Class 4 Herbal Ethics & Safety PDF

BOT MED TERM 1 CLASS 4: HERBAL ETHICS & SAFETY DR. FIONA SMULDERS ND LEARNING OBJECTIVES By the end of this lecture, students will be able to: 1. Discuss ecological, ethnobotanical, social and environmental concerns in relation to herbal medicine and its practice under the framework of naturopath...

BOT MED TERM 1 CLASS 4: HERBAL ETHICS & SAFETY DR. FIONA SMULDERS ND LEARNING OBJECTIVES By the end of this lecture, students will be able to: 1. Discuss ecological, ethnobotanical, social and environmental concerns in relation to herbal medicine and its practice under the framework of naturopathic medicine 2. Identify and describe the ethics and standards of practice that must be considered when prescribing herbal medicine 3. Understand the safe use of herbal medicine in the context of toxicity, contraindications and interactions TAKE A MOMENT TO CONSIDER… Are you familiar with these plants? Have you used them? Do you see them in stores? Do your friends/family/colleagues use them? 1. Echinacea 2. Slippery Elm 3. Sandalwood overextraction from environment these plants are becoming endangered & at risk of extinction we are often reducing availability of medicines for indigenous communities quality of medicine is dependent on quality of herbs; must be sourced from ethical & sustainable place UNITED PLANT SAVERS • Echinacea and Slippery Elm are “At-Risk” of extinction • Sandalwood is at “Critical” risk of extinction https://unitedplantsavers.org/ CONSIDERATIONS FOR HERBAL ETHICS AND SAFETY risk of overharvesting; risk of commercial exploitation of wild plants from their natural habitat cultural appropriation; increase risk of extractive mentality different cultures have different understandings dependent on quality of plants; what of health & disease, also use of herbs for benefit agricultural practices are being used? many products are also contaminated; don’t want to give products that cause more harm than good dose dependent; too much of a good some people metabolize a remedy & see thing could lead us to toxicity realm effects that are the opposite of what we expected/wanted to happen How a herb & drug interact with each other ask your patient what their experiences are with medications & herbs tannins can bind to medication, cause precipitation & *condraindications—when not to use a herb in certain health conditions prevents medication from being absorbed 1. Social & environmental impact 2. Cultural sensitivity and patient autonomy 3. Quality & sourcing 4. Toxicity, allergy & contraindications 5. Herb-Drug & Herb-Herb interactions *medscape to research herb-drug interactions most herbs have synergistic effect; however, can have additive/enhancing effects (bitters); on the other hand, tannins have reducing effects and prevent proper absorption of herbs SOCIAL & ENVIRONMENTAL IMPACT Popularization of herbal medicine and lucrative herbal markets leads to issues of: • Unsustainable harvesting methods leading to species extinction • Biopiracy & corporatization of traditional medicine - resource extraction, commercial exploitation and monopolization of wild plants by international companies without adequate compensation to the Indigenous peoples or countries where the medicine comes from • Cultural appropriation – people using the traditional medicinal practices of another culture with very little or no ancestral connection to that culture. These practices are often passed down through generational knowledge systems. CULTURAL SENSITIVITY & PATIENT AUTONOMY Across the globe, there are different worldviews to approach the use and medicinal effects of plants Culturally-relevant medicinal practices include local customs and beliefs about the workings of the body, the nature of health and disease, and the use of herbal medicines All worldviews and personal decisions regarding healthcare and treatment choices must be honored and respected QUALITY & SOURCING The quality of your medicine depends on the quality of the plants you use. Be mindful of the following: • Herbal products can be contaminated with dust, pollens, insects, rodents, parasites, microbes, fungi, mold, toxins, pesticides and/or toxic heavy metals • Herbal products can be adulterated with prescription drugs to enhance efficacy • Reduced quality of an herb can be due to poor soil quality, unnatural growing conditions and production-focused harvesting techniques https://pubmed.ncbi.nlm.nih.gov/22843016/ HERBAL TOXICITY “What is there that is not poison? All things are poison and nothing is without poison. Solely the dose determines that a thing is not poison.” Paracelsus (1493 – 1541) Depends on: • Dose applied • Time of exposure • • • Susceptibility of tissues & body metabolism Re-generative, elimination & spare capacity of tissues or organs ….the herb & the person. ALLERGIES & CONTRAINDICATIONS Allergies: an individual can have an allergy to a particular plant or to an entire plant family (ex: Asteraceae) Cautions: an herb may cause an undesired effect and may require monitoring Contraindications: an herb must not be used in certain health conditions, reduced organ function (liver/kidney), or stages of life. HERB-DRUG INTERACTIONS 1. Combining herbs and pharmaceuticals that have the same (additive) effects (ex: ginkgo with anticoagulant medications) 2. Combining herbs and pharmaceuticals with opposing (counteracting) effects (ex: stimulant herbs with sedative medications) 3. Changes in the way a substance is absorbed in the gastrointestinal tract (ex: tannins & mucilage) 4. Changes in the way a substance is metabolized and excreted (ex: grapefruit, SJW) *See the Herb-Drug Interactions PDF on ecampus for more examples HERB-HERB INTERACTIONS 1. Bitter & pungent herbs can enhance absorption and assimilation of other herbs. Bitter herbs: gentian, oregon grape, dandelion, etc. Pungent herbs: ginger, black pepper, horseradish, etc 2. Tannins may reduce absorption of other constituents, particularly alkaloids, via precipitation. Tannin-rich herbs: raspberry leaf, green tea, oak bark, meadowsweet, etc. 3. Energetic interactions: warming, cooling, drying, moistening SUMMARY There are many cultural, social, environmental and safety considerations when using herbal medicine in practice. 1. Be respectful and inclusive of different worldviews 2. Use products from trusted suppliers that use high quality, ethical and sustainable sourcing of herbs 3. Stay informed of “at-risk” species and use caution and careful consideration when using these plants 4. Perform a complete medical history (including medication use, allergies, current or past health conditions, pregnancy/lactation, liver/kidney function, etc) before recommending an herbal remedy to ensure safe practice 5. Stay within the therapeutic window of an herb and follow recommended dosing to avoid toxicity THANK YOU. A N D H AV E A L O V E LY D AY