Americans are using complementary and alternative medicine (CAM). How many Americans? What therapies are they using? For what health problems and concerns?
The most comprehensive and reliable findings to date on Americans' use of CAM were released in May 2004 by the National Center for Complementary and Alternative Medicine (NCCAM) and the National Center for Health Statistics (NCHS, part of the Centers for Disease Control and Prevention). They came from the 2002 edition of the NCHS's National Health Interview Survey (NHIS), an annual study in which tens of thousands of Americans are interviewed about their health- and illness-related experiences. The 2002 edition included detailed questions on CAM. It was completed by 31,044 adults aged 18 years or older from the U.S. civilian noninstitutionalized population. Some highlights from these findings begin with the section "CAM Therapies Included in the Survey". To obtain the full report, go to the end of this document.
What Is CAM?
CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. Some health care providers practice both CAM and conventional medicine.
While some scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered through well-designed scientific studies--questions such as whether these therapies are safe and whether they work for the diseases or medical conditions for which they are used. 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.
CAM Therapies Included in the Survey
The survey included questions on various types of CAM therapies commonly used in the United States. These included provider-based therapies, such as acupuncture and chiropractic, and other therapies that do not require a provider, such as natural products, special diets, and megavitamin therapy. (See a complete list of therapies that were included.)
The results were analyzed including and excluding two therapies--(1) prayer specifically for health reasons and (2) megavitamins--because earlier national surveys did not consistently include these therapies.
Unless noted otherwise, the statistics are for CAM use during the 12 months prior to the 2002 survey.
How Many People Use CAM
In the United States, 36% of adults are using some form of CAM. When megavitamin therapy and prayer specifically for health reasons are included in the definition of CAM, that number rises to 62%. (See figure 1.)
Who Uses CAM Most
CAM use spans people of all backgrounds. But, according to the survey, some people are more likely than others to use CAM. Overall, CAM use is greater by:
- Women than men
- People with higher educational levels
- People who have been hospitalized in the past year
- Former smokers, compared with current smokers or those who have never smoked.
This survey was the first to yield substantial information on CAM use by minorities, and the major findings so far are shown in figure 2.
The full report provides more details about the characteristics of people who use CAM.
CAM Domains Used the Most
When prayer is included in the definition of CAM, the domain of mind-body medicine is the most commonly used domain (53%). (See figure 3.) When prayer is not included, biologically based therapies (22%) are more popular than mind-body medicine (17%).
CAM Therapies Used the Most
Prayer specifically for health reasons was the most commonly used CAM therapy. (See figure 4, which shows the percentage of people using each of the 10 most common therapies.) Most people who use CAM use it to treat themselves, as only about 12% of the survey respondents sought care from a licensed CAM practitioner.
CAM Therapies Included in the 2002 NHIS
An asterisk (*) indicates a practitioner-based therapy. For definitions of any of these therapies, see the full report or contact the NCCAM Clearinghouse.
Ayurveda*
Biofeedback*
Chelation therapy*
Chiropractic care*
Deep breathing exercises
Diet-based therapies
Vegetarian diet
Macrobiotic diet
Atkins diet
Pritikin diet
Ornish diet
Zone diet
Folk medicine*
Guided imagery
Homeopathic treatment
Hypnosis*
Massage*
Meditation
Megavitamin therapy
Natural products
(nonvitamin and nonmineral, such as herbs and other products from plants, enzymes, etc.)
Prayer for health reasons
Prayed for own health
Others ever prayed for your health
Participate in prayer group
Healing ritual for self
Qi gong
Reiki*
Tai chi
Yoga
Use of Natural Products
As shown in figure 4, about 19% (or one-fifth) of the people surveyed used natural products.
See figure 5 for the most commonly used natural products and for the percentages of natural product users who took those products.
