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Do We Need NCCAM?

I was just about to start writing this blog about yesterday's thought-provoking article regarding some legislators' calls to eliminate the NIH's National Center for Complementary and Alternative Medicine (NCCAM). But before I got going I remembered I wanted to do a bit of preliminary research in preparation for next Tuesday's "Eat, Drink and Be Healthy" column about probiotics. When I Googled the term, the most useful Web site that turned up was from -- guess where? -- NCCAM.

In the face of this challenging economy, lawmakers are absolutely right to scrutinize every dollar the government spends. Their questions as to whether the NCCAM is earning its $122 million annual keep are perfectly legit.

On the other hand, as Americans' interest in and use of complementary and alternative treatments rise, it's good to have some agency sorting out pros and cons, benefits and risks, efficacies and false promises. Might those tasks be easily shifted elsewhere?

One reader commented that it's our universities' role to conduct the kind of research that's needed to validate or debunk alternative treatments. Of course, one of NCCAM's major functions is to review research grant applications from academic institutions and award funds to the most worthy projects.

If that funding were left entirely to the private sector, would there be conflicts of interest? If a supplement maker, for instance, is charged with determining whether its supplements cure colds or reduce cancer risks, can we trust those findings?

Here's another thought: Some alternative therapies have the potential to interfere with conventional treatments. Physicians and patients need to know whether a dietary supplement, for instance, is likely to interfere with the action of a prescription drug. If an agency such as NCCAM doesn't fund such research, who will? Probably not the pharmaceutical companies.

Still, despite my professional use of the NCCAM Web site, I'm on the fence. How about you? Do you think we taxpayers should keep funding the NCCAM? Or would that money be better spent elsewhere?

Note your opinion here, and please elaborate on your answer in the Comments section below.

By Jennifer LaRue Huget  |  March 18, 2009; 7:00 AM ET
Categories:  Alternative and Complementary Medicine  
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Comments

With hundreds of billions of dollars wasted on health insurance "contracts" with "pre-existing" condition exemptions, hundreds of millions wasted on pharmaceutical drugs, unnecessary operations, hospitals that are unable to provide itemized billing, undocumented and unproven medical procedures, expensive lab tests that show nothing is wrong and YOU want to focus on eliminating the one area that is showing promise in breaking the monopoly of the medical profiteers, the NCCAM?

I suggest you do a bit more research - such as at the NCCAM's own web site where the preliminary indications of a number of double blinded placebo controlled tests show, for example, that Homeopathy succeeded, got positive results, and in a few instances performed better than the available over the counter remedy for the same problem.

The problem is that "health" journalists are not taking the time to get past the innuendo against Homeopathy, or the latest tirade against old Prince Charles and do some research on the incredible growth of alternative medicine - people do not keep coming back to something that does not work or is JUST placebo.

Are you willing to research the experiments of one M. Ennis, a skeptic of Homeopathy who still had the courage to publish the results of an experiment which went contrary to her scepticism and for which even she admits science has no known explanation? These experiments have been repeated in 2007, and 2008, repeatedly and still with positive results.

Have you looked up the work of researcher Dr. Iris Bell MD, PhD or seen her presentation in the Homeopathy debate that occured at the Univ. of Connecticut?

Have you read anything of the theories of Dr. Rustum Roy, world famous scientist, Professor Emeritus and author of a world famous textbook on crystalline chemistry?

Have you read of the work of Dr. Niemtzow on Acupuncture and how the United States military has now authorized him to start training MD's in Acupuncture treatment to treat our wounded soldiers, including amputees?

Once you have done some research on subjects such as those perhaps the tone of your article will change to a topic such as why we are not allocating many more hundreds of millions of dollars for research in these vitally important fields and providing evem more money to NCCAM while reforming the FDA and the busted standard medical system which seems to keep turning out killer drugs like Vioxx on a fairly regular basis.

Meanwhile, do yourself a favor, toss books by Ben Goldacre or Dr. Edzard Ernst, the world famous "authority" on alternative medicine who has never bothered to get an advanced degree in any field of alternative medicine, into the trash and see if you can start covering these issues with some semblance of objectivity.

Posted by: ScepticsBane | March 18, 2009 9:56 AM | Report abuse

Homeopathy is a bunch of B.S., ScepticsBane. Now that that is out of the way . . .

My fundamental problem with NCCAM is a philosophical one. Basically, I believe in evidence-based medicine. I actually don't care whether it falls under the somewhat arbitrary definition of "alternative" or "mainstream" medicine. Thus, the question becomes: Why is a center set aside from the rest of NIH to study "alternative" medicine? The rest of NIH is not devoted to "mainstream" medicine -- it's simply studying particular health issues and there's no reason that acupuncture or other "alternative" treatments couldn't be studied as part of other institutes.

