In April 1966, Time magazine, in a provocative Easter week cover story, asked the question, “Is God Dead?” In 2005, a similar question might be applied to an entirely different area: “Is Alternative Medicine Dead?”
In the 1960s, the adjective “alternative” started to be applied to “medicine” to distinguish more natural therapies and approaches to healing, many of them quite traditional and very long standing, that by the middle of the twentieth century had become, in the face of conventional allopathic medicine’s dominance, truly an alternative model. From the 1960s through approximately the late 1980s, alternative, or as it was sometimes called, “holistic,” medicine, including clinical nutrition, herbs, homeopathy, chiropractic, naturopathy, acupuncture, and a number of other mostly non-toxic approaches, gained increasing popularity. By the early 1990s, there were reports that one third or more of all Americans were using some form of alternative medicine. In a highly influential 1993 medical journal article, David Eisenberg, M.D. of Harvard University and his colleagues asserted that unconventional therapies were in extremely widespread use. Their study also included the mind-boggling finding that Americans were making more visits annually to alternative or unconventional care providers than they were to conventional “primary care physicians.”
Growing political potency and public pressure, arising primarily from alt med’s expanding economic power base, led to interest in alternative medicine on the part of what had been the field’s historic adversaries – mainstream academia and the government. (In previous decades, the entire U.S. conventional medical-industrial complex, including medical schools and the federal government, had consistently ignored or actively denigrated alternative healing approaches.) Of particular note was the creation in 1991-’92 of a permanent home for alt med at the National Institutes of Health, the result of bipartisan Congressional legislation. The Office of Alternative Medicine at the NIH (originally called the Office of Unconventional Medical Practices) was expanded to an NIH center and given a new name in 1998, the National Center for Complementary and Alternative Medicine. With the help of government and academia, “CAM” (complementary alternative medicine) quickly became the new buzzword. “CAM” was intended to legitimize (some of) alternative medicine. Between 1992 and 2004, the federal budget for CAM increased an astounding 10,000 percent!
The large amounts of money, matched or exceeded by investments on the part of mainstream academic medical schools and the private sector (the so-called natural products industry), resulted in the fast tracking of the “integration” of alt med into the conventional allopathic medical model – the largely bankrupt paradigm that continues to dominate health care in the United States to this day (CAM notwithstanding). A vast majority of the thousands of CAM studies funded by the NIH involve the use of mostly lightweight “natural” modalities but not as primary alternative therapies, rather as watered down complements or adjuncts to conventional medical practices – modalities like meditating while undergoing cytotoxic cancer chemotherapy in order to presumably better tolerate the chemotherapy. This integration is hardly balanced as the conventional therapies remain dominant.
Twenty, or even ten, years ago, hundreds of holistic medical conferences, periodicals, and books regularly explored the potential of primary alternative medicine, including nontoxic and innovative approaches to cancer. The names of primary alt med clinical and research pioneers like Pauling, Kelley, Contreras, Burton, and Hoxsey were widely known and helped to define the field. With the government’s and academia’s entry into the alt med landscape in the 1990s, however, the new CAM model took over, quickly displacing alt med, and within a decade alt med and its original pioneers had become a rather quaint and archaic vestige of an earlier era. Alternative medicine, once perceived as threatening to the hegemony of allopathy, had been redefined as “CAM” and had been recast as something predictable, controllable, safe, and marketable.
In 1999, according to a study on CAM use in cancer published in the Journal of Surgical Oncology, “The popularity of complementary/alternative medicine (CAM) is an international phenomenon. The prevalence of CAM use is estimated at 25% among residents of the United Kingdom, 50% among German, French, and Australian populations, and 42% to 69% among residents of the United States.” The same study found that “Overall, 99.3% of the participants [cancer patients in the study] had heard of CAM, and 83.3% had used at least one CAM therapy.”
By 2005, the transformation of alt med into CAM is almost complete. Few people seem to be mourning, or even to be taking any notice of, the changes. That’s because most of the self-selected leaders of alt med/CAM had long ago given up on the commitment to primary alternative healing and the independence that commitment requires. They had been seduced and co opted by the powers that be, their egos stroked and flattered, only too happy to take the grant money that was suddenly available almost for the asking. It was not uncommon for CAM’s “masters,” as a growing number actually had the chutzpah to call themselves, to bask in the new attention and professional recognition – and licensing – that were offered to them on a silver platter after years of toiling in obscurity.
These self-selected, largely unearned leaders have become the spin doctors for CAM, weaving tales of the supposed positive news about CAM and integrated medicine to their constituency, the millions of Americans interested in and desperate for alt med as something viable and real. But with the valuable heritage of true alt med receding ever more quickly in society’s rear view mirror, that constituency has few real standards for evaluation, and for comparing today’s CAM model with what alternative healing is supposed to be about. (Interestingly, while thousands of studies have pointed to the clinical benefit of nutrition, herbs, and other non-toxic alternative modalities in recent decades, there have been few studies into the effects and the value, if any, of combiningalternative/non-toxic approaches with conventional allopathic treatments – the bedrock of CAM.)
