Alternatives to drugs

Is a drug the only way to treat an illness?

Humans have used medications for millennia to treat ill-health. Today, manufactured pharmaceuticals dominate treatment. Pills are convenient, can be made and distributed easily, and provide a standard solution that is known to work (though not on everyone).

However, some argue that the emphasis on drugs reflects the dominance of the pharmaceutical industry, which is geared up to produce packaged pharmaceuticals and puts huge sums into marketing its products. Other possible treatment options may be unfairly neglected.

Surgery is another medical option, but is generally a last resort, when pharmaceutical routes have been exhausted or no drug treatment exists.

Prevention is likely to be increasingly significant, particularly as the genetic contributions to common diseases are discovered, and individual susceptibilities identified. A sceptic might say that we already know how to stay healthy - eat a balanced diet, drink in moderation, take exercise and don't smoke - but it is possible that certain dietary regimes might benefit some people.

Vaccines are another highly successful prevention strategy. After several years in the doldrums, vaccines are a growing industry, as seen with the launch of the vaccine against human papilloma virus to prevent cervical cancer.

Psychotherapies (talking therapies) have developed significantly in the past few decades. The evidence for cognitive behavioural therapy, which attempts to tackle patients' negative ways of thinking and behaving, shows the approach to be effective in a range of conditions, including eating disorders, depression and post-traumatic stress disorder. Such a treatment for bulimia was the first psychotherapy approved by the National Institute for Health and Clinical Excellence (NICE). However, there is a shortage of trained providers and psychotherapy is perceived to be costly, so its use remains limited.

A potential therapy of the future could be transcranial magnetic stimulation. This non-invasive technique uses magnetic fields to disrupt nerve impulses in localised areas of the brain. In experimental work, encouraging results have been obtained in depression, bipolar disorder, schizophrenia and other conditions.

Of potentially wider significance is the use of stem cells. The hope is that stem cells could be used to repair or replace damaged tissue. While some advocate moving quickly to use stem cells clinically, others urge caution and argue that more needs to be learned about their biology. As with other emerging technologies, it tends to be small biotech companies that are pursuing stem cell approaches. (See Stem cells - too fast too soon? Wellcome Science issue 2 [PDF 1.2MB].)

If there is little 'product', it may be difficult to secure funding for clinical trials for such approaches. A UK trial of stem cells to treat heart failure, for example, is relying on charitable donations.