There is a lack of data to support the perception that clinically significant herb-drug interactions are common and the overuse of prescription drugs for pain, sleep and colds should be causing more concern, according to Josephine P. Briggs, M.D., director of the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH).
Dr. Briggs outlined how NCCIH is working to provide solid methods to evaluate the clinical importance of herb-drug interactions during a keynote speech delivered at AHPA's Annual Member Meeting held at Expo West on March 5. She noted that there is a lack of standards for herb-drug interactions and that most herb-drug interactions identified in current resources are hypothetical, inferred from animal studies, cellular assays or based on other indirect means.
"A misplaced fear about herb-drug interactions is why physicians don't recommend herbs," Dr. Briggs said. "But concerns about herb-drug interactions is often poorly founded and not based on rigorous studies."
NCCIH's herb-drug interaction initiative is looking to develop rigorous evaluation standards for herb-drug interaction testing and to use test cases of five widely used test products and established probe drugs to determine clinically validated criteria.
Dr. Briggs also expressed concern about the prevalent use of OTC and prescription drugs for sleep, pain and colds.
She highlighted data from several studies to demonstrate the potential negative side-effects of the widespread use of drugs.
Regarding drugs for colds, Dr. Briggs said that an estimated two million illnesses and 23,000 deaths annually are caused by antibiotic resistance.
Regarding drugs used for sleep, she noted that there has been a dramatic increase in the use of benzodiazepines, especially among older populations. She also noted that supplements like lemon balm, melatonin and valerian show promise in helping people sleep without the negative side-effects of drugs.
Regarding drugs for pain, Dr. Briggs highlighted the recent increase in deaths involving opioid analgesics, which rose to more than 16,000 in 2010, a 21 percent increase since 2006.
Overall, drug induced deaths surpassed suicides in 2005 to become the second most common cause of death. In 2007, there were nearly 40,000 drug related fatalities compared to 45,000 motor vehicle fatalities.