Updated on 01/25/2013 12:01PM

National groups press for uniform medication list and rules

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National regulatory officials are confident that the 38 states conducting Thoroughbred racing will soon adopt a set of uniform rules governing the use of a limited suite of therapeutic medications.

Sound familiar?

Similar expressions of confidence have been voiced over the last 50 years, but the rules of most racing jurisdictions, especially in regard to therapeutic medications, remain stubbornly diverse despite continual efforts to align standards.

This time, officials say, will be different. Supporters of the new rules say that momentum has been building for adoption of the regulations because of a confluence of factors, including the completion of scientific studies establishing threshold levels for therapeutic medications, a concerted effort to gain consensus, and a drumbeat of highly unfavorable news coverage of the sport’s medication policies and treatment of its horses. Finally, the new rules sidestep making any change regarding the raceday use of furosemide, the anti-bleeding medication that has been a lightning rod for debate.

“There’s nothing holding this back,” said Ed Martin, the president of the Association of Racing Commissioners International, an umbrella group for racing commissions that intends to distribute the model rules to individual states by the end of January. “This effort has a head of steam behind it.”

But despite that confidence and the support of some of the most powerful organizations in racing, significant hurdles remain. Many veterinarians and horsemen, who feel they have been unfairly characterized during the debate over medication usage, continue to resist some changes in policies, contending that new rules could prevent them from properly treating horses. In addition, many states that have tackled some of the problems now being addressed by the national groups have gone to great lengths over the last several years to research and pass their own rules that may be in conflict with the recommendations of the national groups. Additional changes may be greeted with resistance by those commissions.

While the adoption of uniform medication rules and a list of permitted therapeutic medications has long been an industry priority, the stakes may by higher this time. The drug-testing programs and medication policies of all sports are under the microscope from a variety of news organizations and advocacy groups, and racing – whose equine athletes have no say in how they are treated – has borne more than its share of scrutiny over the past year. A failure to adopt uniform policies, according to supporters of the effort, may give the sport’s critics additional ammunition when arguing that racing is not serious about addressing shortcomings in its regulations.

At the core of the effort is a list identifying 24 medications that will be permitted to be administered to horses. A partial list of the medications identifying 17 commonly administered therapeutic drugs, such as painkillers and anti-inflammatories, was provisionally approved by the RCI in December. Fearful of losing momentum after a busy month of meetings and negotiations with regulators and policy groups, the RCI plans to distribute that list to racing commissions in the next several weeks, with the recommendation that the list be adopted wholesale by its member jurisdictions. Regulations regarding the other seven drugs will probably be distributed later this year, though there may be modifications.

“Our next challenge is to take these reforms and incorporate them into the rules of racing, across all jurisdictions,” said Jim Gagliano, the president of the Jockey Club, which has long advocated for uniform rules that clearly identify permitted drugs. “The safety of our competitors and the integrity of competition are clear priorities as we promote the sport to a new generation of fans.”

Individual racing states maintain their own lists of permitted medications, which can appear in specific concentrations in postrace samples. The rules often differ from state to state, not only in the identity of the drugs, but also in the levels of the drugs that are allowed to appear in postrace samples.

Permitted medications are regulated through so-called threshold levels, which provide limits to the concentrations that can appear in postrace samples without triggering penalties. The levels allow horsemen to treat horses for the common conditions that can affect all athletes, such as soreness and breathing problems, while preventing a veterinarian or trainer from using a medication so close to a race that it affects racing performance, either by giving the horse an advantage or by deadening the ability to feel pain.

Under the new rules, any drug that does not appear on the list will be strictly prohibited, and any finding in a postrace test will be treated as a violation. Positives for any of the prohibited drugs – a list that will include hundreds of specifically identified drugs along with any unlisted drug that a horseman may experiment with – will draw harsh penalties under a set of rules that the RCI and the Jockey Club intend to forward to racing jurisdictions later this year. Those rules, devised two years ago by the Jockey Club, will probably include a “three-strikes” provision that could address concerns that racing is far too lenient on repeat offenders. Under the three-strikes provision, any trainer who has three positives for prohibited drugs in a certain time span could lose his license.

