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Oct. 6, 2000 (Washington) -- Can acupuncture help relieve arthritis pain? Is meditation a good means of avoiding heart disease? Are dietary supplements a legitimate alternative to conventional medications? How can we know for sure that any alternative therapy is truly effective or safe? A White House commission is set to address these and many other questions about complementary and alternative medicine. The goal? To help initiate some desperately needed clinical research.
Over the last decade, Americans' fascination with complementary and alternative medicine literally has exploded, giving rise to an estimated $5 billion-a-year dietary supplement industry alone. While experts believe as many as half of all Americans use at least one form of alternative therapy to treat everything from arthritis to cancer, a number of unanswered questions remain regarding the true value of these non-conventional alternatives to traditional medicine due to an overall lack of clinical research.
Now, some of these answers finally may be around the corner. A White House-appointed commission will review complementary and alternative therapies and look at how these therapies can be tested, how conventional doctors can be trained to use them, and how these therapies can be integrated safely into conventional medicine.
Created by an executive order in March, the commission Thursday inaugurated this process by addressing what is perhaps one of the more perplexing questions: How can these alternative therapies be tested and their effectiveness determined?
"Research is crucial. We need answers," James Gordon, MD, chair of the presidential commission, tells WebMD.
But establishing research agendas for some alternative therapies will be problematic.
"It is possible to apply strict scientific methods to test a number of these alternatives," says Jeffery White, MD, a director at the National Institutes of Health's National Cancer Institute. But testing some alternatives, such as acupuncture and meditation, will be complicated, adds Leanna Standish, PhD, director of research at Bastyr University in Kenmore, Wash., a university devoted to researching and teaching alternative practices.
In the case of acupuncture and meditation, it will be difficult to come to a universal conclusion on the effectiveness of these alternative therapies because how they are administered varies so widely from one practitioner to another. Universal treatment guidelines are a cornerstone of conventional medicine, but in the case of alternative therapies, standardizing the treatment will not always be possible, Standish says.
In terms of creating clinical trials, there will be additional obstacles to overcome, Floyd Leaders, founder and CEO of Botanical Enterprises, a maker of dietary supplements, tells WebMD. Even when the therapy can be standardized, as in the case of dietary supplements, testing whether a product prevents a medical condition is almost impossible, he says. "How can you determine whether the condition was prevented without following the individual their entire life?" Leaders asks.
Getting experienced researchers involved in tests of complementary and alternative therapies also may be a problem, White says. Right now, experienced clinical researchers are somewhat reluctant to participate in these types of trials because alternative therapies are still not considered legitimate medicine, he says.
One way to address this obstacle is to schedule workshops to bring these researchers in contact with practitioners of alternative therapies so that they can educate each other about their respective fields, White suggests.
In the meantime, the NIH already is funding some research into alternative therapies for conditions such as cancer, White says. But the NIH has had a difficult time launching new research initiatives into alternative therapies because a large number of the proposals it receives are for trials that are not always appropriately designed, he says.
The good news is that "interest is very high on all levels," Gordon says. Not only does the commission enjoy bipartisan support from Congress, but it also benefits from the public's own growing interest in alternative therapies, he says. "It is one of these situations where everyone stands to benefit," he tells WebMD.
The next step of the commission will be to hold additional public meetings to address remaining issues, such as how can alternative therapies co-exist with conventional medicine. It also plans to hold town hall meetings across the country to gauge the public's opinion. An interim report is scheduled for next summer, but the commission's final recommendations probably will not be known until March 2002, when the commission faces its final deadline.