Why Herbs Aren’t Drugs — and How to Use Them Safely
One of the biggest misconceptions about herbal medicines arises from how deeply modern culture equates them with the properties and actions of pharmaceuticals. As acculturated in an industrialized Western society, we’re conditioned to view all medicine through the lens of the dominant biomedical model — one based on isolation, concentration, and control.
Typically designed to work quickly and forcefully, pharmaceutical drugs produce powerful, targeted effects on specific biochemical pathways. Herbal medicine, on the other hand, works more slowly and holistically, influencing the body through complex interrelationships that build dynamic balance (homeostasis) and resilience over time, typically through less invasive and more modulating effects.
This isn’t to say one is better than the other — they serve different purposes. Biomedical interventions are invaluable for serious or emergency situations, when rapid and forceful action is necessary. For example, quickly lowering dangerously high blood pressure, or offsetting the debilitating impacts of a stroke, is more effective with a pharmaceutical than turning to an herbal remedy.
Herbs are not typically used for such acute emergencies, but rather to support long-term healing and regulation. Still, their effects can be profound, working deeply to restore underlying health rather than simply suppressing symptoms. Herbs, unlike drugs, can sometimes work deeper and more closely to the root of an issue. However, it's essential to understand that herbs are never a replacement for drugs, even when their intended use sometimes overlaps with biomedical approaches.
Herbal medicine arises from nature itself. It's the most ancient form of healing, rooted in our evolutionary relationship with plants. Even our distant relatives — like the Neandertals — are known to have used medicinal herbs such as yarrow and chamomile, likely for digestive or wound-healing purposes. Long before documented history, and long before humans existed as a distinct species, human-like ancestors were experimenting with wild roots, leaves, and resins for nourishment, healing, and spiritual connection. Our relationship to plants is fundamental to our evolution, and that relationship was forged long before we came into existence.
Today, more than 80% of the world’s population still relies on herbal medicine as a primary form of care [1]. From this broader perspective, it’s modern industrial humans who are the exception — more dependent on lab-made, chemically isolated drugs rather than the living plant allies that shaped our biology for millions of years. Therefore, herbal medicine is not really an "alternative," but rather something deeply ancient and common throughout the world, and something that can be safely integrated into any healing and wellness strategy.
1. Ethnomedicinal Plant Use and Practice in Traditional Medicine, ed. by Akash Saklani, Navneet, and B. S. Bhandari (Hershey, Pennsylvania: IGI, Global, 2020)
Herbs Versus Drugs
Pharmaceuticals and herbal medicines differ profoundly in how they act in the body.
Drugs are synthetic or highly concentrated chemical compounds designed for specific, targeted effects. Each tablet or capsule is an exact molecular copy of the last — highly standardized to produce consistent pharmacological outcomes. Because of this precision and potency, pharmaceuticals must be carefully dosed. Too much can cause toxic overload, organ damage, or death. This is why medical doctors undergo extensive training and must be licensed to manage their use responsibly.
Herbal medicines, by contrast, are derived from intelligent, living systems. A tea, tincture, or powder made from a whole herb contains a complex array of hundreds — sometimes thousands — of compounds that work together synergistically. The proportions of these constituents vary depending on how and where the plant was grown, the season it was harvested, and even local stressors like drought or pests.
These biochemical variations are part of the plant’s adaptive intelligence — and part of why whole herbs act in a more balanced, modulating way in the human body. It's also why isolating and controlling their effects in clinical trials is more challenging than with pharmaceutical drugs, as each plant and preparation will differ based on a multitude of environmental conditions the plant was subjected to. Common plants also can’t be patented by any corporation, which is why funding and incentives for extensive studies are less available than with a novel chemical compound.
Yet an herbal preparation is also a byproduct of evolutionary variation. Many herbs are highly useful in combating ever-evolving pathogenic microbes (viral, parasitic, and bacterial), many of which have become resistant to pharmaceutical compounds. Since no two plants are exactly the same, the issue of resistance doesn't enter the picture in the same way.
