Are You Considering Using Complementary and Alternative Medicine (CAM)?

Decisions about your health care are important--including decisions about whether to use complementary and alternative medicine (CAM). The National Center for Complementary and Alternative Medicine (NCCAM) has developed this fact sheet to assist you in your decision making about CAM. It includes frequently asked questions, issues to consider, and a list of sources for further information.

Key Points

• Take charge of your health by being an informed consumer. Find out what scientific studies have been done on the safety and effectiveness of the CAM treatment in which you are interested.
• Decisions about medical care and treatment should be made in consultation with a health care provider and based on the condition and needs of each person. Discuss information on CAM with your health care provider before making any decisions about treatment or care.
• If you use any CAM therapy, inform your primary health care provider. This is for your safety and so your health care provider can develop a comprehensive treatment plan.
• If you use a CAM therapy provided by a practitioner, such as acupuncture, choose the practitioner with care. Check with your insurer to see if the services will be covered.

1. What is complementary and alternative medicine?

Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be a part of conventional medicine. 1 People use CAM therapies in a variety of ways. CAM therapies used alone are often referred to as "alternative." When used in addition to conventional medicine, they are often referred to as "complementary." The list of what is considered to be CAM changes continually, as those therapies that are proven to be safe and effective become adopted into conventional health care and as new approaches to health care emerge.

2. How can I get reliable information about a CAM therapy?

It is important to learn what scientific studies have discovered about the therapy in which you are interested. It is not a good idea to use a CAM therapy simply because of something you have seen in an advertisement or on a Web site or because someone has told you that it worked for them. (See sidebar for some tips on evaluating the information you see on a Web site.) Understanding a treatment's risks, potential benefits, and scientific evidence is critical to your health and safety. Scientific research on many CAM therapies is relatively new, so this kind of information may not be available for every therapy. However, many studies on CAM treatments are under way, including those that NCCAM supports, and our knowledge and understanding of CAM is increasing all the time. Here are some ways to find scientifically based information: Talk to your health care practitioner(s). Tell them about the therapy you are considering and ask any questions you may have about safety, effectiveness, or interactions with medications (prescription or non-prescription). They may know about the therapy and be able to advise you on its safety and use. If your practitioner cannot answer your questions, he may be able to refer you to someone who can. Your practitioner may also be able to help you interpret the results of scientific articles you have found. Use the Internet to search medical libraries and databases for information. One database called CAM on PubMed (see "For More Information"), developed by NCCAM and the National Library of Medicine, gives citations or abstracts (brief summaries) of the results of scientific studies on CAM. In some cases, it provides links to publishers' Web sites where you may be able to view or obtain the full articles. The articles cited in CAM on PubMed are peer-reviewed--that is, other scientists in the same field have reviewed the article, the data, and the conclusions, and judged them to be accurate and important to the field. Another database, International Bibliographic Information on Dietary Supplements, is useful for searching the scientific literature on dietary supplements (see "For More Information").

Questions to ask when evaluating Web site information: Who runs the site? Is it Government, a university, or a reputable medical or health-related association? Is it sponsored by a manufacturer of products, drugs, etc.? It should be easy to identify the sponsor. What is the purpose of the site? Is it to educate the public or to sell a product? The purpose should be clearly stated. What is the basis of the information? Is it based on scientific evidence with clear references? Advice and opinions should be clearly set apart from the science. How current is the information? Is it reviewed and updated frequently? For more tips on evaluating information on the Web, read NCCAM's "10 Things To Know About Evaluating Medical Resources on the Web."

If you do not have access to the Internet, contact the NCCAM Clearinghouse (see "For More Information"). The staff is available to discuss your needs with you and assist you in searching the peer-reviewed medical and scientific literature. Visit your local library or a medical library to see if there are books or publications that contain scientific articles discussing CAM in general or the treatment in which you are interested. Thousands of articles on health issues and CAM are published in books and scientific journals every year. A reference librarian can help you search for those on the therapy that interests you.

3. Are CAM therapies safe?

Each treatment needs to be considered on its own. However, here are some issues to think about when considering a CAM therapy.

• Many consumers believe that "natural" means the same thing as "safe." This is not necessarily true. For example, think of mushrooms that grow in the wild: some are safe to eat, while others are poisonous.
• Individuals respond differently to treatments. How a person might respond to a CAM treatment depends on many things, including the person's state of health, how the treatment is used, or the person's belief in the treatment.
• For a CAM product that is sold over the counter (without a prescription), such as a dietary supplement, 2 safety can also depend on a number of things:
  • The components or ingredients that make up the product
  • Where the components or ingredients come from
  • The quality of the manufacturing process (for example, how well the manufacturer is able to avoid contamination).

The manufacturer of a dietary supplement is responsible for ensuring the safety and effectiveness of the product before it is sold. The U.S. Food and Drug Administration (FDA) cannot require testing of dietary supplements prior to marketing. However, while manufacturers are prohibited from selling dangerous products, the FDA can remove a product from the marketplace if the product is dangerous to the health of Americans. Furthermore, if in the labeling or marketing of a dietary supplement a claim is made that the product can diagnose, treat, cure, or prevent disease, such as "cures cancer," the product is said to be an unapproved new drug and is, therefore, being sold illegally. Such claims must have scientific proof.

• For CAM therapies that are administered by a practitioner, the training, skill, and experience of the practitioner affect safety. However, in spite of careful and skilled practice, all treatments--whether CAM or conventional--can have risks.

Article Contents provided by National Association for Complementary and Alternative Medicine (NCCAM).

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