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Jul 30, 2009 03:10 PM | 41
People in the U.S. spent $33.9 billion last year on alternative health goods and services, ranging from antioxidant supplements to yoga, according to a new study released today by the National Institutes of Health (NIH).
About 38 percent of adults are using some sort of alternative treatment (known as “complementary and alternative medicine” or CAM), and what they’re buying makes up about 11 percent of total U.S. out-of-pocket health care spending, the report states.
“With so many Americans using and spending money on CAM therapies, it is extremely important to know whether the products and practices they use are safe and effective,” Josephine Briggs, director of NIH’s National Center for Complementary and Alternative Medicine, said in a prepared statement.
Spending on natural products ($14.8 billion), such as omega oils or St. Johns Wart, of which the effectiveness remains unproven by the U.S. Food and Drug Administration (FDA), was about a third of what people spent on prescription drugs annually; and total visits to alternative treatment practitioners, such as chiropractors or acupuncturists, were equivalent to about a quarter of the out-of-pocket money spent on physician visits.
“This underscores the importance of conducting rigorous research and providing evidence-based information on CAM,” Briggs said, “so that health care providers and the public can make well-informed decisions.”
With about $4.1 billion going to yoga, tai chi and qigong classes (and $200 million to other relaxation techniques) annually, are Americans any more equanimous? A study by the American Psychological Association in 2007 (the same year the CAM data was collected) found that about half of Americans reported an increase in stress over the past five years and more than two thirds of Americans reported physical and/or psychological symptoms of stress.
If alternative medicines still seem like a gamble, keep in mind that spending on these treatments was just a touch less than the $34 billion people lost in nontribal-owned U.S. casinos last year.
Image courtesy of iStockphoto/evgenyb
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41 Comments
Add CommentSomeone should start a line of products called "Placebo". They could have snappy subtitle like "You'll feel better, unless you think you won't!"
Reply | Report Abuse | Link to thisThe ancient herbalists knew what they were doing. Many naturally occurring substances have potent medicinal effects. Also, just because the FDA says one thing or another, doesn't mean it's true. They are quite notorious for being just plain unreasonable and slow when it comes to certain things. It has taken YEARS for stevia based sweeteners to hit the market in the US because the FDA thought they might be dangerous... despite the fact that stevia meets all the requirements for safe herbs. It had nothing to do with safety and everything to do with the artificial sweetener industry.
Reply | Report Abuse | Link to thisAs for St. John's Wort (specifically noted in this article), many studies have shown that it is just as effective at treating mild to moderate depression as antidepressants. They are almost completely ineffective at treating severe depression... but so are the major antidepressants.
In the old times, the people lived off the land. If the plants they used for medicine didn't work, they wouldn't have used them. Trying to undercut this by suggesting that natural remedies are useless is completely dishonest. This is especially true when you consider that many pharmaceuticals came from natural sources. Penicillin comes from fungi, Aspirin comes from willow bark, and the list goes on.
Natural remedies are also a threat to man-made remedies based on the simple fact that you cannot patent nature. If a plant can be useful, but cannot be patented, then anyone can sell it, and therefore it is more difficult to make money off of it. In other words, why should I buy St. John's Wort, when I can grow it in my backyard? Big pharma knows this and the lobbyists dole out money to politicians to affect laws accordingly.
The FDA is slow. Would you be willing to accept safety and effectiveness studies done by big pharma if they were of the same quality as the CAM studies? I certainly wouldn't. Why should I use different criteria for snake oil?
Reply | Report Abuse | Link to this
Reply | Report Abuse | Link to thisNat said it well, most 'natural' remedies are bogus though fish oil is proven and as or more effective than most pills.
The facts is most pills are not effective and can even kill you. I got fibromialgia but it turned out to be Lipitor anf Zocor caused depression in me so now I do fish oil, aspirin, diet and should exercise is much better that the medicine that is suppose to help.
Why we need universal health care is everyones records with lifestyle we can at the push of a program button find the causes and cures, effectiveness for many of our health problems, medicines cutting medical costs by 1/3.
Thank you Nathaniel. I agree with you 100%. I have been an herbalist all my life. Alternative medicine works for me.