The reality, however, is that promoters of "alternative" medicine are unwilling to hold their treatments to the same standards that we hold "mainstream" medicine. Specifically, we want double-blind placebo-controlled studies.

Tom Harkin's comments that he is disappointed with NCCAM because it hasn't set out to "prove" alternative treatments illustrates this phenomenon. He's upset that, so far, most of NCCAM's findings, when done in stringent scientific experiments, have failed to show promise for alternative treatments. Clearly, he misunderstands how science works and he has this bizarre belief that NCCAM should simply "prove" that alternative treatments work.

The fundamental problem is, then, that people like Harkin walk into this issue with pre-set beliefs and are upset when the evidence disagrees with them. When given the choice, they stick with their beliefs rather than the evidence (like ScepticsBane above). Then, they begin to criticize the evidence and do everything they can to attack the scientists who conduct the studies. It's really deplorable.

It's for that reason that I don't particularly care for NCCAM. If supporters of alternative medicine are unwilling to subject their treatments to the same rigorous experimentation and ACCEPT THE RESULTS whatever they may be, then we are no longer talking about science.

Posted by: rlalumiere | March 18, 2009 10:24 AM | Report abuse

I am not aware of Rustum Roy's theories about health, but I know of his expertise in solid state chemistry and structural chemistry, and it would NOT make his opinions about alternative medicine any more valid than that of the average man in the street. He's not in that field.

That's one of the frustrations I have with some friends who are into alternative medicine: they tend to be people who believe something based on who said it (whether it be a friend or a recognized "smart person") rather than the objective basis of the assertion. It doesn't matter if a genius thinks that alternative medicine is right, if he or she has no proof, as in the results of a double-blind clinical study.

Posted by: catherine3 | March 18, 2009 2:02 PM | Report abuse

rlalumiere, obviously all types of medicine need to be held to the scientific process. That is one of the main reasons for the existence of NCCAM -- to conduct research on alternative medicine using the scientific process. But rather than researching CAM under other institutes, it's best left compartmentalized as a separate Center because specialization could result in broader and deeper knowledge that could be shared with the life science community. Also, it would be strange to apportion, for example, the NCI's budget to "alternative" cancer treatments when any underlying mechanisms are not well understood. It is likely some forms of alternative medicine may have a basis in science, and studies could prove that, and then they would no longer be alternative. And if these studies suggest these treatments do not help, then that is also valuable information.

Posted by: nonagon | March 18, 2009 2:30 PM | Report abuse

We do live in a society that is looking toward alternative therapies. In other countries in the world 'alternative'therapies and 'conventional' therapies go hand-in-hand. The two often provide truly complementary therapy.
I too believe in evidence-based medicine. This is exactly why NCCAM needs to exist. The majority of 'alternative' medicine therapies are based on centuries of use on humans. However, we do not know the mechanisms of how these therapies work, possible complications with conventional medicines, and how they function in todays culture.
Unfortunately, research proposals in the 'alternative' medicine field do not often recieve a 'fair' review when integrated into other NIH divisions. Reviewers often have a preestablished bias against 'alternative' medicine proposals or do not have the expertise to properly review the experimental design. In todays society, NCCAM does need to exist in order to foster and promote evidence-based research in 'alternative' medicine. We owe this to the field of science, medicine and to our patients.

Posted by: JeffreyLangland | March 18, 2009 4:13 PM | Report abuse

Why is NCCAM's charter so limited? I want to know if flaxseed oil and cottage cheese really cures cancer, should every doctor prescribe CoQ10 along with statins, why is not prescribing fish oil tantamount to medical malpractice in Italy, how are private clinics around the country curing diabetes, how can a diet free of additives cure fibromyalgia? These are the promising alternatives that need to be researched. NCCAM still needs to exist with the hope that it can be reformed into something that does indeed contribute to evidence based medical science.

Posted by: knowthescience | March 19, 2009 7:30 AM | Report abuse

If you check Senator Harkin's web site, you'll note that in his remarks at the hearing on February 26, 2009 when he commented on how NCCAM seems more focused on disallowing alternative treatments than proving them, you'll see that Senator Mikulski of Maryland co-chaired the hearing.


I would be interested to know whether Senator Mikulski, represenative to a state with a range of health providers and institutions has, as the science-bloggers say, drunk the Woo-Woo Kool-aid regarding alternative treatmenets that seem to have trouble passing traditional methods of scientific proof!

