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INTRODUCTION
Complementary and Alternative Medicine (CAM) has seen a dramatic resurgence in recent years. The reasons for the
gaining popularity of natural medicines are many.
The decline of plant-based medicines and vitamins can be traced back to the rise of science, the scientific method,
and the introduction of the miracle drugs in the early part of the 20th century. These wonder drugs, mostly taken for
granted today, were truly revolutionary and welcomed as the solution to many previously hopeless health problems.
Antibiotics, steroid antiinflammatories (cortisol), and other drugs were developed in laboratories and it was thought
that science would eventually discover the cure for all diseases; things natural became old-fashioned and out of date.
It was the failing of many of these miracle medicines as the century closed that led the world to go in search of
alternatives. The decreasing effectiveness of antibiotics, in particular, spurred the search for replacements. The rise in
popularity of Echinacea (a common herb for colds and flues) can be traced to the decline of antibiotics.
Use of Complementary and Alternative Medicine
How many people use complementary and alternative medicine is difficult to determine. If prayer, used as a medical
treatment, is included as a CAM treatment, then it is estimated that over 50% of the people in the United States are
users of some from of alternative medicine; without prayer, that number is around 20-30% (depending on the study).
Use of CAM various from religious, cultural, and racial sub-groups, but remains around the 30% range for people in
the United States.
In a study done by the prestigious Journal of the American Medical Association, people who use alternative medicine
tend to be more educated and in poorer health. The top therapies they chose are chiropractic, lifestyle/diet,
exercise/movement and relaxation. Very few of these people chose to only use CAM, often mixing their standard
medications with the alternatives. This presents a potential for harm, as many complementary and alternative
medicines interfere with conventional medications and many CAM therapies lack studies for their potential for
interactions.
The top reasons for a visit to a CAM practitioner is to treat back pain or back problems, head or chest colds, neck pain
or neck problems, joint pain or stiffness, and anxiety or depression. The amount of people using CAM specifically for
mental disorders is similar for other general conditions. In one study, 10% percent of patients with schizophrenia and
30% of patients with an affective disorder (major depressive disorder, bipolar disorders, and anxiety disorders are the
most common affective disorders) consult an alternative care practitioner for either physical or psychiatric symptoms.
It is commonly thought that people visit CAM practitioners because they don’t like or are concerned with the side
effects of standard medications. Patient surveys reveal that this isn’t so. Patients tend to choose complementary and
alternative medicine because CAM it matches their own values, beliefs, and philosophical orientation to life and
health. Dissatisfaction with conventional medicine does not predict who will use CAM.
Defining Alternative Medicine
Alternative medicine is the medicine of many different names. What this medicine encompasses is constantly shifting
and open to opinion and perspective.
Consider the following list: acupuncture; biofeedback training; chiropractic; diets; exercise; energy healing; herbal
remedies; homeopathic treatment; hypnosis; imagery or relaxation techniques; massage therapy; nutritional advice;
spiritual healing or prayer; traditional medicine (for example, Chinese or Indian medicine); training or practice of
meditation, vitamin therapy, yoga.
It is difficult to account for this diverse amount of practice with one term.
Some practitioners prefer the term Natural medicine. This term, however, does not capture the whole concept of the
medicine. While many of the products that are used do come from nature, many do not. For example, S-adenosyl-L-
methionine (SAMe) doesn’t grow on a tree, but is found circulating in our blood and can be manufactured and given to
a patient. Likewise, how natural is it to supplement with vitamins and minerals? The term “Natural Medicine” does not
capture practices such as acupuncture, massage, light therapy and many other common treatments.
Other practitioners prefer the term Complementary medicine. This word suggests a type of medicine complements
standard medical practice. This term has been combined in recent years with alternative medicine to produce another
term: Complementary and Alternative Medicine (CAM). CAM practitioners offer treatments that are either an alternative
or a complement to standard medicine.
Integrative medicine is latest term that attempts to describe this approach. Many practitioners who use this term feel
that the term “Integrative” more accurately describes the collaboration between standard medicine and alternative
medicine instead of assuming one is better than another.
Complementary and Alternative Medicine is probably the most accurate description of the medicine. Complementary
and Alternative Medicine describes an approach that can stand on its own, and is an alternative to standard medicine,
and at other times, these medicines and modalities are complementary to standard medicine. Many supplements
used in CAM practice have been studied in combination with standard medicine and they often help these medicines
work better or reduce the side effects of prescription medications.
