Alternative medicine
In 1992, the United States National Institutes of Health established an office to study alternative medicine. This agency later became known as the National Center for Complementary and Integrative Health. Its creation marked a turning point in how the government viewed practices that lacked biological plausibility. These methods claim healing effects but fail to meet standards of testability or repeatability. Unlike modern medicine which uses clinical trials to prove effectiveness, alternative therapies often rely on testimonials or anecdotes. They may be based on religion, superstition, or belief in supernatural energies. Some practitioners use terms like holistic or natural to suggest their methods are superior to conventional science. Critics argue these labels create a false dichotomy between effective treatments and those that do not work. A 2015 World Health Organization report defined traditional medicine as knowledge indigenous to different cultures. When used outside its original setting without scientific evidence it becomes alternative medicine. Many definitions describe it as diverse systems not generally considered part of conventional medicine. The term itself implies there is an effective choice when none exists. Scientists say there is only medicine that works and medicine that does not.
Before the 1970s irregular practitioners were dismissed by the medical establishment as unscientific quacks. Western medicine increasingly incorporated scientific discoveries while irregular practice became marginalized. In 1974 the American Medical Association abolished its quackery committee and closed down its Department of Investigation. This shift allowed previously rejected practices to reorganize under new branding. By 1983 mass marketing of alternative medicine had become so pervasive that the British Medical Journal noted endless streams of books urging public adoption of treatments ranging from meditation to drilling holes in skulls. The counterculture movement of the 1960s fueled rising interest in these therapies. Patients sought alternatives due to frustration with limitations and side effects of science-based medicine. Social attitudes shifted toward cultural relativism and skepticism of authority figures. Marketing campaigns portrayed these methods as natural and holistic compared to Big Pharma. The expression alternative medicine came into widespread use during this period. It grouped together traditional nonwestern practices with other unproven or disproven methods. The industry grew rapidly despite lacking biological plausibility. A 2002 survey found 36 percent of U.S. adults used some form of complementary and alternative medicine. Expenditures increased by 50 percent between 1990 and 1997. Hospitals began offering these therapies at alarming rates. More than 70 percent of hospitals offering CAM were located in urban areas.
Homeopathy involves repeated dilution of substances until only water remains. Developed before knowledge of atoms or basic chemistry it claims a substance causing symptoms in healthy people cures similar symptoms in sick people. Naturopathy is based on belief that the body heals itself using supernatural vital energy guiding bodily processes. Many naturopaths have opposed vaccination while scientific evidence does not support claims they can cure cancer. Traditional Chinese Medicine includes acupuncture which inserts needles at specified points to influence flow of qi. Qi is described as a supernatural energy undetected by physics. Ayurveda from India believes three elemental substances called doshas determine health. Imbalances are adjusted using herbs minerals including sulfur arsenic lead and copper sulfate. Safety concerns arose when two U.S. studies found about 20 percent of Ayurvedic patent medicines contained toxic levels of heavy metals. Biofield therapy intends to influence energy fields purported to surround and penetrate the body. Carl Sagan criticized lack of empirical evidence supporting existence of such fields. Chiropractic manipulates spine claiming to unblock Innate Intelligence flowing through vertebral subluxations. Vertebral subluxation is a pseudoscientific entity not proven to exist. Reiki places palms near Chakras believing supernatural energies transfer from practitioner to patient. Herbal remedies include fish oil echinacea ginseng and other plant products sold as nutritional supplements. Only very small percentage of these show any efficacy.
A placebo treatment has no intended therapeutic value yet patients may report improvements after receiving it. A 1955 study suggested substantial part of medicine impact was due to placebo effect though reassessments found flawed methodology. Natural recovery cycles often misattributed to alternative therapies create perceived effectiveness without physiological change. Regression fallacy occurs when extreme results followed by less extreme ones assumed caused by treatment. Patients who receive inert treatments may report improvements that did not occur. David Gorski argues alternative treatments should be treated as placebos rather than medicine. Almost none perform significantly better than placebo in clinical trials. The nocebo effect happens when patients expect harm and perceive harmful effects after taking medication. Distrust of conventional medicine leads some to experience nocebo when taking effective drugs. Asbjørn Hróbjartsson and Peter C. Gøtzsche wrote even if true placebo effect existed one would expect differences between groups due to bias associated with lack of blinding. Researchers use clinical trials to reveal such effects allowing physicians to offer best known solutions. Alternative treatments often refuse to use trials or make them deliberately hard to conduct. Misinterpreted natural course false treatment effect interference all contribute to perceived success despite objective non-existence.