Whole-plant medicines are not single-compound drugs. They tend to support the body’s natural regulatory systems rather than override them. While certain herbs do contain potent active constituents, most are remarkably safe when used appropriately. Adverse reactions and overdoses from common herbal preparations are exceedingly rare compared to those from pharmaceutical drugs, though there are precautions with certain herbs and types of preparations and products containing herbs.
To make a plant behave like a drug, chemists isolate and concentrate a single compound — removing it from its natural matrix of synergistic constituents. This is how many modern pharmaceuticals were developed, often inspired by rainforest or folk medicines. For instance, aspirin was derived from willow bark, morphine from the poppy, and digoxin from foxglove. Many current and emerging cancer treatment drugs have their origin in traditional healing plants. But once a plant compound is isolated and amplified, its safety profile changes dramatically.
So, claims that certain herbs are dangerous based on the adverse effects of an isolated compound are highly questionable, as the whole form of the plant works much differently in the body. For example, Comfrey (Symphytum officinale), an herb with a long history of traditional use, is often feared because isolated compounds from the plant, known as pyrrolizidine alkaloids (or PAs), are toxic to the liver. However, when used in its whole-plant form, the plant behaves very differently, as the toxic compounds are less concentrated. There is much debate surrounding comfrey over this very issue, though, based on my extensive experience using the herb for fifteen years, I think its dangers are highly exaggerated.
Additionally, Elderberry (Sambucus ssp.) and Pokeweed (Phytolacca americana) further illustrate this issue. Elderberries, for instance, naturally contain trace cyanogenic compounds that deter overconsumption by animals — but these break down easily with heat or drying, rendering the berries perfectly safe (and highly beneficial) for humans. See my article on Elderberry that goes deeply into this, and other issues related to the plant. Trace amounts of cyanogenic glycosides are present in many common foods, such as bitter almonds, flaxseeds, or cassava root. Pokeweed, though more potent, rarely causes serious harm even in poisoning cases; it simply must be used with care and in very small doses [2]. The berries, when accidentally eaten, especially by curious children, cause very unpleasant but rarely serious effects. I personally only use Pokeweed for a very narrow range of issues and never exceed one to a few single drops of tincture per dose.
Everyday pharmaceuticals pose significantly higher risks overall than commonly used herbal medicines. Acetaminophen (the active ingredient in Tylenol) is the leading cause of acute liver failure in the U.S., responsible for about 56,000 ER visits and 100,000 poison control calls annually—most due to accidental double-dosing from multiple medications containing the same ingredient [3]. A landmark meta-analysis published in 1998 estimated that adverse drug reactions in hospitals caused over 100,000 deaths per year at that time, not across several decades. No similarly comprehensive update has been conducted since, and newer data tends to be dispersed across different reporting systems. For example, in 2023, the CDC reported around 13,000 deaths from prescription opioid use (a number now fortunately in decline) and nearly 6,000 from antidepressants (though that number broadly includes the category “psychotropic medications")[4].
In comparison, less than 1% of poison control center calls in the U.S. involve dietary supplements or herbal products — and only a fraction of those are linked to actual medicinal herbs [5]. Nearly half of the reports in this category involve caffeine-containing energy or stimulant products rather than traditional herbal preparations. Most calls involving “plants” are due to accidental ingestion of houseplants or wild species, not the use of herbal medicine. The remaining cases typically concern questionable “natural” supplements marketed for weight loss, bodybuilding, or performance enhancement — not the kinds of herbs used in clinical herbalism.
While some studies have linked certain herbs to liver, kidney, or heart toxicity, nearly all of these concerns are based on isolated case reports—not controlled clinical trials or large-scale safety reviews [6]. In evidence-based medicine, case reports are among the lowest levels of evidence, and drawing broad conclusions from a few individual incidents, especially without confirmed causation, can be misleading.
