All you need to know about ... beta2-agonists, codeine and hygenamine

beta2-agonists, codeine and hygenamine in the collimator.

Put in the spotlight by WADA, beta2-agonists, codeine and hygenamine know different levels of notoriety. Update on these substances with Dr. Jacomet.

Substances in the spotlight

WADA has moved up a gear on beta2-agonists. Salbutamol, formoterol and salmeterol have been joined by fenoterol, terbutaline or vilanterol as banned substances. WADA took this opportunity to recall the authorized dosages and insisted that studies were underway to establish an appropriate threshold for urinary concentration for inhaled salmeterol. For its part, higenamine, a product frequently found in food supplements, is a fat-burner beta-stimulant and was at the origin of the suspension, before his total rehabilitation, of French international footballer Mamadou Sakho. The substance itself was not, then, listed by name. She has been since. It should be remembered that codeine is under surveillance. This substance belongs to the narcotics family and can, on degradation, leave traces of morphine leading, if doping control, a positive result. As a reminder, before appearing on the 2016 banned list, Meldonium, at the origin, in particular, of the suspension of the tennis player Maria Sharapova, had also been placed under surveillance. 


To go further: three questions for Doctor Jacomet, Member of the Monegasque Anti-Doping Committee

Beta-2-agonists are drugs that dilate the alveolar bronchioles and therefore allow better breathing by ultimately increasing the arrival of oxygen to the tissues. There is no doubt that these are doping products since they improve performance.

The existence of asthma occurring with intense exertion is proven. It legitimizes the authorization issued to certain athletes to take three of them: salbutamol, formoterol and salmeterol in a restricted and controlled manner by the World Anti-Doping Code.

Codeine is a weak pain reliever. However, the search for an analgesic effect, weak or strong, contributes to improving performance since pain is a limiting factor in performance. In addition, codeine can mask the intake of morphine, a powerful analgesic, by causing the two molecules to appear simultaneously in the urine in the laboratory. However, one is transformed into the other, in small proportion of course, but ultimately very little codeine is sufficient to mask an intake of a large quantity of morphine.

Because codeine is a part of many regular flu medications, it cannot be banned outright. It is normal to place it under surveillance as a warning to deter misuse.

The exact effects of higenamine or norcoclaurine are not really known. Like many molecules extracted from plants, its pharmacology will be written with much delay. The reason for banning its consumption is that if athletes use it, it must have a doping effect! Exploring the effects of a new molecule about which nothing is known may take ten to twenty years. In the meantime, the World Anti-Doping Agency takes the decision to ban it in order to preserve the health of the athlete as much as to prevent doping use. The mere fact that its chemical structure is related to amphetamines is a justification for the authorities' caution.

Hospital biologist
Pharmacologist-Toxicologist at the CHU de Nice
Head of department of the biological addictology and toxicology laboratory at Arcchet 2 hospital
Head of the Doping Prevention Medical Unit (AMPD) in the PACA region

Expert at the Aix-en-Provence Court of Appeal