In 1990, people were stunned when a Harvard researcher published a report showing that more than one-third of Americans use complementary and alternative medicine. But the trend seems to be softening, and even the definition of what constitutes CAM therapy is becoming somewhat problematic.
A federal government survey released today shows only a 2% growth of CAM therapies, such as herbal supplements, meditation, chiropractic and acupuncture from 2002 to 2007. The data, from the 2007 National Health Interview Survey of 23,000 adults and 9,500 children, found that about 38% of adults use CAM and about 12% of children, ages 17 and under. The most common CAM therapies are:
- Natural products that are not vitamins or minerals. The most common of these were fish oil/omega-3/DHA; glucosamine, echinacea, flaxseed oil or pills and ginseng -- 17%.
- Deep breathing -- 12%
- Meditation -- 9%
- Chiropractic -- 8%
- Massage -- 8%
- Others: yoga, 6%; diet-based therapies, 3%; progressive relaxation, 2%; guided imagery, 2%, homeopathic treatment, 1%.
What to make of this? It seems to me Americans are not abandoning conventional Western medicine and are embracing the CAM therapies that research has found to be most useful. For example, fish oil or omega-3 supplements are now widely prescribed in mainstream medicine as evidence shows the substance can cut the risk of cardiovascular disease.
Meditation, massage and yoga are also mainstream practices for dealing with aches, pain and stress. Just this year, the American College of Physicians adopted guidelines for back pain treatment that describe massage, chiropractic and acupuncture as viable treatments. CAM seems to be most popular in areas where mainstream medicine has not had much success, such as in treating chronic pain. In fact, the survey found back pain is the most common reason people turn to CAM therapies."The top four conditions for which adults use CAM are all related to some form of chronic pain," Dr. Richard L. Nahin, a co-author of the report, said this morning in a news conference.
The survey also showed that use of the herb echinacea has fallen in popularity which, one can reasonably speculate, is due to scientific data casting doubt on its effectiveness to prevent or ease respiratory illness. Finally, the survey indicated that some of the same people who use CAM therapies say they delay conventional medical care because they can't afford it. That isn't a ringing endorsement of CAM.
Complementary and alternative therapies are described as "diverse medical and healthcare systems, practices, and products . . . that are not generally considered to be part of conventional medicine." But whether such therapies as fish oil and massage are really CAM therapies is becoming more vague as researchers weigh in on their usefulness, says Nahin.
CAM therapies fall on a continuum with one end having very little, if any, research support and the other end having substantial support, says Nahin, acting director of the National Center for Complementary and Alternative Medicine's Division of Extramural Research. Fish oil and acupuncture for back pain, for example, may be in a "transition period" between mainstream and CAM, he says.
The report can be accessed at NCCAM.
-- Shari Roan
Photo credit: National Center for Complementary and Alternative Medicine