In some cases manufacturers christen a product with a name shared by a street drug. The legal Yellow Jackets that Riggins ingested acted much like an amphetamine. But "yellow jackets" is also the nickname of a popular prescription barbiturate. Perhaps because of the confusion, NVE Pharmaceuticals, the supplement maker, decided to discontinue selling Yellow Jackets but now sells another ephedra product called Yellow Swarm, which, according to a company sales rep, "is basically the same thing with a different name." (NVE did not respond to calls seeking comment on product safety, nor to questions faxed to its New Jersey headquarters.)
Even the term dietary supplement can be confusing. It sounds innocuous, even beneficial. "What kids—especially those health-conscious and interested in sports—don't want to supplement their diet?" says Uryasz. "But the [notion] is a joke. No one is going to suffer because of an ephedra or creatine deficiency. We need to call these things what they are: drugs."
In the wake of Bechler's death on Feb. 17, there has been support for curtailing the sale of products containing ephedra. Senator Richard Durbin (D., Ill.) introduced legislation last week that would require all dietary supplements containing stimulants to prove their safety before sale. So far only one locale, New York's Suffolk County, has banned the sale of ephedra, while a handful of states, and Sean's hometown, have instituted prohibitions on ephedra sales to minors. Some stores in areas without bans have voluntarily demanded to see proof that consumers are over 18. Critics, however, wonder whether these acts could have the same effect as the Joe Camel campaign, creating a taboo that makes supplement products more desirable to teens. "GNC locks the stuff up behind the counter, but it's in a glass container, so everyone can see what's inside," says Perko. "What kid isn't going to be curious about that?" Although GNC spokesperson Stephanie Mangini described ephedra—"when used as directed"—as "a safe and effective part of a comprehensive weight-management program," she said that some GNC stores began locking up ephedra products last fall. GNC also cards potential purchasers, she says. "If these products had warning labels advising people under 18 not to take them, we thought we shouldn't sell them to [minors]," says Mangini.
Vitamin shops offer a dizzying array of products, but often young athletes don't have to venture that far for their "supps": Manufacturers have taken to enlisting coaches as distributors and pitchmen. With supplement deals springing up like shoe contracts, many big-time college athletic departments have endorsement arrangements with supplement companies. For instance, MET-Rx, a leading supplement manufacturer, has deals with more than a dozen schools, including Arizona, Florida State, Stanford, Syracuse and UCLA (MET-Rx also sponsored ABC's college football preview show.)
AdvoCare, a Dallas-based firm, has been particularly adept at forging alliances with coaches. In fact, AdvoCare employs several current or former college coaches. For instance, Joe Hadachek was a sales rep for the company in 1999, while he was coaching football at Division III Buena Vista University in Iowa. (Hadachek, who declined to comment, resigned from Buena Vista in 1999 to work full time for AdvoCare.) Other coaches, including Oklahoma State basketball coach Eddie Sutton and SMU's Faucette, endorse the company's products on its website. AdvoCare even sells a line of products that Faucette says conforms with NCAA guidelines (which forbid not only ephedra but also steroids and amphetamines) and is overseen by Bert Hill, former strength coach for the Detroit Lions. Rachel Olander, a spokesperson for the National Center for Drug Free Sport, which has a toll-free number that pro and college athletes can call anonymously to receive information on supplements, says that many of those calls pertain to AdvoCare. "It's usually, 'My coach is telling me, Take this, but is it safe?' " says Olander. (AdvoCare did not return calls seeking comment.)
Why would a coach agree to sell or endorse a sports supplement? "When I was at the University of Texas, we had a $200,000 budget for supplements," says Faucette, who left the Longhorns for SMU in 2001. "If I can get free supplements for my kids [in exchange] for making a few appearances a year, that's really helping my budget." Says Dave Van Halanger, football strength and conditioning coach at Georgia, and also an AdvoCare endorser, "We made sure it was tested and so forth. Look at Julius Peppers [of the Carolina Panthers, the NFL's Defensive Rookie of the Year, who tested positive for ephedra and was suspended for four games last season]. He was taking a product he knew nothing about."
To others, the concept of coaches endorsing supplements, even if they are not paid by the companies, is a classic conflict of interest. "Who has more credibility with athletes than coaches?" say Uryasz. "When we speak on campuses, we're always telling administrators to be sure that their staff members aren't the pushers."
Dietary and sports supplements fall under the 1994 Dietary Supplement Health and Education Act (DSHEA), which mandates that products derived from herbs and natural sources be classified as food and not drugs. This has been a boon to supplement manufacturers, which can skip the long and often prohibitively expensive process of seeking FDA approval. (In the last two election cycles, dietary supplement manufacturers have contributed more than $3.3 million to federal candidates and political parties, according to the Center for Responsive Politics. Senator Orrin Hatch (R., Utah), who drafted DSHEA and disputes the widely held view that it shields the supplement industry from government scrutiny, was the biggest congressional recipient of industry largesse during the 2000 election cycle, with $41,750 in contributions, according to the center.
Industry critics say the current landscape is like something out of the Wild West. "If you want to start selling supplements today, you don't have to register, you don't have to show your product to be effective," says Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, a consumer advocacy organization. "Just call it natural and it's a free pass—even though there's no reason to think it's less worrisome than a chemical synthesized in a lab."
Bechler's death and the subsequent backlash have forced some supplement manufacturers to reformulate. On Feb. 27 the AMA urged the FDA to take dietary supplements containing ephedra off the market. Manufacturers, many of whom were already producing ephedra-free products, moved to market those alternatives more heavily. Supplements laced with such stimulant alkaloids as bitter orange (also known as synephrine) promise results similar to those of ephedra, though there exists little conclusive evidence that these substitutes are any more or less harmful.