Reply | Report Abuse | Link to thisAbsolutely ridiculous to lump yoga in with unverified (according to the FDA) oral supplements. Aside from other benefits that some may attribute to yoga (equanimity/peace/chakra balance), yoga asanas (poses) in a sustained sequence constitute isometric exercise at the very least. I have done yoga for 13 years, seen my own body, as well as my clients', improve in tone and flexibility. A cardiovascular vinyasa practice will promote weight loss, and it is well documented by the NIH that yoga has been known to lower blood pressure. To insult the practice by inserting it underneath a title that includes the term "snake oil" is ludicrous and sloppy reporting.
Reply | Report Abuse | Link to thisThe "ancients" and old-timers were just as susceptible to the placebo effect as anyone, and the physicians of the time just as susceptible to wishful thinking and confirmation bias. Bloodletting, anyone? Mummy dust? Powdered rhino horn?
Reply | Report Abuse | Link to thisI have to share how irritated I get by this kind of article.
Reply | Report Abuse | Link to thisHow much are people spending on conventional medications and treatments that have been shown to do actual damage or are "off-label" and not shown to be effective for as many uses as they put to?
Why are the studies that ARE available (e.g., fish oil being a good example) not accounted the same respect as equally strong (or weak) studies about conventional drug or surgical treatments?
If the FDA really wants this information on CAM interventions, why is there such miniscule funding available for the research -- with most research funded by interested non-profits?
Why are physicians and others who don't know the available literature or practices in these CAM areas still seen as appropriate, credible experts on their usefulness?
Why are the standards for CAM set higher than those for the pharmaceutical companies and hospitals?
The cynical, irritated me feels she knows the answer to these questions...
Thanks for letting me rant - I feel better now ;-)
"Why are the standards for CAM set higher than those for the pharmaceutical companies and hospitals?"
Reply | Report Abuse | Link to thisThey're not. The reason they're getting this negative attention is because they're not.
If some conventional (AKA tested) drugs are having problems it's because they are under- or improperly tested, but that doesn't mean CAM should be allowed to be under- or improperly tested - it means nothing should be.
Even if it was all attributable to placebo effect, the same is true of the pharmaceuticals, and who cares, as long as it works for people and doesn't cause harm. In general, herbals are cheaper and have fewer undesirable effects.
Reply | Report Abuse | Link to thisIt's also irritating to see the idea of wellness care & preventatives, like the exercise & relaxation benefits of yoga & meditation put in with treatments for specific conditions. Would they include long walks among these "useless" approaches to wellness?
Well said!
Reply | Report Abuse | Link to thisBut Johnay, that's my point on that particular item.
Reply | Report Abuse | Link to this- The FDA approves under-researched drugs and procedures all the time.
- I have seen over my years of involvement in the health care "industry" (and why is health an Industry, we might wonder??) laudatory articles about new medical or surgical interventions with precious little research to support it. And that research having limited numbers of participants or high rates of side-effects.
I have also seen CAM research with good numbers, appropriate statistics, and meaningful outcomes be dismissed because "there aren't enough studies to prove the effect is real".
Deadly interventions have been used in hospitals "off-label", but god forbid a family should try to bring in fish oil for a family member.
And this is just one of my points -- it's the combination of all these attitudes that creates the problem and prevents a useful cooperative solution.
If you aren't aware of the double standard, you either haven't been paying attention or you are hooked in by it or you haven't had your own health crisis you wanted to handle differently or....??
And I agree that nothing should be prescribed until the practitioner knows the likely effects and side-effects for that person (which rules out most meds, actually, since all the research is done in groups, not for predicting individual clinical responsiveness). But why "start" the implemetation of the standards with CAM -- why not visit the financially-lucrative and powerful pharmaceuticals as well -- and take a look at surgical procedures as well while we're at it?
You are spewing nonsense. Drugs cost close to $1 billion dollars in testing and take about 10 years to get on the market and even then can be found wanting before approval or found to have side effects that merit removal. CAM doesn't come near to even spending a fraction of this cost. FDA does not approve off label uses. Where do you get the notion it does? I want the big CAM industry to spend as much testing out the safety and efficacy of their snake oil. I don't want the taxpayer to be paying this. If you ever read the CAM studies, you would see they aren't worth the paper they're printed on. I don't trust anyone. You seem to trust snake oil peddlers. No thank you.
