2025-26 NCAA Drug-Testing and Drug Education Resources
On behalf of the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports, the NCAA Sport Science Institute announces the release of annual updates to the following NCAA drug-testing and drug education efforts:
2025-26 NCAA Drug-Testing Manual: This resource for athletics administrators provides detailed information about the NCAA drug-testing process.
Below is additional information about the NCAA Drug-Testing Program and pertinent educational resources:
NCAA Drug-Testing Program
Changes to the Medical Exception Process.
ACTION REQUIRED- Submitting Medical Exception Pre-Approval and Continued Use Requests through RSRO.
As requested by the membership, additional access options for medical exception pre-approval (MEPA) and continued-use requests have been added to the NCAA's Requests/Self-Reports Online (RSRO). The new options allow schools to limit access to sensitive information by user. Specifically, schools can limit a user’s access to “medical cases only” or prohibit a user’s access to medical cases.
ACTION REQUIRED BY AUGUST 1: Please note, to retain or add access to medical exception cases in RSRO (even if you currently have access), your school’s single-source sign-on administrator must update settings to provide you with medical case access by August 1, 2025. After August 1, users without medical case access will lose visibility to medical exception cases.
More information, including tutorials for updating access and submitting medical exceptions, can be found here.
MEPA Submission Prior to Participation.
As approved by the NCAA's Committee on Competitive Safeguards and Medical Aspects of Sports (CSMAS), schools must submit a MEPA before a student-athlete participates (practice or competition) in NCAA athletics while taking the NCAA banned substance. Failure to submit a MEPA before participation may result in formal notification to the school’s president/chancellor of the school’s failure to comply with NCAA drug-testing policy. Improper MEPA submissions may also result in a legislative sanction for a positive drug test. If a student-athlete requests it, schools can submit an appeal on their behalf following a positive test for a banned substance.
Spironolactone – Continued Use Update.
Once a medical exception (ME) has been granted for the use of spironolactone for any indication for women (e.g., acne, hirsutism, etc.), schools are only required to submit a continued use request once annually.
All other approved use requests will maintain a twice-annual submission requirement for continued use, with one submission required before the student-athlete’s competitive season. Additional information on this topic can be found in the Banned Substances and Medical Exception Process FAQ.
Changes to the NCAA Banned Substance List
CSMAS approved a modification to the NCAA banned substance list to further align with the World Anti-Doping Agency’s Prohibited List. Sports for which beta-blockers are prohibited now includes golf. If a student-athlete in rifle or golf tests positive for a beta-blocker during an NCAA drug test, schools should follow the procedures outlined in Section 8.0 of the NCAA Drug-Testing Manualto request a ME.
Drug-Testing Education Resources
NCAA member schools are legislatively required to educate student-athletes about NCAA banned substances and the products that may contain them at least once annually. CSMAS has approved educational templates for member schools to consider using when educating student-athletes on the NCAA Drug-Testing Program and nutritional and dietary supplements.
Additionally, student-athletes and athletics staff at NCAA member schools have free access to Drug Free Sport AXIS (access code: ncaa1, ncaa2, or ncaa3) to learn more about specific medications and supplements and their associated risk levels related to NCAA banned substances.
Caffeine Educational Resource
Energy drinks continue to be reported by Drug Free Sport AXIS as one of the top five supplement inquiries submitted. Caffeine, one of the ingredients commonly found in these types of drinks, is an NCAA banned substance where a urinary concentration is equal to or greater than 15 mcg/ml.
CSMAS has approved a revised educational resource, Caffeine and Athletic Performance Fact Sheet, which provides information about the effects of caffeine. Student-athletes should consult with their primary athletics health care provider and/or dietitian before including caffeinated products in their nutrition plan.
Cannabinoids Educational Resources
Additional educational resources are now available to support schools in their efforts to prevent, identify and manage problematic cannabis use. The newly developed fact sheets promote a campus-based harm-reduction approach.
Student-athletes continue to test positive for NCAA banned substances potentially due to the use of contaminated supplements. Although overall positive drug tests have declined since 2023-24, the highest numbers of positive tests continue to be for substances found in the hormone and metabolic modulators and anabolic agents banned drug classes. In 2024-25, the substances most commonly found during NCAA drug testing in these drug classes were GW1516 sulfoxide and sulfone, clomiphene, testosterone, LGD-4033 and ostarine. There was an observed increase during 2024-25 of positive tests for ibutamoren, an NCAA banned substance in the peptide hormones, growth factors, related substances and mimetics drug class.
Thank you for your partnership in addressing substance misuse prevention on your campus. For additional information on the NCAA Drug Testing Program or resources on substance misuse, please refer to the resource box at the top of this page or emailssi@ncaa.org.
This email was sent to NCAA Divisions I, II and III Athletics Health Care Administrators, Conference Commissioners, Directors of Athletics, Directors of Mental Health Counseling, Drug-Testing Site Coordinators, Faculty Athletics Representatives, Head Athletic Trainers, Head Coaches, Head Team Physicians, Senior Compliance Administrator and Senior Woman Administrators based on contact information in the NCAA Directory.
