ALTERNATIVE MEDICINE pot

ALTERNATIVE

MEDICINE

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ALTERNATIVE

MEDICINE

Christine A. Larson

Health and Medical Issues Today

GREENWOOD PRESS

Westport, Connecticut ● London

Library of Congress Cataloging-in-Publication Data

Larson, Christine A., 1953–

Alternative medicine / Christine A. Larson.

p. cm.—(Health and medical issues today, ISSN 1558–7592)

Includes bibliographical references and index.

ISBN 0–313–33718–7 (alk. paper)

1. Alternative medicine. I. Title. II. Series.

[DNLM: 1. Complementary Therapies. WB 890 L334a 2006]

R733.L37 2007

610—dc22 2006029482

British Library Cataloguing in Publication Data is available.

Copyright © 2007 by Christine A. Larson

All rights reserved. No portion of this book may be

reproduced, by any process or technique, without the

express written consent of the publisher.

Library of Congress Catalog Card Number: 2006029482

ISBN: 0–313–33718–7

ISSN: 1558–7592

First published in 2007

Greenwood Press, 88 Post Road West, Westport, CT 06881

An imprint of Greenwood Publishing Group, Inc.

www.greenwood.com

Printed in the United States of America

The paper used in this book complies with the

Permanent Paper Standard issued by the National

Information Standards Organization (Z39.48–1984).

10987654321

Science is a search for the truth. The effort to understand the world

involves the rejection of bias, dogma, of revelation but not the rejection of

morality. One way in which scientists work is by observing the world,

making note of phenomena and analyzing them.

Linus Pauling, Ph.D.

This book is dedicated to Dr. Linus Pauling, the only recipient of two

unshared Nobel Prizes for his work. Dr. Pauling received his bachelor’s

degree from Oregon Agricultural College, now Oregon State University, in

chemical engineering and his doctorate in chemistry and mathematical

physics. He is considered one of the greatest scientific minds of the twenti￾eth century. Pauling coined the term orthomolecular medicine in 1968,

describing it as “the right molecules in the right concentration.” Although

I did not know Dr. Pauling, nor was I familiar with his research at the

time, I applied orthomolecular medicine in the process of restoring my

health.

Dr. Pauling died on August 19, 1994, but his work on micronutrients

continues at the Linus Pauling Institute at Oregon State University in

Corvallis, Oregon. This book is dedicated to medical mavericks like Dr.

Linus Pauling, whose work contributes to the understanding of disease, as

well as its resolution through natural approaches. The Linus Pauling Insti￾tute is listed as one of the first two Centers of Excellence for Research in

Complementary and Alternative Medicine in the United States by

NCCAM of the National Institutes of Health (NIH).

CONTENTS

Series Foreword ix

Preface xi

Introduction: What Is Alternative Medicine? xvii

Section One Overview

1 The Origins of Alternative Medicine 3

2 The Theories Underlying Alternative Medicine 29

3 The Business of Alternative Medicine 43

4 Why Consumers Seek Alternative Treatments 53

Section Two Controversies

5 Do Alternative Therapies Work? 65

6 Should Alternative Medicine Be Regulated by

the Government? 77

7 Should Managed Care Provide Coverage

for Alternative Therapies? 85

8 Pharmaceuticals versus Alternative Therapies 93

9 Culture and Health: Who Bears Responsibility for

Health and Healthcare? 105

10 The Future of Health and Healthcare 115

Section Three References and Resources

A Annotated Primary Source Documents 129

B Alternative Medicine Timelines 193

C Glossary 199

D Bibliography 201

Index 209

viii CONTENTS

SERIES FOREWORD

Every day, the public is bombarded with information on developments in

medicine and health care. Whether it is on the latest techniques in treat￾ments or research, or on concerns over public health threats, this informa￾tion directly impacts the lives of people more than almost any other issue.

Although there are many sources for understanding these topics—from

Web sites and blogs to newspapers and magazines—students and ordinary

citizens often need one resource that makes sense of the complex health

and medical issues affecting their daily lives.

The Health and Medical Issues Today series provides just such a one￾stop resource for obtaining a solid overview of the most controversial

areas of health care today. Each volume addresses one topic and provides

a balanced summary of what is known. These volumes provide an excel￾lent first step for students and lay people interested in understanding how

health care works in our society today.

Each volume is broken into several sections to provide readers and

researchers with easy access to the information they need:

• Section I provides overview chapters on background information—

including chapters on such areas as the historical, scientific, medical,

social, and legal issues involved—that a citizen needs to intelli￾gently understand the topic.

