Prior to 2004, ephedra had been readily available to adolescents. Due to reports that use of ephedra produced a number of serious adverse consequences, including death, sales of the compound became illegal in the United States on April 12, 2004. Data are presented from a random sample of 156,050 students in grades 7 through 12 from 185 rural communities across the United States who completed the Community Drug and Alcohol Survey. This study provides a valuable epidemiological benchmark of reported rates of lifetime prevalence of ephedra by adolescents living in rural America before the sale of the drug became illegal (data were collected between 1996 and 2001). While there were small regional, racial, and gender differences, rates of adolescent use were, in general, very low. The highest rates of ephedra use were found among youth using other drugs, particularly stimulants. The study's limitations and implications are discussed.
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