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USADA releases explanatory note on IV ban following BJ Penn's removal from UFC 199

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Stephen R. Sylvanie-USA TODAY Sports

Ever since the United States Anti-Doping Agency (USADA) partnered with Ultimate Fighting Championship (UFC), it's really done a number on plenty of fighters on the roster.

So says Jon Jones.

While the agency has been cracking down on performance-enhancing drug (PED) users, the controversial IV ban has caught a bit of flack from some fighters.

Coincidentally enough, after Penn was flagged for violating said ban because he admitted to using an IV under a doctor's supervision, USADA released an explanatory note detailing exactly why it's no longer allowed.

WHAT'S THE IV RULE?

All IV infusions and/or injections of more than 50mL (~3.4 tablespoons) per 6 hour period are prohibited at all times, both in- and out-of-competition, except for those legitimately received in the course of hospital admissions, surgical procedures or clinical investigations, without an approved Therapeutic Use Exemption (TUE).

If it is a prohibited substance that is administered intravenously or via injection, a TUE is necessary for this substance regardless of whether the infusion or injection is less than 50mL.

Infusions or injections are permitted if the infused/injected substance is not on the Prohibited List, and the volume of fluid administered does not exceed 50 mL per 6-hour period.

WHY THE IV RULE?

To protect clean sport and athlete health and safety. It is a fact that IVs can be used to change blood test results (such as hematocrit where EPO or blood doping is being used), mask urine test results (by dilution) or by administering prohibited substances in a way that will more quickly be cleared from the body in order to beat an anti-doping test.

WHAT ARE THE HEALTH RISKS OF IVs?

Potential risks and complications of IV therapy, include Infection, cellulitis, inflammation of the wall of a vein with associated thrombosis, Bleeding, hematoma/arterial puncture, unintended leakage of solution into the surrounding tissue, air embolism and needle stick to the provider.

Inappropriate levels of electrolytes given by IV can also have serious cardiac, muscular and nervous system effects, even resulting in death.

ARE IVs BETTER THAN ORAL REHYDRATION FOR PERFORMANCE?

Convincing research to support IV fluid administration prior to competition for performance enhancement, rehydration, dehydration prevention, or muscle cramp prevention does not exist.

Current studies do not support the use of IV fluids for rehydration when an athlete can tolerate oral fluids.

American College of Sports Medicine consensus guidelines state, "IV fluids do not provide an advantage over drinking oral fluids and electrolytes."

IV infusions before sample collection could actually prolong the doping control sample process because it has a greater potential to produce multiple dilute samples.

HOW CAN I REHYDRATE AS QUICKLY AS POSSIBLE?

If rapid recovery from dehydration is desired, one should ingest 1.5 L (50 fluid oz.) of fluid for each kilogram (2.2lbs) of body weight lost.

Normal rehydration can be achieved in the vast majority of individuals by drinking and eating normal beverages, such as sports drinks and water, and meals.

Glycerol-induced hyper-hydration or rehydration is not permitted because glycerol is a prohibited substance.

Various sports and athletic organizations such as the American College of Sports Medicine (ACSM) and the National Athletics Trainers' Association (NATA) and others have informative resources to educate on best practices for fluid replacement in athletes.

WHEN IS A TUE NOT REQUIRED FOR AN IV INFUSION?

If the athlete has an acute medical condition where an IV line was essential for treatment in a hospital admission, surgical procedure, or clinical investigation. Examples would be a severely dehydrated athlete with signs of circulatory compromise, the need for an IV line during a surgical procedure, and IV line in the antibiotic treatment of an acute infection, etc...

Clinical investigations to diagnosis medical conditions, such a medical imaging, may also require IV administration of non-prohibited medicine which is permitted.

In emergency circumstances, IVs may also be given by paramedical staff or physicians on the field of play, but an emergency TUE application is required as soon as reasonably possible after treatment has been received. Examples may include a semi- or unconscious athlete, an athlete who cannot tolerate oral fluids, or treatment of an acute injury.

IV infusions during home visits, urgent care or after-hours clinics, boutique IV and rehydration services, and doctor's office visits are not hospital admissions and would require an approved TUE in advance.

As a result of the infraction -- which is a year-round thing -- Penn was pulled from his return bout against Cole Miller, which was set to go down at UFC 199 on June 4, 2016 in Los Angeles, California.

"The Prodigy" vows to not allow the speed bump to derail his mixed martial arts (MMA) return,  which at the moment has no exact timetable.

Moving forward, other combatants can use Penn's case, as well as the USADA explanation, to follow the rules right down to the letter and avoid potential suspensions.