1 University of Tennessee Knoxville Department of Intercollegiate Athletics Substance Abuse Testing Policy and Procedures Revised 07/2012
2 2 Table of Contents Introduction 3 Scope 4 Definitions 4 Education Policy 5 Counseling Policy 5 Confidentiality Policy 6 Drug Testing Policy 6 Frequency of Testing 6 Specimen Collection Procedure 7 Disposition of Positive Test 8 Pre-Participation Drug Test 8 Safe Harbor Program 8 Drug-Free Period 9 Consequences for Positive Drug Test s 10 Level I 10 Level II 11 Level III 12 Appeals 12 Alcohol Policy 12 NCAA Drug Testing Program Protocol 13 IOC/USOC and USADA Drug Testing Guidelines 13 Nutritional Supplement Policy 14 Appendix A: Sample NCAA Division I-A Drug Testing Consent Forms 15 (Includes Banned Drugs and Examples in Each Class) 17 Appendix B: Sample University of Tennessee-Knoxville Drug Testing 19 Consent Form Appendix C: Substance Abuse Testing Flow sheets 20
3 3 I. Introduction: The overall goal of the University of Tennessee-Knoxville (UT-K) Substance Abuse Testing Policy and Procedures is to promote a drug free environment within the UT-K athletic program. The specific objectives included in this goal are: to protect the health, safety, and welfare of the student-athlete; to identify, address, and treat student-athletes with substance abuse problems and concerns; to inform and educate student-athletes and others associated with athletic teams about substance abuse; to protect the institution s integrity; and to promote fair competition in intercollegiate athletics by UT-K athletes. Therefore, the illegal use, abuse, possession, manufacture or distribution of prescribed or illegal substances while a student-athlete at the University of Tennessee-Knoxville is prohibited. In addition, the use of impermissible substances as identified by the National Collegiate Athletic Association (NCAA) or the University of Tennessee-Knoxville is prohibited. A non-exhaustive list of such substances is provided in Appendix A. Education and counseling are the foundations of this Substance Abuse Policy with the aim of alerting both student-athletes and coaches to the potential harm of substance abuse. A drug testing component will be used to help identify those student-athletes at risk for the dangers of substance abuse as well as supplement education and counseling as a deterrent to its use. The UT-K protocol for drug testing is designed to be fair, reliable, and to protect the privacy rights of the student-athlete. Test results are confidential. The test results will not be released to anyone except in accordance with the UT-K Substance Abuse Policy and Procedures or as otherwise required by law. This Policy and Procedures resides under the guidance of the Substance Abuse Education and Screening Committee. The Committee is comprised of: 1. Athletic Director 2. Head Team Physician 3. Director of Sports Medicine 4. Sr. Associate Athletic Director-Administration and Sports Programs 5. Sr. Associate Athletic Director Football Administration 6. Sr. Associate Athletic Director/Senior Woman Administrator 7. Faculty Athletic Representative 8. Senior Associate Vice Chancellor 9. Vice Chancellor for Student Affairs In addition, a Subcommittee will be charged with implementing the Policy and Procedures.
4 4 The Subcommittees will be comprised of: 1. Head Team Physician 2. Director of Sports Medicine 3. Sr. Associate Athletic Director-Administration and Sports Programs 4. Sr. Associate Athletic Director Football Administration 5. Sr. Associate Athletic Director/Senior Woman Administrator The Policy and Procedures are subject to modification by the Athletic Director and the Committee as deemed appropriate. Such modifications will be effective upon notice to the student-athletes and shall not be applied retroactively. This Policy and its sanctions are independent of the NCAA Drug Testing Program. II. Scope: This Policy and Procedures applies to all student-athletes at the University of Tennessee- Knoxville. All student-athletes will be required to sign the UT-K Drug Testing Consent Form on an annual basis (see Appendix B). Student-athletes who do not wish to comply with this policy forfeit their participation in intercollegiate athletics for the University of Tennessee-Knoxville. III. Definitions: Illegal Drug includes narcotics, hallucinogens, depressants, stimulants, or other substances which can affect or hamper the senses, emotions, reflexes, judgment, or other physical or mental activities. Includes prescription medications or substances for a specific medical condition not prescribed by a licensed practitioner (see Appendix A). Legally Prescribed Medication includes medication prescribed by a licensed practitioner for a particular medical condition. The medication must be used in the appropriate amount solely by the individual for whom the medication was prescribed. Documentation of all prescribed medication must be included in the student-athlete s medical chart kept by the UT Sports Medicine staff or Team Physician. Positive Drug Test student-athlete s urine or serum specimen or other analytical procedure showing the presence of an illegal drug. The testing must be performed by an approved professional laboratory. In addition, the following circumstances will also be considered a positive drug test: student-athlete does not provide a specimen at the designated time for testing student-athlete is found guilty of altering the integrity or validity of the specimen or the drug testing protocol student-athlete is found guilty or admits guilt to a legal, administrative, or student disciplinary offense regarding the illegal use, abuse, possession, manufacture, or distribution of prescribed or illegal drug(s).