For this writer, who has been observing the scene close up for three decades, the contrasts between then and now were most recently and readily apparently when comparing two events that took place at the same hotel in New York City a quarter of a century apart: Cancer Dialogue 1980 and the recent CAM Expo. In 1980, a Cancer Dialogue participant, the late Albert Szent-Gyorgyi, M.D., Ph.D., a brilliant, uncompromising, and truly independent minded clinician and scientist who received the Nobel prize for his discovery of vitamin C in the 1930s and who went on to do innovative alt med cancer research, told me that “the purpose of science and medicine has become not to make discoveries but to get grants granted.” In 1980, Szent-Gyorgyi was talking about conventional medicine. By 2005, however, an identical observation could have been made about CAM practitioners and researchers – that they were interested mainly in getting grants granted (and in getting insurance coverage and Medicare payments for their work) and not in making new discoveries that would actually benefit patients.
As a result of these and many other developments, the situation today is one, at best, of mass confusion.
Codex: A looming threat goes largely unexamined
As an example of what the new vision of CAM hath wrought, in the year 2005 – at a big CAM Expo, in the pages of slick CAM medical journals and magazines, in the self-aggrandizing utterances of CAM leaders, and in the actions of government CAM bureaucrats – rarely – in fact, never – is any serious attention paid to the looming threats to natural healing, personal freedom and responsibility, and self care (all of these among the linchpins of alt med) represented by Codex. Codex is the United Nations/World Health Organization-based international trade and regulatory framework on foods that has established new standards for and restricted the availability of herbal and nutritional supplements in Western Europe, the UK, Canada, Australia, and New Zealand. In the transnational, one world-new world economic and political order that is now the status quo, with national sovereignty and autonomy constantly being diminished, Codex-inspired regulations are poised to have a major effect soon in the United States. Ultimately, among other things, it seems certain that Codex will restrict and limit the availability of high potency over the counter nutritional and herbal supplements here as it has in other Western countries.
The last time there was a serious threat to the availability of nutritional supplements in the U.S., in 1993-’94, a groundswell of public interest, channeled by a number of grassroots organizations, helped to mobilize support for Congressional legislative protection for supplement freedom. A decade later, with CAM firmly entrenched, alt med activists in leadership positions have largely been replaced by a new wave of CAM/integrative med proponents who in turn have abdicated leadership on this – as well as other – critical issues, loathe as they are to bite the hand that feeds – the hand belonging to the medical-industrial complex that the original pioneers of alt med once stood in clear opposition to. In reality, growing restrictions on medical choice and self-care including the availability of nutritional and herbal supplements are not incompatible with the self-interest of many proponents of integrative medicine and CAM. Many of these proponents are elitist, mainstream-doctor-wannabes who believe (like orthodox doctors) that the public needs to be protected from itself, and that supplements should be prescription items, available only with the approval of a licensed orthodox or CAM practitioner.
In only a decade, we have gone through the looking glass. But in spite of the extremely high stakes, only a small handful of observers is expressing concern. One of them is attorney Suzanne Harris, who has been monitoring issues relating to freedom of medical choice for more than a decade. In an article on Codex published last November, Harris writes: “What we face here is the fundamental fact that Europe thinks differently. They believe, especially in Germany, the founder of the regulatory concept of medical foods, that doctors should prescribe the meaningful products. So here we are in a global contest. On one side is Europe that believes in strict regulation and doctors’ prescriptions for the really useful products. On the other side is a North American populace that believes in freedom of choice but where many of the staunchest believers in freedom of choice and companies, most likely to be extinguished by the end results of that battle, do not even know that a global battle is raging. And at the center of the mix, we have powerful commercial interests allied with whatever side they think will produce the best market opening opportunities.”
In an article last month titled “The Future of the Nutritional Supplement Industry — The Realities,” Jon Rappoport, another independent observer of current events, has written: “I know one bright executive of an alternative health firm who has quit her job and aligned herself with a company that sells supplements and bankrolls quite expensive clinical trials of its products. This executive is convinced that the future for the bulk of the supplement industry is dark. Only the medically-oriented companies will survive. . .
“If you want continued access to nutritional supplements of your choice, at the potencies you decide you need, I suggest you use this article and get a message out to the supplement companies. The sitting ducks. Don’t bother trying to be sweet and nice. Make your demands. Organize consumer groups. Put on pressure. Squeeze them to do what they refuse to do.”
In a subsequent article on February 27 that is an excellent summary of Codex and the broader context within which Codex is moving forward, Rappoport writes, “Codex is on the march. Other similar players are on the march. I’m not an expert on the overall scene in Europe, but I do know that, in recent years, there has definitely been a reduction in the availability of supplements without a doctor’s prescription. And the EU is working hard toward a further drastic reduction.”