In this email, you’ll find:

2026-27 NCAA Drug-Testing Manual: This resource provides detailed information about the NCAA drug-testing process.

🚨 NCAA Drug-Testing Program Updates

Reminder of Changes to the Medical Exception Pre-Approval and Continued Use Process

RSRO Submission

All requests for use of substances that require a medical exception pre-approval (MEPA) or a continued use medical exception must be submitted through the NCAA Requests/Self-Reports Online (RSRO) system. RSRO provides greater efficiency, clarity and historical record for the process. Additional safeguards were included within RSRO to allow schools to limit visibility of sensitive information to authorized personnel. More information including tutorials for navigating the new process can be found here.

Timing of Submission

Schools must submit a MEPA request before a student-athlete participates (practice or competition) in NCAA athletics while taking the NCAA banned substance. Failure to submit a MEPA request prior to 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 positive drug test for the student-athlete.

MEPA requests are required for substances in the anabolic agents, hormone and metabolic modulators and peptide hormones, growth factors, related substances and mimetics drug classes. Medical exceptions for substances in all other NCAA banned drug classes should only be submitted following a positive NCAA drug test.

Changes to the NCAA Banned Substance List

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports approved a modification to the NCAA banned substance list by approving the removal of oxymetazoline to further align with the World Anti-Doping Agency’s Prohibited List. Oral formulations of this substance remain banned. Student-athletes using oral oxymetazoline should continue to follow the procedures outlined in Section 8.0 of the NCAA Drug Testing Manual to request a medical exception.

Drug-Testing Educational Resources

NCAA schools are required to educate student-athletes about NCAA banned substances and the products that may contain them at least once annually. CSMAS approved a drug-testing educational template for 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 schools have free access to Drug Free Sport AXIS (access code: ncaa1, ncaa2, or ncaa3), which provides information about specific medications and supplements and their associated risk levels related to NCAA banned substances.

Emerging Topics and Trends

GLP-1 Medications and Peptide-Based Products

Schools should be aware of increasing interest and use in GLP-1 medications and peptide-based products. Although GLP-1 medications are not currently an NCAA banned substance, schools should consider potential health and safety implications associated with their use. Conversely, many peptides are included in the NCAA banned drug class of peptide hormones, growth factors, related substances and mimetics. BPC-157, an example of a peptide that student-athletes have reported using, is not approved by the U.S. Food and Drug Administration and would not qualify for an NCAA medical exception. Student-athletes should be cautioned that use of peptide products may result in a positive NCAA drug test.

Supplements and Substances

Student-athletes continue to test positive for NCAA banned substances potentially due to the use of contaminated supplements. The highest numbers of positive NCAA drug tests continue to be for substances found in the hormone and metabolic modulators and anabolic agents banned drug classes. In 2025-26, the most found substances in these drug classes were GW1516 sulfoxide and sulfone, clomiphene, testosterone, LGD-4033 and ostarine.

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 prevention, please refer to the resources at the top of this page or email ssi@ncaa.org.