• Section II provides capsule examinations of the most heated con￾temporary issues and debates, and analyzes in a balanced manner

the viewpoints held by various advocates in the debates.

• Section III provides a selection of reference material, including

annotated primary source documents, a timeline of important events,

and an annotated bibliography of useful print and electronic

resources that serve as the best next step in learning about the topic

at hand.

The Health and Medical Issues Today series strives to provide readers

with all the information needed to begin making sense of some of the

most important debates going on in the world today. The series will

include volumes on such topics as stem-cell research, obesity, gene ther￾apy, alternative medicine, organ transplantation, mental health, and more.

x SERIES FOREWORD

PREFACE

Alternative medicine is a term that causes confusion for most people.

What is alternative medicine? How does it compare with conventional

medicine? What is integrative medicine? Is integrative medicine the same

as alternative medicine? How does alternative medicine compare with

holistic health? What do all of these practices have in common, and what

are their differences? Do they work? Are they safe?

The reason most consumers choose to explore alternative approaches

to healing is a very simple one: what they’re currently doing isn’t work￾ing. The intent of this book is to provide what I refer to as “The Savvy

Consumer’s Guide to Healthcare.” It is the culmination of a journey that

began several years ago, when I experienced health problems. The

restoration of my health and what I learned in the process underlies much

of the material in this book. It also served as the basis for my doctoral

work in evidence-based medicine at the University of Kentucky.

There is a mystique surrounding medicine in which the doctor is seen as

God. As much as I respect science and the men and women who have gone

through the academic process to become clinicians and researchers, they

are not gods. This book strips away the mystique to examine the science

underlying medicine. Science is about seeking the truth, which in medi￾cine equates to knowing what works and what doesn’t. Medicine, in its

true form, is about problem solving—not merely treating the symptoms,

but understanding causal factors that underlie the disease process and, as

a result of that understanding, reversing or eliminating the causal factors,

leading to health restoration.

Depending on the statistics one draws from, roughly 20–50 percent of

medicine is science based. That means that 50–80 percent of what we refer

to as medicine is a virtual unknown: we do not know what works and what

doesn’t work. These statistics may be startling, but they are very useful sta￾tistics. If you have a condition that is troubling, limiting, and maybe even

life-threatening, these statistics can provide you with the hope and encour￾agement to lead you to explore a variety of approaches to healing.

One of the myths surrounding alternative medicine concerns its novelty.

Many alternative approaches date back some 3000–5000 years, with their

origins in Chinese medicine or ayurvedic medicine. If you pray or take

vitamins, which many people do, you are practicing alternative medicine.

If you exercise, modify your diet, or limit your intake of sugars and

refined carbohydrates, you’re practicing alternative medicine. This book

will debunk some of the myths that surround alternative medicine.

Many alternative therapies have not been evaluated for their efficacy.

Some are dangerous, some are a waste of money, and some may com￾pound your health problems. However, there are also many therapies used

in conventional medical practice that have not been evaluated for their

efficacy either. Many are dangerous, some are a waste of money, and

some may compound your health problems. Those are the facts.

This book is written for consumers, novices to the concept of alterna￾tive medicine; it is not written for the scientific community, although I

have relied heavily on the scientific studies that are available on comple￾mentary and alternative medicine. The book’s intent is to provide a broad

overview of alternative medicine, the controversies surrounding it, and the

science underlying it.

There are some 4000 books on alternative medicine. I have attempted

to focus on the scientific sources and to distill that research into a compre￾hensible form for you, the consumer. Toward that end I have focused on

the six categories of complementary and alternative forms of medicine

designated by the National Institutes of Health’s official governing body,

the National Center for Complementary and Alternative Medicine

(NCCAM), as an organizational tool for presenting this information.

NCCAM is the regulatory arm charged with the evaluation of comple￾mentary and alternative medicine for the United States. For consumers

not familiar with the National Institutes of Health (NIH), it is the hub of

medical research, funding, and evaluation for the United States. NCCAM

is to CAM (complementary and alternative medicine) what the FDA is to

prescription drug evaluation.

xii PREFACE

The content of the book, which is part of the series “Health and Medical

Issues Today,” consists of four overview chapters, which provide ground￾ing in the key content, six chapters on “controversies,” which explore the

critical issues that surround alternative medicine, and a section of anno￾tated source material that includes seminal scientific work in the arena of

complementary and alternative therapies.