Health Conditions Prompting CAM Use
People use CAM for a wide array of diseases and conditions. According to the survey, Americans are most likely to use CAM for back, neck, head, or joint aches, or other painful conditions; colds; anxiety or depression; gastrointestinal disorders; or sleeping problems. (See figure 6.) It appears that CAM is most often used to treat and/or prevent musculoskeletal conditions or other conditions involving chronic or recurring pain.
Reasons for Using CAM
The survey asked people to select from five reasons to describe why they used CAM. (See figure 7.) Results were as follows (people could select more than one reason):
- CAM would improve health when used in combination with conventional medical treatments: 55%
- CAM would be interesting to try: 50%
- Conventional medical treatments would not help: 28%
- A conventional medical professional suggested trying CAM: 26%
- Conventional medical treatments are too expensive: 13%
The survey found that most people use CAM along with conventional medicine rather than in place of conventional medicine.
Spending on CAM
The NHIS did not include questions on spending on health care, but the report authors cited spending figures from national surveys conducted in 1997. Those surveys found that:1,2
- The U.S. public spent an estimated $36 billion to $47 billion on CAM therapies in 1997.
- Of this amount, between $12 billion and $20 billion was paid out-of-pocket for the services of professional CAM health care providers.
- These fees represented more than the public paid out-of-pocket for all hospitalizations in 1997 and about half of what it paid for all out-of-pocket physician services.
- $5 billion of out-of-pocket spending was on herbal products.
Eight Great books on complementary and alternative medication
- Complementary and Alternative Medicine: An Evidence-Based Approach (Complementary & Alternative Medicine) by John W. Spencer and Joseph J. Jacobs (Paperback - Feb 21, 2003)
- The Complementary and Alternative Medicine Information Source Book by Alan M. Rees (Paperback - Mar 15, 2001)
- Complementary and Alternative Medicine for Older Adults: Holistic Approaches to Healthy Aging by Elizabeth R. Mackenzie and Birgit Rakel (Paperback - Feb 22, 2006)
- Fundamentals of Complementary and Alternative Medicine (2nd Edition) by Marc S. Micozzi (Paperback - Jan 15, 2001)
- The Desktop Guide to Complementary and Alternative Medicine: An Evidence-Based Approach by Edzard Ernst, Max H. Pittler, and Barbara Wider (Paperback - Aug 16, 2006)
- Mosby's Complementary & Alternative Medicine: A Research-Based Approach (Mosby's Complementary and Alternative Medicine) by Lyn W. Freeman (Hardcover - Jun 9, 2008)
- Professional's Handbook of Complementary & Alternative Medicines (PROFESSIONALS HANDBOOK OF COMPLEMENTARY & ALTERNATIVE MEDICINE) by Charles H Fetrow and Juan R Avila (Paperback - Jun 1, 2003)
- Complementary and Alternative Medicine: Legal Boundaries and Regulatory Perspectives by Michael H. Cohen (Paperback - Jan 12, 1998)
Resource and Support Group for Complementary and Alternative Medicine:
Complementary
and Alternative Medicine (CAM) Online Health
Community and Support Group:
http://communities.healia.com/?q=communities/complementary-and-alternative-medicine-cam
Additional Resources:
- For related articles on Complementary and Alternative Medicine on the Web, click on: “Sphere: Related Content” located at the bottom of this blog post.
- For related books or blog posts with related content in Dr. Jeff’s and Dr. Tanya’s Blog, click on the “Treatments: Alternative” category at the bottom of the post or type in keywords “Complementary and Alternative Medicine” into “Google Search” located in the sidebar.
- For related articles from Psychology Today, click on the “Psychology Today” banner in the side bar and type in Key words, “Complementary and Alternative Medicine” into the Psychology Today “Search”.
- For more books with related content, click any hyperlinked key word in the blog or type in key words, “Complementary and Alternative Medicine“ into “Amazon Search” on the Amazon banner located in the side bar.
Source: The National Center for Complementary and Alternative Medicine (NCCAM), See also blog posts in: Treatments: Alternative
Dr. Tanya Korkosz
Dr. Jeffrey Speller
Psychopharmacology Associates of New England
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