An NFL player caught taking ephedra is often subject to harsher penalties than if he snorted cocaine. An Olympic athlete can lose a medal by taking the supplement.
Baseball and its union, however, allow players to use ephedra, which is suspected in the death of Baltimore Orioles pitcher Steve Bechler and used by millions of Americans trying to lose weight.
That policy is now under increased scrutiny, and players around the league are concerned about the use of the supplement.
Critics say baseball's rules need to be based on science, not politics. The NBA and NHL also don't test for ephedra.
''I don't think there's any way two doctors and two lawyers in baseball are going to do the collective work of hundreds of people over hundreds of hours,'' said Dr. Gary Wadler, a member of the World Anti-Doping Agency's medical research committee.
The Food and Drug Administration has reports of at least 100 deaths linked to ephedra, an herbal supplement derived from the Asian ma huang plant.
Easily purchased over the counter, ephedra products increase metabolism to aid weight loss. Reports have linked the supplement to heart attacks, strokes, seizures, and heatstroke.
Because ephedra is a supplement, it is not regulated by the FDA. Still, FDA Commissioner Mark McClellan said Wednesday that resolving the controversy over ephedra's safety is a high priority.
''If there is a health risk, we need to be on top of it,'' McClellan said.
Wes Siegner, attorney for the Ephedra Education Council, said leaders of the multimillion-dollar business won't draw any conclusions until results from an independent review of ephedra's risks are released next month.
''Clinical data says that when used properly, ephedra is safe, and helps people lose weight,'' Siegner said. ''We don't just want to take that away from people without a reason.''
Bechler died Monday from complications related to heatstroke. His temperature rose to 108.
Bechler had been taking a weight-loss supplement that contained ephedra, which probably contributed to his death, Broward County medical examiner Dr. Joshua Perper said. Toxicology reports won't be ready for about three weeks.
In the meantime, some players at spring training were forced to think about their own supplement use and its risks.
''It's a long haul and it makes your body feel a little bit better,'' Brewers closer Curtis Leskanic said. ''Whatever it takes for you to get through the day, you've got to do that.''
First baseman Derrek Lee of the Marlins said players need to be better educated about supplements.
''A lot of guys might take it and not even know ephedrine is in there,'' Lee said. ''It's just an awareness issue. It's unfortunate this is what it took.''
Under baseball's much-criticized drug policy, only illegal drugs and the most powerful steroids are tested for. Even then, the testing procedures are ''nothing more than public relations,'' says former marathoner Frank Shorter, chairman of the U.S. Anti-Doping Agency.
Baseball spokesman Rich Levin and union head Donald Fehr said it was too soon to say whether the sport should re-examine its policy on ephedra. Even so, several teams greeted players at spring training by encouraging them not to take supplements.
''If you're a player and doing it, if this doesn't open your eyes then something is wrong,'' Phillies manager Larry Bowa said.
Others, meanwhile, know there's only so much the teams can control.
''You're talking about something the FDA can't regulate, so how can we?'' said trainer Larry Davis of the Oakland A's.
The NFL takes a much different view and started testing for ephedra last season.
Shortly after lineman Korey Stringer's heatstroke death in 2001, the NFL banned ephedra, saying it could interfere with the body's ability to regulate heat. (A supplement containing ephedra was found in Stringer's locker, although there's no evidence it caused his death).
A first-time ephedra user can be suspended for four games. Players who test positive for illegal drugs for the first time are not suspended, and instead are tested more often.
''It seems a little strange to have more tolerance for illegal drugs,'' union head Gene Upshaw said.
The International Olympic Committee also banned ephedra. Just as with other banned substances, athletes found with the herb in their system can be suspended, kicked off teams or have medals stripped.
The NCAA also bans the supplement, and tests regularly. The NBA does not ban it, and the NHL only discourages players from using ephedra.
Wadler urged baseball to leave drug policy to groups like WADA.
''Sound policy has to be based on sound science,'' he said. ''You can't have policies based on crisis.''
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