The over-the-counter capsule that the Broward County, Fla., medical examiner implicates in the Feb. 17 death of Orioles pitcher Steve Bechler is a very busy little drug, and, yes, it's a drug and not, as many manufacturers insist, a dietary supplement. One of the ingredients in Xenadrine RFA-1 is the herb ephedra, which contains the chemical ingredient ephedrine, which the FDA classifies as a drug. Ephedra speeds up the metabolism, which theoretically can help you slim down, something Bechler, who reported to spring training 10 pounds over his normal playing weight—and was cited for being out of shape by Baltimore manager Mike Hargrove—was desperately trying to do. But ephedra constricts the blood vessels, raising blood pressure and inhibiting the body's ability to cool itself. And ephedra fires you with such energy that you may not know when to stop exercising. Bechler, 23, only quit running sprints when he collapsed of heatstroke.
Bechler's widow, Kiley, had told him she didn't want him taking ephedra, which the IOC, NCAA and NFL ban. But Bechler didn't listen, and he joins a grim roll of nearly 90 deaths—and about 1,500 reported cases of what the FDA calls "adverse effects," including seizures, strokes and heart attacks—that have been linked to the substance. Among the incidents: Rosanna Porras, a 15-year-old soccer player at Fillmore ( Calif.) High, who died in practice in 1998; Northwestern safety Rashidi Wheeler, who suffered a fatal collapse during a workout in 2001; and Sean Riggins, 16, a football player at Lincoln (Ill.) Community High, who in September 2002 fell ill and developed breathing problems and died suddenly. In the first two cases the victim had a medical condition that some believe was exacerbated by ephedra; in Riggins's case, a coroner ruled that ephedra had caused heart failure. Though ephedra was not found in the bloodstream of Vikings tackle Korey Stringer after his death in July 2001, bottles of the substance were in his locker.
So why do ephedra products sit on neighborhood shelves, bearing names like Xtreme Ultra Orange and Ripped Fuel? The FDA requires that a manufacturer prove that a drug is safe before it can be brought to market. But in 1994 Senator Orrin Hatch (R., Utah), whose state is home to about one fifth of the nation's supplement manufacturers, pushed through the Dietary Supplement Health and Education Act (DSHEA), which decrees that for products derived from herbs and other "natural" sources, the FDA has the burden of proving the product unsafe. Ephedra, as an herb, is covered by DSHEA, even though ephedrine is held to the FDA's more stringent drug standard when it is extracted and sold as medicine. Since then the supplement industry has boomed, more than doubling its annual revenue to $18 billion.
In response to Bechler's death, Rep. John Sweeney (R., N.Y.) wants to suspend all sales of ephedra and plans to introduce legislation to reclassify ephedra as a drug rather than a "dietary supplement." Last October, Sen. Richard Durbin (D., Ill.) led a congressional hearing that revealed that the defense department had removed ephedra products from all stores on military bases after it was found that ephedra was linked to the deaths of 33 servicemen since 1997.
Last week Hatch said, "If the FDA finds an ephedra product to be unsafe, it has the authority to act immediately." It's not that easy, though. Former FDA head David Kessler has written that "Congress has put the FDA in the position of being able to act only after the fact and after substantial harm has already occurred." Indeed, DSHEA emasculated the FDA by requiring it to investigate and rule on a broad and constantly changing range of ephedra products one by one.
Two hours before her husband's death Kiley Bechler left his hospital room to address the Orioles about the dangers of ephedra. "She let everyone know it's just not worth it," says pitcher Matt Riley, 23. "That he's lying on a bed and dying, leaving behind a wife and an unborn child." But if her own husband didn't listen to her, strangers can't be counted on to do so. Which is all the more reason for Congress to overhaul the law, fast.