By Ken Sakamoto, Star-Bulletin
These are some products with extract of ma huang,
an herbal product containgin ephedrine.



Ma huang bill
stimulates debate

Lawmakers consider sharp restrictions
on the herb and other products
containing ephedrine

By Alan Matsuoka
Star-Bulletin

The Chinese, experts in the time trial, have used ma huang for 4,000 years or more. They found that brews of the dry-land shrub made an effective treatment for respiratory ailments like asthma and hay fever. Now a bill passed by the state House would sharply limit ma huang's availability, along with scores of other related products favored by athletes, dieters and swing-shift workers. Officials say the ban is needed, but critics aren't breathing easy.

"You mean the local legislators are going to do that?" said Mits Kawashima, owner of Mits' Basic Foods in Manoa and organizer of the Hawaiian Islands Bodybuilding Championships. "If you take all off the market," he grumbled, "I think that's not right."

At issue are products containing ephedrine, the active component of ma huang. Drug companies have long recognized ephedrine's medicinal value and use it in bronchodilators such as Primatene tablets. Concerns were raised, however, after federal rule changes in 1994 contributed to a spread of dietary supplements that take advantage of the chemical's speedy, amphetamine-like properties -- most prevalently, weight-loss aids and "energy boosters" marketed to help users stay awake or enhance athletic performances.

The stimulant gained notoriety last year when it was blamed in the death of a college student in Florida who overdosed on ephedrine-containing pills touted as an alternative to illegal street drugs. The Honolulu City Council responded by approving a partial Oahu ban six months ago as a stopgap until the Legislature convened.

House Bill 113 HD1 would impose stricter, statewide restrictions by making ephedrine a Schedule IV controlled substance. About a dozen bronchodilators would continue to be sold over the counter, but anything else with ephedrine -- including herbal ma huang -- could be obtained only with a prescription from a medical practitioner registered to handle controlled substances. Products listing other names for ephedrine, like ephedra sinica, as an ingredient also would be pulled from retail shelves.

The debate

The comprehensive ban is being sought by the state Narcotics Enforcement Division, with backing from the city prosecutor's office, the Hawaii Medical Association and Honolulu police. Narcotics Administrator Keith Kamita said the division is troubled about the abuse of products promising more than clearer nasal passages, particularly those like Herbal Ecstacy that attract young people with claims of heightened sexual sensations and legal highs.

"There's always going to be good people who don't abuse it and use it for the reasons that it's been made," Kamita said. "It's a few bad apples."

Although health impacts in Hawaii are sketchy -- the state Health Department said it has gotten inquiries but no complaints -- the U.S. Food and Drug Administration said it has received more than 600 reports of "adverse events" linked to ephedrine products since 1993. Effects ranged from nervousness, to heart attacks, to death, with the complainant typically a young or middle-aged woman using the product for energy or weight loss.


By Ken Sakamoto, Star-Bulletin
A ma huang product label.



Other states already have acted. About 29 have put additional restrictions in place, with 13 scheduling ephedrine as a controlled substance, according to the narcotics division. Some of the motivation comes because ephedrine can be used to manufacture methamphetamine, a drug plaguing Hawaii.

Critics, though, object to the House's broad-brush approach. While doctors, dentists, podiatrists and osteopaths would have prescription powers, acupuncturists, herbalists and naturopathic physicians would be excluded. Downtown naturopath Jason Uchida was disappointed that a key part of his treatment arsenal could be placed out of bounds.

"When ma huang is prescribed responsibly, it has very good results for people who can really use it," he said. "There's really no substance that can substitute for it."

With ephedrine products widely available in mini-marts and elsewhere, enforcement could be a logistical challenge. Even after the Council prohibited sales of products like Herbal Ecstacy, they could still be bought in stores and nightclubs. Some think a ban simply would drive the products underground, or lead to stockpiling before it took effect. Jim Quitan, general manager of Powerhouse Training and Fitness Center in Pearl City, estimates that four out of five weight lifters use ephedrine in their workouts, a practice he said was shared by runners, swimmers and other athletes.

"They always will get it somehow," he said.

The nationwide debate has mobilized the Ad Hoc Committee on the Safety of Ma Huang. The Washington, D.C.-based organization, which lobbies for the herbal industry, has produced volumes of material questioning the accuracy of the FDA's complaints and asserting that clinical trials have never shown serious effects on humans -- and far fewer problems than coffee or aspirin.

The city law allows the sale of sports and weight-loss products to consumers over 21. Councilman Duke Bainum, who sought a stronger ban, said manufacturer pressure led to the exceptions. But Bainum, a physician, supported sections that permit acupuncturists and others to prescribe ephedrine products, and herbalists to sell the plant.

"We were not trying to discourage a different culture's practice of the healing arts," he said.

Soften the ban?

The proposed state ban could be loosened for similar reasons. After the Senate Judiciary Committee considered the bill on Tuesday, Co-Chairman Matt Matsunaga said there were "very, very convincing" arguments showing ma huang's beneficial uses, and little evidence of abuse. A decision will be made April 4.

House Judiciary Chairman Terrance Tom -- whose panel passed the bill after hearing only law-enforcement testimony -- said he is open to changes.

