Ephedrine Under Baseball's MicroscopeFeb 21, 2003 | USA Today
From high schools to the pros, football camps opened last summer amid heightened alert to the dangers of heatstroke. Concern was driven by a rise in heat-related football deaths since 1995 and warnings that certain dietary supplements, those extra somethings of modern sports, put players at greater risk in the heat.
As baseball spring training began this month, those issues weren't on the radar in any way comparable to football.
They are now.
Monday's death of 23-year-old pitcher Steve Bechler of the Baltimore Orioles was attributed to heatstroke. A day later, the medical examiner cited several contributing factors, including that Bechler had been battling a weight problem and was taking a controversial ephedrine supplement, sold over-the-counter as a weight-loss aid and energy booster.
All this brings to mind again the issue raised last season by some former and current players, who said use of illegal, muscle-building steroids is widespread in baseball.
The question is whether baseball will do anything about a substance already outlawed in other arenas of sports.
As usual, opinions are divided.
"I don't really know whether or not to ban (ephedrine) from baseball," New York Mets pitcher Tom Glavine says. "But I think it is important to educate the players and tell them the risks involved. Then it is up to them to make a decision on what to do."
Orioles designated hitter David Segui says "there's almost a witch hunt going on" in the aftermath of Bechler's death. "It hasn't been proven that ephedrine caused his death. There was probably some milk found in his system, too. Did that cause his death?"
But for Orioles pitcher Matt Riley, who lost a friend, the case is clear: Baseball must ban ephedrine.
"I hope so," he says. "I hope it doesn't take another death for them to realize the magnitude of this. If they could feel what I'm feeling, they'd know how much it means to get ephedra out of baseball. Football smarted up and got it out. ... We don't need any more casualties. One's enough."
Supplements containing ephedrine, a stimulant extracted from an Asian plant, ephedra, and typically combined with a caffeine booster, are banned in the Olympics and college sports.
They were banned by the NFL â€” in concert with its players' union â€” following the 2001 training camp death of Minnesota Vikings tackle Korey Stringer. His death was attributed to heatstroke. There were reports that ephedrine bottles were found in his locker, but the toxicology tests showed no ephedrine in his system.
Baseball silent on matter
But ephedrine is not banned by Major League Baseball and its union.
MLB and the union have declined comment on the ephedrine issue.
Not all are silent. Orioles owner Peter Angelos said MLB's negotiators proposed a ban on ephedrine during contract talks last summer and that the union rejected it.
Angelos, an attorney well versed in product liability claims, cautioned that the toxicology report on Bechler's death is still pending. Ephedrine manufacturers also are cautioning patience, while stressing their products are safe when used properly.
This kind of issue isn't new for baseball.
In 1998, a bottle of a supplement called androstenedione, andro for short, was spotted in the locker of Mark McGwire during his march to the home run record. McGwire eventually stopped using the over-the-counter product.
Angelos has asked for a baseball ban on ephedrine or action by Congress to remove its classification under the law as a supplement and make it a prescription drug.
A pamphlet distributed by MLB in spring training cautions that "severe side effects" have been reported due to ephedrine, including high blood pressure, rapid heart rate, seizures, strokes, heart attacks and deaths.
Manufacturers say such reports have no scientific basis and that the products are safe when used according to label instructions.
That leaves players, who might not read the pamphlet or the labels, to make their own choices. If they're looking to drop some poundage, it might be an option. If they're looking for a boost of energy before a weightlifting workout or a game, it might be an option.
Baseball tries steroid test
Now, playing catch-up with the rest of sports, baseball begins a steroid testing program this season. It was negotiated with the union during strike-averting talks last summer.
Many criticize the baseball testing program as inadequate in an era when power hitters look like football linebackers and home runs are flying out of the parks.
The program includes random testing for steroids this year. If 5% or more of the players test positive, there will be random testing for two more years. If 2.5% or fewer test positive in consecutive years, testing will cease.
That new policy still doesn't include a ban on andro, which is prohibited by the Olympics, NCAA, NFL, NBA and others as a steroid â€” no matter how it's classified under federal law.
How do the players get educated about ephedrine?
Some have done it by trial and error.
Oakland Athletics center fielder Chris Singleton, 30, says he tried it early in his career.
