Adderall (et al), competing, and nate

i apologize if nate (or others) has already addressed this. i was wondering how adderall (or similar drugs) have affected your workouts and recovery. also, as this is a banned substance, does this mean you are no longer competing? fyi, i’ve been on vyvanse since 2010 and testosterone replacement since 2003 – both due to side effects of chemo for testicular cancer. never had ADHD, so the drug has a different effect on me than those with ADHD.


Im not Nate, but you can get a TUE for ADHD drugs allowing you to continue using them while competing


Most if not all ADHD meds are only banned in competition ( in the US, may vary in other countries). I would venture to guess most adults with ADHD, myself included, have gone long periods of time unmedicated and using other means to manage. Meaning they can take a few days off and not have issues with worrying about a potential situation of being on it in competition. Also the event itself is usually offering the right kind of stimulation for a few days that you won’t even notice your not on it.

I only started on Ritalin again this year after 15 or so years of not taking it and did 3 races. All of them I just didn’t take any on the days leading up. 1 my Dr is actually the race director for ( and another I’ll be doing this fall). We have discussed that I just stop a few days out.

I personally take any medication whether it be allergies or ADHD after I workout in the morning, if it’s later in the day I don’t think it has an impact on them for me.

Sounds like while your medication may be the same your needs are very different and maybe you can’t stop for a few days, a TUE maybe possible but would be different than for one for someone with ADHD.


I have taken Adderall since 2009 and I compete regularly. When I learned (sometime around 2018 or 2019?) that it was banned in competition I looked into what I should do.

This was also around the time that a rider I know in a 6-degrees kind of way (who has been named in other threads on this board) was handed a 4 year suspension for refusing to take a USADA drug test after winning The Iceman in Traverse City — he subsequently admitted to doping.

I became really anxious about getting tested at some point and how embarrassing that would be, because I feel like all suspensions are immediately interpreted like EPO. I don’t do a ton of USA Cycling sanctioned events, but I went through the process of applying for a TUE for legally prescribed Adderall just in case.

The response I received from USA Cycling was in the form of a question, which was more-or-less: “Are you a national level athlete?” I.e. - was I competing for professional or amateur national championships in any discipline?

When I said “no” they sent me a more formal response that said my application for an exception would be noted for the record, but it was unnecessary to pursue. It also said if I rise to the level of competing on a “national” level I should reapply and they would consider it appropriately.

That felt good enough for me … so I have this document buried somewhere in my inbox that I can produce should I ever test positive (if I am ever even tested) in which USA Cycling told me “don’t worry about it, you’re not good enough” :wink:

I’ll look for the doc and post it here when I have time…


So everyone has talked about TUE, if you are ever at the national level in the US. Small item to add there if you are tested for some reason not under USAC guidance a typical positive results in asking for proof of medical need before it gets reported out of the lab as “positive”. For me sending prescription in has worked covered this.

You also asked about how it impacts your workout and recovery. This is something I have always wondered my self. Nate has mentioned and I am sure its obvious to anyone, if literally nothing else proper medication for someone will ADHD will likely help you get on the bike if you are struggling to get on. Physiologically though there are a few “benefits”, mostly linked directly to increased blood flow when medicated. Simply speaking, increased blood flow could imply more oxygen being brought to the muscle → better VO2 max performance. This is backed up by this study: The ergogenic effect of amphetamine. The increased blood flow also increases heat dissipation in the body, and thus decreases rate of core body temp increase, this is shown in the above study, as well as: Amphetamine enhances endurance by increasing heat dissipation. Both of these studies generally showed an increased TTE. This increased TTE is said to becoming from the lower core temp, and therefore RPE. However, while the core temp may not rise as fast to dangerous levels, muscle temp could increase beyond temps that would cause harm. There are some interesting studies referenced within these that are worth checking out if you have the time. One very important parts of these studies that makes them iffy (by my un-expert opinion) in being applicable to humans in our situation, they used does of 1-2 mg/kg. Personally I take an “average” dose and am at 0.3 mg/kg. One study also noted they only saw significant changes at the 2 mg/kg dose, not the one.