5 5 A positive test for marijuana (> or =15 ng/ml) within 30 days of a previously confirmed positive test for the same will be used for counseling/treatment purposes only and will not count as an additional positive test unless the repeat test shows an elevated level of marijuana from the prior positive test. Appropriate drug/substance metabolism and half-life will be considered along with the specific gravity of the urine specimen in determining subsequent positive drug tests. A positive test for a narcotic prescription pain medication ninety (90) days or longer after the prescription date will be considered a positive test, unless the student-athlete has obtained approval by the Head Team Physician, Team Orthopedists, or their designee, to take a previously dispensed narcotic for a new or exacerbated injury. Documented follow up appointments with the team physician must be available for review by the Subcommittee for consideration in an appeal. The student-athlete may still be subjected to future drug tests in order to rule out misuse or abuse. IV. Education Policy: A presentation explaining the University of Tennessee-Knoxville Substance Abuse Policy and Procedures will be provided to all student-athletes prior to the start of their fall semester or first semester of enrollment on an annual basis. The goal of this presentation will be to discuss the purpose, implementation and sanctions involved. In addition, each student-athlete will be provided a written copy of the Policy and Procedures. The student-athlete will be asked to sign a form acknowledging receipt and understanding of the Policy and Procedures as well as providing voluntary consent to participate in this program. In the event that a student-athlete is under the age of eighteen (18) years, his or her parent(s) or guardian will be asked to sign a consent for the student-athlete (see Appendix B). Student-athletes may refuse to sign the consent for participation in this program. However, such student-athletes will forfeit their participation in intercollegiate athletics for the University of Tennessee-Knoxville. In addition, an educational program(s) shall be designed to inform and teach those involved in intercollegiate athletics about the warning signs and side effects of specific drugs, the associated problems of substance abuse, and its affect on the student-athlete and his/her team. Appropriate rehabilitation, treatment programs, and referral centers shall also be included. Each team and coaching staff, with the assistance of athletic trainers and team physician, shall meet annually to discuss these topics. V. Counseling Policy: Counseling and rehabilitation services will be utilized to provide assistance, direction and resources for student-athletes who need additional support as a result of positive tests, physician referral, or self-addressed needs. Counseling and rehabilitation services will be provided by trained professionals knowledgeable about substance abuse. These professionals will be identified by the Director of Sports Medicine and Head Team Physician. Referrals will originate from the Head Team Physician after meeting with the student-athlete. All counseling and
6 6 rehabilitation services will be confidential with reports on student-athlete s progress provided to the appropriate Subcommittee. VI. Confidentiality Policy: The University will take every effort to maintain the confidentiality of all information and records associated with this policy, including drug-test results, impending sanctions, remedial measures taken by the University, and/or any counseling and rehabilitation services which a student-athlete may receive. Unless otherwise required by law, drug test results and related records may be disclosed only to (1) members of the Subcommittees, (2) the head coach, (3) sports administrator, (4) the team physician, and/or (5) the team s designated drug and alcohol counselor. These individuals are to maintain the confidentiality of all drug test results and related information to the extent possible in the implementation of this policy and the performance of their duties. Additionally, positive drug-test results may be provided to the student-athlete s parent(s). All members of the UT Department of Athletics, including the individuals listed above, are expected to adhere to this Confidentiality Policy at all times. Violation of the policy may incur disciplinary action at the discretion of the Director of Athletics. VII. Drug Testing Policy: All University of Tennessee-Knoxville intercollegiate student-athletes (including athletes who have sustained career-ending injuries) will be tested for banned substances. Testing will be accomplished by the analysis of urine specimens, or other recognized analytical procedures, obtained from the student at the direction of the Head Team Physician or Director of Sports Medicine. The testing procedure will ensure that the specimen being analyzed is identified with the appropriate student-athlete and that the purity of the sample is maintained. All specimens will be coded to ensure confidentiality. All specimens will be collected in a manner so as to minimize the possibility of contamination or misidentification. This collection will be conducted by an agent appointed by the professional laboratory selected by the Head Team Physician, Director of Sports Medicine, and the University Department of Purchasing/Business Services. A. Frequency of Testing: 1. All incoming student-athletes will be tested at or around the time of their Pre- Participation Physical Exam and all returning student-athletes may be tested at the beginning of the fall semester. 2. All student-athletes, including student-athletes still on scholarship who have exhausted their eligibility, will be subject to RANDOM drug testing throughout the year a. The Subcommittee will supply a list of randomly selected names of student-athletes generated by a computer program. The number or percentage of student-athletes subject to
