142 Ephedrine
cathinoneandmethamphetamine. Indeed, ephedrine’s chemical relationship
to amphetamine and methamphetamine is so close that urine tests can mis-
identify ephedrine as those drugs. In an experiment where people received a
substance without knowing what it was, ephedrine produced the same phys-
ical and mental effects asphenmetrazine,methylphenidate,dextroampheta-
mine, and methamphetamine. Ephedrine’s legal status was in flux as this book
was written: Depending on the federal or state jurisdiction, ephedrine might
be Schedule IV or a freely available unscheduled substance; commerce as a
medical drug might be legal, but commerce as a raw chemical might be a
crime.
Drawbacks.Amphetamine was designed in a laboratory to provide a sub-
stitute for ephedrine because of the latter’s drawbacks. A double dose of
ephedrine can be poisonous, in comparison to other drugs with the same
therapeutic effects but that require 10 or 20 times the regular dose to become
severely toxic. For that reason many physicians prefer to avoid prescribing
ephedrine.
Ephedrine can cause skin rash, nausea, diarrhea, constipation, hepatitis, rise
in body temperature, jitteriness, insomnia, hyperactivity, irregular heartbeat,
high blood pressure, heart attack, stroke, seizures, kidney stones, visual and
auditory hallucinations, and paranoid psychosis. Ephedrine can worsen mus-
cle tics; animal experimentation shows the drug causing brain damage that
can lead to the tics seen in Parkinson’s disease. During strong physical exer-
tion, such as bodybuilding, ephedrine may increase danger of heart attack.
Suspicion exists that persons who stop taking ephedrine may be more sensi-
tive to it if they start using the drug again.
Many reports of adverse events come from cases in which a person was
using ephedrine diet supplements commonly found in health food stores. Per-
haps people regard such products as inherently “healthy” and fail to realize
that an ephedrine food supplement can produce a drug overdose or be haz-
ardous if used moderately but for too long.
The U.S. Food and Drug Administration (FDA) became particularly alarmed
at the prevalence of medical problems developed by young healthy users, and
regulatory efforts were increasing when this book was written. Some scientists
say the FDA’s concerns are unfounded and that many physical problems after
ephedrine ingestion derive from a person’s prior medical history or massive
overdose. Nonetheless, the FDA believes that ephedrine may harm people
who already have the following conditions: prostate trouble, psychological
afflictions (including depression and nervousness), high blood pressure, dia-
betes, glaucoma, and ailments of thyroid, kidney, or heart.
Alcoholis an ingredient in some ephedrine inhalers and can influence read-
ings in breathalyzer tests for drunk driving. That problem can be avoided by
a 15-minute wait between using the inhaler and administering a test.
Abuse factors.Historically ephedrine has seldom been abused, but in the
1990s it was cited as growing in popularity among youths, as a recreational
stimulant with euphoric and aphrodisiac effects. Such characteristics have al-
lowed illicit dealers to market ephedrine falsely ascocaine, methampheta-
mine, andMDMA. Some cocaine users find ephedrine less satisfying but still
a satisfactory substitute. Reports of ephedrine addiction exist.