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Page 1: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community
Page 2: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Alternative and Alternative and Complementary Medicine Complementary Medicine

( ACM )( ACM )

Aproposal For RegulationAproposal For Regulation

In Saudi ArabiaIn Saudi Arabia

Prof. Adnan Ahmad AlbarProf. Adnan Ahmad Albar

Dept. of Family & Community medicineDept. of Family & Community medicine

King Abdul-Aziz UniversityKing Abdul-Aziz University

Jeddah, K. S. AJeddah, K. S. A..

Page 3: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

IntroductionIntroduction DefinitionsDefinitions

Extent of PracticeExtent of Practice

Types, claimed benefits, Types, claimed benefits, and scientific evidence.and scientific evidence.

Why do patient seek Why do patient seek ACM .ACM .

Page 4: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Who seeks ACM.Who seeks ACM.

How does it work in view of the How does it work in view of the Biopsychosocial model & the Biopsychosocial model & the concepts of illness and healing.concepts of illness and healing.

Training , education and Training , education and certification in ACM.certification in ACM.

The criticism against alternative The criticism against alternative and complementary medicine.and complementary medicine.

Page 5: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

The place of Evidence in ACM.The place of Evidence in ACM.

The WHO Expert group review of The WHO Expert group review of ACM in ACM in 114114 countries. countries.

Current status and regulation of Current status and regulation of ACM practice in S.A.ACM practice in S.A.

The way forward.The way forward.

Page 6: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

TerminologiesTerminologies

Alternative medicine.Alternative medicine.

Complementary medicine.Complementary medicine.

Natural medicineNatural medicine

Greek medicine.Greek medicine.

Chinese medicine.Chinese medicine.

Herbal medicineHerbal medicine

Page 7: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Indian medicine.Indian medicine.

Arabic medicineArabic medicine

Islamic medicine.Islamic medicine.

Quranic medicineQuranic medicine..

Prophetic medicine.Prophetic medicine.

Ancient medicine.Ancient medicine.

TerminologiesTerminologies

Page 8: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Increasing global practice of Increasing global practice of ancient and new modalitiesancient and new modalities

WHO estimates that WHO estimates that 30%30% of patients of patients seek alternative or complementary seek alternative or complementary medicine.medicine.

A U .S estimation revealed that A U .S estimation revealed that Americans spent Americans spent 27 billion27 billion dollars On dollars On alternative and complementary alternative and complementary medicine in medicine in 19971997..

Page 9: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

In 2000In 2000 a German study a German study reveled that 65% of health care reveled that 65% of health care seekers used herbal medicine. seekers used herbal medicine. Compared to Compared to 45%, 50%, 50.1%, 45%, 50%, 50.1%, 60%60% in America, France, in America, France, Australia, and Canada Australia, and Canada respectively.respectively.

Page 10: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

In U.S.AIn U.S.A..

More patients seek alternative More patients seek alternative medicine than modern primary medicine than modern primary health care facilities.health care facilities.

90%90% of self care practices use of self care practices use alternative medicine.alternative medicine.

Page 11: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Alternative treatment Alternative treatment modalitiesmodalities

Chinese traditional medicine. Chinese traditional medicine. (Herbal, acupuncture, (Herbal, acupuncture, acupressure, massage,cupping, acupressure, massage,cupping, nutritional.)nutritional.)

Indian Medicine: (herbal, Indian Medicine: (herbal, relaxation, reflexology, Yoga, ..)relaxation, reflexology, Yoga, ..)

German(homeopathy,herbal,auriGerman(homeopathy,herbal,auriculopuncture,cupping)culopuncture,cupping)

Page 12: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Naturopathy.Naturopathy.

Osteopathy.Osteopathy.

Greek/Unani medicine (herbal, Greek/Unani medicine (herbal, massage, and relaxation.)massage, and relaxation.)

The 4 Body mixes theory.The 4 Body mixes theory.

Arabic(hijama,cauterization,QurArabic(hijama,cauterization,Quranic,herbal).anic,herbal).

Cauterization.Cauterization.

