FOLKSY MEDICINE

MATTHEW ENIS

AMERICANS ARE TAKING MORE PRESCRIPTION DRUGS than ever before. A recent survey by the American Society of Health-System Pharmacists reveals that at least 51% of adults take two or more prescription medications each day, 46% take at least one, while more than a quarter take multiple meds daily.

There are a number of factors at play, not the least of which is the fact that Americans are living longer, and there are more medications on the market. What's notable, however, is what the 1,000 respondents in the poll also said about herbal supplements and vitamins. More than one-third reported taking an average of four in the preceding week, while 40% reported taking an average of two herbal supplements or vitamins each day. What's going on that mainstream retailers should be aware of?

It may be that shoppers are looking for treatments that fix something more than individual symptoms. Many physicians may view talk of “vital forces” and “dynamic disturbances” as harmless hocus-pocus, but holistic medical practices such as naturopathy and herbalism have long enjoyed a strong base in the natural food sector. And lately homeopathy, another branch of alternative medicine, has been showing a lot of mainstream promise.

Homeopathic medicines have long been a staple at integrative pharmacies and in the supplement aisles of natural food stores, where shoppers can find single-dose remedies for everything from hives to motion sickness. But during the past several years, the category has produced a series of over-the-counter success stories in conventional food, drug and mass channels as well, including products such as Oscillococcinum, the flu remedy from Boiron; allergy and common cold relief products from Zicam; children's earache and teething products from Hyland's; and cold medicines and sleep aids from Nelson's.

With many consumers taking a more active role in educating themselves about personal health management, the products have proven especially popular with people concerned about side effects or drug interactions.

“They ask, ‘What can I do for the flu that isn't going to make me drowsy?’ ‘What do I do if I have a prostate problem and can't take antihistamines or decongestants?’” explained Gary Kracoff, a licensed pharmacist and naturopath at Johnson Drugs, an independent integrative pharmacy in Waltham, Mass. “They're looking for something safe that's going to work with the body and help it do what it's supposed to be doing — getting rid of a cold or the flu.”

Category sales reached $188 million this year in the food, drug and mass channels excluding Wal-Mart, with an additional $57 million in sales in the natural food channel, according to statistics provided by Boiron. Double-digit sales gains have been posted in each of the past five years, with growth exceeding 18% during the latest 52-week period ending July 15.

Homeopathy has a fairly long and interesting history, especially with regard to how it's currently viewed by the Food and Drug Administration. German physician Samuel Hahnemann began developing the field around 1800, based on the hypothesis that if a large dose of a substance causes certain symptoms in a healthy patient, then a very tiny dose of that substance should trigger the body to fight those same symptoms when a patient is sick.

Partly because his peers were still resorting to medieval techniques like bloodletting or prescribing large doses of mercury to “purge” various illnesses, Hahnemann's treatments were considered remarkably effective in his day, and homeopathy quickly became a standard of 19th and early 20th century medicine, and it is still widely practiced and respected in Europe and India.

Detractors in the modern medical community argue that homeopathic remedies are harmless, but are typically so diluted that they can't be credited for anything more than a placebo effect.

Yet despite such disagreements, these medicines enjoy unusually broad regulatory leeway. U.S. Sen. Royal Copeland — sponsor of the original Federal Food, Drug and Cosmetics Act, which granted the FDA its oversight authority in 1938 — was himself a homeopathic physician, and included in the act a special provision for homeopathic remedies, permanently exempting them from most standard regulations. Currently, these medicines are gaining mainstream popularity through positive word of mouth, as well as through recommendations by physicians who are growing more reluctant to prescribe antibiotics as a first resort.

Children's ear infections were one particular concern, Kracoff noted. “There were kids that every week were on another antibiotic — on a low dose for six to eight months sometimes for an ear infection,” he said. “The American Academy of Pediatrics now says that these treatments were doing little more than creating antibiotic-resistant organisms.”

The group, along with the American Medical Association, has adopted new guidelines that encourage pediatricians to monitor most middle ear infections for 48-72 hours before prescribing an antibiotic. OTC remedies such as Hyland's are used by many parents in the meantime to help treat symptoms.

“We introduced our earache drops and tablets into that therapeutic gap,” explained J. P. Borneman, chairman and chief executive of Hyland's, which also offers a range of children's remedies for colic, diaper rash, colds and flu, among other conditions.

Facing a growing number of antibiotic-resistant bacterial diseases, many doctors are adopting a wait-and-see attitude with other conditions as well. “Antibiotics really have very limited usefulness and effectiveness,” noted Matthew Becker, lead practitioner at a Boulder, Colo., location of the integrative pharmacy chain Pharmaca. “They're very good when you have a specific bacterial infection, but many people have been using antibiotics when they are misdiagnosed with a viral infection, and they just don't work for that.”

Kracoff and Becker noted that the integrative pharmacy approach offers patients access to conventional doctor's prescriptions, but also makes an effort to educate customers about the underlying causes of their illness or condition, helping them manage it with suggestions for better nutrition, or adjuncts like herbs, supplements and homeopathic remedies.

“If someone has high cholesterol, for example, there are a lot of things that they could be doing with their diet and with supplements to make them respond better to the medicine or to prevent or lessen side effects,” Kracoff said.

Boiron has developed an 80-hour certification course for pharmacists and physicians interested in learning more about the category, and will soon offer webinars that pharmacists can take to familiarize themselves with homeopathic treatment options.

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