7 7 testing will be determined by the Subcommittee. However, selection of subjects will occur such that all student-athletes will be tested at some point during the academic year. b. The list of student-athletes will be delivered to the Head Team Physician, Director of Sports Medicine, and sports medicine staff. c. Notification to the selected student-athletes will not exceed twenty-four hours. The information will include the location, date and time of the test. 3. A student-athlete and/or entire team may be subject to drug testing based on REASONABLE SUSPICION. a. Reasonable suspicion is defined as one founded on specific, objective facts, which if taken with rational inferences drawn from those facts, and taken as a whole strongly suggest that drug testing may produce evidence of improper use. Reasonable suspicion testing may also be performed for medically warranted reasons as determined by the Head Team Physician. b. Results of a reasonable suspicion drug test will be handled in the same manner as are results of all other drug tests. 4. All student-athletes with previous positives or a history of providing unsatisfactory specimens for analysis (i.e. dilute specimens) will be subject to more frequent drug testing throughout the year as deemed appropriate by the Subcommittee. EXCEPTION: Student-athletes who are enrolled in an intensive outpatient or inpatient counseling and rehabilitation program (see section XI. Consequences for Positive Drug Tests) will not be subject to more frequent drug testing at UT-K while successfully participating in counseling. However, once the program is complete, he/she will be subject to more frequent testing at UT-K. The duration of the program will be determined by the substance abuse counselor but exclusion from testing shall not exceed sixty (60) days. 5. All student-athletes participating in Post-Season Bowl Games or NCAA Championships may be tested prior to their competition in their respective post-season event. B. Specimen Collection Procedures: 1. The student-athlete will be notified by his/her athletic trainer or designee as to the location, date and time of the drug test. 2. The student-athlete shall promptly present for the drug test at the proper location and provide a photo identification to the designated test administrator. 3. Once the student-athlete reports to the drug testing site, he/she may not leave until a specimen is produced. 4. Water bottles, open containers, bags, etc. must be checked at the door. 5. In the event that a student-athlete requests additional oral fluids in order to provide a specimen, only closed or sealed container beverages or water from a drinking fountain will be provided and/or made available. 6. A collection agent appointed by an approved professional laboratory will collect all specimens in a manner so as to minimize the possibility of
8 8 contamination or misidentification. 7. All student-athletes will be directly observed providing a specimen by either the collection agent or an approved sports medicine staff member. 8. All NCAA rules against urine manipulation are applicable. 9. Two specimen containers will be handled by the approved laboratory representative and observed by the student-athlete. The student-athlete will select the containers, provide his/her sample, observe the laboratory representative divide the sample among the two containers, seal the containers, mark the seals, attach the student-athlete s ID number to the containers and place the containers in the device used to transport the specimens to the lab. The student-athlete will then initial the seal on the container. This process is to be performed by the approved professional laboratory personnel under the direct observation of the student-athlete to ensure proper chain of custody. 10. One container will be used for testing purposes and the other container will be frozen and stored by the testing laboratory in case there is an appeal to the test results. 11. The approved professional laboratory courier will transport the specimens to the laboratory where they will be received by a laboratory agent who will sign for them. All signatures will attest that the official seal on the specimen bottle remains intact, and that proper chain of custody was maintained. C. Disposition of Positive Test (see Appendix): 1. All test results are returned by the testing lab directly to the Head Team Physician. 