Posted by: RedBird27 | March 19, 2009 7:32 AM | Report abuse

I have learned to distrust the pharmaceutical industrial complex and many among their medication-delivery personnel (physicians, pharmacists. media-apologists). Too often "evidence-based" medicine leads to conclusions exaggerated beyond actual findings and clouded by statistical gymnastications. For instance, findings often are reported as 70% of pathology-P subjects showed X, implying that 30% showed not-X. In the same experiment, 15% of controls showed X, and 85% showed not-X. If those findings led to the construct of "statistical significance", subsequent verbalizations often suffer from oversimplificationism, ie, people with pathology-P have trait-X. That summary can easily mislead clinicians and consumers. Subgroup considerations are extremely important, as physicians who aren't too bound to financial treadmills are inclined to know. Personally, I have come to fear the pharmaceutical industry, the myths it propagates, and the personnel in its product-creation and product-delivery systems. The heresy inherent in CAM is much needed.

Posted by: TeresaBinstock | March 19, 2009 12:39 PM | Report abuse

I voted to keep NCCAM because there has to be someone who holds the CAM people to the same standards as normal medicine. There has to be someone who does actual evidence based testing of the CAM procedures in as much as there can be. Aside: some of the procedures are so obvious that a sham treatment is impossible.

The same argument that many use against Big Pharm also applies to the CAM community. Not only are there huge bucks in all the various supplements and treatments, but there is only minimal investment and no risk of being sued for malpractice. So I would never, never accept a study done or paid by the CAM community. It would have to be someone like NCCAM.

If, on the other hand, NCCAM is taken over by the "true believers" who say that evidence based information doesn't apply to CAM, then it should be terminated. Its only legitimate function is to test, either in house or fund university studies, alternative medicine treatments and disseminate the results.

Posted by: dkmjr | March 23, 2009 3:21 PM | Report abuse

This entire argument is shortsighted and moot when one takes into account the rise of Epigenetics. I am not a scientist, but I can read....and read I do. I recently saw a great article by PBS Nova Science on Epigenetics: http://www.pbs.org/wgbh/nova/sciencenow/3411/02.html Now since epigenetics studies how environment, nutrition and many many other factors relate to turning on and off cell traits, then how in the world could anyone suggest that NCCAM is not necessary? What about recent stories on 60 minutes about restveratrol: http://www.cbsnews.com/video/watch/?id=4752354n I think there are way to many interest groups fighting for money in this argument. Knocking off a new field of thought (in this country - not in Asia or other continents) just helps put more money in the pockets of some in my opinion who would like to put a chill on the competition. There are new studies coming out all the time on "superfoods" which have many nutrients which fight disease. If this were no so, then why did a drug manufacturer successfully get the FDA to outlaw a once common form of Vitamin B6 as a drug! Now common people like me can't buy it anymore. Don't lecture me on this. I am an average citizen who has much to gain by affordable choices and lifestyle approaches to health that cannot be prescribed by a doctor and picked up at the pharmacy.

Posted by: dlineberrys | March 24, 2009 2:39 AM | Report abuse

Dear Madam/Sir,


I wish to write the following brief letter in response to your articles on acupuncture and alternative medicine in the Post Health section, Tuesday, March 17, 2009. I hope that you can publish it in a future Health section, with editing if necessary:


I am a Doctor of Chinese Medicine and a licensed acupuncturist with many years of clinical training and practice in China, Japan, and now US. I also have been a research scientist at the NIH. I would like to make three points about the Post's articles: First, acupuncture and Chinese medicine should not be lumped with other alternative medicine modalities, because Chinese medicine has a far greater foundation of experience and critical evaluation to establish effective practices -- by billions of patients over several thousand years. Secondly, the reason that some controlled studies show a positive benefit of both "sham" and real acupuncture (relative to no acupuncture) is that "sham acupuncture" in many cases affects neural pathways in the same manner, but to a lesser extent, as that of real acupuncture, so it is not a true negative control. For example, in one study performed by European physicians, the points used for "sham" needling were, according to my knowledge, points that would have a real effect. Thirdly, the Post mentions only one large controlled study showing a significant benefit of real over sham acupuncture. Actually there have been a number of such studies in recent years, with the most pronounced benefits of acupuncture seen in musculoskeletal conditions (back pain, neck pain, etc.) and in relieving chemotherapy-induced nausea. These studies confirm the reports of innumerable satisfied patients who report that acupuncture relieved pain or nausea that was refractory to Western medicine and other alternative modalities.


Sue Sabol, Ph.D., L.Ac.
Acupuncture and Chinese Medicine
7830 Old Georgetown Rd. C-20
Bethesda, MD 20814
E-mail: suesabol@suesabol.com
Web site: http://www.suesabol.com
Telephone: 301-908-1703

Posted by: suesabol | March 24, 2009 9:36 AM | Report abuse

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