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Equine drug testing is a form of drug testing applied to performance horses in regulated competition. Most common in racehorses, drug tests are also performed on horses in endurance riding and in international competition such as the Olympics and FEI-sanctioned competition. Many horses in a competition sanctioned by various national organizations, such as the United States Equestrian Federation in the USA are also tested for improper drug use. An organization for cooperation and harmonization regarding horseracing is the International Federation of Horseracing Authorities (IFHA) that have several members in over 50 countries worldwide. [1]
Before the mid-1980s, the use of high potency performance altering substances in racing was less well controlled due to the inadequacy of analytical technology. Around that time, highly sensitive ELISA testing of horse urine was introduced to racing regulators by a group at the University of Kentucky. [2] This proprietary technology essentially solved the problem of the abuse of high potency drugs in racing horses. ELISA tests are now marketed worldwide out of Lexington, Kentucky. [3] Today, further advances in testing technology have augmented and in many instances replaced ELISA tests to detecting doping.
Traces of therapeutic medications and dietary and environmental substances can be detected using current testing technology. This has created controversy over a "zero tolerance" approach to drug testing, and resulted in the establishment of regulatory limits or "thresholds" (the urine or blood concentration of a substance below which there is no pharmacological activity, i.e., there is no effect, a so-called "No Effect Threshold" or NET).
Recent challenges in drug testing include the development of effective regulatory methods for the newer hormonal products such as the various human recombinant erythropoietin products and variants and growth hormones. A high-quality ELISA test for human recombinant erythropoietin is now available, [4] and recently the first Mass Spectral Confirmation method to detect use of human recombinant erythropoietin (rhEPO) in horses or any species was developed. [5]
The early history of horse doping is unclear, although according to Euripides (480-406 BC), some horses were fed human flesh to make them faster and more savage. However, during Roman times, the use of hydromel for chariot race horses was punished by crucifixion. The evolution of horse doping is less well known over the following millennia, but in 1666, the use of "exciting substances and methods" was prohibited at horse races in Worksop, England. In 1533, there were reports of a substance, probably related to arsenic, being used as a stimulant. After 1800 there is an uptick in the records of horses being prevented from competing (then called "stopped"), and in 1812 a stable boy was hung on Newmarket Heath for arsenic doping of a horse. In 1903, UK law prohibited horse doping and by 1912, saliva tests were introduced for horses which tested for alkaloids such as theobromine, caffeine, cocaine, morphine, and strychnine. In most major racing countries, positive results automatically disqualified horses. Doping took off, however, in the US in 1933 when pari-mutuel betting was legalized. Estimates suggest as many as 50% of horses were doped during this time, leading to a higher incidence of injuries caused by insensitivity to pain and lack of proper muscle coordination - the principal drugs of the era were cocaine, heroin, strychnine, and caffeine. In the later half of the 20th century, anti-doping efforts increased and became standardized by the FEI. [6] A crackdown on horse doping in 2020 motivated Congress to pass the first law establishing federal regulation of the sport of horse racing. This law created the Horseracing Integrity and Safety Authority to create and enforce safety and drug regulations. [7] [8]
Horse Racing regulators in the United States divide drugs and medications into the following categories:
Approximately 25 medications are now recognized by the Association of Racing Commissioners International (ARCI) for therapeutic use in race horses. [9] Recent advances in technology resulting in high sensitivity testing continue to enable the detection of ever smaller trace concentrations of medications. [10] This situation has led to the establishment of "thresholds" or "reporting levels," or "decision levels" (California) depending on the semantic preference of individual jurisdictions. These terms apply to the blood concentration of a medication below which it is believed by scientists and racing authorities that the medication has insignificant pharmacological effect. [11] [12] Thresholds (cutoffs) have long been used in human drug testing, [13] however, the concept has been slow to be accepted by horse racing regulators who rely on the mere presence of a substance as a potential rule violation.