2. Head Team Physician will share positive test results with the Athletic Director. VIII. Pre-Participation Drug Test: Freshmen and transfer student-athletes will undergo a drug test at or around the time of their preparticipation physical examination. As these student-athletes may not be aware of the Substance Abuse Policy and Procedures for the University of Tennessee-Knoxville, positive test results for marijuana will not be considered a first positive result. However, the student-athlete will be required to meet regularly with a designated substance abuse counselor and will be subject to more frequent drug testing as outlined in this program. Student-athletes who test positive for an illegal drug other than marijuana will be subject to penalties and/or sanctions as outlined in the section XI. Consequences for Positive Drug Tests. IX. Safe Harbor Program: Student-athletes will have the opportunity one time during their intercollegiate athletic career to voluntarily identify themselves as having used an illegal drug prior to obtaining a positive test. The Safe Harbor Program can only be used prior to a first positive test result and must be invoked within twenty-four (24) hours from time of drug testing and cannot be used after a positive test is received. The Safe Harbor Program does not apply to any legal, administrative,
9 9 or student disciplinary penalties or proceedings. The Head Team Physician and/or Director of Sports Medicine must be informed by the student-athlete that he/she would like to invoke the Safe Harbor Program. Once invoked, drug testing will proceed. However, a positive result will not count as the student-athlete s first positive test. The Subcommittee and Head Coach will be informed of the student-athlete s use of the Safe Harbor Program but notification to the student-athlete s parents will be voluntary. Any student-athlete who uses the Safe Harbor Program will be required to meet with the designated substance abuse counselor and complete appropriate counseling and rehabilitation as outlined in this program. In addition, more frequent drug testing may be instituted. Failure to comply with this program will result in it being revoked and the positive drug test being reinstated. X. Drug-Free Period: Student-athletes will have an opportunity one time during their intercollegiate athletic career to decrease one level of consequence from a positive drug test result for marijuana only, if they are able to maintain a consecutive twelve (12) month time period of having no further positive drug tests. They will be subject to more frequent drug testing throughout this time period as deemed appropriate by the Subcommittee. In addition, they must adequately participate in and complete substance abuse counseling and rehabilitation as outlined in section XI. Consequences for Positive Drug Tests. If the student-athlete meets all of the above outlined criteria, they will be eligible for consideration by Subcommittee to decrease their Level of Consequence. The studentathlete may be required to submit a written request and/or appear in person before the Subcommittee for consideration to have their level decreased.
10 10 XI. Consequences for Positive Drug Tests: The Head Coach may have team rules regarding substance abuse that affect a student-athlete s eligibility for practice and competition. Such team policies may be more stringent but cannot be more lenient than outlined in this Policy and Procedures. Consequence Level I Level II Level III Test Result First Positive Test for any illegal/banned substance excluding Anabolic steroids or Performance Enhancing Drugs Second Positive Test for any illegal/banned substance or First Positive Test for Anabolic Steroids or Performance Enhancing Drugs Third Positive Test for illegal/banned substance or Second Positive Test for Anabolic Steroids or Performance Enhancing Drugs * Student-athletes with drug tests positive for marijuana with a level < 15 ng/ml will not be considered to have a positive test result but must meet with the Head Team Physician and may be required to undergo substance abuse counseling if deemed appropriate. * Use or possession of certain illegal/banned substances may result in immediate suspension or dismissal by Head Coach or Athletic Director as deemed appropriate. A. Level I (First positive test for illegal/banned substance excluding Anabolic Steroids or Performance Enhancing Drugs): The student-athlete will be required to sign a contract agreeing to all terms set forth by the substance abuse policy, as well as by his/her head coach. Also, the student-athlete will be required to meet with the Athletic Director and/or Sports Administrator and be screened by the Head Team Physician and approved Substance Abuse Counselor to determine if use is sporadic or if there is evidence for physical or psychological dependence. If no evidence of dependence is found, the student-athlete will be enrolled in a substance abuse counseling program approved by the Men s or Women s Subcommittee. The counseling program may be conducted at the University of Tennessee-Knoxville campus and may include individual and/or group sessions as deemed appropriate by the substance abuse counselor. The student-athlete is required to attend all counseling sessions and successfully complete the program unless an absence is approved by the Subcommittee. If a student-athlete is felt to have a physical or psychological dependence, he or she will be enrolled in a more intensive outpatient substance abuse counseling program approved by the Subcommittee. This program may be conducted at a counseling and rehabilitation center in the Knoxville area approved by the Subcommittee. The program will be under the direction of a qualified substance abuse counselor. Failure to complete this program will result in the student-athlete s consequence being elevated to a Level II status.