Reply | Report Abuse | Link to thisLumping categories together to achieve the desired propagandistic effect is something one has come to expect from political organizations eager to exploit irrational fears ( examples: "firearms have caused X injuries or deaths"; "investigators found 100 sexually explicit photos of girls aged 6 to 16").
Reply | Report Abuse | Link to thisBut it's surprising and much more disturbing to find such usage in a publication dedicated to science:
"Spending on natural products ($14.8 billion), such as omega oils or St. Johns Wart, of which the effectiveness remains unproven by the U.S. Food and Drug Administration (FDA)"
What exactly remains "unproven" by the FDA, the effectiveness of "omega oils" (presumably long chain Omega-3, not Omega-6 oils), or of St. John's Wort, or both?
And why should the absence of FDA approval be of any scientific significance?
The patented Androderm testosterone patch is approved by the FDA, yet the use of time-released subcutaneous testosterone pellets is not. And this despite the fact that the latter have been used successfully and without issues for 40 years in the US, and much longer in Europe, while the former are a much newer product with several serious delivery issues.
This has nothing to do with science or good health practice, and everything to do with the FDA's role as the handmaiden of the pharmaceutical industry. The FDA demands clinical trials taking years to complete, and costing millions, to "approve" a drug. And this limits the possibility of approval to drugs that are patentable and owned firms with very deep pockets.
Recently, the FDA has taken this predatory function to another level by proposing to ban the use of pyridoxamine so that a pharaceutical firm prepared to invest in clinical trials may have a monopoly to recoup its investment.
http://www.lef.org/magazine/mag2009/jul2009_B6-Vitamers_01.htm
If "60-second Science" cannot avoid uncritically propagating such mumbo-jumbo, then perhaps it's time to upgrade to "5-minute Science"
As several people have already stated, I also find this article to be rather unresponsible. It lumps in several things such as yoga and tai-chi which DO have proven health benefits - it's exercise, after all - under the umbrella of alternative medicine which apparently has no researched benefits. It's not logically consistent.
Reply | Report Abuse | Link to thisThe true question isn't about the political pigeonholing of what constitutes alternative medicines, but is "how much money do people spend on therapies that do not address the issues that they want to fix as advertised?"
A person drinking water to stay hydrated and healthy is making a good decision; a person drinking water to grow a new lung after one has been removed is wasting their time and money, and that waste is what this article should be addressing, whether it falls under "alternative medicine" or otherwise.
See
Reply | Report Abuse | Link to thisFrom Medscape Pharmacists
Top Herbal Products: Efficacy and Safety Concerns
http://cme.medscape.com/viewarticle/568235
Cases in CAM: Red Yeast Rice -- What's in a Name? Evidence is strong on the cholesterol-lowering benefits of red yeast rice, but not all RYRs are the same. ...
http://cme.medscape.com/viewprogram/17224
Good articles on the stuff that works and the stuff that doesn't.
You'll need to establish a free account.
Katherine Harmon could have written a better article, if she had read the NIH findings first. In most cases, researchers found enough statistically significant benefit to warrant further study, and nothing to warrant the snide, dismissive tone. The list of therapies defined as 'CAM' changes every few years, as ongoing research proves the efficacy of a given procedure, or reveals the 'active ingredient' in a centuries-old herbal remedy.
Reply | Report Abuse | Link to thisThere is a big difference between skeptics and scoffers. Unfortunately, Sciam has become a forum for the latter, printing these blatantly biased and distorted reports without review or challenge. The explicit scoffer position is that a therapy cannot work if we are unable to explain how it works. This is a logical fallacy and a perversion of the scientific method. Reserchers recently discovered that we didn't know how Aspirin worked, our theory was wrong, and yet it worked nonetheless.
If CAM is all in the mind, nothing but 'placebo effect', then we need to discuss the beliefs of the American Thoroughbred. Accupuncture is now the treatment of choice for a variety of potentially fatal or crippling equine ailments -- mandated by insurance companies, after comparing the outcomes of conventional vs alternative therapies. I suggest a brief field trip to Kentucky, give a sugar pill to a suffering mare, say "You'll feel better soon," and see how that works out.
Since when does anyone with a brain depend on the FDA as the last word?
Reply | Report Abuse | Link to thisClearly demonstrated that the FDA and big Pharma are in bed together.
