As executive director of the Racing Medication & Testing Consortium (RMTC) and a practicing veterinarian, I can provide significant insight into an issue that was addressed in the recent editorial by Kevin Blake entitled, “The Real Problem with Drugs in Horse Racing”.
The article points out the dangers of overuse of therapeutic medication–particularly corticosteroids. While the RMTC agrees that every jurisdiction–domestic and international–should be concerned about the potential overuse of therapeutic medication, it is important to note that the National Uniform Medication Program (Program) developed by the RMTC addresses this issue.
The Program focuses primarily on thresholds–not withdrawal times. By comparison, stand down times, a version of withdrawal times, are widely used in England and to a lesser extent in Europe as the editorial suggests. The vast majority of jurisdictions in the United States that have enacted the corticosteroid thresholds (now 20 states representing 94% of U.S. handle) use the withdrawal guidelines as instructive information for the trainer and veterinarian. The RMTC uses thresholds precisely because the use of withdrawal times can be less restrictive than thresholds.
Each of the Program corticosteroid thresholds is based upon the injection of a single corticosteroid into a single joint–often with the lowest label dose of that specific corticosteroid. This allows for control of a minimal amount of corticosteroid that can be introduced into a horse in proximity to a race. The withdrawal guidance relates to the amount of time it takes for the corticosteroid to clear the horse's system and estimates the time needed for a trainer to be safely under the threshold. For corticosteroids in the United States, these withdrawal guidelines range from 7-21 days.
If a veterinarian determines that more than one joint should be injected, they must then increase the withdrawal time accordingly to remain under the threshold. The decision regarding the length of the adjustment is left largely to the veterinarian's professional judgment. But to be clear, the threshold set forth in the Program does not move simply to accommodate different doses or the number of injection sites.
By comparison, the use of a stand downtime as is the case cited in the editorial will hypothetically allow numerous joints to be injected at 14 days and still satisfy the regulatory authorities' requirements. When enacting corticosteroid thresholds, the RMTC was specifically concerned with “six-packs” and twelve-packs”–the name given to the practice of injecting 6 or 12 joints at one time in response to an upcoming race. The use of a stand down time does not prohibit this practice and thus, the actual concentration of a corticosteroid in a horse at the end of the stand down interval could well exceed that which is allowed in the United States.
In reality, what we have seen as a result of the corticosteroid thresholds in the U.S. is more judicious usage of these medications. Because veterinarians are limited in the total amount of a corticosteroid they can use in proximity to racing, a shotgun approach to corticosteroid articular injections is no longer an option.
To claim, as the editorial does, that a difficult-to-enforce blanket stand-down time is the better option, oversimplifies the analysis. That is why the RMTC worked with industry-leading analytic chemists, veterinary pharmacologists, regulatory veterinarians and practicing veterinarians to develop these regulations–because they have the experience and information to best regulate these medications for the health and welfare of the horse.
Dr. Dionne Benson
Executive Director
Racing Medication & Testing Consortium
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