11 11 In addition, the student-athlete may be suspended from intercollegiate athletic competition or team practice/activities as deemed appropriate by the Athletic Director upon consultation with the Subcommittee. At the Athletic Director s discretion, the student-athlete may be permanently suspended from intercollegiate athletic competition at the University of Tennessee-Knoxville. In addition, the student-athlete s scholarship may be terminated in accordance with University policy and NCAA rules regarding the termination of financial aid. B. Level II (Second positive test for illegal/banned substance or First positive for Anabolic Steroids or Performance Enhancing Drugs): The student-athlete will be required to sign a contract agreeing to all terms set forth by the substance abuse policy, as well as by his/her head coach. Also, the student-athlete will be enrolled in an intensive substance abuse counseling program. This program may be conducted at a counseling and rehabilitation center approved by the Subcommittee. The student-athlete is required to attend all sessions and successfully complete the program unless an absence is approved by the Subcommittee. Failure to complete this program will result in the studentathlete s consequence being elevated to a Level III status. In addition, the student-athlete will be suspended from intercollegiate athletic competition and/or team practice/activities for a period of time as deemed appropriate by the Athletic Director upon consultation with the Subcommittee. The suspension will be equal to no less than 10% of the scheduled competitions for the respective sport. A suspension from competitions will begin immediately upon notification of the student-athlete, and will include consecutive countable games of either regular season or post-season. If a student-athlete s season and post-season end prior to serving the full terms of the suspension, the athletic director will determine an appropriate length of a suspension from all team related activities to complete the mandated suspension. At the Athletic Director s discretion, the student-athlete may be permanently suspended from intercollegiate athletic competition at the University of Tennessee-Knoxville. In addition, the student-athlete s scholarship may be terminated in accordance with University policy and NCAA rules regarding the termination of financial aid. C. Level III (Third positive test for illegal/banned substance or Second positive for Anabolic Steroids or Performance Enhancing Drugs) The student-athlete will be permanently suspended from intercollegiate athletic competition at the University of Tennessee-Knoxville. In addition, at the Athletic Director s discretion, the student-athlete s scholarship may be terminated in accordance with University policy and NCAA rules regarding the termination of financial aid.
12 12 XII. Appeals If a student-athlete believes that penalties or sanctions placed upon him/her are made in error, inappropriate, or other extenuating circumstances, then he/she may file a written appeal of these penalties or sanctions. The written appeal must be submitted to the Athletic Director and the Subcommittee within one (1) week of notification of such penalties or sanctions. The appeal must contain an explanation of why the penalties or sanctions should not be enacted with supporting evidence or documentation. The appeal will be considered by a majority of members of the Subcommittee and a Faculty Representative and/or a Representative of the Dean of Students with a recommendation made to the Athletic Director at the next scheduled Subcommittee meeting. The final decision regarding any appeal will be made by the Athletic Director. For appeal issues that have previously been addressed by the full committee (e.g. a non- University of Tennessee physician-prescribed medication), the sub-committee may adjudicate according to past precedent and report their recommendations to the Athletic Director for a final decision, and thereafter to the full committee at the next meeting. If an intercollegiate athletic competition is scheduled prior to the Subcommittee s ability to consider the appeal, the student-athlete may be suspended from that competition in accordance with the designated Consequence Level outlined in this Policy and Procedure. The studentathlete may request an expedited meeting of the Subcommittee to consider the appeal and every effort will be made to meet this request. However, the Subcommittee and/or the Athletic Director is not obligated to render a decision prior to its next scheduled meeting. XIII. Alcohol Policy: A. Statement: Alcohol is involved in over 90% of the undesirable behaviors observed among students on college campuses. This Policy and Procedures should be viewed in the context that lawful responsible consumption or abstinence is expected from the student-athlete and that consumption and/or possession of alcohol by minors in the State of Tennessee is illegal. The goals of the alcohol policy will be to assist student-athletes with alcohol-related problems and to specify treatment for student-athletes experiencing alcohol-related problems. B. Alcohol Abuse Policy: The Head Coach may have team rules regarding the consumption and possession of alcohol that may affect the student-athlete s eligibility for practice and competition. Such policies and sanctions may be more stringent than those outlined in this Policy and Procedures. Alcohol-induced incidents involving student-athletes that causes undesirable behavior with or without legal consequences (i.e. DUI, public intoxication, etc.) will be referred to the
