- The Washington Times - Tuesday, February 18, 2003

The death of Baltimore Orioles pitcher Steve Bechler yesterday promises to re-ignite furious debate about the role of ephedrine and other over-the-counter, performance-enhancing stimulants in high-level sports.
The 23-year-old Bechler died yesterday of heatstroke, a day after collapsing at the team's spring training complex in Fort Lauderdale, Fla. Team sources told The Washington Times Sunday that Bechler, trying to make the team after a brief call-up from the minors in 2002, had a bottle in his locker that contained ephedrine.
Ephedrine, derived from the botanical herb ephedra, is not banned in Major League Baseball, as it is in the NFL, International and U.S. Olympic Committees, and the NCAA. The drug, while safe in low doses, has been linked to heart arrhythmia, elevated blood pressure, seizures and strokes, as well as interfering with the body's ability to combat and regulate heat.
Medical research estimates that 15 football players between 1995 and 2001 died from heatstroke in which ephedrine or creatine is thought to have played a role. The number is more than twice the six recorded between 1985 and 1994.
Such results are far from the substance's intended design of reducing fatigue and weight and boosting the body's ability to burn calories.
"Ephedra is no more or less dangerous than other stimulants by itself," said Dr. Andrew Weil, a prominent Arizona-based physician active in herb therapy and alternative medicine. "The problem is that it is often taken in much too high doses and combined with other drugs. It is packaged and distributed in a dangerous way."
Ephedra has been used in China for more than 4,000 years. The substance, combined with caffeine to produce sleep inhibitors, is also popular with truck drivers. In 1999, sales of ephedrine-related products surpassed $1 billion.
Orioles officials yesterday said they were not aware of Bechler's apparent use of ephedrine and declined to comment further on that, pending the results of an autopsy scheduled for today and a subsequent medical examiner's report. Baseball officials also declined to comment. Broward County medical examiner Dr. Joshua Perper said he believed Bechler's ephedrine bottle existed, but he did not have possession of it.
Orioles physician William Goldiner concurred that ephedrine was a dangerous substance and said its use is discouraged by the team. Goldiner said he has not prescribed ephedrine for any player in the last 15 years.
"We don't have it. We don't supply it. We don't prescribe it," Goldiner said. "I see no reason to have it in the marketplace. I think it should be off the shelves."
The NFL last summer placed ephedrine on its banned substances list after a rash of fatal incidents with the substance at all levels of football. The most prominent such case was Minnesota Vikings lineman Korey Stringer, who collapsed and died from heatstroke-related complications in August 2001. Ephedrine was not found in Stringer's bloodstream during an autopsy. But a bottle of the substance was found in his locker. Stringer's widow has filed a $100 million lawsuit against the Vikings and team doctors.
Subsequent to the start of random ephedrine testing, at least five NFL players tested positive during the 2002 season, including Baltimore Ravens receiver Javin Hunter and defensive rookie of the year Julius Peppers, a Carolina Panthers lineman. But the focal point of current ephedrine debate in football is not the testing, but the punishment.
A positive test mandates an immediate four-game suspension, the same as a positive test for steroids. A positive test for other drugs such as cocaine, conversely, introduces a tiered system of punishment and counseling that is much more lenient at the outset.
"I think they go a little too far with things and not far enough with others," said New York Giants cornerback Jason Sehorn last year.
Baseball does not ban or test for ephedrine, and probably will not for many years. The sport, by many accounts, has by far the weakest drug testing and deterrence programs in pro sports. The MLB Players Association, after heated negotiation, agreed last year to unprecedented drug testing in the sport's new labor agreement.
But that testing only looks for illegal substances such as cocaine, and other drugs that are illegal without a prescription, such as certain types of steroids. Commonly used muscle enhancers, testosterone-boosters such as androstenedione, and a wide variety of stimulants that include ephedrine are permitted.
Furthermore, this year's baseball drug testing is what is called a survey program. There are only two test periods, one during spring training and one during the season. If more than 5 percent of all tests return positive, random testing will then happen for two years. But given that 5 percent translates to 60 players, the threshold is unlikely without random testing.
Baseball owners last year tried to get substances such as androstenedione and ephedrine into the new drug testing. But the union strongly resisted, largely on its long-held grounds that no substance freely available to the general public should be denied to players.
"We are deeply saddened by the death of Steve Bechler, and our thoughts and prayers go out to his wife and family during this difficult time," said Donald Fehr, MLBPA executive director.
The NCAA added ephedrine to its banned substance list in 1997, following an internal study that showed 3 percent of college athletes used it in the preceding year and 50 percent of those users took it solely for improving athletic performance.

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