CNI Multiple Sclerosis Service
Education & Information
About Complementary & Alternative Medicine
Complementary and alternative medicine (CAM) is commonly used in the United States. Studies indicate that one-third to three-fourths of neurological patients use some form of CAM. CAM use tends to be higher in women and those who have conditions that lack definitive cures, have unpredictable courses and are associated with discomfort, pain and side effects from prescription medications. Because these are characteristics of many neurological diseases and the people with neurological disease, CAM use may be more prevalent in people with neurological diseases than in the general population. Many studies have shown that CAM is used by 50-75% of patients with various neurological diseases, including MS, brain tumors, Parkinson’s disease, neuromuscular disease and headache.
What is CAM?
The term complementary medicine refers to therapies that are used in addition to conventional medicine, while the term alternative medicine is used to describe treatments that are used instead of conventional medicine. In the United States, CAM is sometimes defined as medical therapy that is not widely taught at American medical schools or is not generally available in American hospitals. This definition recently has become less clear because unconventional medicine is now taught by many medical schools and is available in some medical communities. Also, as clinical trials are done to evaluate the effectiveness of CAM therapies, some forms of CAM may eventually become components of conventional medicine.
CAM includes a vast number of therapies. Multiple models have been proposed for categorizing these diverse and often unrelated therapies; one of the most useful was developed by the National Institutes of Health (NIH). The NIH model for categorizing CAM therapies is as follows:
- Biologically Based Therapies - Dietary supplements, diets, bee venom therapy, hyperbaric oxygen
- Mind–Body Therapies - Guided imagery, hypnosis, meditation
- Alternative Medical Systems - Traditional Chinese medicine,
- Manipulative and Body-Based Therapies - Chiropractic, reflexology, massage
- Energy Therapies - Therapeutic touch, magnets
Several studies have documented that CAM is used frequently in the United States. One well-known large study was conducted in 1997 and was reported in the medical literature in 1998 by Dr. David Eisenberg. In this study of more than 2,000 people, approximately 42% used some form of CAM. It was estimated that 629 million visits were made to practitioners of alternative medicine; this was greater than the number of visits to all primary care physicians in that year. Nearly 20% of people were taking some type of herb or vitamin along with a prescription medication. Most people used CAM without the supervision of a CAM practitioner, and most people did not discuss their use of CAM with their physicians. As a result, nearly half of the people were using CAM without the advice of a physician or a CAM practitioner. This demonstrates the need for increased communication in this area between patients and health care providers.
Several U.S. studies indicate that the use of CAM continues to be relatively high and will be high in the future. A large analysis of CAM use in the U.S. was conducted in 2002. In this survey, 50% of the general population had used some form of CAM. Another U.S. study found that for those born before 1945, about 30% of respondents used CAM. The percentage of CAM users rose to about 50% for those born between 1945 and1964, and was even higher, about 70%, for those born between 1965 and 1979. This study also found that nearly one-half of people who tried a specific form of CAM continued to use that CAM therapy more than 20 years later. Overall, this study indicates that CAM is not a short-lived phenomenon.
CNI Complementary & Alternative Medicine Service
To address the widespread use of CAM among people with neurological disease and to provide high quality, disease-specific, individualized information, the CNI CAM Service offers the following educational resources:
Individualized Patient Education Service
This educational service is provided in office or by phone and provides objective, disease-specific CAM information relevant to each patient. The service is provided on either a one-time or ongoing basis and includes individualized CAM information about specific neurological conditions and symptoms. Detailed safety and effectiveness information about CAM therapies that are evidence-based and may be beneficial for specific diseases or symptoms will be discussed. Information is also provided about the possible benefits and possible toxic effects of dietary supplements while also analyzing supplement-drug and supplement-supplement interactions.
Patient and Professional Education Programs
Allen Bowling, MD, PhD, Medical Director of the CNI Complementary & Alternative Medicine Service, is available to participate in patient or professional education programs on specific neurological diseases. For these programs, disease-specific CAM information is presented fairly and objectively.