Odd and unknown modalities.Odd and unknown modalities.

Magic and Illegal modalities.Magic and Illegal modalities.

Page 13: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Aromatherapy.Aromatherapy.

Hijama (Air cups and venapuncture).Hijama (Air cups and venapuncture).

Therapeutic touch (reflexology, Therapeutic touch (reflexology, Polarity therapy…)Polarity therapy…)

Ozone therapyOzone therapyChelation(eddeta)Chelation(eddeta)Craniosacral massage(CSF Craniosacral massage(CSF movement)movement)Herbal MedicineHerbal Medicine

Page 14: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Diet and Nutrition Diet and Nutrition treatmentstreatments

1.1. Supplements:Supplements: Folic acid.Folic acid. Soya proteinsSoya proteins Vitamins.Vitamins. Niacin-amide Niacin-amide

2.2. Food elimination:Food elimination: Macrobiotics.Macrobiotics. Vegetarians.Vegetarians.

Page 15: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Body-mind Body-mind interventionsinterventions

Prayers.Prayers.

BiofeedbackBiofeedback

YogaYoga

RelaxationRelaxation

Hypnosis.Hypnosis.

Dance and musicDance and music

NLPNLP

Page 16: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Those for Practicing Those for Practicing alternative and alternative and

complementary medicinescomplementary medicinesIt cures or alleviates.It cures or alleviates.

It complements treatment.It complements treatment.

It helps where modern medicine It helps where modern medicine doesn’t.doesn’t.

No or minimal side effects.No or minimal side effects.

Costs less.Costs less.

Simpler and less invasive.Simpler and less invasive.

No complication or serious side No complication or serious side effecteffect

Page 17: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Those against its Those against its practicepractice

Lacks scientific evidence.Lacks scientific evidence.

Carries serious side effects.Carries serious side effects.

Negatively affects patient Negatively affects patient management.management.

Lacks criteria of diagnosis , Lacks criteria of diagnosis , treatment choice and dose.treatment choice and dose.

No measurable effects.No measurable effects.

costlycostly

Page 18: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Why do patients seek Why do patients seek alternative medicinealternative medicine??

Not receiving enough care.Not receiving enough care.

Poor patient – doctor Poor patient – doctor relationship.relationship.

Loss of trust in modern medicine Loss of trust in modern medicine esp. in chronic and psych cases.esp. in chronic and psych cases.

As a complement.As a complement.

TrialTrial

BelieveBelieve

Page 19: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Characteristics of patients Characteristics of patients seeking alternative seeking alternative

medicinemedicine

More educated.More educated.

Having chronic illness.Having chronic illness.

Having pain-full conditions.Having pain-full conditions.

Having disabling condition.Having disabling condition.

Page 20: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Having psychiatric condition.Having psychiatric condition.

Middle aged.Middle aged.

Women > men.Women > men.

Intolerant.Intolerant.

More spiritually and or More spiritually and or environmentally oriented.environmentally oriented.

Page 21: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

How does it workHow does it work??The Body-Mind- Spirit set.The Body-Mind- Spirit set.

Internal equilibrium reset & Internal equilibrium reset & immunity enhancement.immunity enhancement.

The Biopsychosocial model of The Biopsychosocial model of health care.health care.

Relieves tensions (relaxation and Relieves tensions (relaxation and hypnosis).hypnosis).

Page 22: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Emphasis on human touch and Emphasis on human touch and believe.believe.

Release of therapeutic Release of therapeutic substances.substances.

Pharmacological action.Pharmacological action.

Action on body meridians e.g. Action on body meridians e.g. acupuncture , acupressure , acupuncture , acupressure , massage, cauterization and massage, cauterization and Hijama).Hijama).

Page 23: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

The place of evidence The place of evidence in the practice of in the practice of

ACMACM..