CAM Practitioners
While what is CAM medicine is hard to define, who are CAM practitioners is equally as hard. A medical doctor may
decide to use a vitamin to lesson the side effects of a drug. Is he practicing CAM medicine? Maybe and maybe not. Is
exercise an alternative treatment? What about light therapy for seasonal depression? Clearly herbs and vitamins fall
under the CAM umbrella, but what about yoga or diet? Or what happens when you concentrate an herb so that it
behaves more like a drug? Many drugs, such as digitalis (used for heart disease), began as herbs or are a
concentrated form of the herb.
The medical doctor using herbs and vitamins may consider himself a standard practitioner because the supplements
he suggests are backed by scientific studies. Chiropractors or acupuncturists may consider themselves standard
practitioners and be insulted when they are called alternative. Acupuncture has been around for over 3000 years. Who
is the conventional and who is the alternative practitioner when you look at is through the eyes of 3000 years of
continuous practice?
Clearly, there is a lot of confusion and ever-changing lines that describe CAM medicine and CAM practitioners.
Choosing a CAM Practitioner
Not all CAM practitioners are created equal.
Choosing a CAM practitioner requires some investigative work before entrusting your health to them. There is
potential for harm from a practitioner who doesn’t know what they are doing, or who isn’t aware of the harmful side
effects of not only what they are prescribing, but also the dangers associated with the course of illness. Many
seemingly innocent conditions, like a headache, drooling in a child with a cold, gas and bloating in a post-
menopausal woman all have the potential to be very serious conditions. Does your CAM practitioner know enough to
refer you to medical care if the situation warrants it? Most good CAM practitioners have associations with standard
medical practitioners; make sure to ask about this when interviewing a CAM practitioner.
When visiting any complementary and alternative practitioner, checking their background is essential. Many good
complementary and alternative practitioners attend certified schools, have to pass a licensing exam, and are licensed
by the state in which they live; other practitioners do not have such oversight. While attending a qualified school and
being licensed does not necessarily guarantee that the practitioner is honest and knowledgeable, it does amount to
some measure of safety. Passing an exam that is required for practice ensures a basic level of safety and knowledge
of the practitioner. State boards often act as a secondary oversight of the practitioner and can strip them of their ability
to practice if they fail to meet certain standards.
The most common licensed practitioners are chiropractors and acupuncturists. Most states license chiropractors and
acupuncturists. Naturopathic doctors attend qualified schools and are licensed in some states. Some people call
themselves naturopaths without ever attending a naturopathic medical school and this often leads to confusion.
If the practitioner you are thinking of working with is licensed, then ask to see the license and check with the state
board if you have any questions about them or the type of medicine they use. Asking the practitioner about their
training and any references is also helpful.
If the practitioner is not licensed, then you have more work in front of you. Once again, ask about references and
training, but you will also want to ask about their relationships with medical professionals and what they might do if
they think the alternative methods they are prescribing aren’t working. The severity of your illness is a good barometer
for determining how deeply you should investigate the practitioner. A toenail fungus might as easily be taken care of
through a variety of practitioners, but cancer, heart disease, or severe mental illness is another story. A mild
depression or anxiety might well be taken care of by a trip to the health-food store, but self-medicating can often lead
to troubles.
Depression or anxiety may be a sign of an underlying disease, such as high or low thyroid. Having a qualified
complementary and alternative practitioner and a standard health care practitioner working with you can strengthen
the odds that you are getting the best quality of care.
The Safety of Alternative Medicine
Alternative medicine is far from being completely benign. Many people associate natural with safe; this is often not the
case. Cyanide and arsenic are natural and have the potential for harm. While most CAM therapies are safe, many
have side effects or interfere with standard medical prescriptions. Problems often arise when people take large
amounts of supplements thinking that more is better or are taking supplements along with standard medications
without first checking to see if they might cause problems.
Complementary and Alternative medicines have the advantage of being easily available and taken over-the-counter;
this is also their disadvantage. It is easy to think that since these remedies are so easy to obtain, that they cause no
harm. Natural substances can have side effects or interfere with drugs (either by making the drug stronger, or by
making the drug weaker). If you are taking any prescription medications, you should always check with a qualified
health practitioner before starting any natural therapy.
Supplement quality is also a concern. With very little oversight, supplement companies can skimp on ingredients or
fail to follow good manufacturing practices. Your CAM or standard health care provider is probably the best source for
determining good brands of supplements.
There has also been a recent move to standardize herbal preparations. While standardization is mostly a good thing,
the end result is that the herbs are more highly concentrated. A highly concentrated herb acts much more like a drug
than a benign plant. Standardized St. John’s Wort, for example, interferes with the metabolism of many other drugs
(usually making the prescription drug less effective). Caution must be taken with these medicines....<continued>
Understanding that “natural” does not, necessarily, mean harmless is a good place to start. Checking with your health
care practitioner whenever you decide to start taking a new supplement is essential part of taking care of yourself.