The seven drugs that were not included on the initial list of 17 will probably be treated differently. All seven have anesthetic properties – some of them, such as mepivacaine, have extremely powerful painkilling properties – and the RCI has placed them on a special treatment list that would prevent their use except in situations in which a horse has suffered an injury. In addition, veterinarians will probably be required to provide documentation of a diagnosis requiring the use of any of the seven drugs. Positives for the drugs would make a trainer subject to harsher penalties than positives for the 17 permitted medications but less so than for a positive of a prohibited medication.

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Adoption of the list by the major racing states would serve to consolidate a hodgepodge of regulations covering therapeutic medications, a concept that horsemen say they support. And there’s no arguing that the rules are in need of standardization. One example is clenbuterol, the potent, popular bronchial dilator. Clenbuterol is probably being abused in states where it is legal to administer the drug within days of a race, a liberal policy that allows horsemen to administer the drug regularly to take advantage of its ability to build muscle – a property associated with anabolic steroids, which are highly regulated in racing.

In Louisiana, clenbuterol is legal to administer within 24 hours of post; in Pennsylvania, the withdrawal time is 72 hours out; in Florida, it is five days out; in New York, regulators recently passed a rule banning clenbuterol use within 14 days of a race. Under the recommended rules, states would be asked to ban clenbuterol at 14 days, a limit that is being advocated to prevent horsemen from administering the drug on a regular schedule to build muscle.

Rules on the administration of acepromazine, a sedative, also vary widely. The drug, which is currently on the RCI’s special treatment list, can be administered up to 24 hours of a race in Pennsylvania; up to four days of a race in New York; and up to seven days of a race in Delaware.

The RCI list of the 17 permitted medications includes recommended withdrawal times, which advise horsemen on when it is safe to administer a drug without generating a positive postrace test. Those withdrawal times are, for the most part, based on scientific research funded or reviewed by a medication policy and research group, the Racing Medication and Testing Consortium. The threshold levels are in most cases based on a recommended dosage, and in some cases, such as the painkiller phenylbutazone, the level has been set at a highly specific dose to provide additional protection to vets and trainers medicating horses.

“Absolutely one of the things we always hear over and over again is that the vets don’t mind what the rules are as long as the results are fair and consistent,” said Dr. Dionne Benson, the executive director of the consortium.

Dr. Rick Arthur, the Equine Medical Director for the California Horse Racing Board, said the adoption of rules setting specific withdrawal times across state lines would benefit trainers tremendously.

“It’s finally going to give them the bright line they say they need,” Arthur said.

Horsemen’s organizations, however, say the medication consortium and supporters of the new rules are in some cases overselling the results of the scientific research. Dr. Tom Tobin, a toxicology specialist at the University of Kentucky Maxwell E. Gluck Equine Center and an adviser to the National Horsemen’s Benevolent and Protective Association, said some of the new threshold levels have been established in papers that have yet to be peer-reviewed. He also said horsemen were in danger of being penalized even when following the withdrawal guidelines because some studies were too small to account for the wide variance in metabolic rates in individual horses, which could lead some horses to test positive only because their metabolisms did not clear drugs as fast as the study horses did.

“Horse-to-horse variability inevitably creates the probability that there will be a certain amount of overages,” Tobin said. “They have not yet addressed that in a reasonable way.”

Phil Hanrahan, the chief executive of the National Horsemen’s Benevolent and Protective Association, an umbrella group for horsemen’s organizations in more than two dozen states, called the RCI recommendations “a step in the right direction,” but he was critical of the RCI’s and medication consortium’s reluctance to release the results of some studies and explain the rationale for some withdrawal times.