Page 24: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

الخطورةالخطورة الدليل الدليل االدعاءاتاالدعاءات العالج العالج نوع نوع مم

يجب لكن يجب قليلة لكن قليلةإلى إلى االنتباه االنتباه

تعقيم تعقيم ضعف ضعفوقلة , وقلة , اإلبر اإلبر

بعض عند بعض الخبرة عند الخبرةالممارسينالممارسين

الدراسات* الدراسات* أثبتت أثبتتإزالة يساعد إزالة انه يساعد انه

العمليات بعد العمليات األلم بعد األلم

عالج* على عالج* يساعد على يساعدالمصاحب المصاحب الغثيان الغثيان

والعالج والعالج للبنج للبنجوالحمل والحمل الكيمائي الكيمائي

غير االدعاءات غير وبقية االدعاءات وبقيةمؤكدةمؤكدة

األلم* األلم* يزيل يزيل

اإلدمان* اإلدمان* يعالج يعالج

الربو* الربو*

الحساسية* الحساسية*

االكتئاب* االكتئاب*

القلق* القلق*

الدم* ضغط الدم* ارتفاع ضغط ارتفاع

المعدة* المعدة* إضرابات إضرابات

باإلبر باإلبر الوخز الوخز

AcupunctureAcupuncture

11

توجد ال توجد قليلة، ال قليلة،تعطي تعطي كليات كلياتأو أو شهادات شهادات

ترخيص ترخيص في في بالممارسة بالممارسة

أمريكاأمريكا

دليل يوجد دليل ال يوجد ال العصبي* العصبي* الشد الشد

الربو* الربو*

الزكام* الزكام*

الدورة* الدورة* آالم آالم

الوالدة* الوالدة* تعسر تعسر

المناعة* المناعة* ضعف ضعف

المثانة* المثانة* التهاب التهاب

بزيوت بزيوت العالج العالجالنباتات النباتات

AromatAromatالعطريةالعطريةherapyherapy

22

Page 25: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

الخطورةالخطورة الدليل الدليل االدعاءاتاالدعاءات العالج العالج نوع نوع ممبعض بعض

تحتوى تحتوى العالجات العالجاتسامه مواد سامه على مواد على

الرصاص الرصاص مثل مثلبعض بعض والزئبق والزئبق

الممارسة الممارسة أنواع أنواعاألمر تجعل األمر قد تجعل قد

أسواأسوا

Blood letting , Blood letting , bowl purging bowl purging

induced induced vomitingvomiting

التمارين التمارين الرياضية الرياضية

مفيدة مفيدة واالسترخاء واالسترخاءبعض بعض وكذلك وكذلك

يجب لكن يجب األعشاب لكن األعشاببعض عالج في بعض الحذر عالج في الحذر

الخطرة الخطرة األمراض األمراضالمذكورةالمذكورة

الهضم- الهضم- اضطرابات اضطرابات

القلب- القلب- أمراض أمراض

المفاصل- المفاصل- آالم آالم

الحساسية- الحساسية-

الجروح- الجروح-

القلق- القلق-

الفيروس- الفيروس- الكبد الكبد

عالج عالج ايورفيدا ايورفيدابالغذاء، بالغذاء، هندي هندي

التمارين التمارين الرياضية، الرياضية،

اإليحاء، اإليحاء، اليوقا، اليوقا،الدلك الدلك األعشاب، األعشاب،

33

تسبب تسبب قد قدفي في اضطرابات اضطرابات

القلب القلب نبض نبض

كلوى كلوى فشل فشل

أنيمياأنيميا

Bone marrow Bone marrow damagedamage

الموت تسبب الموت قد تسبب قد

مثبت غير مثبت االدعاء غير االدعاء الشرايين الشرايين تفتح تفتحالمقفولة المقفولة التاجية التاجية

