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A Therapeutic Use Exemption , also known as a Temporary Use Exemption is a term created in 1991 and refers to an official medical document. The document gives an athlete permission to take a medication listed on the World Anti-Doping Agency’s Prohibited List, normally prohibited because its use would be considered a performance enhancing drug. In 2017, the Australian and New Zealand Sports Law Journal referred to the abuse of Therapeutic Use Exemptions as “The Legal Dope”.
An example of a Therapeutic Use Exemption is the World Anti-Doping Agency's exemption for testosterone replacement therapy. The average for a normal functioning male is a 1:1 ratio, but WADA allows up to a 4:1 ratio without testing positive for elevated testosterone. Mixed martial arts do not have as stringent anti-doping regulations as most other sports. The Journal of Legal Medicine quotes Dr. Johnny Benjamin, a medical journalist, as stating that in regards to therapeutic use exemptions in mixed martial arts, “TRT is far too easily abused”.
In 2016, Russian cyberespionage group Fancy Bear disclosed information about Therapeutic Use Exemptions granted to more than 100 Olympic athletes from over 20 countries, raising concerns over the misuse of TUEs for cheating, including Bradley Wiggins using the corticosteroid triamcinolone acetonide in 2011, 2012, and 2013.
In a recent study, 51% of professional athletes interviewed believed that athletes within their sport had received an unnecessary therapeutic use exemption, and another study reported 40% of professional athletes interviewed distrusted the TUE system.