The book is intended to provide basic knowledge and scientific

grounding. If it helps you to understand the realities of healthcare and the

limits of what is currently known, it will have accomplished part of its

task. If it provides you with hope and makes you eager to learn more, it

will have accomplished part of its task. If you come away from the book

understanding the limits of science as well as its merits, you will emerge a

savvy consumer, which is the ultimate purpose of the book.

Chapters 1–4 describe the origins of alternative medicine, the theories

underlying alternative medicine, the business of alternative medicine, and

the consumers who seek alternative therapies. Chapter 1, “The Origins of

Alternative Medicine,” introduces the ten principles of holistic medical

practice, established jointly by the American Board of Holistic Medicine

(ABHM) and the American Holistic Medical Association (AHMA), using

highlights of both scientific studies and sources by leading authors in the

trade press to illustrate the main concepts.

Chapter 2, “The Theories Underlying Alternative Medicine,” provides

information on the thinking that underlies the various complementary and

alternative forms of medicine along with their origins. Chapter 3, “The

Business of Alternative Medicine,” gives the most recent data on dollars

spent on complementary and alternative forms of medical therapies, and

the most popular forms of therapy utilized. It also provides data on who

the consumers of these therapies are.

Chapter 4, “Why Consumers Seek Alternative Treatments,” provides a

detailed analysis, based on the most recent data available, of the reasons

behind the growth of the $47 billion industry called complementary and

alternative medicine and what is fueling that growth.

Chapters 5–10 describe the controversies in the field, looking at critical

issues facing healthcare today, from skyrocketing costs to the emergence of

prescription drug use as the fourth leading cause of death in the United

States; from issues of efficacy and safety in the use of alternative therapies to

regulatory issues in the arena of complementary and alternative therapies;

from issues of culture and its impact on health to errors in medicine and the

benefits and drawbacks of prescription drugs versus alternative therapies.

Chapter 5, “Do Alternative Therapies Work?” focuses on issues of effi￾cacy, the science underlying the use of complementary and alternative

PREFACE xiii

medicine. Included in this chapter are the scientific criticisms of CAM

therapies, as well as references to the Institute of Medicine reports Cross￾ing the Quality Chasm and To Err Is Human, two documents that are

included in their entirety in Appendix A. These are recommended reading

for anyone accessing the healthcare system.

Chapter 6, “Should Alternative Medicine Be Regulated by the Govern￾ment?” looks at safety and efficacy concerns in the use of complementary

and alternative forms of medicine. From a scientific standpoint, medical

therapies should have an established track record, data available to verify its

efficacy. Many alternative therapies do not have the support of substantive

randomized, controlled trials, which underlie good science. This chapter

looks at the issues surrounding that controversy. The critical objectives

should be protection of the consumer from exploitation and ensuring the

safety and efficacy of products or regimens for the consumer. However, con￾sumers need to be aware that the fact that a product has FDA approval does

not necessarily mean that the drug is safe and effective for all consumers tak￾ing it, as illustrated by the case of Vioxx, which is chronicled in the chapter.

Chapter 7, “Should Managed Care Provide Coverage for Alternative

Therapies?” looks at the necessity to shift from the “disease model,”

where consumers do not access the healthcare system until they are dis￾eased, to a preventive model, where consumers utilize tools at their com￾mand, primarily diet and exercise, to maintain health and prevent disease.

You may discover that the best HMO available is yourself.

Chapter 8, “Pharmaceuticals versus Alternative Therapies,” uses scien￾tific data to evaluate safety and efficacy issues surrounding the use of

alternative therapies and prescription drugs. In this area, I have high￾lighted the work of the Institute of Medicine and their seminal works To

Err Is Human and Crossing the Quality Chasm, primarily because they

provide a dispassionate, scientific view of the realities of healthcare and

the unvarnished, raw data that consumers need to become familiar with.

Chapter 9, “Culture and Health: Who Bears Responsibility for Health

and Healthcare?” looks at the basic relationship between culture and health

and the responsibilities surrounding healthcare. The United States currently

spends more on healthcare than any other industrialized nation, and yet our

population is less healthy, with higher incidences of chronic diseases and

reduced life expectancy, than our peer nations. As Barlett and Steele (2004,

p. 13) point out, “Americans pay for a Hummer but get a Ford Escort.” Or,

as various scientific studies that I include report, “we’re spending more but

getting less.” This chapter sheds light on these cultural issues.

Chapter 10, “The Future of Health and Healthcare,” looks at some of

the critical challenges in healthcare today, such as the escalating costs and

xiv PREFACE