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Beyond Western Medicine - Heather Boon, University of Toronto

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Heather Boon, (BScPhm, PhD), a Professor and the Associate Dean of Graduate Education at the Leslie Dan Faculty of Pharmacy, University of Toronto. Dr. Boon will discuss alternative medicine in Canada, including its growth and recent developments, and the relationship between Western medicine and herbal treatments.

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Beyond Western Medicine - Heather Boon, University of Toronto

  1. 1. Complementary andComplementary andAlternative Medicine (CAM)Alternative Medicine (CAM)Heather Boon, BScPhm, PhDHeather Boon, BScPhm, PhDProfessor andProfessor andAssociate Dean for Graduate EducationAssociate Dean for Graduate EducationLeslie Dan Faculty of Pharmacy,Leslie Dan Faculty of Pharmacy,University of TorontoUniversity of Toronto(heather.boon@utoronto.ca)(heather.boon@utoronto.ca)11
  2. 2. OutlineOutline What is CAM?What is CAM? Who uses CAM and why?Who uses CAM and why? Regulation of CAM practitionersRegulation of CAM practitioners Regulation of natural health productsRegulation of natural health products(NHPs)(NHPs) CAM and pharmacy – do pharmacistsCAM and pharmacy – do pharmacistshave a role to play?have a role to play?22
  3. 3. What is CAMWhat is CAM Anything that isn’t conventional medicine?Anything that isn’t conventional medicine? “…“…healing resourceshealing resources that encompass all healththat encompass all healthsystems, modalities, and practices and theirsystems, modalities, and practices and theiraccompanying theories and beliefs,accompanying theories and beliefs, other thanother thanthose intrinsic to the politically dominant healththose intrinsic to the politically dominant healthsystemsystem of a particular society or culture in aof a particular society or culture in agiven historical period. CAM includes allgiven historical period. CAM includes all suchsuchpractices and ideas self-defined by their userspractices and ideas self-defined by their usersas preventing or treating illness or promotingas preventing or treating illness or promotinghealth and well-being… (NIH)health and well-being… (NIH)
  4. 4. 44NIH ClassificationsNIH Classifications Alternative medical systemsAlternative medical systems(e.g., TCM, naturopathy, homeopathy)(e.g., TCM, naturopathy, homeopathy) Mind-body interventionsMind-body interventions(e.g., meditation)(e.g., meditation) Biological-based therapiesBiological-based therapies(e.g., herbs, supplements)(e.g., herbs, supplements) Manipulative and body-based methodsManipulative and body-based methods((e.g., chiropractic, massage)e.g., chiropractic, massage) Energy TherapiesEnergy Therapies((e.g., therapeutic touch, Reiki)e.g., therapeutic touch, Reiki)
  5. 5. 55Who Uses CAM?Who Uses CAM? 20%20% of Canadiansof Canadians visited a CAM providervisited a CAM provider inin20032003 (Canadian Community Health Survey)(Canadian Community Health Survey) Most common CAM practitioners visited:Most common CAM practitioners visited: chiropractic (11%)chiropractic (11%) massage therapy (8%)massage therapy (8%) acupuncturist (3%)acupuncturist (3%) 73% of Canadians73% of Canadians have ever used an NHPhave ever used an NHP(2010)(2010) (http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-(http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2011/135-09/report.pdf)ef/health/2011/135-09/report.pdf) 32% of Canadians use NHPs on a daily basis32% of Canadians use NHPs on a daily basis vitamins and minerals (53%)vitamins and minerals (53%) omega 3 fatty acids/fish oils (18%) andomega 3 fatty acids/fish oils (18%) and herbal teas (11%)herbal teas (11%)
  6. 6. 66CAM RegulationCAM RegulationPractitionersPractitioners Provincial jurisdictionProvincial jurisdiction Many unregulatedMany unregulated Wide variation inWide variation intraining andtraining andcredentialscredentialsProductsProducts Federal jurisdictionFederal jurisdiction Natural HealthNatural HealthProducts (NHPs)Products (NHPs) Regulations fullyRegulations fullyimplemented in 2010implemented in 2010
  7. 7. 77CAM PractitionersCAM Practitioners ChiropractorsChiropractors – regulated in all Canadian– regulated in all CanadianProvincesProvinces Naturopathic MedicineNaturopathic Medicine – regulated in 6– regulated in 6Provinces including OntarioProvinces including Ontario Traditional Chinese medicine andTraditional Chinese medicine andacupunctureacupuncture –pending in Ontario; TCM–pending in Ontario; TCMregulated in BCacupuncture regulated inregulated in BCacupuncture regulated insome other Provincessome other Provinces HomeopathyHomeopathy – pending in Ontario– pending in Ontario Registered Massage TherapistsRegistered Massage Therapists --regulated in Ontario (plus some otherregulated in Ontario (plus some otherProvinces)Provinces)
  8. 8. 88Regulation of Natural HealthRegulation of Natural HealthProducts (NHPs)Products (NHPs) Regulated by theRegulated by the Natural Health ProductsNatural Health ProductsDirectorate (Health Canada)Directorate (Health Canada)since January 1, 2004 (since January 1, 2004 (http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.phphttp://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php)) natural product number (NPN)natural product number (NPN) or (DIN-HM)or (DIN-HM) Quality control and good manufacturing practicesQuality control and good manufacturing practices Risk-based review of safety and efficacyRisk-based review of safety and efficacy Modern health claims vs. traditional use claimsModern health claims vs. traditional use claims
  9. 9. Some Practical AdviceSome Practical AdviceNHPs for ColdsNHPs for Colds99
  10. 10. EchinaceaEchinacea ((Echinacea purpurea; E. angustifolia; E. pallidaEchinacea purpurea; E. angustifolia; E. pallida))1010http://www.cobleskill.edu/courses/orht321/Echinacea%20purpurea%200104.jpg
  11. 11. GinsengGinseng ((Panax quinquefoliusPanax quinquefolius or North Americanor North AmericanGinseng)Ginseng)1111
  12. 12. Oregano (Oregano (Origanum vulgareOriganum vulgare))1212http://2.bp.blogspot.com/-hULRiYTbsSc/UEL352AYn_I/AAAAAAAAh9E/7mFxkQKsABs/s1600/Greek+Oregano55.JPG
  13. 13. 1313http://extremelongevity.net/wp-content/uploads/vitamin-c.jpg
  14. 14. 1414http://ods.od.nih.gov/images/content/Zinc-Pills.jpg
  15. 15. NHPs for ColdsNHPs for ColdsMight HelpMight Help EchinaceaEchinacea (arial parts of(arial parts ofE. Purpurea) forE. Purpurea) fortreatmenttreatment GinsengGinseng (North American(North Americanginseng) for preventionginseng) for prevention Vitamin CVitamin C – 200mg /day– 200mg /dayfor preventionfor prevention ZincZinc – lozenges for– lozenges fortreatmenttreatmentDon’t BotherDon’t Bother Oil of oreganoOil of oregano (no(noresearch)research)1515

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