6. CAM

Question 1

What is CAM?

Answer 1

Complementary Alternative Medicine
“ agroupofdiversem edicalandhealthcaresystem s,practices,and productsthatarenotgeneralyconsideredpartofconventional medicine”

Question 2

What is Complementary or Integrative Medicine?

Answer 2

Refers to use of CAM + conventional medicine

Question 3

What is alternative medicine?

Answer 3

CAM use INSTEAD of conventional medicine

Question 4

What is the 5 classifications of CAM?

Answer 4

Alternative medical systems
Mind-body interventions
Biologically based therapies
Manipulative and body-based methods
Energy therapies

Question 5

Define:

Alternative medical systems

Answer 5

e.g. traditional chinese medicine (TCM), ayurvedici medicine, homeopathy, naturopathy, indigenous healing systems

Question 6

Define:

Mind-body interventions

Answer 6

E.g. meditation, yoga, deep-breathing exercises, qi going, tai chi, guided imagery, biofeedback., dream therapy

Question 7

Define:

Biologically based therapies

Answer 7

Herbal medicine
Bach flower remedies 
bee venom therapy
chelation therapy
Veg juice therapy

Question 8

Define:

Manipulative and body-based methods

Answer 8

Osteopathy
Chiropractic 
Craniosacral therapy
alexander technique
acupuncture
rolfing
kinesiology

Question 9

Define:

Energy therapies

Answer 9

Therapeutic touch
Healingtouch
reiki
Magnet therapy
Light therapy
Crystal therapy
Qi gong

Question 10

How to make homeopathic preparation?

Answer 10

Principle of Similars i.e. like cures like
Preparations must undergo potentisation:
– Serial dilutions of a mother tincture
– Succussion

“Like cures like”
In principle, it’s just extremely diluted toxin with lots of sugar

Question 11

Common homeopathic dilution?

Answer 11

30C dilution= 1 in 100^30

So… very very diluted i.e. not “potent”

Question 12

Homeopathy on the NHS

Answer 12

46m spend a year across UK

4m in scotland

Question 13

Risks associated with homeopathy?

Answer 13

Direct harm
– No risk of interactions with ‘high potency’ medicines

Indirect harm
– Delay in receiving appropriate treatment
– Attitudes of practitioner when dealing with prescribed meds
• Immunisation (75/77 against – Ernst & Schmidt 2002)
• Malaria (10/10 – Singh & Tuff 2006)

Question 14

Regulations around homeopathy?

Answer 14

NO LEGAL REGULATION of homeopaths in the UK
– Society of Homeopaths
– Faculty of Homeopathy
– British Homeopathic Association

BUT Homeopathic products regulated by EU directive i.e. you have to make meds to same standards are other drugs

Question 15

What’s the difference between herbal and homeopathic?

Answer 15

Herbal contains an activate ingredient, homeopathic doesn’t

Question 16

Considerations of St John’s Wort (hypericum)?

Answer 16

Benefits:
Improves outcomes for major depressive patients

Drawbacks:
Interactions with other drugs e.g. 
– Hormonal contraceptives 
– Anti-depressives
– Anti-coagulants
– Anti-epilepsy agents
– Heart medications 
etc etc

Question 17

Risks associated with herbal meds?

Answer 17

Direct harm
– Adverse drug reactions
– Drug interactions
– Quality control

Indirect harm
– Delay in receiving appropriate treatment

Question 18

Regulation of herbal medicine?

Answer 18

MHRA regulates herbal medicines in the UK market
1. Safety, quality, efficacy as per any regular medicine
• Marketing Authorisation (MA)
2. Safety & quality (not efficacy) based on traditional usage
• Traditional Herbal Medicines Registration (THR) i.e. proof of 30yrs of use, not efficacy
3. The “herbalist exemption”
• Regulation 3 of The Human Medicines Regulations 2012

Basically no evidence of efficacy and safety required

Question 19

Manipulative therapy e.g.

Answer 19

Chiropractic and osteopathic therapy

Question 20

Chiropractic practice, what is it?

Answer 20

Treatment of joint malalignment esp spinal cord that can relieve symptoms associated with nerves, organs and muscles

Question 21

Osteopathy, define?

Answer 21

Complementary medicine by manipulation of the skeleton and musculature

Question 22

What is the process of chiropractice?

Answer 22

Detection of ‘subluxations’

• Block the flow of innate intelligence
• Use of x-rays and gadgets

Spinal manipulations (adjustments)

• Including high-velocity, low-amp thrusts
• WITH an audible crack

Question 23

Risk of chiropractic and osteopathy?

Answer 23

Direct harm
– 50% of chiropractic patients suffer an adverse reaction
– Tearing of artery wall leading to stroke
– Injury to the spinal cord
– Chiropractic X rays

Indirect harm
– Delay in receiving appropriate treatment
– Attitudes of practitioner

Question 24

Regulation of chiropractic and osteopathy?

Answer 24

Only two CAM modalities under statutory regulation
– General Chiropractic Council (GCC)
– General Osteopathic Council (GOsC

TIGHTER REGULATION

Question 25

Acupuncture, what is it?

Answer 25

Chi’i as a ‘vital energy’ which flows through meridians. These meridians are associated with major organs. Illness due to disrupted flow of Chi’i

Needle insertion along meridians to restore flow.

• 1-10cm in depth
• With/without rotation
• Left in place for seconds to hours

Question 26

What are the diagnosis processes used in acupuncture?

Answer 26

Inspection, auscultation, olfaction, palpitation and inquiring

Question 27

Risks of acupuncture?

Answer 27

Direct harm
– Infections due to breached barrier
– Pneumothorax

Indirect harm
– Delay in receiving appropriate treatment
– Attitudes of practitioner

Question 28

Regulation of acupuncture?

Answer 28

Premises and practitioners must be licensed
– Via local authority (same as tattooing/body piercing)

Voluntary regulation
– Several organisations, e.g. British Acupuncture Council