Complementary and Alternative Medicine (CAM) has seen a dramatic resurgence in recent years. The reasons for the
gaining popularity of natural medicines are many.
The decline of plant-based medicines and vitamins can be traced back to the rise of science, the scientific method,
and the introduction of the miracle drugs in the early part of the 20th century. These wonder drugs, mostly taken for
granted today, were truly revolutionary and welcomed as the solution to many previously hopeless health problems.
Antibiotics, steroid antiinflammatories (cortisol), and other drugs were developed in laboratories and it was thought
that science would eventually discover the cure for all diseases; things natural became old-fashioned and out of date.
It was the failing of many of these miracle medicines as the century closed that led the world to go in search of
alternatives. The decreasing effectiveness of antibiotics, in particular, spurred the search for replacements. The rise in
popularity of Echinacea (a common herb for colds and flues) can be traced to the decline of antibiotics.
Use of Complementary and Alternative Medicine
How many people use complementary and alternative medicine is difficult to determine. If prayer, used as a medical
treatment, is included as a CAM treatment, then it is estimated that over 50% of the people in the United States are
users of some from of alternative medicine; without prayer, that number is around 20-30% (depending on the study).
Use of CAM various from religious, cultural, and racial sub-groups, but remains around the 30% range for people in
the United States.
In a study done by the prestigious Journal of the American Medical Association, people who use alternative medicine
tend to be more educated and in poorer health. The top therapies they chose are chiropractic, lifestyle/diet,
exercise/movement and relaxation. Very few of these people chose to only use CAM, often mixing their standard
medications with the alternatives. This presents a potential for harm, as many complementary and alternative
medicines interfere with conventional medications and many CAM therapies lack studies for their potential for
interactions.
The top reasons for a visit to a CAM practitioner is to treat back pain or back problems, head or chest colds, neck pain
or neck problems, joint pain or stiffness, and anxiety or depression. The amount of people using CAM specifically for
mental disorders is similar for other general conditions. In one study, 10% percent of patients with schizophrenia and
30% of patients with an affective disorder (major depressive disorder, bipolar disorders, and anxiety disorders are the
most common affective disorders) consult an alternative care practitioner for either physical or psychiatric symptoms.
It is commonly thought that people visit CAM practitioners because they don’t like or are concerned with the side
effects of standard medications. Patient surveys reveal that this isn’t so. Patients tend to choose complementary and
alternative medicine because CAM it matches their own values, beliefs, and philosophical orientation to life and
health. Dissatisfaction with conventional medicine does not predict who will use CAM.
Defining Alternative Medicine
Alternative medicine is the medicine of many different names. What this medicine encompasses is constantly shifting
and open to opinion and perspective.
Consider the following list: acupuncture; biofeedback training; chiropractic; diets; exercise; energy healing; herbal
remedies; homeopathic treatment; hypnosis; imagery or relaxation techniques; massage therapy; nutritional advice;
spiritual healing or prayer; traditional medicine (for example, Chinese or Indian medicine); training or practice of
meditation, vitamin therapy, yoga.
It is difficult to account for this diverse amount of practice with one term.
Some practitioners prefer the term Natural medicine. This term, however, does not capture the whole concept of the
medicine. While many of the products that are used do come from nature, many do not. For example, S-adenosyl-L-
methionine (SAMe) doesn’t grow on a tree, but is found circulating in our blood and can be manufactured and given to
a patient. Likewise, how natural is it to supplement with vitamins and minerals? The term “Natural Medicine” does not
capture practices such as acupuncture, massage, light therapy and many other common treatments.
Other practitioners prefer the term Complementary medicine. This word suggests a type of medicine complements
standard medical practice. This term has been combined in recent years with alternative medicine to produce another
term: Complementary and Alternative Medicine (CAM). CAM practitioners offer treatments that are either an alternative
or a complement to standard medicine.
Integrative medicine is latest term that attempts to describe this approach. Many practitioners who use this term feel
that the term “Integrative” more accurately describes the collaboration between standard medicine and alternative
medicine instead of assuming one is better than another.
Complementary and Alternative Medicine is probably the most accurate description of the medicine. Complementary
and Alternative Medicine describes an approach that can stand on its own, and is an alternative to standard medicine,
and at other times, these medicines and modalities are complementary to standard medicine. Many supplements
used in CAM practice have been studied in combination with standard medicine and they often help these medicines
work better or reduce the side effects of prescription medications.
