Drugs & Medication

Herbal and Synthetic Drugs: A Comparison
–Joel Albers, Pharmacist, Pharm.D., Ph.D.

Prior to the U.S. Civil War, native healers, midwives, herbalists and witches – mostly women – were the primary caregivers. By 1865, the discipline of scientific medicine was imported from Europe, particularly from Germany. The germ theory of disease, specific disease etiology (cause), and the discovery of the tubercle bacillus by Koch, Virchow and Pasteur lent credence to the notion of a specific cure for a specific ailment. Otherwise known as the biomedical model, it became the basis for the production of synthetic drugs, with less emphasis on the whole person or the environment.

Beginning in the 1930s, synthetic drugs gradually replaced the herbals that previously lined the shelves of drugstores throughout the U.S. Synthetic penicillin ushered in the synthetic drug revolution. Synthesized drugs were then given a boost by the Durham-Humphrey Act of 1954, legally designating drugs as ‘prescribed’ by a physician, or ‘over-the-counter’ for self-selection. Herb medicines made their way to food supplement stores.

Herbs are medicinal plants (also called phytomedicinals) that can be administered as the whole plant or plant parts or by extracting one or more ingredients with solvents to yield tinctures, tea or other extracts. Synthetic drugs (what the drug industry calls “pharmaceuticals”) are synthesized chemically in the laboratory to produce drugs not found in nature. One quarter of these drugs used in the U.S. are derived from plants (i.e., opiates, digitalis, Taxol) by extracting the active ingredient from a plant, replicating its structure in the lab and mass-producing it.

Herbal drugs are considered less potent than prescribed medicines. The latter usually contain one highly concentrated active ingredient, while herbs may have several active ingredients that are chemically similar. Herbal ingredients work synergistically to contribute to, or detract from, the therapeutic effect of each individual ingredient.

Whether human-made or natural, the most important criteria for a medicine’s use is safety, effectiveness and quality: identity, purity, potency and stability. Because of a law passed in 1994 designed to cut costs for the corporate dietary supplement industry, herbal medicines are not required to indicate proof of the above. Indeed, this law was not established with the interest of public health in mind. Thus, if one purchases an herbal product, the labeling will contain a disclaimer that reads: “This statement has not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease.” Some companies market the benefits of herbs in breakfast cereals, snack foods, and fruit drinks. Products containing St. John’s wort, echinacea, gingkobBiloba and kava are used to “enlighten your senses” and be “mind-enhancing.” The corporate food industry calls these “functional foods” and accrues an estimated $16 billion in revenues. Such claims about the herbs in these products can mislead consumers about their health benefits.

In the absence of patents and exclusive control of markets, larger drug companies are still reluctant to invest in researching herbals. However, small to medium scale studies have shown that medicinal herbs hold much promise. The U.S. National Institute of Health (NIH) is now conducting large-scale randomized controlled trials on Ephedra, St John’s wort for depression, ginkgo biloba for memory loss, saw palmetto for benign prostate problems, and potential herbal cancer therapies.

Currently, herbs are much less expensive than their human-made counterparts. The average prescription drug price is about $50 for a month’s supply. Herbals cost between $10 and $20 per month supply. Total sales of herbs in the U.S. in 2000 was $16 billion compared with $130 billion for outpatient prescription drugs.

In the future, the use of herbs and synthetic drugs in complementary fashion can reduce toxicities and maximize therapeutic outcomes. Not just the therapies, but the whole system itself will need to operate in a complementary, ethical and inclusive way for the public to receive the most cost-effective and productive healing options.

Sidebar: Deadly Reactionsby Joel Albers

Adverse reactions to legally-prescribed drugs is the fourth leading cause of death in the United States. According to the American Medical Association, legally prescribed pharmaceuticals kill approximately 106,000 hospitalized patients annually, are responsible for an estimated 198,000 related annual deaths and necessitate 23% of all hospitalizations. Deaths from herbals occurs to much lesser extent; the FDA has received over 2,900 adverse event reports (including 104 deaths) about thousands of herbal supplements. The FDA estimates that for every report that at least ten adverse events go unreported. Interactions between prescribed and herbal drugs also lead to many deaths each year, and are quickly becoming a major public health concern.

What You Can Do* Ask accessible health practitioners such as your community pharmacist (free of charge) about the safety, effectiveness and quality control of products.

* Inform your health caregivers of any herbs and prescription drugs (including samples), or over-the-counter drugs, vitamins and minerals, you are taking.

* Educate your practitioner(s) about any information you have obtained about any therapy.