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Medical Exceptions Procedures

Updated June 23, 2020

The NCAA list of banned drug classes (NCAA Bylaw 31.2.3) is composed of substances that are generally purported to be performance enhancing and/or potentially harmful to the health and safety of the student-athlete.

The NCAA recognizes that some banned substances are used for legitimate medical purposes. Accordingly, the NCAA allows exception to be made for those student-athletes with a documented medical history demonstrating the need for treatment with a banned medication. Exceptions may be granted for substances included in the following classes of banned drugs: anabolic agents*, stimulants, beta blockers, diuretics, anti-estrogens*, beta-2 agonists,peptide hormone* and narcotics* (see subpart 2 below). No medical exception review is available for substances in the class of cannabinoids.

  1. Alternative non-banned medications for the treatment of various conditions may exist and should be considered before an exception is pursued.
  2. In the event that the student-athlete and the physician (in coordination with sports-medicine staff at the student-athlete's institution) agree that no appropriate alternative medication to the use of the banned substance is available, the decision may be made to use a medication that falls under an NCAA class of banned drugs.

    Note: The use of an *anabolic agent, anti-estrogen or peptide hormone must be approved by the NCAA before the student-athlete is allowed to participate in competition while taking these medications. The institution, through its director of athletics, may request an exception for use of an anabolic agent, anti-estrogen or peptide hormone by submitting to the NCAA medical documentation from the prescribing physician supporting the diagnosis and treatment.
  3. The institution should maintain documentation that supports the use of medication in the student-athlete's medical record on campus. The documentation can be a letter or copies of medical notes from the prescribing physician that documents how the diagnosis was reached, and that the student-athlete has a medical history demonstrating the need for treatment with the banned medication. The letter should contain information as to the diagnosis (including appropriate verification of the diagnosis), medical history and dosage information.

    ADHD Medication: for a medical exception request for a positive test involving stimulant medication to treat ADHD, the NCAA requires the documentation be accompanied by the required form “NCAA Medical Exception Documentation Reporting Form to Support the Diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and Treatment with Banned Stimulant Medication,” located at
  4. Unless requesting a review for the medical use of an anabolic agent, anti-estrogen or peptide hormone, a student-athlete's medical records or physicians' letters should not be sent to the NCAA unless requested by the NCAA. Also, the use of any substance need not be reported to the drug- testing crew at the time of NCAA drug testing.
  5. In the event that a student-athlete is tested by the NCAA and tests positive for a substance for which the institution desires an exception, normal procedures for reporting positive test results will be followed (See Section 8.0 of the NCAA Drug-Testing Program Protocol). The institution may request an exception at the time of notification of the positive drug test (“A” sample) by submitting documentation to Drug Free Sport International. If the institution fails to provide medical documentation to Drug Free Sport International before the "B" sample is reported as positive to the institution, the student-athlete will be withheld from competition until such time the documentation is received, reviewed and the medical exception granted. (contact
  6. Requests for medical exceptions will be reviewed by the medical panel of the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports.
  7. The NCAA will inform the director of athletics regarding the outcome of the exception request. In the event that the exception is not granted, the institution may appeal this action according to Section 8.0 of the NCAA Drug-Testing Program Protocol.

If you have questions about medical exceptions procedures for the NCAA Drug Testing Program, please contact