القلب مريض القلب وتغني مريض وتغنيأو الجراحة أو عن الجراحة عن

القسطرةالقسطرة

ChelationChelation محاليل محاليل تستعمل تستعمل

على على تحتوى تحتوىEDETAEDETA

44

Page 26: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

الخطورةالخطورة الدليل الدليل االدعاءاتاالدعاءات العالج العالج نوع نوع مم

في الرقبة في عالج الرقبة عالجنادرة نادرة حاالت حاالت

إصابة في إصابة تسبب في تسبباكثر يكون اكثر قد يكون قد

العالج من العالج تكلفة من تكلفةاألطباء األطباء عند عندالتقليدينالتقليدين

أثبتت أثبتت الدراسات الدراساتآالم في آالم فائدته في فائدته

االدعاءات. االدعاءات. الظهر الظهر. مثبته غير .األخرى مثبته غير األخرى

الظهر- آلم الظهر- يزيل آلم يزيل

الصداع- الصداع-

الدورة- الدورة- آالم آالم

المالعب- المالعب- إصابات إصابات

عند- البطن عند- آلم البطن آلمالوالدة الوالدة حديثي حديثي

ChiropracticChiropractic يدوي يدوي عالج عالج

الفقري الفقري للعمود للعمود55

إذا إذا خطورة خطورةفي في استعملت استعملت

األطفال األطفال عالج عالج

مثبته غير مثبته االدعاءات غير االدعاءات

األذن- التهاب األذن- عالج التهاب عالجالوسطىالوسطى

المغص- المغص-

الصداع- الصداع-

المفاصل- المفاصل- التهاب التهاب

االكتئاب- االكتئاب-

التعلم- التعلم- مشاكل مشاكل

Craniosacral Craniosacral therapytherapy ضغط ضغط

على على يدوى يدوىالجمجمة الجمجمة

الفقري الفقري والعمود والعمودانسيابية انسيابية تساعد تساعد

النخاع النخاع سائل سائلالشوكىالشوكى

66

Page 27: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

الخطورةالخطورة الدليل الدليل االدعاءاتاالدعاءات العالج العالج نوع نوع ممسرطان سرطان يزيد يزيد

البروستاتاالبروستاتا

احتمال احتمال يزيد يزيدالقلب القلب أمراض أمراض

النساء النساء عند عند

صناعي صناعي هورمون هورمونفائدته فائدته قوي قوي

مثبتة غير مثبتة وسالمته غير وسالمته

Synthetic Synthetic supplementsupplement

القلب- أمراض القلب- يقلل أمراض يقللوالشرايينوالشرايين

العضالت- العضالت- يبني يبني

العظام- هشاشة العظام- يمنع هشاشة يمنع

الزيهايمر- الزيهايمر- يعالج يعالج

DHEADHEA

في في هورمون هورمونمادة مادة الجسم الجسملصناعة لصناعة اولية اوليةاإلدرنالين , اإلدرنالين ,

االستروجين, االستروجين, التستوسيترونالتستوسيترون

77

يوجد يوجد ال ال

بفوائد بفوائد قصص قصصال ولكن ال شخصية ولكن شخصية

علمية دراسات علمية توجد دراسات توجد

التئام على التئام يساعد على يساعدأو الممزقة أو المفاصل الممزقة المفاصل

الملتهبةالملتهبة

Glucosamine Glucosamine Synthetic Synthetic

supplementsupplement

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Page 28: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

