Louisiana to Reduce Controlled Medication Restrictions

At a time when Thoroughbred racing under the Horseracing Integrity and Safety Authority has added restrictions on the use of many controlled therapeutics in an effort to improve the sport's equine safety and integrity, the Louisiana Racing Commission will move in the opposite direction beginning June 8 and allow more liberal use of such substances. Oddly enough, the LRC also says it is making these changes to improve safety. Louisiana is one of the racing states currently not under HISA's oversight and the state regulator has approved emergency rule changes that will allow horsemen to increase their use of controlled medication in the racing environment. While many of its controlled medication rules already are more liberal than those in place in HISA jurisdictions, the state will soon further reduce those restrictions on medications. Louisiana Racing Commission executive director Steve Landry said the rule changes were needed. "The overall belief was that the pendulum has swung too far," Landry said, noting the changes were based on talks with veterinarians. "It was getting to the point that trainers and veterinarians were so restricted that they couldn't properly train and treat their horses. We thought it had gotten to the point that it was a safety issue for the horses and the humans that were with them—the way the medication restrictions got so tight." These changes will include allowing more liberal use of corticosteroids and clenbuterol. HISA, and prominent racing states such as Kentucky in the years before HISA, have pushed back withdrawal times on corticosteroids in an effort to ensure that pre-race veterinary exams are being conducted with the horses clear of these substances. Clenbuterol, allowed as a controlled medication as a bronchodilator, has long been a substance of concern because of its anabolic potential if abused. Landry said that after talking with the three regulatory vets that are commission members, as well as Steven Barker, who in 2015 retired after 29 years as the director of the Equine Medication Surveillance Laboratory and state chemist to the commission, he's confident that veterinarians will be able to get an honest evaluation of horses in pre-race exams. Landry said that based on those conversations he believes new restrictions on medications could be putting horses in danger, suggesting that if they feel pain in an ankle they may put more stress on a different joint, which could lead to further injury. "We are taking minor things that might not bother a horse normally if we correctly treated them and they are causing major issues because there isn't a proper use of therapeutic medication," Landry said. HISA and industry leaders have pointed to record years in terms of equine safety overall in 2022 and at HISA tracks in 2023 as evidence that the more-restrictive approach to corticosteroids, clenbuterol, and other controlled medications is working. In 2023 HISA tracks saw a 32.5% lower breakdown rate than non-HISA tracks. HISA CEO Lisa Lazarus said the rule changes in Louisiana are very disappointing. "The industry has been moving in such a positive direction on horse welfare," Lazarus said. "This is a major step backward. It has the potential to put the whole industry in a bad light." Lazarus said going forward to be fair to horsemen competing at HISA tracks throughout the year, it will have to consider how to handle horsemen who move from a Louisiana track to a HISA-regulated track. HISA may force such horses to spend time on the vets' list or require testing that confirms all medications of concern are out of the horses' systems. "It will put an additional obligation on those trainers," Lazarus said. The Louisiana Horsemen's Benevolent and Protective Association posted a notice about the changes to its members saying that, "The rules amend the existing Controlled Therapeutic Medication Schedule for Horses—Version 4.1 as published by the Association of Racing Commissioners International. Unless specifically amended by the listed emergency rule, all other existing rules in Version 4.1 are continued to be in effect." LHBPA board president Benard Chatters acknowledged a lack of consensus on the changes by members of his organization—some favored the changes and some opposed—but said he personally is in favor of the updates because they provide more treatment options for track vets. "These changes are in line with the scientific research and what our veterinarians are seeing on the track," Chatters said. "I think you let the vets do what's best for horses and you let the trainers train." Previously Louisiana's controlled medication rule was that of Version 4.1 of the Controlled Therapeutic Medication Schedule for Horses of the Association of Racing Commissioners International but this year the state has opted to move away from that guidance for some controlled medications. Those are the changes scheduled to begin June 8. As litigation over the constitutionality of HISA continues, Louisiana is one of the jurisdictions that continues to regulate controlled medications at the state level. Gov. Jeff Landry, who took office this year, helped lead the legal charge against HISA while in his previous role as the state's attorney general. Among the governor's newly appointed members of the commission this year are a pair of racetrack veterinarians. A recently changed rule has allowed track vets to serve on the commission. In comparing the previous ARCI rule in place in Louisiana (Ver. 4.1, from January 2019) with the new emergency rule that goes in place June 