Ephedra

Beginning in the mid-1990s, ephedra emerged as a substance abused for performance-enhancing and weight-loss purposes. Ephedra is a herb used in dietary supplements as a natural source of alkaloids ephedra. Also known as herbal ecstasy, ma huang, Chinese ephedra, and pennyroyal, ephedra was sold over the counter until 2004 when the U.S. Food and Drug Administration cited it as an unreasonable risk to users and banned its use in energy and weight-loss products and other dietary supplements. In addition, ephedra, which is structurally similar to amphetamines, is a central nervous system stimulant and decongestant and has been used medically to relieve bronchial asthma and in cold medications.

Abuse

People may abuse ephedra for its supposed energy enhancing and weight-loss effects, or to stay awake for studying or partying. While ephedra abuse in the general population is low (approximately 1 percent according to a National Collegiate Athletic Association (NCAA) study, it is much higher among college athletes, averaging almost four times that rate according to the same NCAA study. First reported as an emerging abused substance in the early to mid-1990s, abuse rates continued to rise into the early 21st century, with increases noted particularly among college women athletes and increasingly with students in high school or even younger.

Consequences

Because ephedra is herbal, many users consider it �''natural�'' and therefore not harmful. But its effects range from uncomfortable to lethal. Ephedra, even when taken in recommended doses, can cause dizziness, headache, vomiting, fatigue, insomnia, memory loss, psychosis, nerve damage, increases in heart rate and blood pressure, heart attacks, bleeding in the brain, seizures, stroke, and death. Ephedra was implicated in several high-profile sudden deaths of athletes, including the 2003 death of Baltimore Orioles pitcher Steve Bechler.

Effective Prevention

An environmental management approach to prevention can help curtail ephedra use by students. On campus, for example, social norms marketing campaigns can address any exaggerated misperceptions about the use of ephedra and energy drinks and help to create a healthy normative environment. Prohibiting advertising of energy drinks restricts marketing and promotion of ephedra. Administrators can also revise campus alcohol and other drug policies to specifically include banning ephedra. Off-campus, administrators can ask local bar owners to discourage mixing energy drinks with alcohol to limit the availability of the drug and help prevent dangerous side effects.