Ephedra: Therapeutic use, Treatment. Ephedra rehab.

Last modified: Sunday, 31. May 2009 - 2:10 pm

Official names: Ephedra, Ephedrasinica
Street names: Mahuang, ma huang, desert tea, Mormon tea, American ephedra, European ephedra, Pakistani ephedra, ephedrine, ephedrine alkaloids, pseudoephedrine
Drug classifications: Not scheduled, dietary supplement


Key terms

ADVERSE EVENT: Term used to denote a side effect, or negative health consequence, reported after taking a certain substance. The event may or may not be linked to the substance.
CARDIOVASCULAR SYSTEM: The body system composed of the heart and blood vessels.
DIETARY SUPPLEMENT: A substance sold and marketed under the protection of the DSHEA. These substances are available without a prescription and are not subject to rigorous clinical testing.
DIETARY SUPPLEMENT HEALTH AND EDUCATION ACT (DSHEA): Passed in 1994, this law allows manufacturers to sell dietary and nutrition supplements without federal regulation. According to this act, supplements can be regulated only after they are proven to be harmful to users.
FOOD AND DRUG ADMINISTRATION (FDA): The federal agency responsible for reviewing and regulating drugs and supplements.



Ephedra has a long, varied, and global history. Most varieties of the drug or herb are legal as of 2002. Despite its legal status, however, ephedra is not safe in large quantities. In fact, some non-profit groups, lawyers, and even some physicians and state and federal health agencies claim that ephedra can be harmful. They have sought to ban or at least more strictly regulate products containing ephedra, because these supplements have been associated with some very serious side effects, including strokes and heart attacks.
The earliest known use of ephedra was in ancient China, where it was used as an herbal remedy to treat a variety of ailments. Physicians in the United States began prescribing ephedra in the early part of the twentieth century as a decongestant for stuffy noses and a bronchodilator to open blocked airways.
Today, products containing ephedra and its synthetic or chemical equivalent are primarily used for two purposes in the United States. Ephedra is found in many dietary supplements and energy bars for weight loss and body builders. Ma huang, or ephedra, may also be found in so-called energy-boosting drinks. Both health food stores and supermarkets sell products containing ephedra, such as Easy Trim, Diet Max, Metabolife, Ripped Fuel, and Quick Shot. Some ephedrine supplements such as Ecstasy and Black Beauties have the same name as illegal street drugs. The labels of products containing ephedra may claim that the product will fight fat, build lean muscle mass, curb appetite, boost energy, increase metabolism, and help lose weight. Such claims, however, are not necessarily true.
Ephedra is subject to the Dietary Supplement Health and Education Act (DSHEA), which was passed in 1994. The act essentially protects dietary supplements like ephedra. That is, while U.S. federal agencies can regulate prescription drug and food additives, DSHEA exempts herbal products and supplements from federal regulation. The law states that the United States Food and Drug Administration (FDA) cannot regulate dietary supplements unless, or until, they are proven to be unsafe and pose a risk to users. The United States Drug Enforcement Administration (DEA) monitors ephedrine because it can be used to make methamphetamine.
Today, supplements containing ephedra are at the center of a controversy, with opponents claiming that they are dangerous and should be banned. Supplement makers and the herbal products industry, however, maintain that ephedra is safe and reports of adverse effects are overblown, exaggerated, and inaccurate. The Food and Drug Administration (FDA) has received hundreds of reports of adverse effects of ephedra, including strokes, heart attacks, heart rate irregularities, seizures, psychoses, and death. Dating back to the early 1990s, reports of ephedra-related adverse events raised concern among physicians and legislators. In 1997, the FDA proposed a new rule about ephedra, which would have considered some products containing ephedra as adulterated supplements, making them subject to FDA regulation. The FDA based its adulterated claim on the fact that ephedrine alkaloids resemble amphetamine and, like amphetamine, stimulate the heart and nervous system. However, this attempt to subject ephedra products to regulation failed.
Since 1997, a number of groups have lined up on each side of the ephedra battle. A non-profit group called Halt Ephedrine Abuse Today has spoken out about the dangers of ephedra. On the other side of the battle is the Ephedra Education Council, a group backed and supported by the herbal products industry and supplement manufacturers. Many of the companies that sell products containing ephedra do not want any further restrictions on the products.
A big concern about ephedra is that drug traffickers and laboratory operators are using ephedrine to make methamphetamines (speed). Consequently, in the United States, ephedrine is subject to regulatory laws. The Drug Enforcement Administration (DEA) carefully monitors medications containing ephedrine.
The United States is not the only country concerned about the safety of ephedra. Health Canada, the Canadian health regulatory agency, requested a voluntary recall of products containing both natural and chemical ephedra in 2002, because it received 60 reports of adverse events related to ephedra use.

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