticoids in-competition, but the Executive Committee asked for the implementation to begin on January 1 in 2022.
The organisation says this will allow enough time for broad communication and the education of athletes, their entourages and medical personnel.
It is hoped this leads to a better understanding of the practical implementation of wash-out periods to avoid inadvertent adverse analytical findings.
WADA said this will also allow accredited laboratories the time to update their procedures to incorporate the revised and substance-specific reporting values, as well as providing sports authorities time to develop educational tools for athletes, and for medical and support personnel to address the safe use of glucocorticoids for clinical purposes within anti-doping.
"WADA is pleased to publish the 2021 Prohibited List in its newly designed format; which, we believe, will be easier for athletes and their entourage to navigate," said Olivier Niggli, WADA's director general.
"We kindly ask athletes, their entourage and all stakeholders to review the list carefully and to take particular note of this year's modifications to avoid inadvertent use of substances and methods that are prohibited in sport for 2021.
"Every year, the list undergoes extensive consultation involving some of the most qualified experts in the fields of science and medicine, including chemistry, endocrinology, haematology and pharmacology.
"This helps to ensure that any substance or method that may provide performance enhancement, or that may negatively impact athlete health or the spirit of sport, are considered in a timely manner so as to maintain a level playing field for clean athletes."
The annual revision process of the Prohibited List is overseen by WADA's list expert group, which gathers information and circulates a draft among stakeholders, as well as taking submissions into consideration.
A review was carried out by WADA's Health, Medical and Research Committee, which then made a recommendation to the Executive Board.
The Prohibited List is one of the international standards that are mandatory for all signatories of the World Anti-Doping Code.
It designates what substances and methods are prohibited both in and out-of-competition, and which substances are banned in particular sports.
The list is released three months ahead of it taking effect so that athletes and their entourage can acquaint themselves with any modifications.
For a substance or method to be added, it must be determined that it meets two of the three criteria.
This could be that it either has the potential to enhance or enhances sport performance, it represents an actual or potential health risk to the athletes or it violates the spirit of sport.
Athletes who have a legitimate medical reason for using a prohibited substance or method that is on the list can be accommodated if they meet the criteria to receive a Therapeutic Use Exemption.
WADA will host a web seminar on October 29 titled "2021 Prohibited List and beyond" to assist stakeholders with the implementation.
The webinar is expected to see participants taken through the major modifications, as well as a few key items under review for 2022 by WADA's List Expert Group.
The 2021 Prohibited List, the 2021 Summary of Modifications and Explanatory Notes and the 2021 Monitoring Programme can be downloaded in English and French, with the Spanish version to follow in the coming weeks.
The 2021 Prohibited List can be accessed here.