8, many of the changes are significant. While HISA currently has in place a 14-day withdrawal time for corticosteroids—which is longer than the withdrawal times currently in place in Louisiana for any of the corticosteroids—the state will soon further move those withdrawal times even closer to the race. Those substances under the corticosteroid banner are dexamethasone, triamcinolone, methylprednisolone acetate, and betamethasone. Under the same dosing recommendation, Louisiana will relax the withdrawal time for dexamethasone from the current 72 hours to 48 hours and the threshold has been increased from 5 picograms per milliliter to 15 picograms per milliliter. (Increasing the thresholds could result in what effectively would be a withdrawal time even closer to the race.) The changes for triamcinolone are more dramatic as the withdrawal time has been reduced from seven days to (apparently) 72 hours (more on that below). Despite the reduced withdrawal time, the dosing specification has increased from 9 milligrams to 10 milligrams when administered intravenously. The threshold remains at 100 picograms per milliliter. The rules also will allow for an intra-articular 20-milligram dosage of triamcinolone with the withdrawal time is increased to seven days. (The new withdrawal time for triamcinolone is not clear as the LRC's controlled medication schedule lists 48 hours while the actual rule change under Chapter 17 says that it's 72 hours.) For methylprednisolone the state's current ARCI guidance calls for a 21-day withdrawal time for a 100-milligram dose. The new rule will allow for twice the dose size while reducing the withdrawal time to seven days. The current threshold of 100 picograms will be increased to 2,000 picograms (2.0 nanograms per milliliter). There also will be more latitude for the use of betamethasone as the dosage specification allows for an administration more than six times the current rule, going from 9 milligrams to 60 milligrams while the seven-day withdrawal time stays the same. The 10-picogram threshold remains in place. The corticosteroids are not the only controlled medications that will see changes beginning June 8. The state also will be moving away from ARCI guidance on clenbuterol, a bronchodilator of concern because when abused it can have an anabolic (muscle-building) effect. The current rule calls for a 14-day withdrawal time in Thoroughbreds (oral dosage), but under the June 8 changes this will be reduced to 72 hours. The LRC rule will allow for clenbuterol (brand name Ventipulmin) to be administered up to 725 micrograms with a withdrawal time of 72 hours. Oddly, the guidance for the June 8 changes are listed for an intravenous dosage, as opposed to an oral dosage. Based on that guidance, the intravenous withdrawal time also is 72 hours. (Executive director Landry said the guidance will be updated to include the oral dose.) Chatters noted that because of the humidity in Louisiana, he believes horses have more frequent congestion than in other parts of the country and a more lenient rule was needed. Landry expressed confidence that trainers would use clenbuterol as a bronchodilator. "It does allow trainers to train their horses better," said Landry, who added that the Louisiana veterinarians were confident that the clenbuterol would be out of Thoroughbreds' systems with the 72-hour withdrawal time. For comparison, HISA rules require clenbuterol to be prescribed by a vet for a maximum of 30 days in any six-month period. After the administration concludes, the horse is placed on the vets' list and can't compete until urine and blood samples have been collected that show the clenbuterol has completely cleared. Furthermore, if clenbuterol is detected in a post-race test after no treatment history is provided, the violation is then viewed as an anti-doping violation. Clenbuterol has been central in some of the biggest scandals in racing in recent years. It was being abused so widely in Quarter Horse racing that it was completely banned from that sport—a ban that remains in place in Louisiana. On the Thoroughbred side, a study by New York State Gaming Commission equine medical director Scott Palmer of 100 horses previously trained by trainers Jorge Navarro and Jason Servis, who would both be convicted and sentenced to prison on federal charges related to doping horses, showed that 77% showed the presence of clenbuterol. In Louisiana under the new rules, non-steroidal anti-inflammatory medications (phenylbutazone, Banamine [flunixin], and Ketofen [ketoprofen]) in Louisiana will carry a 24-hour withdrawal time for the administration of one NSAID or, if given in combination, there will be a 48-hour withdrawal time for the first and 24-hour withdrawal time for the second. This is largely in line with the state's current rules although current guidance for flunixin is 32 hours. The dosing specifications will largely stay the same. The biggest change for the NSAIDs will be the more forgiving threshold levels allowed in the horse (the amount permitted before a failed drug test is called). For the primary administration, Flunixin goes from 20 nanograms per milliliter of plasma or serum to 50 nanograms per milliliter, ketoprofen increases from 2 nanograms per milliliter to 3 nanograms per milliliter while phenylbutazone stays the same at 2 micrograms per milliliter of plasma or serum. Beginning June 8 Louisiana also will put in place rules and guidance different from the ARCI on dimethyl sulfoxide, methocarbamol, dantrolene, acepromazine, xylazine, detomidine, butorphanol, omeprazole, calcium gluconate, and acetylcysteine.