Do you trust your doctor? By their own admission, doctors were responsible for thousands of deaths from breast cancer related to hormone therapy because they refused to look at the data right in front of their faces, and instead, depended on the big pharmaceutical companies.
Many of these supplements have been well tested in Europe and proven to be effective, and most, while not as effective as some drugs, have no side effects, which rare for anything the doctor prescribes.
There is nothing wrong with empirical therapy. No one in their right mind will say that a medication cannot work because you don't know the mechanism. Acupuncture mandated by insurance for horses proves its efficacy? That's not a logical fallacy? And no, these supplements haven't been proven in Europe or anywhere for that matter. You are too willing to accept inadequate studies as evidence. Even a sugar pill has side effects. I wonder if the Chinese will treat the outbreak of pneumonic plague with acupunture or homeopathic medicines?
Reply | Report Abuse | Link to thisThis is not a blanket statement for all supplements. I repeat: Many (not all) of these supplements have been well tested in Europe and proven to be effective, and most (not all) have no known side effects.
Reply | Report Abuse | Link to thisMany (not all) supplements have been thoroughly tested by double-blind experiments, and the studies repeated and published in respected, peer-reviewed journals.
The statement: "these supplements haven't been proven in Europe" is categorically false.
Care to back that claim up with a couple of examples? Show us what you accept as evidence.
Reply | Report Abuse | Link to thisThe reason that many herbal products don't get rigorous testing is that they are often also used as foods or have long historical uses with low side effects and high effectiveness. Why test stinging nettle, calendula, turmeric, ginger root, fish oils, medicinal mushrooms, and on and on, when they have been used for so long in many different cultures without problem? Testing fish oil for effectiveness has been done over and over with beneficial results and to get the FDA involved is just plain ludicrous. What are we going to do next, have them test our salad because it hasn't received the same level of testing as a synthetic pharmaceutical ?
Reply | Report Abuse | Link to thisFish oil has been tested and shown effective for lowering triglycerides. In Europe it is standard of care to take a fish oil capsule after surviving a heart attack because it has been shown to decrease sudden incidence by half. Mind you, it is not the regular fish oil but the pharmaceutical grade of the brand Lovaza. You would need to take about 3-4 of the supplemental fish oil capsules to get the amounts of the EPA and DHA in 1 Lovaza capsule. You'll also be getting other oils that haven't been tested.
Reply | Report Abuse | Link to thisJerryd,
Reply | Report Abuse | Link to thisIf you are into fish oil, allow me to recommend Sacha Inti Oil, squeezed from a nut (Plukenetia Volobilis L) native to the Peruvian Amazon. It is all natural, not a thing added, and has 48% Omega 3, 35% Omega 6 and 9% Omega 9. Doesn't cost a fortune either. I have it every time I have a salad.
The people who believe in herbs rather than conventional drugs will not be convinced by this badly written and bitter article. Physicians who do not know anything about CAM will not be convinced to learn about it. This article was obviously written by someone who knows little of alternatives. Their lack of knowledge does not change the fact that for many people alternatives work as well as drugs. Drugs kill thousands of people a year. How many people die of yoga? How many die of fish oil? For that matter, why do Doctors belittle placebos? Why not study the placebo effect rather than drugs? We know, even doctors know, that placebos work well for many people sometimes only for a while, sometimes permanently. Why on earth aren't we studying how to use them MORE rather than trying to ignore their effectiveness?
Reply | Report Abuse | Link to thisWhat is the Placebo effect? How could clay and spittle heal the eyes of a blind man? Or, how could dipping seven times in the Jordan River cure leprosy? Why do homeopathic remedies work (sometimes miraculously), while distilled water does nothing?
Reply | Report Abuse | Link to thisThere is more to life than meets the eye and truth is sometimes stranger than fiction. Quantum physics is in a way helping to "rend the veil" on some mysteries that were formally only the domain of "mystics". At the most basic level, even within the particles of the atom, there are no particles at all, only wavelengths, vibrations, energy oscillating from a physical to non-physical matrix (spirit to matter and matter to spirit). A sine wave of nurturing and rejuvination.
