UBC Reports | Vol. 47 | No. 16 | October
Herbal lore part of students' training
Pharmacists learn quality, effectiveness of alternative medicines
to help patients make informed decisions
by Hilary Thomson staff writer
Ginseng, ginkgo and garlic -- these and other herbal supplements
are often regarded as harmless, but Pharmaceutical Sciences students
are learning that natural doesn't always equal safe.
Taken for everything from arthritis to depression, herbal medications
are used by about 33 per cent of Canadians according to a survey
done this year and sponsored by the Nonprescription Drug Manufacturers
Association of Canada (NDMAC).
Many of these products are bought at pharmacies.
"The risks associated with herbal supplements can be significant,"
says Pharmaceutical Sciences instructor Lynda Eccott who, with colleague
Kath MacLeod, developed an elective course called Alternative Medicines
in Pharmacy Practice.
"That's why it's so important for our students to be prepared
to counsel patients so they can make informed decisions about these
products. Patients may be self-diagnosing a condition that should
be under doctor's supervision, so it's critical that pharmacists
ask the right questions."
The primary risks associated with herbal medicines are lack of
quality and inappropriate use, says Eccott.
Because many of these products are sold as food supplements rather
than drugs, they are currently unregulated so content can vary widely.
For example, of 10 different St. John's Wort products tested, seven
did not meet label claims according to a 1999 study published by
pharmaceutical and health products company Wampole Canada Inc.
In addition, there is a lack of information on product labels about
dosage or potential side effects.
"Clearly, people are buying these products on blind faith," says
Eccott. She adds that many people overuse the products because they
are perceived as completely safe.
Students are taught to help patients decide if a herbal medication
is appropriate for their condition and how to choose the best quality
They also offer advice about dose and duration of therapy and
encourage patients to report side effects.
Other issues include direct toxicity, where herbs may have been
adulterated with a harmful substance.
Negative herb-drug interactions, whether the patient is using
prescription or over-the-counter drugs, can also be a problem and
underlines the need for consultation with a trained health-care
professional, says Eccott.
For example, serious negative interactions can occur when blood-thinning
agents such as aspirin are taken with herbs that act in the same
way such as ginseng, garlic or feverfew.
Pharmacists need to increase their profile in this area of expertise
and make themselves more accessible to the consumers, says Eccott.
The NDMAC survey estimated that consumers use pharmacists and physicians
only 10 per cent of the time for herbal product information and
that they usually are guided by advice offered by family, friends
or health books.