“For what we’re trying to accomplish, secret science shouldn’t be the standard,” Hanrahan said. “If it means some delay in passing a regulation until that study has gone through the normal review process, so be it. It would be premature to base a standard on that.”

The effort to establish a list of approved medications and couple them with recommended withdrawal times is similar to an ongoing effort by the International Federation of Horseracing Authorities, a group that proposes model rules for racing countries around the world. The authority’s list, which is regularly updated and has been widely adopted in jurisdictions outside North America, recommends that member countries adopt withdrawal times for 22 specific drugs, including a withdrawal time that prohibits trainers from administering the anti-bleeding medication furosemide within about 48 hours of a race. Much to the chagrin of officials at the Jockey Club and many North American breeder organizations, furosemide is legal to use on race day in the United States, though it is subject in most states to strict restrictions regarding dosage and time of administration.

It’s a popular misconception that, unlike in the United States, foreign racing jurisdictions do not permit medications to appear in post-race samples and are therefore “zero tolerance” when it comes to medication.  Though the International Federation of Horseracing Authorities list and the RCI list share many of the same drugs, there are important differences. The international authority’s rules are more tolerant toward a wider variety of nonsteroidal anti-inflammatory medications (painkillers) than the RCI rules but less tolerant toward a range of corticosteroids, the anti-inflammatory drugs that are frequently used in the U.S.

Not insignificantly, given the concern in the U.S. over breakdowns of horses, which occur far more frequently over dirt surfaces than turf surfaces that dominate foreign racing, supporters of the RCI effort are targeting corticosteroid use for much stricter regulation. The fear is that frequent injections of a corticosteroid such as methylprednisolone acetate may have a degradative effect on joint tissue, a possibility that is supported by numerous scientific studies. Betamethasone, one of the commonly administered corticosteroids in U.S. racing, is currently allowed to be used up to 24 to 48 hours before a race in most major U.S. racing jurisdictions; the RCI wants that limit extended to seven days.

While state regulators have consistently applauded the medication consortium and the RCI for their work on medication rules, there remains the possibility that states will adopt some of the recommendations while ignoring others. In some states, regulators have adopted different withdrawal times and threshold levels for some of the listed drugs after hard-fought struggles to gain a consensus between regulators and horsemen.

Dr. Arthur, of the California racing board, cautioned that California, like many other major racing states, will have to address each recommendation individually.

“You just can’t adopt these regulations en masse,” Arthur said. “They have to be fit into the administrative structures of each individual state.”

That, however, is not the tactic being recommended by the RCI, which is asking its member states to adopt the withdrawal guidelines by reference, which would allow regulators to conduct one vote on the entire document.

In Kentucky, regulators anticipated that they would be making frequent changes to withdrawal times and threshold levels several years ago and amended the state’s racing laws to include all of the limits within one statute, according to Dr. Mary Scollay, the equine medical director of the Kentucky Horse Racing Commission. Still, Scollay said the commission will need to discuss each of the new recommendations individually, and she said she expected some pushback on several of the new withdrawal times.

The goal of putting all of the limits in one statute “was to make the regulation more nimble,” Scollay said. “If it was the will of the commission to adopt all of them, we could do that pretty easily since we only have to deal with that one regulation.” Scollay said the Kentucky commission has often adopted recommendations approved by the Racing Medication and Testing Consortium, and she said that the commission “has clearly turned toward the RMTC when it acts.”

Gagliano, of the Jockey Club, also pointed to the consortium’s support of the rules as reason enough to get behind them. The consortium board includes representatives from a broad range of racing organizations, including the two major national horsemen’s organizations.

“To us, this clearly demonstrates the growing commitment of a broad base of stakeholders in support of the best safety and health standards for the horse and rider,” Gagliano said.

Martin, the RCI president, said that the time for debate has ended and that the RCI will be pressing its member states to adopt the new medication rules no matter what individual horsemen’s groups might say. Then the RCI expects to distribute recommendations for the uniform penalty code, which the RCI wants adopted by the end of the year as well.

