Complementary and alternative medicine such as acupuncture, herbal supplements and meditation are big business in the United States, totaling nearly $34 billion in out-of-pocket spending, according to a government report released on Thursday.

More than 38 million adults visited chiropractors, acupuncturists and other specialists in alternative care in 2007, the report from the National Institutes of Health found.

About two-thirds of this amount was spent on products such as supplements, with nearly $12 billion going to practitioners, according to the report from the National Center for Complementary and Alternative Medicine.

“Despite this emphasis on self-care therapies, 38.1 million adults made an estimated 354.2 million visits to practitioners of complementary and alternative medicine,” the report said.

Complementary medicine, such as aromatherapy to ease discomfort after surgery, is used with conventional medicine whereas alternative medicine is used in place of it, the center says.

Other findings:

* Complementary or alternative therapies make up 1.5 percent of the $2.2 trillion in total health care expenditures.

* Popular products included fish oil, glucosamine to treat arthritis and echinacea to prevent or treat colds.

* Common treatments included acupuncture, chiropractic and osteopathic manipulation and traditional healing.

* On average, an adult spent $121.92 on visits to providers and paid $29.37 out of pocket per visit.

* People spent $14.8 billion out of pocket to buy nonvitamin, nonmineral, natural products - a third of what is spent on pharmaceuticals.

“With so many Americans using and spending money on (complementary and alternative) therapies, it is extremely important to know whether the products and practices they use are safe and effective,” said NCCAM director Dr. Josephine Briggs.

“This underscores the importance of conducting rigorous research and providing evidence-based information on complementary and alternative medicine so that health care providers and the public can make well-informed decisions.”

Her institute was established in 1998 to conduct this research.

WASHINGTON (Reuters)