I have not been a cyclist before I was diagnosed and medicated so I don’t have a lot of data, but occasionally I will ride unmedicated (I typically ride in the afternoons so just taking the meds after a ride isn’t an option. I went pulled things out from and sorted out the metrics that could be altered by stimulants.


Some caveats to this data:

  • No med sample size is incredibly small of course.
  • No med rides are tempo rides at best.
  • Filtered out rides with an IF more than 80. This was to remove races or hard group rides, and make the data more comparable.
  • Filtered out rides with less than 15 TSS. Didn’t want to include warm ups or spin downs (higher watts/hr for cool downs)
  • Data goes back a year
  • Watt data is not normalized for FTP changes
  • No med rides are spread fairly equally across the time period

Biggest takeaway:
My HR is lower for the same power by about 5 bpm. Avg HR is lower with no meds and intensities are close, actually higher for no meds. watts to HR ratio backs this, as does efficiency (NP/avg HR). That said the RPE is generally a bit higher for the longer rides with out medication. I am also unsure of what impact if any this has on performance or recovery…

Now that I have all this data in there I think I am going to try and do more rides unmedicated, some C races/tuesday night worlds even and see what happens…

Found the response to my TUE application for Adderall those who are interested:


I had a similar response from WTO/Ironman when I asked about a cortisone based med I was taking for low blood pressure. The response was along the lines of “Don’t worry, you’re not good enough for it to matter”. Your results may vary.

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Interesting takes from WTO and USADA as it seems to contradict the majority opinion in other doping threads on this forum. Both of those replies are basically saying participation is fine, just don’t win. Meanwhile in those other threads you have most people saying stay home, when you come in 708th place you ruined the event for the person in 709th.


Buckle up!..

Interesting takes from WTO and USADA as it seems to contradict the majority opinion in other doping threads on this forum.

I think that is because people with hot takes on forums don’t have a sense of how this works at the highest levels, and what the priorities of these agencies actually are. I promise you, it isn’t to catch age groupers abusing ADHD medication.

In a previous (non-cycling) life I was an international level athlete in the WADA/ADAMS testing pool, required to submit whereabouts information, regularly underwent in and out of competition testing, biological passport analysis, etc. In the twilight of my athletic career I also sat on numerous athletes’ council boards, and represented athletes to NSOs, WADA, the IOC, etc. In other words I’ve had extensive interactions with doping control programs both as an athlete, but also on the administrative side.

The number one thing people need to understand is that doping control is a massively resource constrained operation. I think everyone understands that testing is expensive, but the number of touch points involved for a basic out of competition test can be staggering. Just at a high-level:

  • International/national level athletes in the testing pool need to submit their whereabouts quarterly, describing where they are going to be every single day for the next 3 months. This includes training times, travels days, and competitions. You also need to submit a 1-hour mandatory period (not everyone is subject to this) where you absolutely will be available at the location described. Essentially what this means is that if doping control tries to get you at home today, but you are out for groceries, it’s not the end of the world. However, if you put your mandatory period between 6am and 7am (which many athletes do), and you am not available during that time, things get more serious.

  • Doping control officers are trained individuals, not randoms off the street. And depending on your national WADA affiliate’s policies, two or more officers/chaperones may be required during sample collection (in Canada, CCES always required two, USADA did not at the time, but this may have changed since I retired). If the doping control officer is not the same sex as the athlete being tested, then a chaperone of the same sex is required to observe sample collection (i.e., watch you pee). If you are in the biologic passport program, and you are getting blood + urine samples collected, then a trained phlebotomist/nurse also needs to tag along. More and more the doping control officers are getting trained in blood sample collection, and the newer testing kits have made this process somewhat less of a hassle, but it’s still a blood draw, and (at least when I retired) it was still very common for a specifically trained individual to be required for sample collection. Finally, as an athlete you are also entitled to have an elected representative present (coach, friend, etc.) to observe the entire procedure.

  • So just to recap at this point: It’s 6am and potentially 3 people show up at your door:

    1. The doping control officer.
    2. The chaperone, either because your WADA affiliate requires it, or because the doping control officer is not the same sex as you.
    3. The phlebotomist.

