The Potentially High Risks of Alternative Health Care
By: Michelle Gamage, Local Journalism Initiative Reporter
Originally published in The Tyee
Alternative health care is on the rise in Canada, and with it, the risks associated with unproven therapies.
New research from the University of British Columbia’s school of nursing and the University of Alberta’s Health Law Institute found 42 per cent of people in Canada used at least one risk-associated alternative health-care therapy or product in the last year.
“Risk-associated” means the dangers associated with the therapy outweigh its benefits. Of the people who said they had tried risk-associated alternative health care in the last year, 68 per cent said they had tried physical manipulation, such as forceful chiropractic spinal or cervical manipulative procedures, and 55 per cent said they had tried herbal/nutritional supplements, making supplements and physical manipulation the most popular therapies.
A smaller number of people said they’d tried even higher-risk therapies, such as taking supplements that contain heavy metals (14 per cent), having a chiropractor adjust their neck as a form of physical manipulation (32 per cent) and taking intravenous therapies for vitamin supplements (eight per cent).
“A big part of the problem is people don’t know what is alternative and what is biomedical,” said Bernie Garrett, the study’s lead researcher and a professor and associate director of the UBC school of nursing.
The study defines an alternative therapy as a therapy that isn’t accepted by scientific consensus. This research forms the second part of a larger project looking at risk-associated alternative health practices. The first part of the study, published in 2022, defined what the practices are.
No medical procedure is risk-free, Garrett pointed out. Removing a burst appendix, for example, can be risky, but it can also save a patient’s life.
But the benefits of injecting IV fluids to boost your body’s vitamin levels “are virtually zero” because your kidneys flush out the surplus anyway, Garrett said.
The study said herbal treatments can hurt people when they cause toxicity, unwanted drug interactions and “psychological harm.”
Chiropractors can cause strokes and headaches, break arteries in the spine and cause bleeding in the eyes.
Risk-associated alternative health-care therapies can even lead to major physical injury or death. This outcome is rare, Garrett said, but multiple Canadians have died after receiving IV treatments from naturopathic doctors.
Infections or complications including from an IV are possible even in a health-care setting.
The study notes how traditional Chinese medicine practices of cupping and acupuncture are widespread in Canada and even promoted by some doctors and athletes to reduce pain and a number of other symptoms. But the study says the practices “remain controversial in terms of both efficacy and safety,” pointing to several studies and reports about possible harms, such as abscesses.
For the study, 1,492 Canadians were surveyed and asked what risk-associated alternative health-care therapy they tried, when and why.
Of the people who said they’d tried at least one type of risk-associated alternative health-care therapy, 68 per cent said they’d tried physical manipulation, 55 per cent had tried unproven herbal/nutritional therapy, 50 per cent said they’d tried general risk-associated alternative health-care therapies and 42 per cent said they’d tried alternative belief therapies. Alternative belief therapies can include acupuncture, homeopathic vaccines, “faith healing” and using IVs for vitamin supplementation.
It’s worth noting that these results come from an online, self-reported survey sample, so the numbers could be slightly inflated, said David Hardisty, an associate professor of marketing and behavioural science at UBC who was not involved with the study.
Chiropractic neck manipulation was reported by 13 per cent of all respondents who used risk-associated alternative health-care therapies.
“Chiropractic is a well-established and widely used form of alternative health in Canada,” the study notes. It also shows older people are more likely to try physical manipulation, which may be because they have more back pain and are seeking relief, said Garrett.
The study adds that there remains a lot of controversy with some chiropractic interventions, including manipulation of the neck.
The College of Chiropractors of BC told The Tyee it is required under the Health Professions Act to regulate chiropractors and have inquiry and discipline processes to enforce standards of practice and professional ethics. Chiropractors are also required under the Health Care (Consent) and Care Facility (Admission) Act to tell their patients about the risks and benefits of all procedures, it added.
The variables informing the use of different varieties of alternative health care varied by income and other factors. People who work in health care are 50 per cent more likely to try physical manipulation than those outside the field.
People with an annual income of more than $50,000 were more likely to try unproven herbal/nutritional therapies, Asian respondents were less likely than white respondents to try any alternative health care, and men were the least likely to try anything, compared with all other genders.
Garrett said he thinks the reason people with higher education are more likely to try risk-associated alternative health-care therapies is socio-economic status: they generally make more money and can afford to try expensive therapies. Terminal illnesses such as cancer with high mortality rates and distrust in the medical system can also be factors.
Garrett said lax advertising laws have allowed the prevalence of risk-associated alternative health-care therapies to increase over the past 20 years. Alternative health care can use the same marketing as deceptive advertising or health scams, the study notes.
The influence of marketing and media
There are a lot of ways in which social media makes people more likely to trust the information they’re seeing on it, UBC’s Hardisty said.
Humans are more likely to trust information from people we know or people like us, and to listen to and believe personal stories with tangible outcomes compared with analytical stories backed up by statistics, he said.
Then there’s what’s known as “regression to the mean,” where people eventually get back to their own baseline of health over time; and the placebo effect, where a treatment can lead you to think you’re feeling better, rather than actually being effective. These factors can lead to false assumptions about the success of alternative therapies, Hardisty said.
People posting these positive experiences on social media can create a domino effect: they get stuck in information bubbles about the benefits of alternative health care without knowledge of the potential risks, or the benefits of conventional medicine, he said.
Hardisty said he’s heard people talk about mistrust of “big pharma” or “big medicine” because it is driven by profit. But alternative health care is also driven by profit: from the people producing supplements, to the influencer on social media, to the practitioner prescribing and selling the supplements.
“You really can’t escape the profit motive,” he said.
Garrett said governing bodies need to do more to regulate potentially hazardous practices and to publicly disclose when a practitioner hurts a patient and how they were reprimanded.
B.C.’s school system could also play a role in reducing potential harms caused by alternative medicine by helping people better understand the medical system and think critically about alternative health products, Garrett added.
The Tyee contacted the College of Naturopathic Physicians of BC with questions about how it regulates and reports injuries, and how naturopaths are trained to use IVs, but did not hear back by press time.