CAM Practitioners
While what is CAM medicine is hard to define, who are CAM practitioners is equally as hard. A medical doctor may
decide to use a vitamin to lesson the side effects of a drug. Is he practicing CAM medicine? Maybe and maybe not. Is
exercise an alternative treatment? What about light therapy for seasonal depression? Clearly herbs and vitamins fall
under the CAM umbrella, but what about yoga or diet? Or what happens when you concentrate an herb so that it
behaves more like a drug? Many drugs, such as digitalis (used for heart disease), began as herbs or are a
concentrated form of the herb.
The medical doctor using herbs and vitamins may consider himself a standard practitioner because the supplements
he suggests are backed by scientific studies. Chiropractors or acupuncturists may consider themselves standard
practitioners and be insulted when they are called alternative. Acupuncture has been around for over 3000 years. Who
is the conventional and who is the alternative practitioner when you look at is through the eyes of 3000 years of
continuous practice?
Clearly, there is a lot of confusion and ever-changing lines that describe CAM medicine and CAM practitioners.
Choosing a CAM Practitioner
Not all CAM practitioners are created equal.
Choosing a CAM practitioner requires some investigative work before entrusting your health to them. There is
potential for harm from a practitioner who doesn’t know what they are doing, or who isn’t aware of the harmful side
effects of not only what they are prescribing, but also the dangers associated with the course of illness. Many
seemingly innocent conditions, like a headache, drooling in a child with a cold, gas and bloating in a post-
menopausal woman all have the potential to be very serious conditions. Does your CAM practitioner know enough to
refer you to medical care if the situation warrants it? Most good CAM practitioners have associations with standard
medical practitioners; make sure to ask about this when interviewing a CAM practitioner.
When visiting any complementary and alternative practitioner, checking their background is essential. Many good
complementary and alternative practitioners attend certified schools, have to pass a licensing exam, and are licensed
by the state in which they live; other practitioners do not have such oversight. While attending a qualified school and
being licensed does not necessarily guarantee that the practitioner is honest and knowledgeable, it does amount to
some measure of safety. Passing an exam that is required for practice ensures a basic level of safety and knowledge
of the practitioner. State boards often act as a secondary oversight of the practitioner and can strip them of their ability
to practice if they fail to meet certain standards.
The most common licensed practitioners are chiropractors and acupuncturists. Most states license chiropractors and
acupuncturists. Naturopathic doctors attend qualified schools and are licensed in some states. Some people call
themselves naturopaths without ever attending a naturopathic medical school and this often leads to confusion.
If the practitioner you are thinking of working with is licensed, then ask to see the license and check with the state
board if you have any questions about them or the type of medicine they use. Asking the practitioner about their
training and any references is also helpful.
If the practitioner is not licensed, then you have more work in front of you. Once again, ask about references and
training, but you will also want to ask about their relationships with medical professionals and what they might do if
they think the alternative methods they are prescribing aren’t working. The severity of your illness is a good barometer
for determining how deeply you should investigate the practitioner. A toenail fungus might as easily be taken care of
through a variety of practitioners, but cancer, heart disease, or severe mental illness is another story. A mild
depression or anxiety might well be taken care of by a trip to the health-food store, but self-medicating can often lead
to troubles.
Depression or anxiety may be a sign of an underlying disease, such as high or low thyroid. Having a qualified
complementary and alternative practitioner and a standard health care practitioner working with you can strengthen
the odds that you are getting the best quality of care.
The Safety of Alternative Medicine
Alternative medicine is far from being completely benign. Many people associate natural with safe; this is often not the
case. Cyanide and arsenic are natural and have the potential for harm. While most CAM therapies are safe, many
have side effects or interfere with standard medical prescriptions. Problems often arise when people take large
amounts of supplements thinking that more is better or are taking supplements along with standard medications
without first checking to see if they might cause problems.
Complementary and Alternative medicines have the advantage of being easily available and taken over-the-counter;
this is also their disadvantage. It is easy to think that since these remedies are so easy to obtain, that they cause no
harm. Natural substances can have side effects or interfere with drugs (either by making the drug stronger, or by
making the drug weaker). If you are taking any prescription medications, you should always check with a qualified
health practitioner before starting any natural therapy.
Supplement quality is also a concern. With very little oversight, supplement companies can skimp on ingredients or
fail to follow good manufacturing practices. Your CAM or standard health care provider is probably the best source for
determining good brands of supplements.
There has also been a recent move to standardize herbal preparations. While standardization is mostly a good thing,
the end result is that the herbs are more highly concentrated. A highly concentrated herb acts much more like a drug
than a benign plant. Standardized St. John’s Wort, for example, interferes with the metabolism of many other drugs
(usually making the prescription drug less effective). Caution must be taken with these medicines....<continued>
Understanding that “natural” does not, necessarily, mean harmless is a good place to start. Checking with your health
care practitioner whenever you decide to start taking a new supplement is essential part of taking care of yourself.