“Some of these issues have been discussed long enough,” Martin said. “It’s time to act.”

Corrections: An earlier version of this article misstated the policy for race-day medication in foreign jurisdictions and misstated the policy for clenbuterol in Pennsylvania. Most foreign jurisdictions permit some level of medications in post-race samples, but they do not permit medication to be administered on race day. Pennsylvania has a 72-hour withdrawal time for clenbuterol, not an unregulated policy on administration.


RECOMMENDED DRUGS LIST

The ARCI has compiled a list of 24 medications to be regulated by threshold levels. The 17 therapeutic drugs below have been reviewed by the Racing Medication and Testing Consortium; withdrawal times for the five special interest drugs have not yet been established.

Therapeutic

Medication Category Recommended withdrawal time

Betamethasone

cortico anti-inflammatory

7 days

Clenbuterol

bronchial dilator

14 days

Dantrolene

muscle relaxant

48 hours

Dexamethasone

cortico anti-inflammatory

72 hours

Diclofenac

painkiller

48 hours

DMSO*

topical anti-inflammatory

48 hours

Firocoxib

painkiller

14 days

Flunixin

painkiller

24 hours

Furosemide

diuretic (anti-bleeding)

4 hours

Glycopyrrolate

stomach acid treatment

48 hours

Ketoprofen

painkiller

24 hours

Methocarbomal

muscle relaxant

48 hours

Methylprednisolone

cortico anti-inflammatory

7 days

Omeprazole

ulcer treatment

24 hours

Phenylbutazone**

painkiller

24 hours

Prednisolone

cortico anti-inflammatory

Pending

Triamcinolone acetonide

cortico anti-inflammatory

7 days

*DMSO can be administered in several ways, including as a paste, as an injectible, or orally. The withdrawal time applies to use as a paste; other administrations prohibited 
**The dose of phenylbutazone that can be used at 24 hours is strictly regulated


Special interest

Medication Category

Acepromazine

sedative / tranquilizer

Butorphanol

opioid painkiller

Detomidine

sedative

Lidocaine

anesthetic

Mepivacine

anesthetic/painkiller

Procaine Penicillin

antibiotic/local anesthetic

Xylazine

sedative

 

