American College of Medical Toxicology and The American Academy of Clinical Toxicology

View all recommendations from this society

Released September 26, 2013

Don’t use homeopathic medications, non-vitamin dietary supplements or herbal supplements as treatments for disease or preventive health measures.

Alternative therapies are often assumed safe and effective just because they are “natural.” There is a lack of stringent quality control of the ingredients present in many herbal and dietary supplements. Reliable evidence that these products are effective is often lacking, but substantial evidence exists that they may produce harm. Indirect health risks also occur when these products delay or replace more effective forms of treatment or when they compromise the efficacy of conventional medicines.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American College of Medical Toxicology’s (ACMT’s) Board of Directors established a Choosing Wisely® work group in 2013 to develop a list of items for the Choosing Wisely® campaign. Members of the work group were chosen to represent various practice settings within the field of medical toxicology, including ambulatory, acute and population-based practice. Work group members included the President of the College, the Chair of the Practice Committee, the Chair of the Positions and Guidelines committee and other academic leaders within the medical toxicology community. All work group members also represented the American Academy of Clinical Toxicology (AACT). The first list was released by the work group in 2013 and in 2014, the work group reconvened to develop a second list of items for the campaign. A second preliminary list was disseminated to all members of ACMT and AACT for review, commentary and potential additions. Additional feedback was solicited from leaders within the field of medical toxicology. The work group reviewed all responses, and narrowed the list to the final five items based on a review of scientific evidence, relevance to the specialty and greatest opportunity to improve care, reduce cost and reduce harm to patients.The final list was approved by the ACMT Board of Directors and the AACT Board of Trustees.

The ACMT and AACT disclosure and conflict of interest policies and be found at www.acmt.net and www.clintox.org respectively.

Sources

Woodward KN. The potential impact of the use of the homeopathic and herbal medicines on monitoring the safety of prescription products. Hum Exp Toxicol. 2005;24:219–33.

Thompson E, Barron S, Spence D. A preliminary audit investigating remedy reactions including adverse events in routine homeopathic practice. Homeopathy. 2004;93:203–9.

De Smet PA. Health risks of herbal remedies. Drug Saf. 1995;13:81–93.

Farah MH, Edwards R, Lindquist M, Leon C, Shaw D. International monitoring of adverse health effects associated with herbal medicines. Pharmacoepidemiol Drug Saf. 2000;9(2):105–12.

Drew AK, Myers SP. Safety issues in herbal medicine: implications for the health professions. Med J Aust. 1997;166:538–41.