"It made me feel like my heart was fluttering at times, and it was scary, so I decided it wasn't for me," he says. "But I think it's up to each individual to be responsible for his own health. We're supposed to be men here. ... We shouldn't need babysitters."
Philadelphia Phillies outfielder Pat Burrell, 26, says he tried ephedrine while at the University of Miami. "It gave me terrible heartburn, and I've never used it again."
Some clubs say they do discourage use of ephedrine.
"We want to know what everybody is taking and why they take it. We tell our players not to take ephedra," says San Francisco Giants trainer Stan Conte.
Pittsburgh Pirates general manager Dave Littlefield says he repeated the same appeal this week in a meeting with players. "From a policy standpoint, we don't condone any of our players taking these. You realize that some people do."
But there are other influences.
Los Angeles Dodgers first baseman Fred McGriff, 39, says when he came into baseball, there was pressure from the competition for a job. Now there's pressure to get bigger and stronger and hit more home runs.
"Thirty home runs in a season used to be a good thing," he says. "Now, you hit 30 home runs and they ask, 'What's wrong with you?' As a young guy, there's a lot of pressure that never used to be there."
Bechler case should be heeded
For Bechler, at the Orioles' camp, the intent was on slimming down.
Broward County (Fla.) medical examiner Joshua Perper says that based on his interviews with Bechler's family and Orioles officials, the pitcher was taking a product called Xenadrine RFA-1, which includes ephedrine and caffeine and is identified on its label as an "clinically proven weight loss catalyst."
Perper says the results of toxicology tests won't be known for two or three weeks, and ephedrine isn't the only contributing factor he has cited.
He says Bechler was dieting to get down from 249 pounds, 10 over his listed weight, and that he had little food in his stomach the morning he collapsed. Lack of food can lead to dehydration.
Perper also says Bechler had borderline hypertension and indications of liver problems.
The warning label on a bottle of Xenadrine RFA-1 says, "Consult a physician or licensed health professional before using this product if you are at risk of, have a family history of, or are being treated for" assorted conditions, including high blood pressure (hypertension) and liver problems.
Xenadrine is marketed by Cytodyne Technologies, Inc., of Manasquan, N.J.
Cytodyne attorney Shane Freedman says in a statement, "Until the toxicology report becomes available, it is sheer speculation as to whether Mr. Bechler ever used ephedra products or whether ephedra played any role whatsoever in contributing to his death. It is premature, bordering on reckless, for the Broward County Medical Examiner to suggest that ephedra products were involved in Mr. Bechler's death."
Freedman adds, "What is clear is that Xenadrine has been the subject of numerous clinical trials on humans which have conclusively demonstrated that the product is safe and effective when used as directed."
In big league locker rooms, players also are taking a wait-and-see approach.
"I am not going to talk about whether it should be banned or not, but I think it would be hard to tell a grown man that he can't take something an 18-year-old can still buy over-the-counter," says New York Mets pitcher Mike Stanton, 35.
"It's going to be a topic of discussion for a while. We need to get all the facts, and then make a decision about what happened. Very few times does something happen because of one thing or another."
Orioles pitcher Rick Helling says that after Stringer's death in 2001, he stopped using ephedrine.
"I just threw it all away, whatever I had left," says Helling. "Since then I take supplements every once in a while but I make sure there's no ephedrine in it. Mostly I take protein shakes now, stuff like that. Every once in a while, if I'm trying to get my body fat down, I'll use Xenadrine, but the kind with no ephedrine in it."
On the Cytodyne Web site, Xenadrine EFX is touted for "unprecedented fat-burning results without containing ephedrine!"
"I don't know if it's helped me at all. I don't take it often, not at all during the offseason," Helling says. "I'll never do anything to jeopardize my health. I've got a wife and two kids at home. Baseball is what I do for a living, but it's not my life."
Does Helling think Bechler's death will change the habits of others? "You would've thought it would've changed guys after Korey Stringer died, and it did change some.
"But some guys are still going to do their own thing. ... Athletes are just like the rest of the public. You see something that says it will burn body fat and help performance, well, everybody wants to look great and get stronger. Everybody's looking for an edge. The only thing you hope is that people do it safely."