Decline in ADHD Medication Exemptions Among MLB Players

In a recent report by Thomas M. Martin, the independent program administrator for Major League Baseball's (MLB) drug program, it was revealed that only 54 major league players received Therapeutic Use Exemptions (TUEs) for medications used to treat Attention Deficit Hyperactivity Disorder (ADHD) during the past year. This figure marks a significant decline from 61 exemptions in the previous year and a steep drop from 119 in 2013. The most commonly prescribed medications for ADHD include Adderall, Ritalin, and Vyvanse.

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The report also highlighted that MLB conducted a total of 11,700 drug tests in the year concluding with the 2025 World Series, slightly below the record of 11,783 tests from the year ending with the 2023 World Series. This year's testing comprised 9,400 urine samples and 2,300 blood samples aimed at detecting Human Growth Hormone (HGH). Notably, only two tests returned positive results, leading to disciplinary actions against players on 40-man rosters.

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The two players who faced suspensions were Atlanta Braves outfielder Jurickson Profar and Philadelphia Phillies closer José Alvarado. Profar received an 80-game suspension on March 31 for testing positive for Chorionic Gonadotrophin, a hormone associated with testosterone production. He stated that he did not knowingly ingest the banned substance. Similarly, Alvarado was banned for 80 games on May 18 after testing positive for external testosterone, which Phillies president of baseball operations Dave Dombrowski attributed to a weight loss drug the pitcher had taken during the offseason.

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The decline in TUEs for ADHD medications may reflect a growing awareness and scrutiny regarding the use of performance-enhancing drugs in sports. The reduction in exemptions could indicate a shift in how ADHD is managed within the league, potentially leading to more stringent evaluations of players seeking such exemptions.

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Thomas M. Martin's report underscores the ongoing efforts by MLB and the players' association to maintain the integrity of the sport through rigorous drug testing and monitoring. The decrease in ADHD medication exemptions may also signal a commitment to ensuring that players are not using these medications as a means to gain an unfair advantage.

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Some critics argue that the stringent regulations surrounding ADHD medication may disproportionately affect players who genuinely require these treatments for their health and performance. They contend that the current system may not adequately accommodate the needs of these athletes while maintaining fair competition.

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• “Profar said he didn't knowingly take the banned substance.” — Jurickson Profar, Atlanta Braves Outfielder

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The findings from this report highlight the ongoing challenges and complexities surrounding drug use and regulation in professional sports, particularly regarding mental health treatments like ADHD.

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