May 1, 2009 Dear SB Student-Athlete and Parent/Guardian: Greetings from Stony Brook! We would like to take this opportunity to remind you that the Sports Medicine Staff is accessible and responsible for the prevention, diagnosis, treatment, referral, and rehabilitation of athletic related injuries as well as education and counseling of the student-athlete. A Certified Athletic Trainer will address these topics at each team orientation meeting conducted before practices commence. In addition, there are five issues which you need to be aware of in preparation for participation in Stony Brook Athletics. Please read the following material very carefully. 1) NEW! Use of Prescription Medications – Even though a medication is prescribed does not imply that it is allowed. The NCAA recognizes that some banned substances are used for legitimate medical purposes. Accordingly, the NCAA allows exceptions to be made for those student-athletes with a documented medical history demonstrating the need for regular use of such a drug. Exceptions may be granted for substances included in the following classes of banned drugs: stimulants, beta blockers, diuretics and peptide hormones.
Examples of banned prescription medications are: Adderall, Ritalin, Concerta, etc
For ADHD medication: Requires specific written documentation that demonstrates the studentathlete has undergone a clinical assessment to diagnose ADHD, is being monitored routinely for use of the stimulant medication, and has a current prescription on file, in order to be approved for a medical exception to the banned drug policy. Contact a certified athletic trainer for more information @ 631-632-6448.
For other banned medications: Complete documentation is REQUIRED! See page 9 and the “2008-09 Drug-Testing Exceptions Procedure (Medical Exceptions)” www.ncaa.org/health-safety 2) Do Not Use NCAA Banned Substances – All student-athletes are subject to Institutional Drug Testing in addition to the NCAA Year-Round Drug Testing program. Stony Brook University (SBU/SB) supports the NCAA’s policy prohibiting student-athletes from using performance enhancing drugs and/or illegal substances. The NCAA list of banned drug classes is composed of substances that are generally reported to be performance enhancing and harmful to one's health. SBU and the Department of Athletics are committed to maintaining a safe and healthy environment where student-athletes can develop socially, academically and athletically to their fullest potential. Part of maintaining such an environment is ensuring the student-athletes’ physical and mental well-being. The NCAA regularly updates material on their web site. It is the student-athletes responsibility to review the information provided by the NCAA and SB Athletic Department with regard to banned substances.
The guidelines of the National Center for Drug Free Sport, Inc (pg 4)
List of the more common drug names which are banned (pg 4)
NCAA Banned-Drug Classes 2008-09 (pg 5-6); check for 09-10 update in July 09
NCAA Drug Testing Program www.ncaa.org/health-safety
SB Student-Athlete Drug Testing Program www.goseawolves.org 1

3) Do Not Use Dietary Supplements (including Herbal) - Many nutritional/dietary supplements contain NCAA banned substances. In addition, the US Food and Drug Administration (FDA) does not strictly regulate the supplement industry; therefore, the purity and safety of nutritional/dietary supplements cannot be guaranteed. Impure supplements may result in a positive NCAA drug test. The use of supplements is at the student-athlete’s own risk. Student-athletes should contact their institution’s certified athletic trainers for further information. What’s in the bottle is not always on the label! If you don’t know what you are taking, you are risking both your health and your eligibility. Ignorance is no excuse for a positive drug test!
See Sports Supplement Health Warning attached (pg 7)
The NCAA and the SB Department of Athletics do not approve or endorse any nutritional/dietary supplement product despite the fact that some manufacturers make that claim. 4) Heat Illness is Preventable - University coaches, administrators and medical personnel all play a significant role in preventing heat illness by following the NCAA Guidelines regarding the Prevention of Heat Illness. However, you, the student athlete, play the largest role!
See page 8-9 for heat illness prevention strategies to follow as you prepare for the season 5) SB Athletic Insurance Policy - You are responsible for having insurance or purchasing Student Health Insurance. SB Department of Athletics provides a secondary/excess policy for injuries sustained during a coach-supervised sport related activity.
The “Athletic Insurance Questionnaire 2009-10”, available on the web site at http://goseawolves.collegesports.com/school-bio/ston-athletic-training.html, must be completed and returned to the Sports Medicine Department.
If procedures identified in the attached letter (page 10) are not followed, the SB Department of Athletics will not be responsible for any bill payment. In addition to these items, student athletes are required to download documents from the Seawolves Sports Medicine web site (see link below). At the end of this packet (page 11) you will find a “Sports Medicine Check List” of items which need to be returned to the Sports Medicine Staff; Parental/guardian signature is required regardless of age. The NCAA web site referred to during this documented will be updated to reflect 2009-10 material later this summer. Please check it prior to arrival on campus. Should you have any questions regarding these issues, please do not hesitate to speak to a Stony Brook Certified Athletic Trainer. Have a safe and enjoyable summer! Go Seawolves! Sincerely,

