New Directions

The need for careful research on complementary and alternative health practices remains compelling. Tens of millions of Americans are spending $34 billion per year (mostly out-of-pocket) on a variety of complementary approaches, most often without any solid evidence about safety or usefulness.

The opportunities to make real differences in some very challenging health issues are equally compelling. After a decade of mainly exploratory research across a broad array of interventions, practices, products, and disciplines, emerging scientific evidence points toward the need for more targeted investment in selected complementary approaches.

The initial years of NCCAM were formative—both in defining how to study complementary and alternative practices, and in determining what holds genuine scientific plausibility and promise for the future. Periodically, articles and commentary appear in the media scrutinizing—and sometimes distorting—NCCAM's initial approach to the study of complementary and alternative health practices. However, these pieces serve as opportunities to highlight our history, current portfolio, and areas of scientific promise reflected in the Center's strategic plan.

Today, NCCAM has developed a sharply focused vision emphasizing two areas: developing better strategies for managing pain and other such symptoms for which current medical management options are often insufficient, and integration of evidence-based complementary practices into strategies that will help promote healthier behaviors. These priorities are based on sound scientific evidence and require state-of-the-art methodology and technology. Prominent examples include a growing body of work on a variety of promising non-pharmacological complementary approaches for chronic pain and research on the biological effects and safety of natural products.

With respect to accomplishments of the past decade, NCCAM-funded research has resulted in more than 3,000 scientific publications in peer-reviewed scientific journals, and these results have been widely covered in the popular press. Furthermore, there is good evidence that people are hungry for this information and are incorporating it into their health care decisionmaking. Notable in this regard is the impact that the results of major studies have had on consumer spending on various dietary supplements. Also of note is that NCCAM-funded research has raised flags about contamination, adulteration, and excessive claims that have prompted the Food and Drug Administration and the Federal Trade Commission to take action.

NCCAM research has also influenced practice by health professionals. Considering a growing body of research through the rigorous lens of evidence-based medicine, the American College of Physicians and American Pain Society now include a number of complementary approaches—massage, acupuncture, and chiropractic—in their 2007 clinical practice guidelines for managing chronic low back pain. Complementary approaches are increasingly being integrated into conventional care in a variety of settings. For example, the Departments of Defense and Veterans Affairs are exploring integration of non-pharmacological approaches into strategies for managing pain and stress disorders.

NCCAM was created by an act of Congress in recognition of the public's use and interest. Congress placed NCCAM within the National Institutes of Health to ensure that its research rested on the same standards of excellence and scientific rigor as the rest of NIH research, and all research funded by NCCAM is subjected to a highly competitive peer review process.

The public has a right to know how we are investing taxpayer dollars. Detailed information about the research we fund can be seen on this website, the findings are published in respected medical journals, and the results are influencing consumer buying habits and being integrated into medical practice.