    From your end there is also:

    1. Your elected representative if you so chose to have one.
    2. Yourself - the athlete being tested.

    We’re 5 people deep, and we haven’t even begun the test yet!

  • Depending on where you live/train, doping control officers may not necessarily be available in your area 24/7 so they may need to travel in, and the time of the other required individuals such as the phlebotomist will need to be booked.

  • The testing procedure / sample collection itself is not an instantaneous process. Part of why many athletes choose the early morning for their mandatory period is because they are going to be woken up by the door-knocks (and man do they knock hard!) of doping control, and most people have some level of urinary urgency as soon as they get up in the morning. Sometimes you are not so lucky, and you have gone to the bathroom minutes before they show up, or they come at some other time of day, or show up during practice and you are dehydrated. Some people, understandably, have a near impossible time peeing while someone is staring at their genitals. This is actually more common in (for lack of a better term) lower-level athletes who aren’t regularly tested, and the whole testing process itself is a bit nerve wracking and overwhelming. However, there are absolutely world-class athletes who get tested dozens of times per year who have this problem every single time. For in competition tests, it’s extremely common for people to sometimes take hours to pee, especially for endurance sports.

  • In addition to the sample collection itself, there are several formalities around the procedure. ID verification, paperwork… lots of paperwork, even sample kit selection. What is sample kit selection? When a doping control officer shows up at your door they have a giant duffle bag filled with testing kits. You the athlete choose the kit you want to use, break the safety seals, etc. This is one of the many parts of the process designed the guarantee confidence, prevent tampering, etc.

  • Speaking of the kits, you aren’t peeing into mason jars from CVS. These are precision manufactured, tamper-proof, custom kits specifically designed for this process. Those of you who have seen the documentary Icarus might have a cynical view on the tamper-proof nature of these kits, but just know they are constantly being iterated upon, and it took a coordinated effort from the KGB + compromised lab directors to successfully open and re-close the bottles. Since then, the bottle locking mechanisms have been further improved.

  • Doping control officers also need to cary a few instruments with them to test the specific gravity and pH of your sample. If the specific gravity is too low, i.e., your sample is too dilute because you’ve been pounding waters in order to be able to pee, you need to start the entire process again from zero. This often involves selecting a new kit, new paperwork, and doing what’s called a “partial” sample collection form.

  • Once everything is done and dusted, forms signed, samples separated into A/B, and sealed into their containers, they need to sent to the lab. The mere transport of these samples is a non-trivial exercise, and two big things need to be controlled for: The first is security/chain of custody - there are myriad control points that go into this from the design of the kits themselves, to the shipping containers, to WADA procedures and policies. The second is just ensuring sample viability - these are biologic samples, so things like temperature and time-in-transit on their way to the lab are critical factors that need to be controlled in order to sustain their viability.

  • WADA accredited labs are not a dime a dozen. Most countries have no WADA accredited labs and need to utilize labs in other countries. The US has two WADA accredited labs: UCLA and Salt Lake. These labs operate at the absolute highest standards of practice, and have the most sensitive equipment and highly trained individuals (read: expensive) for detecting metabolites in urine and endocrine levels in blood.

  • Back when I was involved the average cost of all this was estimated to be around $500 per test. This is virtually guaranteed to be higher now, as it’s not a basic economies of scale problem where we get to continue performing the same exact tests every year at ever reducing marginal costs. Doping sophistication is constantly improving, meaning the science required to detect this is needs to evolve with it. This means more sensitive equipment, new analysis techniques, new test development, experts in more fields (endocrinology, pharmacology, chemistry, etc.)

Phew that was a lot! There is much more involved, but I really just want people to have a high-level sense of how many moving parts there are for a standard part of doping control programs. Roughly 10,000 to 15,000 out of competition tests are performed globally by WADA affiliates every month, the resources required to bring this to bear are astronomical. This doesn’t even include in-competition testing which, depending on the month, can sometimes double or triple these figures.

