Pills and potions

Ifeolutembi Fashina examines the value of alternative and complementary medical practises

Alternative and complementary medical (A&CM) practices have experienced a surge in popularity as well as long-standing criticism. The recent decision of the British health service not to cover such treatments brings this issue to prominence. These practices are often accompanied by emotional guidance and are rooted in indigenous knowledge; beliefs, religions and cultures. What constitutes alternative medicine differs round the world.

While regions apply this form of medicine at different rates, trends suggest that those in more rural areas and poor and middle-income countries tend to rely more heavily on A&CM due to indigenous beliefs, inability to access modern medicines and the longstanding existence of these forms of therapy.  

The A&CM treatments for physical and mental ailments date back to ancient times, and in South East Asia, Africa, South America and the Caribbean were the main means of healthcare before globalization. The World Health Organisation (WHO) and independent researchers have established that many countries still practice alternative and complementary medicine at significant levels.

Usually, knowledgeable individuals in these societies passed down knowledge of local herbs and other treatments and apply their know-how in community healthcare. This knowledge transfer still occurs, as recorded by scientists, in countries such as Benin Republic and Gabon where indigenes administer local herbs to treat children suffering from malaria, diarrhoea and respiratory illnesses. Several countries in Asia have opted to integrate traditional practices with modern medicine, with India especially providing formal education in the area.

People in North America and parts of Europe also utilise A&CM. This has been attributed to a lack of confidence in modern medicine and the fear of adverse effects of chemically derived drugs. Common forms of complementary therapies adopted in the West include acupuncture, dietary supplements and homeopathy.

Opinions differ on whether the effects of treatments such as homeopathy and acupuncture are more than placebo effects. The scepticism of the scientists towards these forms of therapy is not due to spite, but rather stems from the lack of empirical information. To understand this, one must be aware of the process of modern drug development which involves clinical trials to examine drug efficacy. The quantities of therapeutic molecules required for treatment must be determined and also the specific effect they have on the patient’s condition.

Many ancient herbal therapies formed the basis of present day medications, as pharmacists derive many basic drugs through extraction and isolation of molecules from herbs. For example, the painkiller paracetamol was developed from the acetylsalicylic acid present in willow bark used traditionally to treat pain. This process of isolation ensures that only the desired bioactive molecules are obtained and reduce the probability of side effects.

Treatments such as acupuncture rely on the degree of pain relief and mood upliftment reported by individuals, which are both subjective and difficult to quantify. The use of dietary supplements, homeopathy, and similar treatments have not yielded convincing results in terms of efficacy; however, people use them and report them to be effective. Investigations into the efficiency of dietary supplements have also yielded contradictory results in studies. Finally, variation in individual drug metabolism due to genetic differences is not accounted for in traditional and complementary medicine, unlike in modern medicine.

Because complement treatments have not originated in scientifically verifiable processes, it is difficult to quantify their effects in large scale studies. However, a series of recent studies have suggested that the physiological effects of acupuncture on the brain may be similar to those observed on admission of placebos to patients. Studies using functional magnetic resonance imaging (FMRI) scans on the brain show that placebos stimulate neurotransmission paths similar to those taken by opioids and marijuana. Therefore, the relief patients seemingly obtain from non-herbal treatments could be attributed to the placebo effect or a yet-to-be fully understood function of human physiology.  

This suggestion is not far-fetched when considering studies carried out in the 2000s on Inflammatory bowel disorder (IBS) sufferers  whereby patients received sham acupuncture. Better pain relief was reported by those given sham acupuncture in comparison to those who had no treatment at all.

The placebo effect was also tested in a study on asthma patients, with placebo recipients (fake inhalers) reporting greater relief than their physical measures indicated. This suggests that there is some human factor which plays a role in the not-fully-understood placebo effect and may explain some of the cures reported by users of complementary medicine.

Hence, the draw of these alternative medicines in Western countries could be the human factor or exhibition of compassion by the health personnel involved. Countries where alternative medicines is more mainstream could be continuing the process of knowledge production interrupted by the introduction of modern medication by older and new forms of globalization.

 The WHO, being attentive to the potential advantages of A&CM, has formulated policies that regulate alternative medicines and integrate them with mainstream healthcare worldwide. However, the advantages of well-understood modern medical treatments should not be overlooked, and should be utilised fully by individuals suffering from serious conditions. As science is an ever-evolving field, the role of alternative medicine could be redefined, upon understanding more of its effects on the body.