By: Jennie Rees
I recently posted online at courier-journal.com an editorial written by Marty Maline, the executive director of the Kentucky division of the Horsemen’s Benevolent and Protective Association. The editorial, titled “Guilty Until Proven Innocent,” dealt with issues facing trainers today in this era of increasingly sophisticated post-race drug testing for horses, the problem arising from environmental contamination and how a couple of recent court decisions could be giving horsemen more defenses against the overarching “trainer responsibility” mandate.
Dr. Dionne Benson, executive director of the Racing Medication & Testing Consortium (RMTC) and practicing veterinarian, was offered the opportunity to respond to some of the issues raised, specifically the research behind the medications for which the RMTC has established threshold levels in pursuit of attaining uniform medication across the country in the sport. Her own editorial appears below. – Jennie Rees
Editor: As Executive Director of the Racing Medication & Testing Consortium (RMTC) and a practicing veterinarian, I can provide significant insight into an issue that was not correctly addressed in the recent “HBPA editorial: Guilty Until Proven Innocent” by Martin Maline that was published by the Courier-Journal on September 25, 2015.
The article focused on a number of complex drug testing issues that deserve further explanation from a scientific point of view. This response focuses specifically on Mr. Maline’s assertion, near the end of his editorial, that 19 of the 26 medications on the RMTC’s Controlled Therapeutic Substances list (CTS) “have no research to support the findings.” He then speculated that unexplained actions by a Deputy Attorney General of Delaware in a high-profile betamethasone enforcement action are further evidence that the RMTC’s uniform medication regulations lack “peer-reviewed research.” These statements are so categorically false and misleading that they cannot be ignored or allowed to go unchallenged.
The CTS is one of the four elements of the National Uniform Medication Program (NUMP). The other elements are Third-Party Lasix Administration, Laboratory Accreditation, and the Multiple Medication Violation Penalty system. The horseracing industry developed the NUMP over the past several years at the urging of and with broad input from all segments of the industry, including horsemen. Currently, many industry organizations, racing commissions and individuals in the industry are working in a concerted fashion to implement the NUMP in every horseracing jurisdiction in the U.S. The ARCI just announced a new Compliance Committee to encourage their members to adopt the NUMP.
The CTS is the product of considerable investment by the horse racing industry. Development of the CTS has been a significant focus of the RMTC since its formation in 2001. The RMTC not only oversees medication administration studies but also contracts for the analytic chemistry work required to detect and quantify the effects of medication on racehorses. Based upon this research, the industry can assert with confidence that the CTS sets forth thresholds to protect the health and welfare of racehorses while allowing for reasonable treatment options for veterinarians and trainers. Such reliable research and analysis are fundamental to the integrity of horseracing. This is not just a US effort, but parallels similar international efforts in Europe and Australia. Some research has been collaborative to avoid duplication.
Contrary to Mr. Maline’s contention, peer-reviewed papers exist for a majority of these studies. In some cases, there are even multiple publications by multiple research facilities. Where the research has not yet been published, there is still a significant peer-review process for every substance on the CTS that is conducted by the RMTC’s Scientific Advisory Committee (SAC).
The SAC has varied over its existence from 12-17 members consisting of the horse racing industry’s leading analytic chemists, pharmacologists, regulatory and racetrack veterinarians. Taken as a whole, the members of the SAC have hundreds of years of experience in the regulation of illegal drugs and therapeutic medications in horseracing. Many, if not most, have extensive experience in the scientific review process as authors and reviewers. It is the SAC’s job to review all research and the resultant data that we utilize to recommend inclusion on the CTS list. Before adopting a specific threshold, the SAC scrutinizes and approves the study design, the analytic chemistry, and the resultant data. For comparison, a typical peer-reviewed scientific publication may have only 1-3 reviewers. To date at least 22 peer-reviewed scientific papers have resulted directly or indirectly from the RMTC’s efforts – most of them related to substances on the CTS.
To suggest that the CTS has no research to support its findings, as the Mr. Maline has done, or to attack the CTS because a small number of research projects are still awaiting publication, is to completely misunderstand the process by which it was created. As stated above, a quick visit the RMTC website reveals a complete listing of all published research that has been available for several months. In addition, the RMTC staff routinely provides this information to any regulator, veterinarian or horseman who inquires.
Seventeen (17) jurisdictions in the United States have already adopted the CTS, including Kentucky. In many of these states, the CTS replaced piecemeal regulations based primarily upon the constantly changing capabilities of the state’s drug test laboratory instead of the rigorous scientific research behind the CTS. It is ironic that Mr. Maline objects to the national standards implemented via the CTS because absent these testing standards, positive findings for many of the substances included on the CTS can be prosecuted at lower concentrations even though the horse’s performance is not affected. That is because many such substances are detectable at concentrations far below the thresholds established by the CTS.
Moreover, the RMTC is working diligently to establish research based regulatory limits for other medications and even for some of the substances mentioned elsewhere in Mr. Maline’s editorial that are prevalent in the environment and might lead to false positive drug tests. We welcome the involvement of the NHBPA in that important ongoing process.
For the first time, the horse racing industry has an opportunity to move forward together – by adopting the National Uniform Medication Program in its entirety. We have made great strides toward that end in the past 2 years. In order to fulfill this goal, however, all the stakeholders must embrace this change.
Dionne Benson, DVM