13 13 Subcommittee. The alcohol policies as well as resultant sanctions and/or penalties will be determined and maintained by the Subcommittee. Repeat alcohol offenses may have the same sanctions and/or penalties as outlined in section XI. Consequences for Positive Drug Tests. XIV. NCAA Drug Testing Program Protocol Drug screening will be administered pursuant to the guidelines set forth in the NCAA Drug Testing Program. Drug testing legislation can be found in the Division I manual and on the NCAA Web Page at Prior to participation, each student-athlete will be required to sign a NCAA Drug Testing Consent Form (see Appendix A) which will be administered by the sports medicine staff. Per NCAA rules, any failed drug test administered by the NCAA: 1. if tested before competition, will result in the student-athlete being disqualified from competition and the loss of one (1) year of eligibility. 2. if tested during or after competition, will result in a team penalty (which may include disqualification from and/or forfeiture of competition), and the loss of one (1) year of eligibility for the student-athlete. 3. will be subject to the terms/conditions of the University of Tennessee- Knoxville Substance Abuse Policy and Procedures. XV. IOC/USOC and USADA Drug Testing Guidelines Please be advised that all student-athletes involved in competition sanctioned by some other National Governing Body (NGB) must acknowledge that: 1. medication prescribed by your physician, and approved for use by the NCAA, may contain substances prohibited by your sanctioned NGB. 2. Over-the-counter medications may contain substances prohibited by your sanctioned NGB. 3. Vitamin, herbal, and nutritional supplements purchased over-the-counter or via the internet may contain substances prohibited by your sanctioned NGB.
14 14 XVI. Nutritional Supplement Policy Student-athletes should not take any nutritional supplement unless it is approved by the Head Team Physician. However, there is no guarantee that an approved supplement will NOT contain a contaminant or unlisted prohibited substance that could create a positive drug test. NCAA POLICY STATES THAT ANY PROHIBITED SUBSTANCE DISCOVERED BY A DRUG TEST IS THE RESPONSIBILITY OF THE STUDENT-ATHLETE, AND CORRESPONDING PENALTIES WILL APPLY. Therefore, all student-athletes are cautioned against ingesting any supplements other than those provided by the athletics department. Educational information regarding the risks associated with taking non-approved nutritional supplements will be provided to all student-athletes as part of the annual Compliance meeting at the beginning of the fall semester. Additional education will be provided at the student athlete s or coaches request. If a student-athlete requests to take a supplement not supplied to him/her by the athletic department, he or she is required to provide either the Head Team Physician, or his or her designee, product information such as the name, manufacturer, ingredient list, recommended dosage, etc. The supplement will be evaluated using Drug Free Sport s Resource Exchange Center (REC). Since multiple supplements may have identical names, it is preferred the student-athlete provide a sample package of the product in order to insure accuracy when describing the product to Drug Free Sport. The Head Team Physician, or his or her designee, will contact Drug Free Sport via the REC, with a description of the supplement. The student-athlete will be required to meet in person with the Head Team Physician once the product evaluation is received from REC. The student-athlete is then required to sign and date a form acknowledging the information received and, due to the lack of industry regulations, the risks associated with taking any supplement. The NCAA requires that every athletic department appoint an individual or individuals to act as a designated resource for student-athlete questions related to banned drugs and nutritional supplements. The Head Team Physician will act in this capacity for the University of Tennessee Athletic Department. While other athletic department staff members, such as the Sports Dietician and/or Athletic Trainers, may provide education to a student-athlete regarding supplement use, this counseling does not replace then information and stipulations provided by the Head Team Physician with respect to the risks of taking a nutritional supplement or the pro s and con s of supplement use. Any student-athlete wishing to take a nutritional supplement not provided by the athletic department will be required to meet with the Head Team Physician.