Kathryn A. Koshansky, MS, ATC Assistant Athletic Director for Sports Medicine

Stuart B. Cherney, MD Head Team Physician 2

1) NCAA Medical Exceptions – including case examples for use of stimulants, finasteride (Propecia), and testosterone. This stricter application will be applied effective August 2009. The NCAA list of banned drug classes is composed of substances that are generally reported to be performance enhancing. The NCAA bans performance enhancing drugs to protect student-athlete health and safety and ensure a level playing field, and it also recognizes that some of these substances may be legitimately used as medications to treat student-athletes with learning disabilities and other medical conditions. Accordingly, the NCAA allows exceptions to be made for those student-athletes with a documented medical history demonstrating the need for regular use of such a drug. The benefit of a medical exception procedure is that in most cases the student-athlete’s eligibility remains intact during the process. Exceptions may be granted for substances included in the following classes of banned drugs: stimulants, beta blockers, diuretics, anti-estrogens, anabolic agents (steroids)*, and peptide hormones* (Bylaw 31.2.3). (*anabolic agents and peptide hormones must be approved by the NCAA before the athlete is allowed to participate while taking these medications. The institution, through its director of athletics, may request an exception for use of an anabolic agent or peptide hormone by submitting to The National Center for Drug Free Sport (Drug Free Sport) any medical documentation it wishes to have considered.) In all cases, a student-athlete, in conjunction with his or her physician, must document that other non-banned alternatives have been considered prior to requesting the medical exception for the use of a medication containing a banned substance. It is the responsibility of the institution to educate student-athletes about this policy, and to follow-up with any student-athlete who identifies the use of a banned medication to determine if standard non-banned medications have been pursued and documented. In order for a student-athlete to be granted a medical exception for the use of a medication that contains a banned substance, the student-athlete must: 1. have declared the use of the substance to his or her athletics administrator responsible for keeping medical records, 2. present documentation of the diagnosis of the condition, and 3. provide documentation from the prescribing physician explaining the course of treatment and the current prescription. Requests for medical exceptions will be reviewed by physicians who are members of the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports. Medical exceptions will be granted if the student-athlete has presented adequate documentation noted above. Unless requesting a review for the medical use of an anabolic agent or peptide hormone, a studentathlete's medical records or physicians' letters should not be sent to the NCAA unless requested by the NCAA. Also, the use of the substance need not be reported at the time of NCAA drug testing.

excerpt from 2008-09 NCAA Drug Testing Program www.ncaa.org

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2) Student-athletes will be tested for the following banned drugs categories, based on the guidelines of the National Center for Drug Free Sport, Inc: 1. 2. 3. 4. 5. 6. 7. 8.