Therapeutic medications (or drugs) [14] [15] are properly used to alleviate pain and to allow or promote healing. However, in the sport of horse racing powerful painkilling drugs may be used on a daily basis, often in combination with several other potent drugs, to enable injured horses to train and race before their injuries are fully healed. When this happens, the logical result is that additional injury can occur, rapidly accelerating the need for ever more powerful drugs to keep a horse racing. Official state testing reports do not, however, confirm that such use is widespread in post race samples, although it does occur. Federal laws allowing great latitude for veterinarians to use medications pose a concern for racing regulators who believe improper or over use puts racehorses at greater risk of crippling injuries and death. Jockeys are also exposed to far greater risk, as medicated horses are much more likely to suffer catastrophic breakdowns during a race sending horses and riders tumbling. In a series of articles on drugs and racing [16] The New York Times estimates that approximately 24 horses are killed as a result of injuries incurred during a race each week in America, though the question of how many of these deaths are linked to misuse of medication is undetermined.
For decades, outside scrutiny had been focused on the question of whether horse trainers seek increasing access to pre-race drugs to keep sore horses in training and racing. But in recent years the focus has broadened to include attending veterinarians for racehorses. Experts contend that veterinarians who provide drugs to keep injured horses racing violate veterinary practice laws regarding proper ethics, standards and practices.
The issue of legal and illegal drug use in horse racing is again under review by the U.S. Congress [17] with legislation pending before the House of Representatives and the Senate to create uniform pre-race drug rules and penalties applying in all racing states. The Interstate Horse Racing Improvement Act [18] is endorsed by some of the most prominent names in the thoroughbred racing industry although groups representing other equine breeds, veterinarians, horsemen, and regulators have serious concerns.
Identification of these substances in a horse is viewed with great regulatory concern. Testing for these substances usually proceeds at the highest level of sensitivity possible, so-called "zero-tolerance" testing. About 1100 or so substances are classified by the Association of Racing Commissioners International (ARCI) Uniform Classification System for Foreign Substances as potentially performance-enhancing in a five-class system. The most complete listing of such substances is found online. [19]
Stimulants
Among the equine stimulants are amphetamines, as well as the amphetamine-like drugs such as methylphenidate (Ritalin).
Tranquilizers
Horses can also be medicated to win by relaxing them, and allowing the horse to run its best possible race or show with an appearance. The widely used tranquilizer acepromazine, and any number of related or equivalent agents, have been used in this way. Higher doses of tranquilizers can also decrease a horse's performance.
Bronchodilators
Improving a horse's "wind" by opening its airways through the use of bronchodilators may also improve performance, especially in an animal that is sub-clinically broncho-constricted. Some bronchodilators can also have a stimulant effect.
Behavioral modifiers
Veterinarians certify horses as being sound in "wind and limb". Medications that can affect these parameters and also the "attitude" or "behavior" of a horse have the potential to affect both the presentation of a horse and also, presumably, the outcome of a race.
The Introduction of ELISA testing (1988)
In the mid-1980s, equine drug testing was for all practical purposes dependent on a screening technique called thin layer chromatography (TLC). This technology is not particularly sensitive, and in the mid-1980s some horsemen were reportedly attempting to affect the outcome of horse races by using high potency narcotics, stimulants, bronchodilators, and tranquilizers with impunity. In 1988 ELISA testing was introduced to racing by a group at the University of Kentucky. It soon became the primary technique employed in equine drug testing. ELISA is an acronym for Enzyme Linked Immuno Sorbent Assay. Simply put, an ELISA test is a variant on the home pregnancy test technology. It requires a drop of urine, can be performed relatively rapidly, is highly sensitive, and test results can be read by eye. Initially, the ELISA tests were "one-step" tests meaning that urine was added to the test well followed by the addition of antibody for the test. This was expensive as much more antibody was wasted than reacted on the test. Later, a cheaper "two-step" method was devised. Currently, at least one company in the US primarily deals in "one-step" tests, while the other two in the US deal in "two-step" tests.
Confirmatory Testing
While ELISA screening or testing is fast and fairly sensitive, it is far from specific. The second and absolutely critical step in the drug testing process is confirmation of positive ELISA tests using more sophisticated techniques such gas or liquid chromatography combined with mass spectrometry (GC/MS, LC/MS, or LC/MS/MS). Mass spectrometry is the gold standard drug identification. It is also extremely sensitive. Some drug testing laboratories have moved toward using the more specific mass spectrometric techniques as their primary screening and testing technique.