Between 2001 and 2003 four children died in Australia because parents chose ineffective naturopathic homeopathic or other alternative medicines over conventional therapies. Direct harm results from adverse patient outcomes while economic harm causes monetary loss without health hazard. Indirect harm delays appropriate treatment or creates unreasonable expectations discouraging families from accepting medical care. Associate Professor Alastair MacLennan reported a patient nearly bled to death on operating table after neglecting mention she took powerful anticoagulant potions. Some herbal remedies cause dangerous interactions with chemotherapy drugs radiation therapy or anesthetics during surgery. Patients with impaired hepatic or renal function more susceptible to side effects of alternative remedies. Homeopathic preparations extremely dilute often beyond point where single molecule remains yet alcohol concentration may exceed allowed limits. FDA regulates homeopathic products differently since 1938 exempting them from good manufacturing practice requirements related to expiration dating. Toxic heavy metals found in Ayurvedic products caused elevated blood lead levels in 40 percent of tested users. Incidents of poisoning attributed to use of these compounds in United States. Unvalidated mental health practices can lead individuals to forgo effective treatments creating opportunity cost. Even innocuous treatments indirectly produce negative outcomes when they delay proper intervention.
The alternative medicine lobby successfully pushed for far less regulation than conventional medicine receives. In Germany herbs tightly regulated half prescribed by doctors covered by health insurance. Half American alternative practitioners are licensed MDs while others operate without same licensing laws. Promotion allowed even when demonstrably no effect exists only tradition of use. U.S. Food and Drug Administration issued online warnings about medication health fraud including section on Alternative Medicine Fraud. Ayurvedic products generally not approved before marketing. Thirty-one states have child-abuse religious exemptions requiring federal money grants. National Center for Complementary and Integrative Health spent more than US$2.5 billion on research since 1992 none demonstrating efficacy. NIH Office of Cancer Complementary and Alternative Medicine gave out grants around $105 million each year for several years. Testing alternatives with no scientific basis called waste of scarce research resources. CAM tolerated contradiction without thorough reason experiment. Policy at NIH never says something does not work only different version dose might give results. Marketing part of training required in alternative medicine traced back to methods used by Hitler and Goebels promoting pseudoscience. Special consideration must given issue conflicts of interest where researchers risk unidirectional bias due uncritical belief chosen subject.
Edzard Ernst first university professor of Complementary and Alternative Medicine characterized evidence many techniques weak nonexistent negative. He published estimate 7.4 percent based sound though believes may overestimate. In 2011 he concluded 95 percent studied including acupuncture herbal medicine homeopathy reflexology statistically indistinguishable from placebo treatments. A 2003 CDC project identified 208 condition-treatment pairs 58 percent studied randomized controlled trial 23 percent assessed meta-analysis. Cochrane Library had 145 CAM-related systematic reviews 340 non-Cochrane reviews. Analysis found 38.4 percent concluded positive effect possibly positive 4.8 percent no effect 0.7 percent harmful 56.6 percent insufficient evidence. Conventional treatments reviewed showed 41.3 percent positive possibly positive 20 percent no effect 8.1 percent net harmful 21.3 percent insufficient evidence. Steven Novella neurologist at Yale School of Medicine wrote government-funded studies used lend appearance legitimacy to treatments not legitimate. Marcia Angell proposed healthcare practices classified solely scientific evidence if treatment rigorously tested safe effective science-based medicine adopts regardless considered alternative beginning. Richard Dawkins defined set practices cannot tested refuse tested consistently fail tests. If technique demonstrated effective properly performed trials ceases alternative simply becomes medicine. Level misinformation now reached point dangerous unethical ethics-free zone time change this.
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Common questions
When did the United States National Institutes of Health establish an office to study alternative medicine?
The United States National Institutes of Health established an office to study alternative medicine in 1992. This agency later became known as the National Center for Complementary and Integrative Health.
What percentage of U.S. adults used some form of complementary and alternative medicine according to a 2002 survey?
A 2002 survey found that 36 percent of U.S. adults used some form of complementary and alternative medicine. Expenditures increased by 50 percent between 1990 and 1997 during this period of rapid growth.
How many children died in Australia due to parents choosing alternative medicines over conventional therapies between 2001 and 2003?
Four children died in Australia between 2001 and 2003 because parents chose ineffective naturopathic homeopathic or other alternative medicines over conventional therapies. Direct harm results from adverse patient outcomes while economic harm causes monetary loss without health hazard.
What did Edzard Ernst conclude about 95 percent of studied alternative treatments in 2011?
Edzard Ernst concluded in 2011 that 95 percent of studied alternative treatments including acupuncture herbal medicine homeopathy and reflexology were statistically indistinguishable from placebo treatments. He published an estimate of 7.4 percent based on sound evidence though he believes the figure may be an overestimate.
Why do toxic heavy metals appear in Ayurvedic products according to U.S. studies?
Toxic heavy metals found in Ayurvedic products caused elevated blood lead levels in 40 percent of tested users. Incidents of poisoning attributed to use of these compounds occurred in the United States.