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The Prolixin Problem

The Prolixin Problem
 
February 15, 2010
By Kent H. Stirling, FHBPA Executive Director
 
 
Uniformity in medication rules still seems a long way off.
 
The RMTC made some great strides and then began to bog down in some areas.  Most notable was the promised development of thresholds for some forty plus commonly used therapeutic medications.  Although promised to horsemen for years, they were pushed to the back burner and down the RMTC priority list and replaced by anabolic steroids which jumped to the top of the RMTC priority list.  This occurred after a Representative from Kentucky pushed the issue of banning them in a Congressional hearing two years ago.  As I recall he suggested horsemen give up their simulcasting rights under the Interstate Horseracing Act (IHA) of 1978 if anabolic steroids were not banned in the United States.
 
So limits of detection were developed for anabolic steroids by the RMTC so that horsemen would know how long to refrain from racing if they had used them on their horses.  The RMTC had no choice but to take action on anabolic steroids or let Congress do it for us.  But no other threshold was developed, just the withdrawal times for four anabolic steroids.
 
Now we have the Florida Racing Laboratory which does the drug testing for both Florida and Kentucky coming up with some new or enhanced tests and for the first time ever in Florida calling not just one but a flock of positives on Fluphenazine (Prolixin).  Prolixin is a long-acting tranquilizer now frequently used to treat hyperactive horses that would normally train on acepromazine pills.  Acepromazine pills take the edge off horses and make them easier to train and less dangerous to those involved with them.  Without them or Prolixin there can be a serious safety issue with certain horses for both the horse and those working with it.
 
Acepromazine is an excellent short-acting tranquilizer and was at the top of the RMTC Priority List, but given in pill form (to stop multiple injections and to save money) it builds up in the horse’s system to where you are playing Russian Roulette trying to guess how long it will take to clear the horse’s system.  It can be detected for more than a month even though it’s pharmacological effect is gone in about a day.  So to prevent acepromazine positives for their clients, vets will often give Fluphenazine which was in the RMTC’s second priority group for a threshold.
 
The Florida Fluphenazines that I have seen were administered at between 8 and 43 days with most over 24 days.  The RMTC website lists the withdrawal time in Florida at 7 days.  I understand this is anecdotal information, but it is still the best current information and a lot of horsemen and their vets rely on it.  When I trained in Florida years ago it was “understood” that 7 days was the withdrawal time for Prolixin.
 
After the Florida Lab armed with its new more sensitive tests began calling  Fluphenazine positives, I had a warning placed on the overnights advising Florida horsemen to discontinue the use of Fluphenazine until further notice.
 
This warning was seen in Kentucky (again whose testing is also done by the Florida Lab), and the Kentucky Medical Director sent the following advisory to Kentucky horsemen which stated:
 
The Kentucky Horse Racing Commission has a withdrawal guideline of seven days for fluphenazine deaconate (Prolixin).  This withdrawal guideline is unchanged.  The regulation of the use of this medication in Kentucky is directed by Kentucky regulation.  The implications of the recent positives in Florida for fluphenazine are only for horses destined for racing in Florida.  Florida’s medication policy has no bearing on drug testing or medication enforcement in Kentucky and Kentucky horsemen may continue to honor the 7 day withdrawal for fluphenazine with confidence.
 
Like Florida, Kentucky has no published threshold for fluphenazine, just the 7 day withdrawal time.  The strange thing about Fluphenazine is that it has a depletion curve that pretty much flat-lines or stays the same for weeks.  Therefore, the Florida lab which can call positives on Fluphenazine in Florida, can not call one in Kentucky, because, for example, a five day withdrawal can’t really be differentiated from a 30 day withdrawal.
 
Now this whole ugly situation could have been avoided if Florida had a notification or phase in period like Kentucky when new or more sensitive tests are about to be used for a therapeutic medication.
 
The even worse situation for the horsemen involved is that Prolixin is an ARCI Class 2 substance and a RMTC Penalty Class “A” which calls for a “minimum one-year” license suspension.  So is uniformity in medication rules for the use of Prolixin now a one year suspension in Florida and not even a written warning in Kentucky?
 
Uniformity in medication rules still seems a long way off.