15 15 APPENDIX A: SAMPLE NCAA DRUG TESTING CONSENT FORMS Form 11-3d Academic Year Drug-Testing Consent NCAA Division I For: Student-athletes. Action: Due date: Sign and return to your director of athletics. At the time your intercollegiate squad first reports for practice or the Monday of the institution's fourth week of classes, whichever date occurs first. Required by: NCAA Constitution and NCAA Bylaw Purpose: To assist in certifying eligibility. Effective date: This consent form shall be in effect from the date this document is signed and shall remain in effect until a subsequent Drug-Testing Consent Form is executed. Requirement to Sign Drug-Testing Consent Form. Name of your institution: You must sign this form to participate (i.e., practice or compete) in intercollegiate athletics per NCAA Constitution and NCAA Bylaw If you have any questions, you should discuss them with your director of athletics. Consent to Testing. You agree to allow the NCAA to test you in relation to any participation by you in any NCAA championship or in any postseason football game certified by the NCAA for the banned drugs listed in Bylaw (attached). Additionally, if you participate in a NCAA Division I sport, you also agree to be tested on a year-round basis. Consequences for a Positive Drug Test. By signing this form, you affirm that you are aware of the NCAA drug-testing program, which provides: 1. A student-athlete who tests positive shall be withheld from competition in all sports for a minimum of 365 days from the drug-test collection date and shall lose a year of eligibility; 2. A student-athlete who tests positive has an opportunity to appeal the positive drug test; 3. A student-athlete who tests positive a second time for the use of any drug other than a "street drug" shall lose all remaining regular-season and postseason eligibility in all sports. A combination of two positive tests involving street drugs (marijuana, THC or heroin), in whatever order, will result in the loss of an additional year of eligibility; 4. The penalty for missing a scheduled drug test is the same as the penalty for testing positive for the use of a banned drug other than a street drug; and 5. If a student-athlete immediately transfers to a non-ncaa institution while ineligible because of a positive NCAA drug test, and competes in collegiate competition within the 365-day period at a non-ncaa institution, the student-athlete will be ineligible for all NCAA regular-season and postseason competition until the student-athlete does not compete in collegiate competition for a 365-day period. *Student-athletes will be provided with an updated version of this form (as needed) on a yearly basis.
16 16 Drug-Testing Consent NCAA Division I Form 11-3d Page No. 2 Signatures. By signing below, I consent: 1. To be tested by the NCAA in accordance with NCAA drug-testing policy, which provides among other things that: a. I will be notified of selection to be tested; b. I must appear for NCAA testing or be sanctioned for a positive drug test; and c. My urine sample collection will be observed by a person of my same gender. 2. To accept the consequences of a positive drug test; 3. To allow my drug-test sample to be used by the NCAA drug-testing laboratories for research purposes to improve drug-testing detection; and 4. To allow disclosure of my drug-testing results only for purposes related to eligibility for participation in NCAA competition. I understand that if I sign this statement falsely or erroneously, I violate NCAA legislation on ethical conduct and will jeopardize my eligibility. Date Date Signature of student-athlete Signature of parent (if student-athlete is a minor) Name (please print) Date of birth Age Home address (street, city, state and zip code) Sport(s) What to do with this form: Sign and return it to your director of athletics at the time your intercollegiate squad first reports for practice or the Monday of the institution's fourth week of classes (whichever date occurs first). This form is to be kept on file at the institution for six years. *Student-athletes will be provided with an updated version of this form (as needed) on a yearly basis.
17 NCAA Banned Drugs 1. The NCAA Bans The Following Classes of Drugs. a. Stimulants; b. Anabolic Agents; c. Alcohol and Beta Blockers (banned for rifle only); d. Diuretics and Other Masking Agents; e. Street Drugs; f. Peptide Hormones and Analogues; g. Anti-estrogens; and h. Beta-2 Agonists. Note: Any substance chemically related to these classes is also banned. The institution and the student-athlete shall be held accountable for all drugs within the banned drug class regardless of whether they have been specifically identified. 2. Drugs and Procedures Subject to Restrictions. a. Blood Doping; b. Local Anesthetics (under some conditions); c. Manipulation of Urine Samples; d. Beta-2 Agonists permitted only by prescription and inhalation; e. Caffeine if concentrations in urine exceed 15 micrograms/ml. 3. NCAA Nutritional/Dietary Supplements Warning. Before consuming any nutritional/dietary supplement product, review the product with your athletics department staff! *Student-athletes will be provided with an updated version of this form (as needed) on a (1) Dietary supplements are not well regulated and may cause a positive drug-test result. (2) Student-athletes have tested positive and lost their eligibility using dietary supplements. (3) Many dietary supplements are contaminated with banned drugs not listed on the label. (4) Any product containing a dietary supplement ingredient is taken at your own risk. It is your responsibility to check with the appropriate athletics staff before using any substance.
