ABSTRACT
In 2016, several events conspired to draw attention to cyclists misusing the World Anti-Doping Agency’s provision for a therapeutic use exemption (TUE). The need for TUEs stems from the possibility that athletes may have illnesses or conditions legitimately treated by substances included on WADA’s ‘Prohibited List’. The evidence that athletes and medical professionals have conspired to use TUEs for non-therapeutic purposes is cause for concern. This concern should be taken more seriously in light of the lessons illustrated by the spread of artificial erythropoietin (EPO) into professional cycling during the 1990s. This article examines the EPO era in cycling and identifies five ingredients that led EPO to become ubiquitous in professional cycling. The article then examines evidence of TUE misuse in cycling to determine whether the similar ingredients from the EPO era exist. The article concludes that cycling has likely not entered a TUE era as several key ingredients appear missing. However, the article warns that conditions may change and suggests several reforms that could help professional cycling avoid fostering a culture with widespread TUE misuse.
