Alternative Medicines' Popularity Prompts Concern: Use of Alternative and Complementary Remedies on the Rise

Donya C. Arias

Nations Health. 2004;34(6) 

More than a third of Americans use some form of alternative and complementary medicine, according to a new federal survey, and international public health officials are warning that such remedies need better regulation and monitoring.

The National Center for Complementary and Alternative Medicine at the National Institutes of Health released a survey in late May that showed 36 percent of U.S. adults use some form of alternative remedies. They defined complementary and alternative medicine as a group of diverse medical and health care systems, practices and products that are not currently considered to be part of conventional medicine. Those practices include acupuncture, meditation, the use of herbal supplements and prayer. When prayer used specifically for health reasons is included in the definition of complementary and alternative medicine, the number of U.S. adults using complementary and alternative medicine rises to 62 percent.

"The data not only assists us in understanding who is using (complementary and alternative medicine), what is being used, and why, but also in studying relationships between (complementary and alternative medicine) use and other health characteristics, such as chronic health conditions, insurance coverage and health behaviors," said Stephen E. Straus, MD, director of the National Center for Complementary and Alternative Medicine.

The survey, which was administered to more than 31,000 U.S. adults, was conducted as part of the Centers for Disease Control and Prevention's 2002 National Health Interview Survey. Questions on 27 types of complementary and alternative medicine therapies commonly used in the United States were based on 10 types of provider-based therapies such as acupuncture and chiropractic care and 17 other therapies that do not require a provider. Those included herbs or botanical products, special diets and megavitamin therapy.

The study showed complementary and alternative medicine use was greater among a variety of population groups, including women, people with a college education, those who had been hospitalized within the past year and former smokers. This was the first survey to collect substantial information about complementary and alternative medicine use among minorities. For example, the results showed black adults were more likely than Asian or white adults to use complementary and alternative medicine when megavitamin therapy and prayer were included in the definition.

"Over the years, we've concentrated on traditional medical treatment, but this new collection of complementary and alternative medicine data taps into another dimension entirely," said National Center for Health Statistics Director Edward J. Sondik, PhD. "What we see is that a sizeable percentage of the public puts their personal health into their own hands."

The World Health Organization estimated that 80 percent of the population in many developing countries relies on alternative medicine. As the use of complementary and alternative medicine rises globally, so do the reports of adverse reactions. WHO issued guidelines in June that call for readily available information for consumers and an easy-to-use system for reporting adverse reactions, among other things.

Although WHO has no exact statistics on global complementary and alternative medicine use, officials cited a jump in reported adverse reactions in China from 4,000 between 1990 and 1999 to more than 9,800 in 2002 alone.

Duchy Trachtenberg, MSW, who heads APHA's Alternative and Complementary Health Practices Special Primary Interest Group, is working on a complementary and alternative medicine study to be published in APHA's American Journal of Public Health that echoes some of the NIH findings. She and colleagues conducted a preliminary survey of complementary and alternative medicine use among attendees at the 2003 APHA Annual Meeting to gauge such use in public health practice.

"The recent study data are not surprising given the steady increase in the use of (complementary and alternative medicine) by the American public," Trachtenberg said. "Many people are drawn to a more holistic public health equation, as they recognize the importance of self care and value alternative therapies as an integral part of that equation."

More information on the federal complementary and alternative medicine survey is available from http://nccam.nih.gov. The "WHO Guidelines: Developing Information on Proper Use of Traditional, Complementary and Alternative Medicine" can be found online at www.who.int/medicines/library/trm/consumer.pdf.

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