الخطورةالخطورة الدليل الدليل االدعاءاتاالدعاءات العالج العالج نوع نوع مم

تحدث- أن تحدث- يمكن أن يمكنضرر ضرر

هناك- يكون هناك- قد يكون قدالعالج مع العالج تداخل مع تداخل

إجراء مع إجراء أو مع أوجراحيجراحي

الطبيب- الطبيب- استشر استشر

بعض هناك تكون بعض قد هناك تكون قدغير ولكن غير الفائدة ولكن الفائدة

علمية . بتجارب علمية .مثبتة بتجارب مثبتة

الذاكرة- الذاكرة- ضعف ضعفGinkgoGinkgo

االكتئاب- االكتئاب-

البروستات- البروستات- تضخم تضخم

من- أرخص من- أنها أرخص أنهااألدوية األدوية

أقل - الجانبية أقل اآلثار الجانبية اآلثارأخرىأخرى-

العالج العالج باألعشابباألعشاب

99

خطورة- توجد خطورة- ال توجد الالعالجات العالجات من من

خطورة- خطورة- هنــاك هنــاكاستعمال استعمال فــي فــي

من النوع من هذا النوع هذاعن بدال² عن العالج بدال² العالج

اكثر اكثر عالجات عالجات فاعليةفاعلية

الفائدة- نحو الفائدة- جدل نحو جدل

هناك- تكون هناك- قد تكون قدولكن محددة ولكن فائدة محددة فائدة

بعينه لمرض بعينه ليس لمرض ليس

وجيه- سبب يوجد وجيه- ال سبب يوجد الفائدة لها أن فائدة يفسر لها أن يفسر

أو السرطان أو في السرطان فيأمراض أو أمراض السكر أو السكر

القلبالقلب

المفاصل- المفاصل- التهاب التهاب

الربو- الربو-

الزكام- الزكام-

الحساسية- الحساسية-

السكري- السكري-

السرطان- السرطان-

القلب- القلب- أمراض أمراض

المثلي المثلي العالج العالج

HomeopathyHomeopathy

1010

Page 29: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

الخطورةالخطورة الدليل الدليل االدعاءاتاالدعاءات العالج العالج نوع نوع مم

توجـــــد توجـــــد ال ال

الدراسات الدراسات بعض بعضتخفف أنها تخفف تقول أنها تقول

األلم.األلم.

القولون- القولون- تساعد تساعدالعصبيالعصبي

الغثيان- الغثيان-

التدخين- التدخين- ترك ترك

الربو- الربو-

الهيموفيليا- الهيموفيليا-

المعدة- المعدة- اضطرابات اضطراباتالهضمي الهضمي والجهاز والجهاز

االكتئاب- االكتئاب-

العصبي- العصبي- الشد الشد

اإلدمان- اإلدمان-

الجلدية- الجلدية- األمراض األمراض

التنويم التنويم HHالمغناطيسيالمغناطيسي

ypnotherapyypnotherapy

1111

في- في- خطورة خطورةبعض بعض استعمال استعمال

األعشاب.األعشاب.

اآلن- اآلن- ممارسته ممارستهفي قانونية في غير قانونية غيرالواليات الواليات معظم معظم