Additionally, when critically examined, the conclusions drawn by researchers in such studies are highly questionable and often reflect a scientistic bias against herbs and natural remedies. Most adverse reactions to herbal products result from adulteration, mislabeling, and the addition of more dangerous ingredients rather than specific herbs themselves.
Many reported reactions to “herbal products” actually involve combination supplements, multivitamins, gummies, or formulas with multiple active ingredients. Without proper analysis, it's nearly impossible to attribute an adverse effect to a single herb. In contrast, toxicity from fat-soluble vitamins — particularly vitamin A — is well documented and more common than serious reactions to most properly prepared herbal supplements. Much of the fear surrounding herbal safety is based on weak evidence, isolated case reports, or products that were contaminated or mislabeled rather than issues with the herbs themselves.
Citations:
2. See: David D. Gummin, James B. Mowry, Michael C. Beuhler, Daniel A. Spyker, Laura J. Rivers, Ryan Feldman, Kaitlyn Brown, Nathaniel P.T. Pham, Alvin C. Bronstein & Carol DesLauriers (2023) 2022 Annual Report of the National Poison Data System® (NPDS) from America’s Poison Centers® : 40th Annual Report, Clinical Toxicology, 61:10, 717-939.
3. See the following:
Larrey Dominique and Pageaux Georges-Philippe (2005), “Drug-Induced Acute Liver Failure,”European Journal of Gastroenterology and Hepatology, 17 (2), 141–43.
Lee William M. (2007), “Acetaminophen Toxicity: Changing Perceptions on a Social/Medical Issue,”Hepatology, 46 (4), 966–70.
Catlin, Jesse R., Cornelia Pechmann, and Eric P. Brass, “Dangerous Double Dosing: How Naive Beliefs Can Contribute to Unintentional Overdose with Over-the-Counter Drugs,” Journal of Public Policy & Marketing, 34.2 (2015), 194–209
Schwartz, Erika MD, and Melissa Jo Pelter. Don’t Let Your Doctor Kill You: How to Beat Physician Arrogance, Corporate Greed and a Broken System (Post Hill Press, 2015), p. 143
4. Lazarou, J et al. “Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies.” JAMA vol. 279,15 (1998): 1200-5; See also: National Institute on Drug Abuse, “Drug Overdose Death Rates.”
5. Again, see: Gummin et. al, 2022 Annual Report of the National Poison Data System® (NPDS) from America’s Poison Centers® : 40th Annual Report; Note that an updated 2023 version is now available but consistent with the previous year.
5. See: Brown, Amy Christine. “An Overview of Herb and Dietary Supplement Efficacy, Safety and Government Regulations in the United States with Suggested Improvements. Part 1 of 5 Series.” Food and Chemical Toxicology, 107, no. Pt A (2017): 449–471.
Herb–Drug Interaction
While most common herbs are food-like in their safety and function, some do interact with medications and have specific precautions — primarily through their influence on liver enzymes or blood chemistry.
For example:
St. John's Wort (Hypericum perforatum) stimulates certain liver enzymes (notably CYP3A4), which can accelerate the metabolism of drugs — reducing their effectiveness. This includes antidepressants, birth control pills, and organ transplant medications.
Ginkgo biloba can mildly thin the blood and may increase bleeding risk during surgery.
Licorice root (Glycyrrhiza glabra), in large or chronic doses, can raise blood pressure or deplete potassium, which may conflict with diuretics or heart medications. Licorice root should always be taken synergistically with other herbs and never at high dosages for extended periods, as side effects can be severe, though not life-threatening or seriously harmful.
Chinese Skullcap (Scutellaria baicalensis) may affect liver enzymes as well, so caution is advised when combining it with multiple medications. We don't have enough data to be sure of its potential interactions, but it has a long history of traditional use in TCM (though for centuries before widespread pharmaceutical use).
Kava Kava root (Piper methysticum) can stress the liver if combined with alcohol or other hepatotoxic drugs. Only the root should be used. The leaf can be very hepatotoxic and result in liver failure (though herbal suppliers do not sell this).
