Horse Racing’s Quest For Safety Fuels Push For National Medication And Drug Standards

This is the second in a series of posts, corresponding with horse racing’s Triple Crown, examining safety issues facing the sport. Part one appears here.

When nine horses leave the gates at Pimlico in the second leg of horse racing’s Triple Crown Saturday afternoon, they will mark the end of a sporting era. For the last time, the Preakness Stakes will be run under medical and drug testing rules that are set solely by the state of Maryland, thanks to an agreement among eight mid-Atlantic and northeastern states that will set uniform medication and drug testing standards beginning in 2014.

The compact, agreed to by New York, New Jersey, Pennsylvania, Delaware, Maryland, Virginia, West Virginia and Massachusetts, is the result of push to bring some uniformity to horse racing’s medication and drug rules that has lasted for nearly a decade, years in which the sport has faced questions about both performance-enhancing drugs and therapeutic medications used to treat horses both in the days leading up to races and on race days themselves.

Horse racing banned the use of anabolic steroids in 2008, when Kentucky Derby winner Big Brown tested positive for Winstrol, a performance enhancing drug, and runner-up Eight Belles collapsed shortly after the finish line and was euthanized on the track. But other drugs, mostly therapeutic in nature and used to treat routine injuries, are still wildly prevalent, raising questions in an American industry that is dealing with higher rates of catastrophic breakdowns and fatalities among its horses than its foreign counterparts — and a general lack of data and research into how to improve it.

“Racing fatality rates in the U.S. are two- to three-times higher than other major racing countries that don’t allow phenylbutazone and other drugs,” Dr. Rick M. Arthur, the equine medical director at the University of California-Davis and the California Horse Racing Board, said at The Jockey Club’s annual meeting last year. “My international colleagues have no doubt our medication policies, especially in phenylbutazone, are the cause of this disparity. I’m not convinced it is that simple, but there is no question medication regulation is the most glaring difference between U.S. and other major racing countries.”

The eight-state compact is not the first major step toward addressing and improving the medication of horses in the United States — in a business regulated on a state-by-state basis, states have made their own adjustments to which drugs can be used and when they can be administered. But the compact is the biggest step in streamlining the process and standardizing medical practices and drug testing across state lines. With the help of scientists and experts across the industry, the eight states identified 24 drugs that are “appropriate for therapeutic use in racehorses to treat illness or injury” and set standards for when they can be administered and how much of the drugs can be present in a horse’s body on race day. It also identified other drugs that cannot be present in a horse on race day under any circumstances.

“It makes infinite sense,” Alan Foreman, the chairman of the Thoroughbread Horseman’s Association, said of the compact he helped develop, noting that the eight states to which it applies make up 60 percent of the national horse racing industry and are home to 18 racetracks within a 200 mile radius. The goal is to create uniformity in the regulation and testing of nonsteroidal anti-inflammatory drugs (NSAIDs), which are common therapeutic medications, and corticosteroids, another form of anti-inflammatory often used to treat joint degradation and musculoskeletal pain. That will make it easier for horse owners and trainers to comply with rules as they cross state lines, and, according to Foreman, it will give American horse racing the “strictest drug testing system of any sport in the world.”

It could also make the sport safer for its primary participants — the horses.

“There’s never been a study that can link medication, especially therapeutic medication, to breakdowns,” Dr. Dionne Benton, the executive director of the Racing Medication Testing Consortium, which was instrumental in the development of the eight-state compact, said. “That’s not to say there isn’t a connection, but it’s never been shown. The goal of this program is to reduce the number of medications used in horses when they’re close to being raced.”

Where therapeutic drugs fit into horse safety, though, is in the evaluations of horses before they race. NSAIDs and corticosteroids are still important to treatment and maintenance of horses when used similarly to how human athletes utilize anti-inflammatories and pain medications. But when they are used too close to race day, and when horses have an excessive amount of the drugs in their system on race day, they can prevent veterinarians from fully evaluating the soundness of a horse that is about to take the track.

“Our goal is to allow the vet to treat the horse, then come back and see how the horse responds before sending it out to race,” Benton said. “We want the vet that’s evaluating the horses to have the best picture of the horses possible. We want to give them the tools to do the best job they possibly can.”

Such drugs can’t mask an injury like a fracture, she added. “But you can make a horse that’s a little sore look better. If the vet doesn’t see that, they can’t make an evaluation of how serious it is.” By decreasing the levels of drugs like phenylbutazone, a popular NSAID, in a horse’s body near race day, Benton said, “we’ve been able to improve the view the vet gets.”

The task force convened by New York Gov. Andrew Cuomo (D) after the state’s Aqueduct Park suffered an alarming increase of race-related fatalities came to a similar conclusion, saying that “the use of these medications too close to the race may have limited the ability of the (New York Racing Association) veterinarians to identify the presence of pre-existing conditions disposed to progressing to catastrophic injury.” The task force recommended better regulations of corticosteroids and other therapeutic drugs by reducing the amount allowed present in a horse on race day, which in practice increases the number of days before a race that such drugs can be administered. When Aqueduct’s 2013 spring meet ended in April, the number of catastrophic breakdowns was down more than 60 percent, Foreman, who participated on the task force, said.

“There were other reforms implemented – it wasn’t just the corticosteroids,” Foreman said. “But clearly those recommendations helped to cut down on the breakdowns. No question about it.”

Still, the eight-state compact will apply to less than a quarter of the 38 states in which horse racing takes place, leaving some of horse racing’s biggest epicenters uncovered by the new drug standards. The RMTC, though, has been pushing other states to join the compact, and Foreman is confident that some will before the standards first begin going into effect in January.

“We are now taking it beyond the region, and I am very confident that Kentucky, California, Illinois, Texas – I think the major racing states are going to embrace this program in the coming months so that they are in line with us in implementing it on January 1,” he said. “I am very confident you are going to see this program grow across the country and become the mechanism for a uniform medication program in the United States.”

A national uniform standard has been a goal for regulators and horsemen alike. The hard part is coming up with standards on which they all agree.

“Everyone wants national standards, but the hard part is deciding what those standards are,” Benton said. “In many ways they’re very similar, but in other cases, there are some significant differences. Everybody thinks their way, what they’re used to, is right. It’s going to take some compromises, and it’s not an easy process.”

Developing those standards, as the RMTC and other regulatory bodies continue to do, could provide a innumerable benefits to the sport. The standards will lead, Foreman said, not only to national medical and testing standards, but also to national cooperation on failed tests by horses owned or trained by the same horsemen in different states. And they could, in the end, result in a giant step forward for an business still trying to figure out how to best take care of its horses.