Amphetamines Cocaine Tetrahydrocannabinol (THC or marijuana) Drug analogs (designer drugs) Barbiturates and Benzodiazepine Opiates (Morphine, Codeine, Demerol, Heroin, etc) Natural and Manufactured hallucinogens Anabolic Steroids

Common Names of NCAA Banned Substances STIMULANTS Caffeine Ephedrine Ma Huang Strychnine Cocaine Amphetamines Ecstasy And many more…

DIURETICS Acetazonlamide Flumethiazide Metolazone Triamterebe And many more… PEPTIDE HORMONES HCG ACTH HGH EPO And many more…

ANABOLIC AGENTS Anabolic Steroids Androstendione Norandrosteindione DHEA Methyl testosterone Testosterone Nandrolone And many more…

STREET DRUGS Heroin Marijuana-THC Cocaine Ecstasy And many more…

Please be aware, this list is not all-inclusive! There are many common preparations used for colds and allergies, asthma, etc found in these categories. Obviously, medicinal use of these products is usually OK, but the metabolism of the substance depends on dosage and body metabolism. Therefore, it is best to stay away from or have products checked against the very lengthy “Banned-Drug Classes” located on page 6 and in the SB Athletic Training Room..

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3) SPORTS SUPPLEMENT HEALTH WARNING Many dietary supplement products available over the counter or on the Internet contain androstenedione (andro), creatine or ephedra. These products are not regulated or tested by the FDA and some have been reported to cause negative health consequences ranging from cramps or headaches to kidney problems and acne. To help you identify these substances listed below are the names of some of the widely marketed products in each category. Keep in mind these are examples. By no means is this list intended to be all inclusive! ANDROSTENEDIONE* 3-Andro Xtreme Animal Stak Andro-Gen Nor Andro Ripped Fuel Stack Andro-Stack Nor-Stak Androstat Nor-Tek *Related compounds include 19-norandrostenedione, androstenediol, and dehydroepiandrosterone (DHEA).

CREATINE Animal Max ATP Advantage Cell-Tech Creaject Crea-Tek Creatigen Creatine Booster Creatine Fizz Fuel CreaVate Effervescent Creatine Elite

LifeSmart's Creatine Chews Mass Action Micronized Creatine Muscle Milk Perfect Creatine Phosphagen Power Creatine SyntheVol Teen Advantage Creatine Serum Xtra Advantage Creatine Serum

EPHEDRA (MA HUANG) 3-Andro Xtreme Adipokinetix Amphetra-Lean Animal Cuts BetaLean Carbolizer Clenbutrx Diet Boost Diet Fuel Dyma-Burn Xtreme Dymetadrine Xtreme ECA Stack Energel Ephedrine 25 Extreme Ripped Force Herbal Phen-Fen Herbalife Hydroxycut

Ignite Kranker fat Burner Lipo-6 Metabolife 356 Metab-O-Lite Metacuts Nitro Speed Ripped Force Ripped Fuel Thermadrene ThermaPro Thermo Speed Trim Fast Ultimate Energizer Ultimate Orange Ultra Chromaslim Xenadrine RFA-1 Yellow Jacket 7

4) HEAT ILLNESS RISK FACTORS (excerpts taken from the web sites identified on pg 9): Air temperature, humidity, and dehydration are common risk factors associated with heat illness. In addition, the following factors also put student-athletes at increased risk:

