Foreword
EVERYONE INVOLVED IN the delivery of health care is now aware of the increased interest in complementary and alternative medicine (CAM), especially herbal, or botanical, medicine. According to several recent North American surveys, a growing number of people are using some form of complementary or alternative medicine. In Canada, approximately 70% of the population reports regularly using a natural health product, such as an herb, vitamin, or mineral, but only about 20% of Canadians reported seeing a complementary healthcare provider, indicating a high level of self-medication.
Botanical, or herbal, medicine is becoming big business for pharmacists. Almost all retail pharmacies now sell herbal products, and a large proportion of pharmacists report receiving questions about herbs and other natural health products from patients, as well as other members of the health-care team. Although some see botanical medicine as a new "niche" for pharmacy, the debate about whether botanical medicine belongs in pharmacies or in health food stores is becoming heated. The opponents of the sale of botanical products in pharmacies emphasize the fact that most pharmacists have little or no training in this field. Opponents also perpetuate the notion that herbs have not been "scientifically" tested in human studies for their medicinal action and safety. Educating pharmacy students with respect to herbal medicine is increasing, however, and the majority of North American jurisdictions now include some explicit reference to natural health products in standards of practice or guidance documents for pharmacists.
Patients are looking for authoritative information about medicinal herbs -- including their effectiveness, safety, and standard dosages -- that they can rely on for self-medication and that they can bring to the attention of their physicians or pharmacists. While questions about echinacea and ginseng could once be ignored as a passing trend, health-care professionals are now expected to be knowledgeable about many common herbs. This book is written for the patient and the health-care professional looking for current and authoritative scientific information so as to improve understanding of the medical properties of common herbs and to promote communication between patients and health-care providers.
Initially, this project was planned as a correspondence course with the objective of training pharmacists about botanical medicine. After much deliberation, it was decided that the best approach would be to prepare a series of monographs reviewing the herbal medicines most often seen by pharmacists in clinical practice. A very special team had to be created to make sure this project was a success. As one of the primary sites of training in CAM in Canada, the Canadian College of Naturopathic Medicine (CCNM) agreed to manage the day-to-day running of the program. To ensure that the information was correct and balanced, an advisory board of experts was established to review all the material. The majority of the monographs were also submitted to the Canadian Council on Continuing Education in Pharmacy (CCCEP) for its approval. The project was completed in the summer of 1998 and culminated in the publication of the reference book The Botanical Pharmacy, addressed specifically to pharmacists and botanical medicine professionals, in 1999. In 2003, the information was updated to include research conducted in the interim, revised to increase the accessibility of the information for the common reader, and published as The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs. To prepare this second edition, a complete, systematic review of the scientific literature was conducted for each of the 50 herbs and 5 additional herbs -- ashwagandha, bitter orange, hoodia, oregano, and red clover -- and a new section on the use of these herbs in managing common health conditions was added as a quick gUide for the patient and consumer.
One of the cornerstones of pharmaceutical and medical care is helping patients and customers to make informed decisions about their health care. Likewise, patients owe it to themselves to learn as much as possible about any preventative or therapeutic treatment they may be considering. As patients' options expand to include botanical medicine, or medicinal herbs, as an acceptable form of health care, pharmacists and physicians are being asked to wade through large amounts of information -- sometimes reliable, sometimes not -- to help patients make the most informed choices possible. When patients choose to make use of botanical products, it is important for pharmacists and physicians to provide monitoring and report adverse effects, as well as herb-drug or herb-herb interactions, when necessary. This role requires pharmacists or physicians who have good working knowledge of botanical medicine and who can apply problem-solving skills to "fill in the gaps" of our current knowledge of these products.
The authors hope that this book will provide health-care professionals with a foundation of knowledge from which they can with confidence counsel patients about the use of botanical products. For patients and consumers, while this book will not answer all your questions about medicinal herbs, we hope that it will be a useful resource for understanding the safe use of these herbs and for posing informed questions to your pharmacists or physicians. Your good health is what we all want to ensure.
