Alternative attitudes to complementary medicine

It is easy to assume that people who use complementary and alternative medicines will hold anti-scientific views. After all, the scientific community is largely united in opposition to treatments such as homeopathy, reiki and faith healing, so why would the reverse not also be true? Surely the population is divided into two camps with opposing, incompatible views on which form of medicine works?

Little research had been done to test this assumption until Dr Paul Stoneman and colleagues decided to look into the extent to which people's attitudes toward science actually relate to their usage of alternative medicines. Their conclusions are somewhat surprising.

They found that the population is actually split into three main groups, rather than two. There are the groups we’d expect to find: one set of people who trust science while having no belief in complementary and alternative medicine (or CAM for short), and another group who do not trust conventional medicine or their GP or the pharmaceutical industry but do believe strongly in CAM (especially homeopathy). So far, so predictable.

We should be careful not to confuse usage of alternative medicines with support for them

However, the study (published in the journal PLOS ONE) also found evidence of a third group. These are people who trust science, who believe in conventional medicine, who are happy to take modern pharmaceutical treatments on the recommendation of their doctor, and yet confess to having tried a complementary remedy of some sort.

So what is going on here?

“We should be careful not to confuse usage of alternative medicines with support for them,” argues Dr Stoneman, Lecturer in the Department of Sociology. “When we were looking at the motives for using CAM, the primary reason people cited was ‘Well, why not?’

“We found that it's usually something people do in addition to standard treatments. It’s relatively cheap, it's easily accessible, and there's this perception that there are no side-effects, so when these people are ill they just try lots of treatments and see what works.”

As well as being interesting to social scientists, this is an attitude that may cause problems for the medical profession, as Dr Stoneman explains: “A U.S. study found that the number of people who inform their GP when they are taking a course of CAM is actually low. Because they see complementary medicine as something natural that is completely different from conventional treatments, and without side effects, it's not something they think their doctor needs to know about.

“But there are possible interactions between alternative treatments and prescribed pharmaceuticals. For example, you can buy a cheap over-the-counter product called 5-HTP or 5-Hydroxytryptophan, which is a serotonin precursor that people use to help them sleep. Clinical trials suggest it may have some efficacy, but if you take it in addition to an anti-depressant you could induce serotonin syndrome and die. And that is not the only example of potentially dangerous interactions. Think of valerian, or St John’s Wort.”

The number of people who inform their GP when they are taking a course of complementary medicine is low

If the lay public doesn’t understand the potential danger from mixing alternative treatments with conventional medicine, they may refrain from informing their GP when they are using them. Imagine that someone has suffered an adverse reaction because of an interaction between a herbal remedy and a conventional medicine, but their medical records only record what they have been prescribed. Doctors treating the condition may infer that the conventional medicine is causing the problem, hindering identification of the right treatment in what may be an urgent situation. This is where the situation becomes problematic, and where research of this kind becomes vital.

“We’ve made some inroads here,” says Dr Stoneman, “but it would be interesting to find out more about people’s awareness and perception of different forms of CAM. Where are they getting their information from, what recommendations are they getting, and how does this fit into their overall lifestyle and programme of medicine?

“There aren't really any population estimates of CAM usage in the UK, although parliamentary committees have said that they are necessary. Looked at from that perspective, we really need more research to find out who is taking what, and why.”