That would be good news to Kailua resident Wallace Klein. The independent distributor for Shaperite Concepts Inc. said thousands of Hawaii people spend at least $1.2 million annually for ma huang weight-loss supplements, including his sister-in-law, who lost 50 pounds in five months and has held her weight for a year.

"Like all good doctors, you should treat those ailments needing attention with the least invasive, least intrusive remedies," he told lawmakers. "You would not cut off a hand to remove an infected finger, nor amputate a leg to get rid of a diseased toe."

Lawmakers act to put dangerous
drug makers in withdrawal

By Alan Matsuoka
Star-Bulletin

Crystal methamphetamine comes from somewhere, and usually it's a clandestine laboratory. Honolulu police have counted about a dozen such labs since the start of 1996, and anticipate more. The problem, though, is the state doesn't have a law that says drug manufacturing is illegal. The Legislature is moving to change that.

Senate Bill 1277 SD1 would make kitchen chemists pay for their crime by imposing a 20-year maximum prison sentence for the manufacture of a dangerous drug. It's aimed particularly at the "ice" factories, mandating a 10-year minimum for anyone convicted of manufacturing methamphetamines. The Senate Judiciary Committee said crystal meth "presents an imminent public health threat as a highly addictive drug linked to violent behavior."

The bill is one of 10 this session endorsed by the Law Enforcement Coalition, composed of the four county police chiefs, the four prosecutors and the state Attorney General's office. Deputy AG Kurt Spohn said the state up to now could either turn to the feds -- who have a manufacturing law -- or prosecute for possession. But the amount possessed could drop the sentence out of Class A-felony territory.

"What happens is sometimes you have a case where it's a major drug dealer, and they have just finished a shipment, so the only thing the state is left with is the possibility of prosecuting them for a 'C' felony," Spohn said.

Police said the labs found here were converting the powder form of methamphetamine -- preferred on the mainland to shoot-up or snort -- to the smokeable crystal form favored here.

The simple conversion process usually involves materials like acetone, a highly flammable fluid blamed for a fire in a Crosspointe townhouse lab last year. Lt. Kevin Thomas of the HPD's Narcotics/Vice Division said the law would help protect people from the dangers of having a lab "right next door to your house where your kids may be playing." The incentive to set up a lab is considerable, he said: A dealer could realize up to a 400 percent profit by converting powder methamphetamine and selling gram amounts of the crystal form on the streets.

Police have not nabbed anyone yet for turning ephedrine into methamphetamine or, a step further back, extracting ephedrine from over-the-counter drugs. But a slew of recipes are just a Web page away, and such sophistication may be a matter of time -- if not already here. State Narcotics Division Administrator Keith Kamita said, "There are some cases where we're looking at people who are actually cooking." Since more dangerous materials are needed, "the chances of blowing your neighbor up, there's a good chance of that," he said.

Honolulu police are taking the threat seriously, with the narcotics/vice airport detail reporting crystal meth seizures tripling from 1995 to 1996.

Other drugs affected

Other drugs would be scheduled as a controlled substance under House Bill 113 HD1, or moved to a higher level of dangerousness. Among them, with descriptions from Narcotics Enforcement Division testimony:

Ketamine Hydrochloride. Often called "Special K," the animal tranquilizer combines the effects of phencyclidine (PCP) with the visual sensations of LSD, although touted as better than both since it lasts for an hour or less. Ketamine's impact depends on factors such as body size and the way it is taken. A solid form is snorted, put into drinks or smoked. A liquid form can be injected. A certain dosage may result in "K-land, a mellow, colorful wonder-world," while a larger dose can create a "K-hole, an out-of-body, near-death experience." The drug would be classified as a Schedule III substance.

Flunitrazepam/Rohypnol. The original "date-rape" drug. Users mix it with alcohol to enhance the feeling of drunkenness, and women have been sexually assaulted after their drinks were spiked with the drug. Abuse is widespread among street gangs near the Mexican border, who use it to sedate women for gang rape or gang initiation. It is sold by prescription in Mexico, South America, Europe and Asia, but is not legal in the United States. The drug would move from Schedule IV to Schedule I, the category for substances with the highest degree of danger and abuse. HLR Service Corp., a subsidiary of manufacturer Hoffmann-LaRouche Inc., said in opposition that it is not aware of abuse in Hawaii and that Rohypnol is a medication in the same family as Valium.

Gamma Hydroxybutyrate. GHB, or Liquid X, had caught the attention of authorities as another date-rape drug. Commonly put into fruit drinks, it produces feelings of relaxation and euphoria and has powerful sleep-inducing properties. Authorities warn that overdoses can lead to nausea, seizures and a comatose state that can last six hours. The drug would be classified as a Schedule I substance. Critics say GHB, which occurs naturally in the body, has been used in Europe for 35 years as an anesthetic and stress reducer and to treat ailments such as insomnia and alcohol withdrawal. They say dangers are overstated and there has been only one undocumented allegation of a date rape using GHB in the United States. Attention was focused after GHB was inaccurately linked to the death of actor River Phoenix, they say.



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