CAM in Sweden – a brief overview



In Sweden (Stockholm County, 2000), the most commonly used CAM therapy is massage, with 57% of the respondents reporting ever-use, followed by natural remedies (including herbs such as ginseng and Q10 remedies, etc.), chiropractic, and acupuncture (26%).

Sweden does not have a coherent policy on CAM, but certain steps during the past 30 years indicate that the country is getting closer to such a policy. Back in 1984, acupuncture was approved as a pain relief method by The National Board of Health and Welfare, naprapathy (similar to chiropractic) was approved in 1994, and chiropractic in 1999.

In 2000, Karolinska Institutet (Stockholm) initiated the first courses in CAM for physicians and students, and in 2005, the institute received a private donation of 43 mill. SKK (4.5 mill. €), which was used to establish “Osher centrum för integrativ medicin”: http://ki.se/ki/jsp/polopoly.jsp

Very little written legislation explicitly regulates CAM practitioners in Sweden. Health personnel are not allowed to practice CAM without an evidence base, neither inside nor outside their profession. There are a few exceptions, though: if a patient initiates the request for it, no alternative conventional treatment options exist, and the treatment is given in conjunction with normal care. It is also required that no risk associated with the treatment be expected.

The paradox



Sweden is an example of a WHO member country with national health legislation that contradicts practice. According to a survey, health personnel have been recommending 19 different complementary methods, six of which are considered evidence-based in Cochrane Collaboration reviews.

Although there is a policy–practice paradox and a legal separation between CAM and the biomedical community in Sweden, the country has made small steps towards reconciling the two: a proposed government-supported CAM registry, courses on CAM provided at universities around the country, and the establishment of CAM research units at medical universities. One of the objectives of the registry was to create an official checklist of certain standards to be met by the practitioners.

Like in Norway and Denmark, only a few CAM practitioners are medical doctors, and within the medical society, interest in CAM has not been very popular in the past. The attitude, though, seems to be changing, and a growing number of doctors are showing their interest in CAM publicly. “Svensk Läkarförening för Komplementär Medicin” (Swedish Association for Complementary Medicine) was formed in 1977 and has approx. 200 members.


Text: Jesper Odde Madsen

Sources:

Use of complementary and alternative medicine in the Scandinavian countries. Scandinavian Journal of Primary Health Care. Borghild Hanssen et al.

Emerging Complementary and Alternative Medicine Policy Initiatives and the Need for Dialogue. Journal of Alternative and Complementary Medicine. Kjersti E. Knox et al.

Complementary and Alternative Medicine, research, development and education. Motzi Eklöf and Anna Kullberg.

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by David Finer