Complementary and Alternative Medicine (CAM)

Question 1

What is complementary alternative medicine?

Answer 1

“ a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of conventional medicine”–National Centre for CAM (NCCAM).

Question 2

What is Complementary or Integrative Medicine?

Answer 2

Refers to use of CAM together with conventional medicine

Question 3

What is Alternative Medicine?

Answer 3

Refers to use of CAM in place of conventional medicine

Question 4

What are Alternative medical systems?

Answer 4

eg. Traditional Chinese Medicine (TCM), Ayurvedic Medicine, homeopathy, naturopathy, indigenous healing systems.

Question 5

What are Mind-body interventions?

Answer 5

eg. meditation, yoga, deep-breathing exercises, qi gong, tai chi, guided imagery, biofeedback, dream therapy.

Question 6

What are Biologically based therapies

Answer 6

eg. herbal medicine, Bach flower remedies, bee venom therapy, chelation therapy, vegetable juice therapy

Question 7

What are Manipulative and body-based methods?

Answer 7

eg. osteopathy, chiropractic, craniosacral therapy, Alexander technique, acupuncture, Rolfing, kinesiology

Question 8

What are Energy therapies?

Answer 8

e.g.. therapeutic touch, healing touch, reiki, magnet therapy, light therapy, crystal therapy, qi gong

Question 9

What are the five NCCAM categories?

Answer 9

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

Question 10

Describe the principle of Similars in homeopathy.

Answer 10

Preparations must undergo potentisation:
– Serial dilutions of a mother tincture
– Succussion

Question 11

What are the direct harms of homeopathy?

Answer 11

No risk of interactions with ‘high potency’ medicines

Question 12

What are the indirect harms of homeopathy?

Answer 12

• Delay in receiving appropriate treatment
• Attitudes of practitioner
  • Immunisation (75/77 against – Ernst & Schmidt 2002)
  • Malaria (10/10 – Singh & Tuff 2006)

Question 13

Describe the regulation of homeopaths in the UK.

Answer 13

No legal regulation of homeopaths in the UK
– Society of Homeopaths
– Faculty of Homeopathy
– British Homeopathic Association

Homeopathic products regulated by EU directive

Question 14

What are the drug interactions of St John’s Wort (Hypericum)?

Answer 14

– Hormonal contraceptives
– Anti-depressives
– Anti-coagulants
– Anti-epilepsy agents
– Heart medications 
– Anti-cancer agents 
– Anti-virals for HIV
– ... all this and more!

Question 15

What are the direct harms of herbal medicine?

Answer 15

– Adverse drug reactions
– Drug interactions
– Quality control

Question 16

What are the indirect harms of herbal medicine?

Answer 16

– Delay in receiving appropriate treatment

Question 17

Describe the regulation of herbal medicine.

Answer 17

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

Question 18

What are the direct harms of chiropractic and osteopathy?

Answer 18

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

Question 19

What are the indirect harms of chiropractic and osteopathy?

Answer 19

– Delay in receiving appropriate treatment
– Attitudes of practitioner
• Anti-vaccination

Question 20

Describe the regulation of chiropractic and osteopathy.

Answer 20

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

Question 21

Hoe does acupuncture describe Ch’i as a ‘vital energy’?

Answer 21

Ch’i (Qi, “ch-ee”) as a ‘vital energy’
– Flows through ‘meridians’
– Meridians associated with major organs – Illness due to disrupted flow of Ch’i

Question 22

What is acupuncture?

Answer 22

Insertion of needles along meridians
– Restores flow of Ch’i
– 1 – 10cm in depth, with/without rotation
– Left in place for seconds to hours

Question 23

What are the direct harms of acupuncture?

Answer 23

– Infections

– Pneumothorax

Question 24

What are the indirect harms of acupuncture?

Answer 24

– Delay in receiving appropriate treatment

– Attitudes of practitioner

Question 25

Describe the regulation of acupuncture.

Answer 25

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

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