What is the difference between conventional, complementary, and alternative medicines and therapies?
Conventional therapies are prescribed by a doctor and are based on scientifically-proven evidence from clinical studies. Complementary therapies refer to treatments that you take in addition to conventional medications. Alternative medicine is something that replaces conventional medical treatment.
Complementary and alternative medicines (CAMs) are not scientifically proven. There is some evidence that some CAMs are effective, especially in addressing quality of life issues (i.e., emotional well-being, stress management, and pain management). Questions remain, however, as to their reliability and long-term effectiveness.
Are CAMs safe?
Several complementary medicines are considered safe because there is scientific evidence to support their safety and effectiveness. Some types of yoga, guided meditation, various forms of exercise, and acupuncture can all be considered safe complementary therapies that promote better health care and symptoms management. Usually, these types of therapies are used in conjunction with conventional care or even at a doctor's suggestion. However, keep in mind that complementary medicines are not intended to treat any disease state. They are used to enhance emotional well-being and quality of life.1 Alternative therapies are generally not prescribed by a conventional medical practitioner because their effectiveness is not based on scientific evidence. Alternative therapies are usually used in place of conventional therapy to treat a disease and this can be dangerous. Herbal supplements can fall into this category when they are used in this manner.
How you respond to an herbal therapy can vary, depending on your state of health and the type of treatment. “Natural” dietary supplements sound safe to use, but remember the manufacturer is the one making the claim, not the Food and Drug Administration. Safety depends on a number of things including the ingredients being used, where the ingredients come from, and under what conditions they are processed and manufactured. Before taking a non-prescribed supplement, visit the FDA website and see if any information is available regarding its safety.
Some supplements have been found to be contaminated or to contain ingredients that are not listed on the label, and some may even have different amounts of ingredients than are listed on the label. Some supplements my interfere with conventional medications. Be sure to discuss with your doctor before taking any vitamin or herbal supplement.
See also: Nutritional Supplements
Why would someone consider an unproven alternative therapy?
Some people may turn to alternative therapies when all conventional roads have been exhausted, or they might be concerned about the toxic side effects of conventional medicines and want to try an alternative therapy first (although herbal supplements can cause side effects as well). For people from certain cultures, alternative therapies may be considered “conventional.” Others may choose an alternative therapy simply because they do not trust conventional wisdom.
What are the different types of CAMs?
According to the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health, there are 4 categories of CAM practices:1
- Whole Medical Systems (e.g., traditional Chinese medicines, acupuncture, ayurveda)
- Mind-Body Medicine (e.g., meditation, yoga, tai chi)
- Biologically-based Practices (e.g., dietary and herbal supplements)
- Manipulative and Body-based Practices (e.g., reflexology, massage)
How popular are CAMs?
According to a 2002 national survey of 17,295 women, about 40% of women have used some form of complementary or alternative therapy. The most popular type of CAMs were biologically-based therapies (23.8%) followed by mind-body therapies (20.9%). The study showed that CAMs were frequently used in combination with conventional medicine.2
Another survey of 2,500 participants (51% of whom were women) found that people take vitamins and supplements for a variety of reasons; mostly because they perceive them as “healthy” or “good for you.” The survey showed that 14% of respondents took herbals/supplements and that among prescription drug users 16% also took an herbal/supplement. This does raise concern among health care professionals as they may be unaware of their patients taking an herbal/supplement with a conventional medicine.3
How do I find reliable information regarding CAM therapies?
Talk to your doctor about what you would like to know regarding a therapy you are considering. Your doctor might be able to answer any questions; if not, he or she may be able to direct you to someone who can. Read up on the therapy you are interested in by searching the Internet or going to a library and finding books related to the subject. Also, look at Understanding Research Studies on this site so you can evaluate the evidence you come across.
Finally, there are a number of government web sites you can visit for information on clinical trials, scientific reports, product recalls, and consumer safety alerts regarding CAM therapies.
- U.S. Food and Drug Administration: http://www.fda.gov
- Center for Food Safety and Applied Nutrition: http://www.fda.gov/Food/default.htm
- Information on recalls and consumer safety alerts: http://www.fda.gov/Safety/default.htm
- National Center for Complementary and Alternative Medicine: http://nccam.nih.gov
How do I find a certified CAM practitioner?
Ask your doctor, other health care professional, or other knowledgeable source for a referral or for information on finding a CAM therapist. Contact your local hospital or medical school/university to see if there is a CAM practitioner on staff. Check with your state, county, or city health department and to find out if there is a list of registered, licensed practitioners in your area. For a list of CAM organizations, try the National Library of Medicine's Directory of Information Resources http://dirline.nlm.nih.gov.
Once I have located a therapist, what should I do?
You will want to know as much about the practitioner as you can. At the same time, be prepared to give as much information on your medical history as you can. Before your first appointment, ask if you can meet with the practitioner beforehand or have a telephone interview. Get a sense of the person and the environment in which he or she works to ensure you are going to be comfortable with treatment. You will want to know the practitioner's training, background, qualifications, and experience with dealing with others that have the same complaint as you. Ask about the benefits and the risks, if any, of therapy, if there will be any side effects, and if therapy will affect any of your daily routines.
Will insurance cover CAM therapy?
Some insurance policies do cover certain kinds of CAM therapies. If you have insurance, read your policy to see if the type of therapy you are seeking is covered. Some policies cover acupuncture or other CAM therapies. Check with the therapist and see if she/he accepts insurance. If you don't have insurance or if the treatment is not covered, find out how much each session is going to cost you and estimate how many visits you will need. This way you can calculate the total cost of treatment and decide if it is economically feasible.
1. National Center for Complementary and Alternative Medicine (NCCAM). National Institutes of Health. August 3. Available at: http://nccam.nih.gov/. Accessed August 7, 2007.
2. Upchurch DM, Chyu L, Greendale GA, et al. Complementary and alternative medicine use among American women: findings from The National Health Interview Survey, 2002. J Womens Health (Larchmt). Jan-Feb 2007;16(1):102-113.
3. Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. JAMA. Jan 16 2002;287(3):337-344.