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More Than One-Third of Americans Use CAM, Says Government Survey

Thirty-six percent of U.S. adults older than 18 years used some form of complementary and alternative medicine (CAM) in 2002, according to a new government survey. When prayer specifically for health reasons is included in the definition of CAM, the number of U.S. adults using some form of CAM in the past year rises to 62%.

The survey, administered to more than 31,000 representative U.S. adults, was conducted as part of the Centers for Disease Control and Prevention’s (CDC) 2002 National Health Interview Survey. Developed by the National Center for Complementary and Alternative Medicine (NCCAM) and the CDC’s National Center for Health Statistics, the survey included questions on 27 types of CAM therapies commonly used in the United States. These included 10 types of provider-based therapies, such as acupuncture and chiropractic, and 17 other therapies that do not require a provider, such as natural products, special diets, and mega- vitamin therapy.

The results of the survey provide the "most comprehensive data ever obtained about the use of complementary and alternative medicine by the U.S. adult population," says Stephen E. Straus, MD, director of the Bethesda, MD-based NCCAM. The survey looked at usage rather than safety or effectiveness. It asked why people are using CAM, what practices they are using, and for what health conditions, he says.

It appears that most of the individuals surveyed who have ever used CAM used it within the 12 months that the survey was conducted, says Richard L. Nahin, PhD, MPH, senior advisor for scientific coordination and outreach for NCCAM. The survey revealed that CAM use was greater among a variety of population groups, including women; people with higher education; those who had been hospitalized within the past year; and former smokers, compared to current smokers or those who had never smoked.

CAM approaches most often were used to treat back pain or problems, colds, neck pain or problems, joint pain or stiffness, and anxiety or depression. However, only about 12% of adults sought care from a licensed CAM practitioner, suggesting that most people who use CAM do so without consulting a practitioner. According to the survey, the 10 most commonly used CAM therapies and the approximate percent of U.S. adults using each therapy were:

  • Prayer for own health, 43%
  • Prayer by others for the respondent’s health, 24%
  • Natural products (such as herbs, other botanicals, and enzymes), 19%
  • Deep breathing exercises, 12%
  • Participation in prayer group for own health, 10%
  • Meditation, 8%
  • Chiropractic care, 8%
  • Yoga, 5%
  • Massage, 5%
  • Diet-based therapies (such as Atkins, Pritikin, Ornish, and Zone diets), 4%

The 19% use of natural products appears to be an increase from previous surveys done in the 1990s, Nahin says. The most commonly used natural products were echinacea (40.3%), ginseng (24.1%), Ginkgo biloba (21.1%), and garlic supplements (19.9%). The survey data indicate that echinacea probably was used for the relief or prevention of either head colds or chest colds. Clinical trials currently are underway to study this use of echinacea, he notes. Another interesting finding is the continued use of the herbal product kava, which has been linked to liver disease.

In addition to the types of CAM therapies, researchers identified several reasons respondents use CAM. These include:

  • 55% of adults said they were most likely to use CAM because they believed that it would help them when combined with conventional medical treatments;
  • 50% thought CAM would be interesting to try;
  • 26% used CAM because a conventional medical professional suggested they try it;
  • 13% used CAM because they felt that conventional medicine was too expensive.

There is a high rate of CAM use for diseases or conditions associated with chronic or recurring pain, Nahin says. "It may be that the public is turning to complementary and alternative medicine because it’s not getting relief [from these conditions] from conventional medicine." In fact, 28% of the people who responded to the survey said they used CAM because they thought conventional medicine would not help them. "We need to identify further the reasons they thought this and for what conditions they thought conventional medicine was ineffective."

Although the survey gives important information about the current use of CAM, it also provides a baseline against which future comparisons can be made, Straus says. "We at the national center will be relying heavily on the results of this survey to help guide our research and research training investments. We prioritize those practices and products that are more widely used by the public and for which there is greater suggestion of some benefit in activity. This survey will help us shape our future investments."

For complete survey results, see