األمريكيةاألمريكية

علمي دليل علمي هناك دليل هناكمراعة فائدة مراعة على فائدة على

السلوك السلوك التمارين , التمارين , الغذائي الغذائي

بعض, بعض, الرياضية الرياضيةغير , البقية غير , األعشاب البقية األعشاب

مؤكدةمؤكدة

المفاصل- المفاصل- التهاب التهاب

الربو- الربو-

االكتئاب- االكتئاب-

الفتور- الفتور-

الدم- ضغط الدم- ارتفاع ضغط ارتفاع

الجهاز- الجهاز- اضطرابات اضطراباتالهضميالهضمي

الجلد- الجلد- مشاكل مشاكل

السرطان- السرطان-

العالج العالج الطبيعي الطبيعي

NaturopathyNaturopathy

, الصوم, , الغذاء الصوم, الغذاءالدلك, الدلك,

األعشاب, األعشاب, المثلي المثلي العالج العالج

1212

Page 30: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

الخطورةالخطورة الدليل الدليل االدعاءاتاالدعاءات العالج العالج نوع نوع مم

المضاعفات- المضاعفات- قليلةقليلة

معترف معترف الشهادات الشهاداتمعظم في معظم بها في بها

في في الواليات الواليات أمريكاأمريكا

الظهر- آالم الظهر- يقلل آالم يقلل

دراسات- توجد دراسات- ال توجد البقية على بقية كافية على كافية

االدعاءاتاالدعاءات

الظهر- الظهر- ألم ألم

المفاصل- المفاصل- ألم ألم

المالعب- المالعب- إصابة إصابة

الصداع- الصداع-

األرق- األرق-

االكتئاب- االكتئاب-

الربو- الربو-

الهضم- الهضم- عسر عسر

OsteopathyOsteopathyعالعاليدوي يدوي ج ج

للعضالت للعضالت والعمود والعمود

تساعد تساعد الفقري الفقريمن من الشفاء الشفاء

اإلصابة اإلصابة والمرضوالمرض

1313

هيدروجين هيدروجين الغير الغير بيروكسايد بيروكسايد

سام سام مخفف مخففمرض على مرض وخطر على وخطر

واإليدز واإليدز السرطان السرطان بالفائدة دليل يوجد بالفائدة ال دليل يوجد ال

السرطان- السرطان-

المفاصل- المفاصل- التهاب التهاب

اإليدز- اإليدز-

العالج العالج باألكسجين باألكسجين

األكسجين األكسجين حقن حقنأو األوزون أو أو األوزون أوالهيدروجين الهيدروجين

أو أو بيروكسايد بيروكسايدالجلد طريق الجلد عن طريق عن

عالي عالي o2o2ضغط ضغط

1414

Page 31: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

The The WHOWHO expert group expert group report on ACM in report on ACM in 114114 countries in Africa, Asia, countries in Africa, Asia, Europe, North and South Europe, North and South America, and the Middle-America, and the Middle-easteast

Page 32: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Germany is leading in the Germany is leading in the practice of homeopathy, practice of homeopathy, auriculo-puncture, and herbal auriculo-puncture, and herbal medicine.medicine.

In the NHS of the U.K. there are In the NHS of the U.K. there are >50000>50000 registered alternative registered alternative medicine practitioners.medicine practitioners.

Training, Certification, Training, Certification, legislation, and registration are legislation, and registration are more in USA, and Europe.more in USA, and Europe.

Page 33: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

>50%>50% of the countries have of the countries have systems of registration, systems of registration, licensure and training for licensure and training for alternative and complementary alternative and complementary medicine.medicine.

In China there are In China there are 25002500 alternative medicine hospitals alternative medicine hospitals and thousands of practice and thousands of practice centers , centers , 525000525000 practitioners practitioners and and >800>800 factories for factories for alternative medicine products.alternative medicine products.

Page 34: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

In India In India 28602860 alternative alternative medicine hospitals , medicine hospitals , 2210022100 practice centers, and practice centers, and 8750087500 practitioners.practitioners.

> 280000> 280000 practitioners in practitioners in Indonesia and Indonesia and > 700> 700 factories of factories of alternative medicine (100 big alternative medicine (100 big ones).ones).

Page 35: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Herbal medicine is very common Herbal medicine is very common in China, India, Korea, Australia, in China, India, Korea, Australia, USA, Germany, Malaysia, USA, Germany, Malaysia, Indonesia, Singapore, Pakistan, Indonesia, Singapore, Pakistan, Bangladesh.Bangladesh.

Page 36: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

The Practice of The Practice of AcupunctureAcupuncture in the USAin the USAAcupuncture in licensed in Acupuncture in licensed in 4242 states.states.

1400014000 registered non-physicians registered non-physicians acupuncturists .acupuncturists .

30003000 registered physician registered physician acupuncturists.acupuncturists.

All practitioner set a unified All practitioner set a unified written examination and some written examination and some states give a practical exam.states give a practical exam.

Page 37: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Training programs for non-Training programs for non-physicians lasts physicians lasts 33 years. years.

Training for physician last one Training for physician last one year.year.

1212 states allow practice through states allow practice through referral from a modern medicine referral from a modern medicine practice only.practice only.

CME and CPD are conditional.CME and CPD are conditional.

Page 38: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Chiropractic in USAChiropractic in USA

> 70000> 70000 registered practitioners. registered practitioners.

>16>16 accredited schools. accredited schools.

Training for Training for 4-54-5 years. years.

A unified written and clinical oral A unified written and clinical oral examinationexamination

Page 39: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

The practice of alternative The practice of alternative medicine in Saudi Arabiamedicine in Saudi Arabia

Common Practices:Common Practices: Quranic & Prophetic recitations.Quranic & Prophetic recitations. Bone healers.Bone healers. Herbal shops.Herbal shops. Herbal healers.Herbal healers. Hijama.Hijama.

Page 40: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

CauterizationCauterization

Acupuncture Acupuncture

Massage and manipulative Massage and manipulative therapies.therapies.

