Oakland Tribune: Federal regulation best option for ephedra

AS much as we agree emotionally with Sen. Jackie Speier's quest to ban dietary supplements containing ephedra from the California marketplace, the policy that makes the most sense is for the federal government to regulate the use, sale and distribution of the dangerous herb.

The main concern, of course, is whether the Federal Drug Administration, Congress or anyone else at the national level will actually do something about the to-date uncontrolled substance linked to a mounting number of deaths.

Whether toxicology tests confirm that use of Xenadrine, an over- the-counter stimulant containing ephedrine, was a factor in professional pitcher Steve Bechler's death, evidence of ephedra's potentially lethal effects has grown steadily.

A recent study by the San Francisco Veterans Affairs Medical Center says in 2001, ephedra accounted for 64 percent of the health problems associated with herbs reported to poison-control centers. That came on the heels of the New England Journal of Medicine study linking 54 deaths to the supplement and warnings by both the Pentagon and Canada not to use ephedra-based products.

That growing history of toxicity is why Sen. Speier, D- Hillsborough, sponsored a bill passed last year requiring that warning labels be put on dietary supplements containing ephedra and banning their use by minors.

Ephedra-based products speed up one's metabolism, accelerating heart rate, raising blood pressure and constricting blood vessels, thus damaging the cardiovascular system and inhibiting the body's ability to cool itself.

As Speier asked in the wake of Bechler's spring training death, "How many more people have to die before we decide that ephedra poses an unacceptable risk to the public?"

Hopefully none, but that depends on the federal government responding quickly and decisively. We need to start looking at dietary supplements in the same way we do prescription drugs.

Federal law passed by Congress in 1994 limits government regulation of the $17 billion dietary supplement industry. That clearly needs to be changed in the case of ephedra-based products, and other "natural substances" that may pose serious health risks. If that means putting them through a testing process akin to that required for prescribed medicines, so be it.

But at the very least, the Food and Drug Administration and Health and Human Services need to have the power and take the initiative to curb or outright ban the sale of herbs and supplements believed to be dangerous while they're tested. If there's any question or doubt about its safety, the substance should be pulled from shelves until tests prove otherwise.

Caveat emptor is always wise when dealing with herbal supplements. Consulting with one's physician before taking any dietary supplement, especially if you have a chronic condition, should be routine.

Congress needs to change the 1994 law limiting federal oversight of dietary supplements. Warning labels are necessary when substances may counteract or conflict with prescribed medicines.

The lack of regulation amounts to millions of Americans unwittingly playing roulette with their health and lives by taking supplements with potentially adverse effects. Government has a responsibility in such matters. And, to guarantee uniformity and continuity of oversight, federal action is best. At times, however, it is not as responsive as lower levels of government.

That is why Gov. Gray Davis signed Sen. Speier's 2002 bill in spite of a preference for federal regulation. He urged the FDA to move quickly to regulate ephedra last April, noting that there was more than sufficient evidence of its harmful effects to act.

We agree with the governor that it is "more effective when the federal government regulates drugs because then you don't have a mishmash of state standards." Unfortunately, it's almost a year since Davis wrote the letter.

The latest studies and Bechler's death will hopefully prompt the federal government to move quickly to control and limit the use of ephedra-based products. If it doesn't, the California Legislature should not adjourn this year without considering Speier's ban. It could save California lives while Washington fiddles.