18 NCAA Banned Drugs Page No. 2 Some Examples of NCAA Banned Substances in Each Drug Class NOTE: There is no complete list of banned substances. Do NOT rely on this list to rule out any supplement ingredient. Check with your athletics department staff before using any medication or supplement. 1. Stimulants. e.g., amphetamine (Adderall); caffeine (guarana); cocaine; ephedrine; fenfluramine (Fen); methamphetamine; methylphenidate (Ritalin); phentermine (Phen); synephrine (bitter orange); methylhexaneamine, etc. Exceptions: phenylephrine and pseudoephedrine are not banned. 2. Anabolic Agents (sometimes listed as a chemical formula, such as 3,6,17-androstenetrione). e.g., boldenone; clenbuterol; DHEA (7-Keto); nandrolone; stanozolol; testosterone; methasterone; androstenedione; norandrostenedione; methandienone; etiocholanolone; trenbolone; etc. 3. Alcohol and Beta Blockers (banned for rifle only). e.g., alcohol; atenolol; metoprolol; nadolol; pindolol; propranolol; timolol; etc. 4. Diuretics and Other Masking Agents (water pills). e.g., bumetanide; chlorothiazide; furosemide; hydrochlorothiazide; probenecid; spironolactone (canrenone); triameterene; trichlormethiazide; etc. 5. Street Drugs. e.g., heroin; marijuana; tetrahydrocannabinol (THC); and synthetic cannabinoids (e.g., Spice, K2, JWH-018, JWH-073). 6. Peptide Hormones and Analogues. e.g., growth hormone (hgh); human chorionic gonadotropin (hcg); erythropoietin (EPO); etc. 7. Anti-Estrogens. e.g., anastrozole; tamoxifen; formestane; 3,17-dioxo-etiochol-1,4,6-triene (ATD); etc. 8. Beta-2 Agonists: e.g., bambuterol; formoterol; salbutamol; salmeterol; etc. Any substance that is chemically related to the class, even if it is not listed as an example, is also banned (unless otherwise noted)! Information about ingredients in medications and nutritional/dietary supplements can be obtained by contacting the Resource Exchange Center, REC, 877/ or password ncaa1, ncaa2 or ncaa3. It is your responsibility to check with the appropriate athletics staff before using any substance. *Student-athletes will be provided with an updated version of this form (as needed) on a yearly basis.
19 APPENDIX B: SAMPLE UNIVERISTY OF TENNESSEE-KNOXVILLE DRUG TESTING CONSENT FORM UNIVERSITY OF TENNESSEE-KNOXVILLE CONSENT FORM University of Tennessee-Knoxville Athletic Department P.O. Box Knoxville, TN Consent to Drug Testing and Authorization for Release of Information I hereby acknowledge that I have received a copy of the University of Tennessee-Knoxville Substance Abuse Testing Policy and Procedures for Intercollegiate Student-Athletes. I hereby consent to have a sample(s) of my urine, or other approved specimen, collected and tested for the presence of drugs, both illegal and prescription, and banned substances, in accordance with the provisions of the University of Tennessee-Knoxville Substance Abuse Testing Policy and Procedures. I authorize the employees or agents of the University of Tennessee to send my urine or specimen sample(s) to a professional laboratory of the University s choice for actual drug testing. I also authorize the employees or agents of the University of Tennessee to provide the results of all drug tests to the Chancellor, Athletic Director, Head Coach, Sport Administrator, Head Team Physician, Director of Sports Medicine, substance abuse counselor(s), and my parent(s) or legal guardian(s). I hereby release the University of Tennessee, its Board of Trustees, its officers, employees, and agents from any and all liability that may result from the release of such information and records as authorized by this form. I have read, understand, and agree to comply with the University of Tennessee-Knoxville Substance Abuse Testing Policy and Procedures for Intercollegiate Student-Athletes. I have also been given the opportunity to ask questions about the policy and procedures and have had my questions answered satisfactorily. I understand that signing this form is consideration for my being permitted to participate in intercollegiate athletics at the University of Tennessee-Knoxville. Student-Athlete s Printed Name: Student-Athlete s Signature: Student-Athlete s Date of Birth: Sport: Date: Witness or Parent/Guardian s Signature: (Parent/Guardian Signature Required if Student-Athlete is Under Age of 18) (Approved by OGC )
20 20 APPENDIX C: Distribution of Positive Test(s) Results: University of Tennessee Notification of Positive Test(s) Results Drug Test Results Delivered via secure website Head Team Physician Meet with Athletic Director Chancellor Head Coach Sport Administrator Student- Athlete Meets with Substance Abuse Counselor
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