Zero Tolerance Testing
Zero tolerance testing is not testing down to "zero" molecules, which no chemist can accomplish, but rather testing to the limit of detection (LOD) of the best available technology. In other words, "zero tolerance" refers to the racing regulators' philosophy in regulating drug use in race horses—even trace amounts of drugs are not tolerated. [20] While detecting trace amounts may be an entirely appropriate approach for performance altering substances which have no approved veterinary use, it is not considered appropriate for therapeutic medications which may be present in trace amounts having negligible or no pharmacological activity. Therapeutic medications are approved substances used to maintain the health and welfare of horses.
Thresholds, including “no effect thresholds” (NETs)
The equine blood concentration of a medication below which pharmacologic activity is insignificant.
Withdrawal time
The length of time after the administration of a medication required for the metabolism and elimination of the medication. After this time the medication no longer present or has insufficient concentration to produce a pharmacological effect.
Today, the sensitivity of the testing labs utilized by regulators has become so sensitive that horsemen raise concerns about environmental transfers that may have occurred and can now be detected at the picogram level.
Amphetamine is a central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. Amphetamine was discovered as a chemical in 1887 by Lazăr Edeleanu, and then as a drug in the late 1920s. It exists as two enantiomers: levoamphetamine and dextroamphetamine. Amphetamine properly refers to a specific chemical, the racemic free base, which is equal parts of the two enantiomers in their pure amine forms. The term is frequently used informally to refer to any combination of the enantiomers, or to either of them alone. Historically, it has been used to treat nasal congestion and depression. Amphetamine is also used as an athletic performance enhancer and cognitive enhancer, and recreationally as an aphrodisiac and euphoriant. It is a prescription drug in many countries, and unauthorized possession and distribution of amphetamine are often tightly controlled due to the significant health risks associated with recreational use.
Stimulants are a class of drugs that increase the activity of the brain and the spinal cord. They are used for various purposes, such as enhancing alertness, attention, motivation, cognition, mood, and physical performance. Some of the most common stimulants are caffeine, nicotine, amphetamines, cocaine, and modafinil.
A medication is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and relies on the science of pharmacology for continual advancement and on pharmacy for appropriate management.
Erythropoietin, also known as erythropoetin, haematopoietin, or haemopoietin, is a glycoprotein cytokine secreted mainly by the kidneys in response to cellular hypoxia; it stimulates red blood cell production (erythropoiesis) in the bone marrow. Low levels of EPO are constantly secreted in sufficient quantities to compensate for normal red blood cell turnover. Common causes of cellular hypoxia resulting in elevated levels of EPO include any anemia, and hypoxemia due to chronic lung disease.
The therapeutic index is a quantitative measurement of the relative safety of a drug. It is a comparison of the amount of a therapeutic agent that causes toxicity to the amount that causes the therapeutic effect. The related terms therapeutic window or safety window refer to a range of doses optimized between efficacy and toxicity, achieving the greatest therapeutic benefit without resulting in unacceptable side-effects or toxicity.
In competitive sports, doping is the use of banned athletic performance-enhancing drugs by athletic competitors, as a way of cheating. As stated in the World Anti-Doping Code by WADA, doping is defined as the occurrence of one or more of the anti-doping rule violations set forth in Article 2.1 through Article 2.11 of the Code. The term doping is widely used by organizations that regulate sporting competitions. The use of drugs to enhance performance is considered unethical, and is prohibited by most international sports organizations, including the International Olympic Committee. Furthermore, athletes taking explicit measures to evade detection exacerbate the ethical violation with overt deception and cheating.
Phenylpiracetam, is a phenylated analog of the drug piracetam. It was developed in 1983 as a medication for Soviet Cosmonauts to treat the prolonged stresses of working in space. Phenylpiracetam was created at the Russian Academy of Sciences Institute of Biomedical Problems in an effort led by psychopharmacologist Valentina Ivanovna Akhapkina. In Russia it is now available as a prescription drug. Research on animals has indicated that phenylpiracetam may have anti-amnesic, antidepressant, anticonvulsant, anxiolytic, and memory enhancement effects.
