Schools battling rising use of ephedra by student athletes

By Carol Chmelynski

2/19/02 – Students as young as those in middle school are turning to sports supplements, such as ephedra, to build their muscles, enhance their athletic performance, boost their popularity, and maybe even win a college scholarship.

Ephedra-based supplements are legal, and anyone can buy them without a doctor's prescription or a parent's permission in just about any supermarket or drug store.

Youths are taking sports supplements such as Androstenedione, creatine, and ephedra, which go by the names Andro Xtreme, Teen Advantage, and Metabolift, as a shortcut to leaner, stronger bodies.

A recent Blue Cross and Blue Shield survey found that nearly a million American students ages 12 to 17 have taken muscle-building supplements. Twenty percent of those surveyed said they know someone who was taking them. About 2 percent of children ages 10 to 14 have taken supplements.

What youths don't know, or choose to ignore, are their side effects. They also tend to disregard the dose recommendations on the label and the warning stating "Not for use by individuals under the age of 18."

Since 1994, dozens of deaths nationwide have been linked to products containing ephedra, according to the Food and Drug Administration. The FDA, in a 1996 statement on ephedra, cited side effects such as increased blood pressure, nervousness, tremors, headaches, seizures, heart attacks, strokes, and death. When combined with caffeine, the danger increases. Researchers are not sure of the long-term health effects.

On Jan. 9, the Canadian government issued a voluntary recall of products containing ephedra. And the International Olympic Committee, the National Football League, and the National Collegiate Athletic Association ban its use.

In California, state Sen. Jackie Speier is pushing legislation to prohibit ephedra sales to minors. It stalled in Assembly last year but she hopes to revive the bill this year. "Warning labels should be clear and conspicuous," she says. "And we've got to embark on a huge education program."

Actually, scientists know very little about how these supplements affect the body. At best, they produce slight changes in performance, and at worse, could be deadly. But even if they do nothing, experts stress, these supplements are dangerous "gateway drugs," because teens can become "psychologically addicted" and move on to harder substances, such as steroids.

The problem is getting worse. The 2001 Monitoring the Future survey, funded by the National Institute of Drug Abuse (NIDA), reports that 3.7 percent of high school seniors said they have used steroids at some point in their lives. In 2000, 2.5 percent reported steroid use.

The survey, which questioned 44,000 students on drug use at 424 schools across the nation, also found that past-year steroid use by seniors rose to 2.4 percent from 1.7 percent in 2000. Disapproval of steroid use decreased among seniors from 88.8 percent in 2000 to 68.4 percent in 2001.

"We have to pay attention to this in schools," NIDA Associate Director Timothy Condon says. "If we see this continuing, we've got a big problem."

Among the programs schools are using to address this issue are NIDA-funded ATLAS and ATHENA, developed by Linn Goldberg of Oregon Health and Science University.

ATLAS (Athletes Training and Learning to Avoid Steroids) teaches teenage boys about the dangers of drugs and the risks in supplements. It also shows them how to teach their fellow athletes to get results without supplements.

ATHENA (Athletes Targeting Healthy Exercise and Nutrition) focuses on girls and also addresses eating disorders.

Goldberg says teens who participated in these programs "got stronger, had less body fat, better nutritional practices, a 50 percent reduction in the use of supplements, and a more than 50 percent reduction in the use of steroids."