The psychosocial aspects of complementary and alternative medicine.

Approximately one in four persons in the United States uses complementary and alternative medicine (CAM). Out-of-pocket costs of CAM rival medical treatment at $21.2-32.7 billion versus $29.3 billion, respectively. Users of CAM tend to have high incomes and high levels of education. They also have medical conditions not easily treated by modern medicine such as chronic pain, poor mental health, human immunodeficiency virus infection, and cancer. The most common therapies are noninvasive (acupuncture, chiropractic, massage), however, consumption of dietary supplements has grown dramatically. Patients often use CAM in addition to modern medicine and are reluctant to discuss CAM with their physicians. Pharmacists' professional approach to science may bias them against CAM therapies. Complementary and alternative medicine use should be included in visit histories and discussed in an objective, nonjudgmental manner to encourage patient disclosure.