A biopharmaceutical, also known as a biological medical product, or biologic, is any pharmaceutical drug product manufactured in, extracted from, or semisynthesized from biological sources. Different from totally synthesized pharmaceuticals, they include vaccines, whole blood, blood components, allergenics, somatic cells, gene therapies, tissues, recombinant therapeutic protein, and living medicines used in cell therapy. Biologics can be composed of sugars, proteins, nucleic acids, or complex combinations of these substances, or may be living cells or tissues. They are isolated from living sources—human, animal, plant, fungal, or microbial. They can be used in both human and animal medicine.
Clenbuterol is a sympathomimetic amine used by sufferers of breathing disorders as a decongestant and bronchodilator. People with chronic breathing disorders such as asthma use this as a bronchodilator to make breathing easier. It is most commonly available as the hydrochloride salt, clenbuterol hydrochloride.
Recurrent airway obstruction, also known as broken wind, heaves, wind-broke horse, or sometimes by the term usually reserved for humans, chronic obstructive pulmonary disease or disorder (COPD) – it is a respiratory disease or chronic condition of horses involving an allergic bronchitis characterised by wheezing, coughing and laboured breathing.
Performance-enhancing substances, also known as performance-enhancing drugs (PEDs), are substances that are used to improve any form of activity performance in humans. A well-known example of cheating in sports involves doping in sport, where banned physical performance-enhancing drugs are used by athletes and bodybuilders. Athletic performance-enhancing substances are sometimes referred as ergogenic aids. Cognitive performance-enhancing drugs, commonly called nootropics, are sometimes used by students to improve academic performance. Performance-enhancing substances are also used by military personnel to enhance combat performance.
A drug is any chemical substance that when consumed causes a change in an organism's physiology, including its psychology, if applicable. Drugs are typically distinguished from food and other substances that provide nutritional support. Consumption of drugs can be via inhalation, injection, smoking, ingestion, absorption via a patch on the skin, suppository, or dissolution under the tongue.
Lisdexamfetamine, most commonly sold under the brand name Vyvanse and Elvanse among others, is a stimulant medication that is used to treat attention deficit hyperactivity disorder (ADHD) in children and adults and for moderate-to-severe binge eating disorder in adults. Lisdexamfetamine is taken by mouth. Its effects generally begin within two hours and last for up to 14 hours. In the United Kingdom, it is usually less preferred to methylphenidate for the treatment of children.
Erythropoiesis-stimulating agents (ESA) are medications which stimulate the bone marrow to make red blood cells. They are used to treat anemia due to end stage kidney disease, chemotherapy, major surgery, or certain treatments in HIV/AIDS. In these situations they decrease the need for blood transfusions. The different agents are more or less equivalent. They are given by injection.
Donald Hardt Catlin was an American anti-doping scientist and one of the founders of modern drug-testing in professional sports.
Oxilofrine is a substituted phenethylamine stimulant drug chemically related to ephedrine and to synephrine.
A drug class is a group of medications and other compounds that have similar chemical structures, the same mechanism of action, similar modes of action, and/or are used to treat the similar diseases. The Food and Drug Administration (FDA) has worked on classifying and licensing new medications for many years. However, the FDA's Drug Evaluation and Research Center categorizes these new medications based on both their chemical and therapeutic class.
Doping in figure skating involves the use of illegal performance-enhancing drugs (PEDs), specifically those listed and monitored by the World Anti-Doping Agency (WADA). Figure skaters occasionally have positive doping results but it is not common. Bans can be enforced on figure skaters by the International Skating Union (ISU) and each country's individual skating federation. These bans can often be career ending due to the competitive nature of figure skating. A ban may be revoked if it can be proved that the skater tested positive for a prescribed medication. Some figure skaters will use PEDs to help with recovery time, allowing them to train harder and longer. Figure skating is an aesthetic sport that combines both athleticism and artistic licence, where weight-loss substances will have little effect on athletic performance but skaters may be perceived as more graceful and sleek, which is required for an athlete to be competitive.
The Horseracing Integrity and Safety Authority (HISA) is a private self-regulatory organization that regulates the sport of Thoroughbred horse racing in the United States. It is empowered by the Horseracing Integrity and Safety Act of 2020 to propose and enforce regulations related to safety and anti-doping aspects of the sport.