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After further review, the committee in 2003 raised additional concerns: “larger numbers of case reports of abuse, dependence and withdrawal syndrome for tramadol than for any other analgesic” aside from butorphanol, a potent and tightly controlled painkiller.

Also on the list: butorphanol nasal spray, and the combination medications sumatriptan/naproxen and acetaminophen/aspirin/caffeine.

While powerful opioid pain drugs such as butorphanol, codeine/acetaminophen and tramadol/acetaminophen are likely effective migraine treatments, they are not recommended for regular use, the researchers said.

In October 2011, the three-member racing board cited infractions including syringes containing a painkiller and a sedative found in Dutrow’s desk, and the painkiller butorphanol — an opioid analgesic — found in the urine of his horse Fastus Cactus in 2010 after it won at Aqueduct Racetrack.

The three-member racing board in October cited infractions including syringes containing a painkiller and sedative found in Dutrow’s desk and the painkiller butorphanol, an opioid analgesic, found in the urine of his horse Fastus Cactus in November 2010, after it won at Aqueduct Racetrack.