When customers get an undisclosed prescription drug in an over-the-counter supplement, they aren’t getting a bargain, and they may be getting a far more dangerous chemical cocktail than they’d expected. Lamar Odom, a former NBA player and a reality-show personality, was hospitalized Tuesday. In a call to 911, his companions said he’d combined cocaine with herbal sexual-performance supplements. Thousands of people every year have bad reactions to pills they’d never suspected could harm them.
The problem is that supplement users often don’t know what’s in the bottles they buy, and they can’t check to see if the supplements will react badly with other drugs or medical conditions. The Food and Drug Administration (FDA), for example, has warned customers to avoid Reload, one of the potency drugs Odom is said to have taken, because the pills tend to include more drugs than are disclosed in the ingredient list. The FDA has found that Reload sometimes contained the active ingredient in Viagra (sildenafil). When that drug is taken in tandem with nitrates (often used for heart disease), it can cause blood pressure to plunge dangerously low. Users of Viagra are warned about that, but Reload users may not be aware of it.
Deceptively labeled “herbal” sexual-performance supplements can become a game of Russian roulette for consumers. In a 2015 study of 150 “herbal” sex supplements (not all of which turned out to be truly herbal) in the Journal of Pharmaceutical and Biomedical Analysis, 59 percent of products included drugs that weren’t mentioned on their ingredient lists. Twenty-seven percent contained prescription drugs, and 34 percent contained slightly modified versions of prescription drugs. A quarter of the samples that contained prescription drugs and/or designer drug variants exceeded the maximum recommended dose.
Hidden ingredients in sexual and other supplements can cause medical emergencies. In a recent study in the New England Journal of Medicine, researchers tracked emergency room visits at 63 hospitals for 10 years (2004-13) to see how many patients came in as the result of supplement use. The researchers estimated that supplements cause 23,005 emergency room visits and 2,154 hospitalizations per year nationally. Twenty-one percent of these visits are the result of children accidentally taking supplements meant for adults, but the remaining 79 percent result from adults deliberately using supplements.
The three most common supplement types sending adults to the ER were weight loss (25.5 percent of ER visits), multivitamin or unspecified vitamins (16.8 percent), and energy (10 percent). Sexual-enhancement supplements were tied with calcium supplements as the fourth most likely cause of an ER visit (3.4 percent).1
The study doesn’t make it possible to estimate which supplements are the most dangerous. Weight loss supplements could rank first as a cause for ER visits because they are particularly likely to contain dangerous drugs or because they are widely used.
Sexual-enhancement supplements were responsible for a far larger share of men’s visits to the emergency room than women’s (14.1 percent of all supplement-linked visits for men, a too-small-to-measure share for women). All in all, sexual-enhancement supplements were estimated to cause 617 ER visits per year. Lamar Odom’s visit, linked to those substances, is simply the one that made the papers.