Bringing this all back to the TUE for an age grouper… The best (but still not very good) analogy I can make here is it’s a bit like emailing the Department of Justice to let them know that your vehicle registration has expired, but there are legitimate extenuating circumstances about why this happened, and you will be taking care of it immediately. Officially they care, and maybe they will say in accordance with the National Traffic and Motor Vehicle Safety Act you need to take care of this immediately. But in practice their position will be to do nothing, they aren’t going to redirect the FBI to pre-emptively deal with your case. If you happen to get pulled over - which is extremely unlikely in relative terms - you will probably need to explain yourself, etc., but otherwise we are relying on you to do the right thing here because our finite resources are otherwise consumed dealing with serious crime.

I am oversimplifying but TUEs broadly have two flavors: pre-emptive, and retrospective. The majority of cases, even for world-class athletes in testing pools, fall in the later category. There are a lot of things that are prohibited that people do not realize. Just getting an IV hooked up to you is a prohibited method in many contexts (let alone potentially prohibited substances contained in that IV), but is obviously acceptable given a legitimate medical need. Now if you go the hospital and one of the first things they to do you is hook an IV into your arm, they are not going to call USADA first to check if it’s okay. They’re not even going to check if it’s okay after the fact. But, if for whatever reason this comes up post-hoc, you can leverage the hospital records in your TUE. Just due to the standard of care in many medical scenarios, and the administrative overhead required for TUEs, it’s just not practical or even possible in most cases for these to be done pre-emptively. Where and when they need to be done pre-emptively is really a whole other discussion and goes into anti-doping code policy specifics, but even the majority of these are similar to the response @batwood14 received which is “okay, thanks for letting us know, if this comes up in a test we’ll pursue it at that time”.

Meanwhile in those other threads you have most people saying stay home, when you come in 708th place you ruined the event for the person in 709th.

There is a lot of virtue signalling, hand wringing, and armchair experting on forums across the internet by people who have never had to truly participate in an anti-doping program (either as an athlete, or on the doping control side) beyond competing in an event that had some lip-service level of doping control present or maybe being selected for a test once at such an event. The reality is that most age-groupers and weekend warriors will take something or do something in the course of a year that is either a prohibited substance or method, without realizing it, be none the wiser, then get online and start talking about how ridiculous it is that someone in their Cat-5 race is on Concerta.

Most people are not trying to cheat, and are taking medications to address a legitimate medical issue. They are probably being taken in a way that does not confer a performance benefit relative to whatever issue they are managing, i.e., a diabetic taking insulin. When it comes to people who are trying to cheat at the age group level, my (perhaps somewhat controversial) take on this is really just - whatever man, you do you. People should mentally reframe this and think about it the same way they would think about someone cheating in a local golf club tournament by lying about their score or moving their ball. Is it annoying? Yes. But more than anything it’s just sad and somewhat hilarious that a mediocre athletes who is paying (read: not being paid) to do a leisure activity is cheating at it. It’s a reflection on a deeper set of insecurities and problems that person is dealing with, and overthinking their issue, legitimate or not, for yourself is not worth it - control the variables you can control, ignore the rest.

I have been paid to do sport. It has been my livelihood. I know more than most what is to have something actually taken away by people not respecting the rules. At the level I was at, which I’ll describe as “working-class” athlete, meaning a few positions +/- made a big difference in race winnings, bonuses, potential sponsorships, team selection, and my general ability to sustain myself - the material impact was real. I never let this interfere with my passion for sport or pursuit of excellence - you shouldn’t either.

tl;dr - Do the right thing. Don’t cheat. It’s always better to ask and inform (like @batwood14 did) your relevant NSO / governing body / anti-doping institution. Unless you are in the testing pool or otherwise national/world-class you are probably not the target, but if get tested something does come up be prepared to explain yourself (with medical documentation and records).


Outstanding post. I now know more about drug testing than I ever wanted to :rofl: I’m not sure how I feel about the 10-15k tests per month. It either means the sport is relatively clean (ie, at that rate, they should be catching a lot more cheats), or the dopers are way ahead of the tests and getting away with sophisticated programs that beat current testing protocols

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Amazing insight, thank you!

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