Homeopathy.Homeopathy.

Nutritional therapyNutritional therapy

NLPNLP

Page 41: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

No well set rules and No well set rules and regulations.regulations.

No registration.No registration.

Poor supervision.Poor supervision.

Community pressures for Community pressures for exceptions.exceptions.

No clear criteria for required No clear criteria for required training, and accreditation.training, and accreditation.

No training centers or No training centers or programs.hprograms.h

Page 42: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Towards safe practice Towards safe practice of alternative of alternative

medicine In The medicine In The Arab countriesArab countries

Page 43: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

A)A)Short term measuresShort term measures

Allow it as complementary and not Allow it as complementary and not alternative to modern medicine.alternative to modern medicine.

Ensure ethical consideration.Ensure ethical consideration. Autonomy.Autonomy. Beneficence.Beneficence. Non-maleficienceNon-maleficience Justice.Justice.

Page 44: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Register all practitioners.Register all practitioners.

Register all used herbs and allow Register all used herbs and allow useful and harm less ones.useful and harm less ones.

License for practice of specified License for practice of specified treatment modalities based on treatment modalities based on training, certification, and training, certification, and experience.experience.

Page 45: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Encourage shared care and Encourage shared care and bilateral referral.bilateral referral.

Control advertisement.Control advertisement.

Records, documentation, and Records, documentation, and statistics.statistics.

Allow its practice in announced Allow its practice in announced places as past of modern places as past of modern medicine facilities and based on medicine facilities and based on set standerds.set standerds.

Page 46: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Forbid treatment of serious or Forbid treatment of serious or infectious diseases infectious diseases (Malignancies, cardiovascular, (Malignancies, cardiovascular, Aids, …etc.)Aids, …etc.)

Ensure liability.Ensure liability.

Encourage controlled bioethical Encourage controlled bioethical research work.research work.

Adhere to countries medical Adhere to countries medical practice by laws.practice by laws.

Page 47: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

What modalities to be allowedWhat modalities to be allowed? ?

Classification of the therapeutic effects of Classification of the therapeutic effects of alternative medicine treatment modalitiesalternative medicine treatment modalities::

1.1. Invalidated treatmentsInvalidated treatments “Don’t allow” “Don’t allow”

2.2. Non validated:Non validated: Potentially harmless.Potentially harmless. Potentially useful.Potentially useful. Potentially harmful.Potentially harmful. Potentially uselessPotentially useless

3.3. Validated treatmentsValidated treatments “regulate and allow “regulate and allow practice”practice”

Page 48: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Who could be currentlyWho could be currently licensed licensed? ?

Physician with one year Physician with one year certified training in a specific certified training in a specific field of ACM. Practitioners field of ACM. Practitioners with Post graduate of with Post graduate of bachelor degrees.bachelor degrees.

Practitioner with accredited Practitioner with accredited 2-3 years diplomas and one 2-3 years diplomas and one year of supervised practice.year of supervised practice.

Page 49: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

B)Long term measuresB)Long term measures Establish The Saudi Council for Establish The Saudi Council for

Alternative and Complementary Alternative and Complementary Medicine ( SCACM ) either Medicine ( SCACM ) either separate or under SCHS toseparate or under SCHS to: :

Review and determine allowed practices Review and determine allowed practices and their pre-requisites.and their pre-requisites.Training, CME, CPD, and certification of Training, CME, CPD, and certification of practitioners.practitioners.Accreditation:Accreditation: PlacesPlaces PersonsPersons Certificates & training.Certificates & training.

Licensure.Licensure.

Page 50: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Practice guideline.Practice guideline.

Quality control measures.Quality control measures.

Health information center.Health information center.

Information center.Information center.

Research center.Research center.

Herbal medicine laboratory.Herbal medicine laboratory.

Alternative medicine industry.Alternative medicine industry.

Page 51: Alternative and Complementary Medicine ( ACM ) Aproposal For Regulation In Saudi Arabia In Saudi Arabia Prof. Adnan Ahmad Albar Dept. of Family & Community

Thank YouThank You