All of creation is composed of God's Light, Energy and Consciousness and has Innate Intelligence. Even the smallest microbe can hunt for food, eat, excrete and multiply. Plants and herbs and even rocks and minerals have "intelligence". We are in a simbiotic relationship with all other parts of life. We are hollistic, multidemensional beings. There are bodies terrestrial and bodies celestial, wheels within wheels as Ezekiel saw them. We have a Fire body (memory), a Air body (mind, mental), a Water body (emotion, desire), and a Physical body. Our brain is like a computer which the mind uses. Our heart has as many or more neurons than the brain and at the etheric level, in a secret chamber within the heart, burns an Unfed Flame which is the Portal to the Kingdom of Heaven and to our Higher Mental Body, the Christ Mind that was also in Christ Jesus.
When we have accessed that Higher Mind we have vastly greater powers of creation. The Placebo effect is actually a result of our mind and the power of belief to cause matter to conform to our needs. We can endow substance with our light and energy from God to restore balance to imbalanced systems. When we develope the mastery that Jesus demonstrated we can even fill in the etheric pattern of a severed ear and restore its physicality or take clay and spittle and endow it with the light to re-create an eye that was formerly blind. These things I do, ye shall do and more were the words of Jesus.
Homeopathy is a tincture of an herb (intelligent life) which is diluted to a degree that no trace of it can be found physically. According to the degree of the dillution it will have an effect on either the emotional, mental or etheric body where the cause of the imbalance is located so that balance can also be restored to the physical body.
This has got to be the dumbest Scientific American article I ever read.
Reply | Report Abuse | Link to this"Spending on natural products such as omega oils or St. Johns Wart [sic], of which the effectiveness remains unproven by the U.S. Food and Drug Administration ...".
Someone who doesn't know the difference between 'Wart' and 'Wort' and who refers to omega-3 polyunsaturated fatty acids as omega oils is obviously clueless.
What have fish oils got to do with complementary and alternative medicine? They are nutrients! You can get them from eating fish. If you don't eat fish, you can get the bio-identical fatty acids from supplements. And if the author wants to know what these "omega oils" could possibly be good for, she could go to a couple of government websites: http://ods.od.nih.gov/eicosanoids/ and http://efaeducation.nih.gov/. to find out.
And only the FDA can prove the effectiveness of natural products?
Can any ignoramus write for the Scientific American now?
As a Nutritional Biochemist having deeply studied many CAM therapeutic systems, I find that the challenge is to individualize therapies. While many herbs, homeopathics, foods, nutritional elements, vitamins, minerals, oils, etc. are helpful and can be very therapeutic, each person responds to these products individually. One can NOT over-generalize in broad sweeping condemnation nor affirm magical powers of benefit or cure. This must be science based.
Reply | Report Abuse | Link to thisFortunately, the quality and quantity of the research is increasing widely , helping us to have more options at lower cost and fewer side effects than orthodox pharma products. One should NOT throw out all pharma either.
Natural medicines and systems of healing all have their place alongside of orthodox western conventional modalities and medicine.
And what we do with our bodies (movement, relaxation, food consumption, emotional actions and reactions, spiritual or faith-based affirmation, our livelihood, how we interact with nature, and what we do with our time and energies ALL make up the net result of our health and well-being.
CAM.... why not change the acronym to stand for Several Complementary and Alternative Medecines. So it would read as SCAM. Much more appropriate, right?
Reply | Report Abuse | Link to thisThere is some truth to what you re saying here regarding lobbyists etc., and I certainly wouldn't want to throw the baby out with the bathwater regarding herbal medicines; but the fact remains that the vast majority of CAM is absolute nonsense. It just doesnt work and you have to remember that many CAMists have their own agendas as well.
Reply | Report Abuse | Link to thisSorry I have to reply to this comment:
Reply | Report Abuse | Link to this"why is there such miniscule funding available for the research", since it was set up NCCAM has spent HUNDREDS of millions of dollars researching CAM and they ve yet to come up with a single treatment that cant be done better, cheaper or safer with conventional medicine.
Um, not to be the writing police, but in the fourth paragraph of the piece, St. John's Wart should be St. John's Wort - otherwise, we're using a holy dude's skin growths as a therapeutic treatment. And that would be quite some miracle! :)
Reply | Report Abuse | Link to thisIt looks like about 98% of the people here agree that it is better to work with nature using natural holistic remedies rather than against nature using unnatural treatments.
