A randomised controlled trial to assess whether tapentadol and dihydrocodeine have the potential to enhance performance and represent an actual or potential health risk to athletes.

Code: 241C18AM

Tapentadol and dihydrocodeine are potent narcotic analgesics. They are currently on WADA's Monitoring Programme as there is concern that they may be used as replacement drugs for the recently prohibited tramadol, to confer a performance advantage by reducing exertional pain and allowing an athlete to work even harder. The drugs' centrally mediated side effects may also present a risk to athletes by reducing motor control which may increase risk of injury to the athlete and their competitors.

This project will employ an experimental design that identifies whether these narcotics allow

athletes to work harder by reducing pain, and thus allow for a better performance. It will also assess whether they impair a rider's stability and control of their bicycle. Therefore, the main outcome of this project will be to provide robust experimental evidence to inform whether the in-competition use of tapentadol and dihydrocodeine should be regulated due to potential ergogenicity and athlete safety.

Twenty-one highly trained cyclists will complete a randomised, controlled, double-blinded crossover study design. Participants will ingest tapentadol, dihydrocodeine, or a placebo and complete an assessment of their balance/stability during intense cycling followed by a laboratory cycling task that replicates the time/intensity demands of professional road cycling. Together, the cycling tasks will involve fixed-intensity and self-paced time trial cycling, amounting to approximately 1.5 hours of hard cycling - a duration and intensity that is representative of the context in which narcotic analgesics are purportedly taken to enhance performance. Exercise performance (completion time), perceptual responses (perceived pain and effort) and participant's control of their bike (lateral movement) will be compared between conditions, with results used to inform consultation with WADA regarding the S7 Narcotics category of the Prohibited List.