1. Nutrition Supplements. Nutritional supplements may contain stimulants, such as ephedrine, ma huang or caffeine. These substances can dehydrate the body and/or increase metabolism and heat production. 2. Medication/Drugs. Certain over the counter and prescription medications may make an athlete more susceptible to heat-related problems. These include antihistamines, decongestants, certain asthma medications, medications for attention deficit disorder (ADD), diuretics, and alcohol. For example, aspirin and antihistamines can change sweat patterns. Aspirin causes an increase in sweat loss, and when taken in large doses may cause an increase in body temperature above that resulting from physical activity alone. Antihistamines, on the other hand, decrease the athlete’s rate of sweating. The use of stimulants while exercising can increase the risk of heat illness. 3. Susceptible Student Athletes. Those with inadequate acclimatization or aerobic fitness, excess body fat, history of heat illness, inadequate hydration, using substances with diuretic or stimulant effects and those who push themselves to capacity are very susceptible. In addition, those with medical conditions such as fever, gastro-intestinal illness or sickle cell trait are vulnerable to heat illness. 4. Acclimatization/fitness level. Prevention of heat illness begins with aerobic conditioning which provides partial acclimatization to the heat. Student-athletes should gradually increase exposure to hot and/or humid environmental conditions over a period of seven to 10 days to achieve heat acclimatization. Each exposure should involve a gradual increase in the intensity and duration of exercise until the exercise is comparable to that likely to occur in competition. When conditions are extreme, training or competition should be held during a cooler time of day. 5. Hydration. Dehydration (hypo-hydration) must be avoided not only because it hinders performance, but also because it can result in profound heat illness. If you are thirsty, you are already dehydrated! Student-athletes should be encouraged to drink as much and as frequently as comfort allows. They should drink 1-2 cups of water the hour preceding workouts, and continue drinking during the activity (every 15-20 minutes). For activity up to 2 hours in duration, most weight loss represents water loss, and that fluid loss should be replaced as soon as possible. Following activity, the athlete should re-hydrate with a volume that exceeds the amount lost during the activity. A 2 pound weight loss corresponds to approximately 1 quart of fluid loss. Urine color can be used to assess hydration. Dark colored urine = Dehydrated. If urine output is plentiful and the color is “pale yellow or straw colored” the athlete is probably not dehydrated. Carbohydrate/electrolyte drinks should only be used 1-2 hours prior and during recovery (after) activity; not during! Avoid use of salt tablets – inhibits physiological heat loss! Dangerous hyper-hydration is also a risk if athletes drink based on published recommendations and not according to individual needs. 6. Clothing. Clothing and protective equipment increase heat stress by interfering with the evaporation of sweat as well as inhibiting other pathways for heat loss. Dark colored clothing increases the body’s absorption of solar radiation. Rubberized suits should never be used!

HEAT ILLNESS WARNING SIGNS Dehydration can seriously compromise athletic performance and increase the risk of exertion heat injury. It is important to recognize the following signs and symptoms: • Thirst • Weakness • Cramping • Pale or flushed skin • Irritability • Dizziness • Nausea • Visual disturbance • Headache • Excessive fatigue • Rapid and weak pulse • Decreased performance If heat illness is suspected, prompt emergency treatment is recommended. For more information, contact your team physician or certified athletic trainer.

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For more information regarding these issues, you can go to the following web sites:  National Collegiate Athletic Association: www.ncaa.org/health-safety  NCAA list of banned-drug classes: http://www.ncaa.org/wps/ncaa?ContentID=282  National Center for Drug-Free Sport: www.drugfreesport.com  National Center for Drug-Free Sport – Resource Exchange Center: www.drugfreesport.com/REC; Division 1 institutions use the password ncaa1  National Athletic Trainers Association: www.nata.org  Stony Brook University Athletics: www.goseawolves.org  Stony Brook University Sports Medicine: www.goseawolves.collegesports.com/school-bio/ston-athletic-training.html

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May 1, 2009 Dear Student-Athlete & Parent/Guardian, On behalf of the Stony Brook University Department of Athletics I would like to inform you of the athletic insurance provided for all participants on SBU intercollegiate athletic teams. It is essential that all policies and procedures are followed in order for any claims to be processed. Delay in payment and/or loss of coverage may result if these guidelines are not followed. Please review this document carefully.

Type of coverage The Stony Brook University Department of Athletics provides an Excess (Secondary) Policy for its student-athletes. This requires that all bills must first be submitted to the student-athletes primary insurance. The student-athletes personal medical policy will be the primary coverage and must always be exhausted first.

About the Athletic Accident Insurance Policy 1. 2. 3. 4.

