What is complementary and alternative medicine?
Complementary and alternative medicine is health-related treatment that is mainly provided outside the healthcare service.
Examples of complementary and alternative medicine are:
- acupuncture
- aromatherapy
- homoeopathy
- reflexology
The National Research Centre in Complementary and Alternative Medicine (NAFKAM) has a list of CAM treatments (nafkam.no, in Norwegian).
The Norwegian Alternative Treatment Act (in Norwegian) regulates what is and is not considered CAM treatment in Norway.
As a general rule, religious activity is not considered a form of complementary and alternative medicine. In some cases, treatment of a religious nature may still be considered complementary and alternative medicine. This applies, for example, if the treatment:
- is being marketed
- promises healing
- is a paid service
Beauty and wellness treatments are not usually considered CAM treatments.
Other names for complementary and alternative medicine
Alternative medicine
The Alternative Treatment Act came into effect in 2004. The official term was then changed from alternative medicine to complementary and alternative medicine. In everyday speech, the term alternative medicine is still used.
Natural medicine
In everyday speech, many people use the term natural medicine for CAM treatment. Sometimes natural medicine is used about alternative use of remedies from nature, while other times the term is used about CAM treatment in general.
Complementary therapy
The term complementary therapy is used when the patient uses alternative forms of treatment, in addition to treatment from the health service. This is not an official term and does not change the legal requirements related to the CAM treatment being provided.
Integrative therapy
Integrative therapy is used when alternative forms of treatment are part of the treatment provided by the health service. Examples of integrative therapy are hospitals that offer acupuncture or art therapy, in addition to standard treatment.
What are CAM providers permitted to do?
A CAM provider is a person who is not an authorised health professional and who offers and provides health-related treatment outside of the healthcare service. CAM providers can provide treatment to the seriously ill if the goal is not to treat the disease itself.
For example, they are allowed to provide treatment to:
- alleviate the symptoms resulting from the disease
- strengthen the immune system
- alleviate the side effects of medical treatment
CAM providers can make diagnoses and provide treatment based on their own theories. Their understanding of health and disease does not have to correspond to knowledge from the health sciences.
What are CAM providers not permitted to do?
The law limits what CAM providers are permitted to do.
They are not permitted to:
- perform medical procedures or provide treatment which could potentially seriously endanger the health of the patient
- provide treatment for infectious diseases that could endanger public health or safety, such as infectious meningitis
- provide treatment for serious illnesses and disorders, such as
- cancer
- multiple sclerosis (MS)
- severe depression
- schizophrenia
The exception is if the patient’s doctor agrees that the patient can receive alternative treatment for the disease. When healthcare professionals provide CAM treatment, they must also comply with the Norwegian Health Personnel Act (in Norwegian).
How many people use CAM treatment?
It is estimated that about 25 per cent of the Norwegian population received treatment from a CAM provider in 2022.
If natural products (such as ginseng, garlic and ginger) and self-help techniques for therapeutic purposes (such as yoga and meditation) are also included, about 40 per cent used CAM treatment in 2022.
Your rights
CAM providers have a duty of confidentiality, and you have the right to access your medical records.
In principle, the Patient and User Rights Act applies to healthcare from the public health service, but does not apply to CAM treatment. This means that you cannot demand that the public healthcare services facilitate the use of CAM treatment. You also cannot demand that the public authorities assist you if you are dissatisfied and wish to complain about the treatment.
Payment for CAM treatment
When using CAM treatment outside the public healthcare services, you must pay for it yourself. It is the CAM providers who decide how much it costs.
If the treatment is part of the public healthcare services, you can have your expenses covered. Some insurance companies also cover expenses for treatment such as acupuncture, massage therapy, etc. In these kinds of cases, you usually have to pay a user fee. Read more about payment for health services.
Side effects following CAM treatment
All healthcare carries a risk of side effects, including CAM treatment.
Direct risk of side effects
The risk of direct side effects from CAM treatment varies greatly depending on the treatment method used. Reported side effects vary from:
- Mild and harmless side effects such as transient nausea and headache.
- More serious side effects such as infections and symptoms of poisoning.
Indirect risk of side effects
If you postpone necessary treatment from your doctor by using CAM treatment instead, this may cause your health condition to worsen.
Risk of improper medical treatment
There is also some risk of improper medical treatment. For example, there are cases where acupuncture needles are inserted incorrectly and result in a punctured lung and a hole in the heart.
What should you think about in advance?
You should never replace necessary treatment from a doctor, hospital or other public health services with CAM treatment.
Talk to your doctor about any treatment you are receiving. Medications, supplements and natural products can cause side effects when used alone. They can also affect each other’s effectiveness if you use them at the same time. If your doctor is unsure about whether your use of healthcare products is safe, it is possible to contact RELIS (Norwegian regional drug information centres). You can also search the RELIS database yourself.
Talk to your CAM provider about the health problems you are seeking help for. Ask how the methods they use should be able to help you, how many rounds of treatment will be required, and whether there are any aspects of the treatment you should be aware of.
Use impartial sources to make health choices. On the NAFKAM website, there is an online directory in Norwegian with an A-Z list of common CAM treatments. You can read about:
- what the treatment involves
- what research says about the effectiveness of the treatment
- the risk of side effects
Can I file a complaint about the treatment?
If the treatment provider belongs to a practitioners’ organisation, you can try filing a complaint with the organisation. Most providers who belong to an organisation state which organisation they belong to, for example on their website. You can also try to find out which practitioners’ organisation your practitioner belongs to in the Brønnøysund Register Register of CAM treatment practitioners.
There is no public agency you can file a complaint with about the CAM treatment you have received. This is because CAM providers are not subject to healthcare oversight by the government.
The exception is if the treatment was provided by a healthcare professional, or within the healthcare services. You then have the right to complain if you believe your rights as a patient have not been upheld, or if you believe you have not received the health or care services you are entitled to.
Supervision
Although there is no public agency you can file a complaint with about the treatment itself, other aspects of CAM treatment may be subject to government supervision:
- Marketing of CAM treatment services and products: the Norwegian Consumer Authority (in Norwegian)
- Food, including health-related products such as dietary supplements: The Norwegian Food Safety Authority
- Medications and medical devices: The Norwegian Medical Products Agency (DMP). This also applies to:
- Homoeopathic medicines
- Plant-based medicines
- Natural medicines
- Laser and light equipment: The Norwegian Radiation and Nuclear Safety Authority (DSA)
CAM treatment abroad
The legislation that regulates CAM treatment only applies in Norway. In other countries, other laws apply. Other countries have different definitions of what is considered CAM treatment and how such treatment is regulated.
If you are considering travelling abroad for treatment, you should always investigate what rules apply in the country you are going to. Investigate:
- which laws apply
- what rights you have