By Rob Stein
Washington Post Staff Writer
Thursday, December 11, 2008
More than one-third of adults and nearly 12 percent of children in the United States use alternatives to traditional medicine, according to a large federal survey released today that documents how entrenched acupuncture, herbal remedies and other once-exotic therapies have become.
The 2007 survey of more than 32,000 Americans, which for the first time included children, found that use of yoga, "probiotics," fish oil and other "complementary and alternative" therapies held steady among adults since the last national survey five years earlier, and that such treatments have become part of health care for many youngsters.
"It's clear that millions of Americans every year are turning to complementary and alternative medicine," said Richard L. Nahin of the National Institutes of Health's National Center for Complementary and Alternative Medicine, which released the survey. "The use of complementary and alternative medicine seems to have stabilized in the United States."
The most commonly used are dietary supplements and herbal products such as echinacea, flaxseed oil and ginseng, followed by deep-breathing exercises, meditation, chiropractic therapy, massage and yoga. Although fewer Americans were using certain diets and trying herbal remedies such as echinacea to cure colds, the popularity of acupuncture, meditation, yoga and massage grew.
"I think it's fair to say we can conclude that this is part of the steady state of medical care in the United States," said David Eisenberg, director of the Harvard Medical School's division for research and education in complementary and integrative medical therapies. "I think the news is complementary and alternative medicine use by the U.S. public is here to stay."
Others said the findings were disturbing because most alternative treatments have not been scientifically validated and those that have been rigorously tested have overwhelmingly been found to be ineffective.
"They are either unproven or disproven," said Wallace Sampson, founding editor of the Scientific Review of Alternative Medicine. "Acupuncture is a placebo. Homeopathy is one step above fraud. It goes on and on. The fact that they are so widely used is evidence for how gullible large segments of our society are."
Some critics went further, saying studies have found that some dietary supplements might increase the risk of some serious health problems, including cancer. Parents could be putting their children at risk if they deny them proven mainstream treatments, they said.
"In addition to the fact that these things are unproven and potentially dangerous, they also feed the mentality that you can forgo proven treatments in favor of these magic potions," said Seth Asser, a pediatrician and consultant to Children's Healthcare Is a Legal Duty, a nonprofit group that opposes faith healing and other nontraditional medical practices.
The survey comes soon after a flurry of large studies failed to validate the suspected benefits of many "antioxidants" widely used to try to stave off cancer and other diseases. Just this week, two large studies found no evidence that taking vitamins E and C and selenium reduces the risk of prostate and other cancers.
The new survey of about 23,300 adults and 9,400 children was conducted by the federal Centers for Disease Control and Prevention's National Center for Health Statistics as part of a broader ongoing study.
Adults were most likely to use alternative therapies for pain, including in the back, neck or joints. Women were more likely to use them, as were those who are more educated and more affluent.
Because children presumably use alternative medicine mostly because their parents provide it, use among children closely mirrored that of adults. Children whose parents used alternative treatments were almost five times as likely to have used one, compared with children of parents who did not.
The most common reason children used alternative therapies was also back or neck pain, followed by colds, anxiety or stress, musculoskeletal problems and attention-deficit disorder or attention-deficit hyperactivity disorder. About 16.4 percent of adolescents received such treatments, compared with 10.7 percent of those ages 5 to 11 and 7.6 percent of those too young to go to school.
The findings will help set priorities for studying such therapies, Nahin said.
"There are hundreds, if not thousands, of therapies that the public is using. The National Institutes of Health is slowly going through that cornucopia to study them and provide information to the public," he said.
Critics said the survey was being used to justify continued government spending on research into such treatments.
"There's a tremendous amount of money being wasted on this," said Stephen Barrett, who runs Quackwatch (http://www.quackwatch.org), which monitors false medical claims. "That money could be used to do research on something that has been waiting in line to get money."
Nahin acknowledged that there are legitimate concerns about many alternative therapies. Dietary supplements are not regulated as closely as standard medication, leaving them more likely to be contaminated, for example. And some products can interfere with prescription drugs.
But Nahin said government-funded research into such therapies is useful, citing a federal study that concluded that St. John's wort was ineffective. After the results were released, use of the herbal remedy dropped sharply, he said.
"The research is working," he said. "It's doing what it's supposed to do, which is provide reliable information to the public so they can make decisions."