The policy only covers intercollegiate athletic injuries, which occur during participation in coach supervised intercollegiate activities (i.e. practice, games, and travel); The policy DOES NOT cover general illnesses; All off-campus Physical Therapy/Occupational Therapy must have prior approval from the SBU Sports Medicine Staff, before reimbursement is considered; Dental injuries ARE NOT covered if the sport requires that a mouth guard be worn and the student-athlete was not wearing one properly at the time of the injury.

Procedures to Follow When an Injury Occurs If any of the following procedures are not followed, the SBU Department of Athletics will not be responsible for any charges incurred due to examination and/or treatment: 1. All athletic injuries must be reported to the sports medicine staff within one day of occurrence; 2. The sports medicine staff will coordinate all medical referrals; 3. All claims are made through the athletic training room; 4. All bills must first be submitted to the student-athletes primary carrier, The SBU Athletics insurance information will be provided to the provider for his/her office to submit to once primary insurance has been processed. In the event the office does not/will not submit to secondary, it is your responsibility to submit any outstanding itemized bills, Explanation of Benefits (EOB’s), and/or letter of denial to Eric Lehnert (see below); 5. If seeking a second opinion, you must ensure that the provider accepts your insurance and is in-network prior to obtaining any services from them. **Important Notes: 1. You must notify the Sports Medicine Staff as soon as possible if there is any change in insurance; 2. Notify your insurance carrier once you/your child becomes age 19 as a full time student status; this issue has presented obstacles for student-athletes in the past. All questions or correspondence should be addressed to: Eric Lehnert Phone #: (631) 632-4720 Stony Brook University Fax #: (631) 632-3231 Indoor Sports Complex email: [email protected] 100 Nicolls Rd. Stony Brook, NY 11794-3500 Thank you for your cooperation. Go Seawolves! Sincerely,

Eric Lehnert, MS, ATC, EMT-CC Assistant Athletic Trainer

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SPORTS MEDICINE REQUIRED DOCUMENT CHECK LIST 2009 **Failure to complete and return this document to the SBU Athletic Training Room will result in inability to participate in strength & conditioning or team practice. Student Athlete Name________________________________ (please print!)

Student ID#_________-_________-_________ Sport_________________________________

ACKNOWLEDGEMENT OF RECEIPT, REVIEW & UNDERSTANDING OF THE FOLLOWING: (1 through 3 are required by ALL student-athletes) _________ 1. Heat, Banned Substances, Supplements, Prescription Meds, Insurance (HBSPI) Letter (initial) a. NEW PROCEDURE- Prescription Medication b. Banned Substances > Institutional and Year- Round NCAA Drug Testing c. Supplements > Sports Supplements Health Warning d. Heat Illness > Risk Factors& Warning Signs e. Complete Documentation is required > Insurance (see #2 below) _________ 2. Insurance (initial) > Procedural letter from Assistant Athletic Trainer > See SBU Sports Medicine web site for form > Return Questionnaire & copy of insurance card **PARENT SIGNATURE REQUIRED! _________ 3. Assumption of Risk (initial) > See SBU Sports Medicine web site for form > Sign and return _________ 4. New Student Athletes Health History (New Only!) (initial) > See SBU Sports Medicine web site for form > Sign and return _________ 5. Returning Student Athletes Medical Questionnaire (Returners Only!) (initial) > See SBU Sports Medicine web site for form > Sign and return I certify that I have received, read and understand the documents listed above. I am well aware of the information presented and the risks involved during participation in Stony Brook Intercollegiate Athletics.

____________________________________________ Signature of Student-Athlete

_____________________ Date

___________________________________________ Signature of Parent/Guardian (MANDATORY!)

_____________________ Date

Please return all documents (hand deliver or mail) as soon as possible to: Kathryn A. Koshansky Assistant Athletic Director for Sports Medicine Athletic Department Stony Brook University Stony Brook, NY 11794-3500 Phone 631-632-6448 11

Sports Medicine Staff only: Initial: ________ Date: ________