Herbal Medicine Regulation in the UK—Implications for the US
A Healthnotes Newswire Opinion
Recently, the Prince of Wales’s Foundation for Integrated Health published a report entitled ”Recommendations on the Regulation of Herbal Practitioners in the UK” (Herbal Medicine Regulatory Working Group, September 2003). The study was commissioned in response to a growing interest in complementary and alternative medicine (CAM) in order to establish guidelines for the proper training of herbal medicine practitioners, and for the safe use and prescription of herbal preparations.
As more people choose CAM therapies, including herbal medicine, homeopathy, acupuncture, and therapeutic nutrition, the question arises as to how to protect the public while ensuring the accessibility to natural medicine. To address this issue, the UK is proposing to set standards for the training of herbal medicine practitioners and to revamp their laws regarding the use and availability of herbal remedies.
There are approximately 1,300 herbal medicine practitioners in the UK. Practitioners of Western herbal medicine, Chinese herbal medicine, Ayurvedic medicine, and Tibetan herbal medicine are represented by several different professional organizations; however, no single accepted process is in place for the training and licensing of herbal medicine practitioners.
Under current UK law, the manufacturers of over-the-counter herbal remedies must not make any written claims about a remedy’s effects. Herbal preparations may also be dispensed following a face-to-face consultation between an herbal medicine practitioner and a patient, with some restrictions on the strength, dosage, and types of herbs that may be prescribed. However, there are no restrictions as to who carries out the consultation; in other words, anyone could present himself or herself as an herbal medicine practitioner, conduct practitioner–patient interviews, diagnose medical conditions, and prescribe herbal remedies, including “restricted” herbs, according to the presumptive diagnosis.
The Herbal Medicine Regulatory Working Group recommended the formation of an herbal council that would be responsible for the accreditation of educational institutions and programs in herbal medicine training. Graduates of these programs would then be eligible for registration with the government and held to certain standards of conduct and ongoing professional development. These registered practitioners would be allowed to make diagnoses, recommend herbal treatments, and make referrals to other medical professionals as appropriate. Over-the-counter herbal remedies would still be available, but only registered herbal practitioners would be able to prescribe the restricted remedies. Of note, most herbalists generally regard some of the herbs on the restricted list as nonharmful.
How, then, should this inform future CAM regulation in the United States? Currently, CAM practitioners are not subject to federal law; rather, their regulation is carried out on a state-by-state basis. Naturopathic medicine, massage therapy, and traditional Chinese medicine/acupuncture are some of the professions regulated by individual state governments. With some notable exceptions, herbal remedies are available for over-the-counter sale.
The system proposed by the UK has the advantage of setting federal standards for the training of herbal medicine practitioners, making the choice of an adequately trained practitioner an easy one for the consumer. However, a possible disadvantage is that once a tight regulatory system is in place, limits and regulations may also be set on other CAM therapies. This could potentially lead to restricted access to substances and therapies that are currently accessible, such as vitamins and minerals.
In the opinion of this author, appropriate training of CAM practitioners is an important public safety measure. That said, many of the therapies employed by these practitioners are, and should continue to be, available to the general public. To meet both of these needs, the role of federal and state governments should be to promote informed choice on the part of the healthcare consumer. People should be able to easily identify the credentials of the practitioner from whom they are receiving care, and still have access to over-the-counter remedies that have a history of safety.
Kimberly Beauchamp, ND, earned her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She cofounded South County Naturopaths in Wakefield, RI. Dr. Beauchamp practices as a birth doula and lectures on topics including whole-foods nutrition, detoxification, and women’s health.
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