SUMMARY OF ARTICLE July 29 (Reuters) from: Nature Medicine (1997;3(8):824-827)

RESEARCHING ALTERNATIVE MEDICINE

Do 'alternative' medicines and therapies really heal? If so, how? Dr. Wayne B. Jonas, the director of the federal government's recently created Office of Alternative Medicine (OAM), believes answering questions like these to be the main goal of his agency. "Developing an environment in which the courage and resources to pursue these types of investigations can emerge is the Office's main role," writes Jonas in the current issue of the journal Nature Medicine. Demand for so-called 'alternative' or 'unconventional' medicines and therapies continues to grow each year - Jonas reports that in the year 1990 one in three Americans sought alternative care, "constituting over 400 million (office) visits, more than to all conventional primary care physicians."

He says this demand disproves the stereotypical image of the alternative-care patient as either 'neurotic', or embittered with conventional methods of healing. In reality, "over 80% of (patients seeking alternative remedies)... used them along with conventional medicine," Jonas explains. "In other words, these are the same patients seen in the office of the average physician."

There is one major difference between conventional and unconventional therapies, however: only conventional medicine comes with the stamp of exhaustive scientific research to back up its claims to efficacy.

Jonas sees the OAM's main role as the facilitation and stimulation of similar research into the benefits -- and possible risks -- of alternative therapies. When Congress created the OAM as a branch of the National Institutes of Health (NIH) in 1994, it set four main goals for the agency:

. to spur the evaluation of various alternative treatments.

. to investigate possible benefits of alternative care.

. to establish an "information clearinghouse" -- a centralized resource the public could come to with questions regarding unconventional therapies.

. to support research training in alternative medicine practices.

Jonas believes much of the lay public needs little convincing about the efficacy of some highly-touted alternative 'cures'. He cites the widespread use of herbal products like ginkgo bilboa against dementia and Alzheimer's disease, garlic against heart disease, and St. John's Wort to fight depression. Therapies like acupuncture, vitamin supplementation, and homeopathy have been around for decades, if not centuries, and have become almost 'mainstream'. And yet, Jonas contends that "without a more concerted research effort, therapeutic options in these areas will remain underdeveloped."

Part of the OAM's annual $12 million budget will pursue those research efforts. For example, Jonas says "the Office is currently working with the National Institutes of Mental Health and the Office of Dietary Supplements in setting up a multi-center, randomized, controlled trial to test a whole plant extract of St. John's Wort for the treatment of depression. The mechanism of action and active components are not established for this herb."

Jonas believes efforts such as these stretch the boundaries of 'conventional' research. They may also bring unexpected rewards. "If the ancient wisdom of herbalism can be developed into a modern approach," he says, "...then a whole new world of low-cost therapeutic options will open up to us."

He urges similar investigations of such 'unconventional' approaches, including mind/body therapies, homeopathy -- even spiritual healing. What is most important, Jonas says, is that researchers remain open to new (and sometimes, very old) ideas. "It is the role of the OAM to bring together both the best of science and the best of unorthodox approaches to healing," he explains. "By asking new questions, we can see a new and expanded horizon in science -- a horizon that extends far beyond that which confronts us now."


SOURCE: Nature Medicine (1997;3(8):824-827)