Reply | Report Abuse | Link to thisIt is possible that the 38% of Americans who are doing fine with holistic health are the ones who Obama is complaining about because they don't have "health" insurance that gets the country deeper into debt with the drug companies?
Drugs = Toxins, against nature, extra burden on elimination organs, not healthy.
Natural remedies = Building blocks of nature, Elimination of Toxins, healthy.
Which do you prefer? If you prefer drugs, then you call natural remedies "snake oil." You want to talk "snake oil?" Did you know that the US Medical System is the 3rd leading cause of death? According to a 2000 report by Dr. Barbera Starfield in the Journal of the American Medical Association:
12,000 deaths from unnecessary surgeries;
7,000 deaths from medication errors in hospitals;
20,000 deaths from other errors in hospitals;
80,000 deaths from infections acquired in hospitals;
106,000 deaths from FDA-approved correctly prescribed medicines.
The total of medically-caused deaths in the US every year is 225,000.
38% of Americans have damn good heads on their shoulders. They know what's what. I feel good that I can trust at least 38% of Americans to do the right thing. What about you?
SciAm needs to stick to scientific discoveries, not propaganda. BTW: Your link to that 2007 study by the APA doesn't work.
You can find a range of dosage recommendations from doctors and medical authorities at http://www.buy-fish-oil.com/how-much-fish-oil-dosage-per-day-should-i-take/ Amazing story about the Sago coal miner being treated with 15 grams of fish oil per day.
Reply | Report Abuse | Link to thisYou can find a range of interesting fish oil dosage recommendations at http://www.buy-fish-oil.com/how-much-fish-oil-dosage-per-day-should-i-take/ Amazing case history about the Sago coal miner being treated with 15 grams of fish oil per day.
Reply | Report Abuse | Link to thisAfter come across this post I think that fish oil is better than snake oil because I think that there are more benefits of fish oil. You can check for more details at http://www.energyfirst.com/omega-3-fish-oil
Reply | Report Abuse | Link to thisWas natural remedies here first .....or the medical..?
Reply | Report Abuse | Link to this<a href="https://www.easy2swallowvitamins.com/products/Melatonin.html">Vitamins for Memory</a> are essential for our body.
Reply | Report Abuse | Link to thisI've just got to tell you all that as a veterinarian and Certified Traditional Naturopath I've spent days researching and copying articles for specific treatments for a patients MD to read and they won't read the articles. Their minds are made up and they don't have the time to explore outside what they have learned in medical school. I've given up on that big waste of time and energy. I'm just going to help as many people as I can. Where else is a client going to find a doctor to actually listen to their problems, ask questions and try to help them figure out what is wrong? So what if it takes 90 minutes/consult. People often get healed because they know somebody actually cares and are willing to listen to them before suggesting a treatment! Often the patient themselves are the very best doctor they have if they would only listen to that still small voice within. If that is placebo (and I think that often alternative healing hooks into this technique through the power of intention) then so be it.
Reply | Report Abuse | Link to thisIt really depends which one you have - see this compare the market style comparison of leading fish oil supplement brands in the UK
Reply | Report Abuse | Link to thishttp://www.nuique.com/blog/index.php/2011/12/vegetarian-vegan-omega-3-epa-dha-vs-fish-oil-supplements/
As an acupuncturist, I recommend natural supplements to my clients on a regular basis with the recommendation that they discuss it with their doctor or pharmacist. Natural remedies have been around as long as people have and many of them are just as effective as pharmaceuticals. Where do people think that most pharmaceuticals are derived from? The danger that can come from oral supplements is when they are purchased from unreliable suppliers or taken in the wrong dosage or combination. Most people do not realize that herbal supplements can have side effects and can interact with other medicines. That's why it is important to know what you're taking and get advice from an herbalist or pharmacist.
Reply | Report Abuse | Link to thisAs for the money Americans spend on alternative therapies, it is much less than what they spend in a doctor's office. I work in conjunction with several doctors and am very familiar with insurance billing. I believe that alternative health care is becoming so popular because people are actually seeing the results they want with it, without paying for high priced medical visits. Plus, acupuncture, massage, and other forms of alternative health care offer much more of a preventive component than western medicine does. Alternative medicine can be a lifesaver. But, as with anything else, it must be administered and performed properly by a qualified practitioner. http://www.acupuncturebaxley.com/