Ephedra for fun, performance and losing weight

Cas Barendregt and Brigitte Boon
Chapter from Drugs in Society
Radcliffe Publishing 2007

Substances that contain ephedra are known to aid weight loss and enhance athletic performance. Until April 2004 in the Netherlands, products containing this substance were available in pharmacies but also in so-called 'smart shops' (establishments where legal psychoactive substances are sold, usually for leisure purposes), where they were marketed as drugs for recreational use. On 6 April 2004, the Dutch government classified ephedra alkaloids as a medical drug in the Act on the Provision of Medical Drugs.

This has led to a de facto ban on their sales. It is unlikely that ephedra alkaloids will become offcially registered as a regular medicinal drug, because their primary effects serve no medical purpose. Ephedra contains two active ingredients, ephedrine and pseudo-ephedrine, both of which stimulate the autonomic nervous system in the same way as the endogenous neurotransmitter adrenaline. In Europe, these substances are classified as precursors - that is, substances which, following a chemical reaction when mixed with other substances, become an intrinsic part of a new product. As precursors, ephedrine and pseudo-ephedrine are used to produce the synthetic stimulant drug methamphetamine.

Ephedra is a generic term for a number of extracts from ephedra-containing herbs that are known under their Chinese name Ma huang. As a traditional medicine, ephedra was used as a bronchodilator to treat asthmatic complaints. Ephedra is a substance that, when swallowed, acts as an amphetamine-like stimulant. As a crude product it commonly occurs in the form of fine grains, but for retail purposes it is usually mixed with other substances, such as caffeine, and sold in tablet form. Simultaneous use with caffeine or aspirin increases the effect of ephedra.

The use of ephedra may have negative effects on health. There are indications that even small quantities of ephedra alkaloids may increase the risk of hypertension, stroke, myocardial infarction (heart attack) and psychosis. Moreover, the combination of ephedra with cafeine or aspirin may increase some health risks, such as the development of psychiatric symptoms and cardiovascular disease.

Much of our knowledge of ephedra is based on medically oriented studies from the USA. In the Netherlands (and in the rest of Europe), no social studies on ephedra use have been published. Therefore the purpose of the exploratory study reported here was twofold - to explore the behaviour and perceptions of a self-selected sample of Dutch ephedra users and, one year after the offcial ban on ephedra use in the Netherlands, to document its impact on these users.