Kratom (Mitragyna speciosa) interacts with opioid receptors in the brain. While traditionally used in small amounts for energy and pain relief, concentrated modern preparations—especially extracts and powders—pose significant risks. Kratom can cause dependence and withdrawal symptoms similar to opioids, and combining it with alcohol, sedatives, or prescription painkillers increases the risk of respiratory depression and liver toxicity. Chronic high-dose use may also affect blood pressure, digestion, and hormonal balance. For safety, Kratom should never be used in combination with other substances that depress the nervous system or burden the liver.
However, the vast majority of herbs — particularly nutritive tonics like dandelion, oatstraw, nettle, or hawthorn — function in the body much like foods. They nourish rather than override, and they can often be used alongside other treatments without issue. Still, because each body is unique, it’s wise to start with small amounts and observe how your body responds. When in doubt, consult a qualified herbalist or holistic practitioner familiar with both botanical and pharmaceutical interactions.
How to Use Herbs Safely
Choose whole-plant preparations: Teas, tinctures, and infusions made from the whole herb preserve the plant’s natural balance of compounds. These forms are the safest and the least taxing on the digestive and detoxification systems.
If allergies to known herbs or common foods are present, use extra caution when trying new herbs and especially avoid complex formulas.
Know your source: Grow your own herbs when possible — it’s the surest way to know their quality. Again, purchase from trusted suppliers or small herbal apothecaries that prioritize organic and ethically sourced materials. Choose organic products when possible.
Be cautious with encapsulated, powdered supplements, or other products: Powdered herbs, herbs in capsules, or added to various products are convenient but carry the highest risk of contamination or mislabeling, especially when purchased online. Avoid unknown brands or imported blends marketed for “energy,” “weight loss,” or “male enhancement,” which are often adulterated with synthetic drugs or stimulants. Read labels carefully and avoid using herbs mixed with other types of supplements (like multivitamins, drinks, or powdered formulas for athletic or fitness enhancement).
Start simple and slowly: It’s always best to use herbs as single preparations (with only one herb ingredient) rather than part of a complex blend or formula. That way, you can better assess potential reactions. If using formulas, ensure they’re prepared by competent, experienced herbalists or reputable companies.
Educate yourself: Before using any new herb, read about its properties, energetics, and known interactions. Herbs are powerful — understanding their nature is part of the medicine.
Work with experienced practitioners: A trained and experienced herbalist can help you navigate herbal safety, customize formulas, and identify possible contraindications for your body or current medications.
The Bigger Picture
When used properly, most common herbs are not only safe — they’re deeply supportive to the body’s innate intelligence. Herbal medicine bridges the gap between food and medicine, nourishing us at the level of cells, organs, and even on deeper spiritual levels.
Unlike synthetic drugs, which target isolated mechanisms, plants communicate with the body’s regulatory systems as a whole — reminding us that healing is ultimately not about control but relationship.
When used in their natural forms, and with respect for their complexity, herbal medicines are among the safest and most effective healing tools we have — not antiquated relics of the past, but vital allies for the modern world.
Herbal medicines should not be treated as equivalent to pharmaceutical drugs. While interactions can occur and responsible use is essential, the vast majority of herbs — when taken appropriately as teas, tinctures, infusions, or high-quality encapsulated preparations — work safely and synergistically alongside both conventional and alternative healthcare approaches.
Get Further Support
If you’re curious about using herbal medicine safely and effectively, I offer individualized herbal consultations through my holistic practice in Vista, California. My approach blends traditional herbal knowledge with modern insights in nutrition and integrative health, helping you find herbal preparations and lifestyle strategies that fit your unique needs.
Whether you’re managing chronic stress, supporting digestion, or enhancing immune balance, I can help you navigate herbal safety, dosing, and potential interactions with medications.
Learn more or schedule a session via Zoom or at my Vista-based herbal and bodywork clinic — where ancient plant wisdom meets modern wellness.
Further Resources
Here are some trusted suppliers of bulk herbs and herbal preparations I personally recommend:
NourishWholeness (Etsy shop)