Nathan More than 1 year ago
can't stop lughing. every state has officials appointed by gov't. no way, ever, they will give up their powers and/or agree on anything. even if they did, the chemists will find new synthetics that are better than the current ones and will never be detecte.
Bellwether4U More than 1 year ago
We have heard all that BS for many moons...when the powers that be & lets hope its not the FED step in & start passing out JAIL/PRISON/LIFETIME BANS (its right around the corner) a TON of this BS will STOP!!!...PERIOD...ty...
Ann Maree More than 1 year ago
"Many veterinarians and horsemen, who feel they have been unfairly characterized during the debate over medication usage, continue to resist some changes in policies..." In the harshest of terms, they need to get over it! They say the definition of insanity is doing the same thing over and over again. There is little patience among the public to continue the "status quo." All in the industry need to view this as an opportunity to boost confidence in the sport, albeit that confidence won't be truly won over until they get rid of the raceday meds, including lasix. Every time those opposed to getting rid of lasix get together, they say it's "for the horses". Unless and until they can answer the question of why does the rest of the world get along without it, they just don't have a leg to stand on. The emperor has no clothes!
Horse Cents More than 1 year ago
This is a step in the right direction, but honestly it still feels like a much needed baby step and is little more than cosmetic to make the new generation of horse player feel all warm and fuzzy about the sport of horse racing. There is huge problem not being addressed here. Testing and the funding to do proper testing, and uniform testing. The main focus is on therapeutic meds and some known pain killers, etc. But no mention of the new breed of performance enhancing drugs. EPO and other blood doping agents more suited to the thoroughbred and other type drugs needs to be addressed and uniform testing needs to be in place. Clearly we don't want powerful pain killers to allow a lame horse to get around the track and possibly break down. Clearly we need to control and have uniformity in thresholds to keep the playing field manageable to all trainers no matter what track they compete on. Clearly all trainers need to know what is allowed and what is illegal and no excuses. But it's still only slightly different than what we have now. It's a good thing to have all the medication rules in place for all at all tracks. But this means little if testing is not improved, far more comprehensive, and inclusive of performance enhancers. For me, a slight overage of bute which would amount to a person taking four aspirins rather than two, does not come close to the potential damage to horse and racing fan when a powerful pain killer or blood doping agent is used. A bronchial dilator will help a horse breath better and run better but not over his best ability, and a painkiller will allow a horse to run through his pain but not better than his best ability, but a blood doping agent will allow a horse to carry his speed far beyond his normal and natural ability. Just ask Lance Armstrong. It's nice to have all these uniform medication rules in place, and just say everything else is illegal. Is it really if we don't take the time to stay on the forefront of emerging performance enhancers? It doesn't matter if it's illegal if we don't test for it and make sure the funds are available for all tracks to do so.
chad mc rory More than 1 year ago
Uniformity has got to be established... Look at the huge swing in regs for clenbuterol, from no reg at all to 5 days out in other states.
Horse Cents More than 1 year ago
As I said, I agree with that, and believe their points on clenbuterol are solid.
Ray Sousa More than 1 year ago
The drug and cheating issues in us horse racing have to be addressed at every level.from uniform rules to how the samples are collected and by whom and how secure are the university labs that receive the samples and do the testing.then the punishment for cheating has to be very punitive with huge fines and expulsion .the fact is right now the stewards have very little power or expertise to investigate betting rings and the authority's show no interest in going after race fixing.so while nobody's minding the store the thieves have a ball.as we've seen in Australia even top jockeys and trainers can collude with mobsters to fix races if investigating is left to the racing officials.it took a murder and police involvement to bring down a massive betting and race fixing ring that involved some of Australia's top jocks.i suspect it's a lot worse here since there is no oversight and the proof is in the results.
Milan Milosevic More than 1 year ago
hopefully this become reality
BigAfan More than 1 year ago
This is something that should have happened a long time ago.
Timothy Bullock More than 1 year ago
Where were these drugs when horse racing was being conducted in the 19th century and the early part of the 20th century? I'm sure horses were OK back then. Turning back the hands of time shouldn't cause an uproar.
kingsailor2 More than 1 year ago
Great article I wish that the Jockey Club would butt out - they have no expertise in this area and are simply trying to gain power at the expense of the people who really understand the racing aspect of racehorses. They commissioned that stupid Wall Street advertising firm survey whose results had nothing to do with thoroughbred racing. Just stick to the trademark searches for names, please.
chad mc rory More than 1 year ago
King, it looks like all of the sanctioning bodies must get together on this to make it happen and it's gotta.
kingsailor2 More than 1 year ago
Yes, agree with you on that one, Mr. C McR.
Ann Maree More than 1 year ago
Yep, we should leave it all up to "those who really understand the racing aspect of racehorses." That's how we got into the mess the sport is in. It has degenerated from no lasix to every horse needs it. We have fallen from an average of 11 starts per year to less than 6. Lifetime starts barely reach 11 or 12. Last year's crop of top three year olds was totally decimated by the end of the year. Yes, just let the same group that has run the sport into the ground keep doing what they have been doing. Sounds like a plan.
chad mc rory More than 1 year ago
OK Ann Maree, then YOU do it...
raymond More than 1 year ago
None of these medications should be used while a thoroughbred is in training on the premises of any racing venue. If used at all they should only be used while a thoroughbred is away from the track and in personal care at a farm. Before a thoroughbred is allowed on the grounds to return to trainiing it must go through a series of test for any medications and if found to be posoitive for any shall not be allowed to continue training and removed from the grounds immediately.