Homeopathy: Witchcraft Is Not An Alternative
    By Enrico Uva | October 25th 2011 02:45 PM | 3 comments | Print | E-mail | Track Comments
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    I majored in chemistry, worked briefly in the food industry and at Fisheries and Oceans. I then obtained a degree in education. Since then I have...

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    Most people outside of Quebec have probably never heard of Jean-René Dufort, a biochemistry graduate, science journalist and host of an hilarious political satire on Radio Canada. In 2004 in Belgium, after it had been announced that homeopathy would be covered by misinformed insurance companies, medical professors, a TV producer, a publicist, and ordinary citizens swallowed large quantities of over-the-counter homeopathic solutions based on lethal substances such as snake poison and deadly nightshade. 

    Since homeopathic cures consist of highly diluted extracts, no one was harmed in the event that was publicized as a mass suicide. Years before, for an article in a Quebec consumer magazine (Protegez-Vous or "protect yourself") , Dufort had also ingested several bottles of homeopathic medicine in an "attempted suicide" to expose homeopathic medicines.

    In between these well-publicized events there have been rigorous investigations with the following conclusion:

    Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.
    And yet homeopathic medicines are still found on pharmacy shelves and on the internet. Here's a gem of an online advertisement from an online homeopath and supposed nutritionist:
    For example, if you have a child that is gentle and quite clingy but generally sweet natured, he or she might be given a few doses of Pulsatilla. Alternatively, if your child is somewhat fearful and quiet, has a taste for indigestible things (paper, chalk etc.) , then it may be that Calc carb would be given.
    Just a few years ago, according to National Health Statistics Reports, Americans spent $2.9 billion on homeopathic medicines alone, which does not include the cost of homeopathic advice or direct contact with the witchdoctor.. Even in reporting the statistics, homeopathy is included under the label of "alternative". But what is clearly the equivalent of placebo medicine should be branded as such. Otherwise the existing term can act as soliciting.

    If the infinite dilution concept is effective therapeutically and if water has a memory for medicine, then why can't it have a recollection for vitamins, carbohydrates, essential minerals, and essential fatty and amino acids ? The nutritional equivalent of homeopathy hasn't been marketed yet because you can make money off the placebo effect far longer than you can profit off starvation.

    Here's Dufour on homeopathy after Health Canada announced its flaky stance on the issue in 2006. It's in French, however, in case you are not one of the world's quarter of a billion people who understand the language!

    In this funnier video (unrelated to homeopathy), Dufort pokes fun at misuse of statistics in a Montreal tabloid.



    Placebos are very useful, but require the belief in a positive effect of the medication. If a placebo would be branded as such, this effect would be gone. As long the use of placebos is restricted and advertised as additive or to cure insubstantial illnesses, they should proof both, an economical and medical sound treatment, very much preferable to classical (miss) treatments of such cases. I am almost sure, based on my understanding of economical and patient physician relations, that such cases are more then 50% of all uses of medication. Obviously their limits must be observed. Homeopathic medications are ideal placebos. And all studies seem to prove this when saying only as effective as placebos. I have heard about classic medication that not even reached that point in studies (don't ask me for a quote, somebody else here probably knows).

    Placebos are very useful, but require the belief in a positive effect of the medication. If a placebo would be branded as such, this effect would be gone.
    True, but if someone is uninformed enough to buy homeopathic medicine , there's a good chance they wouldn't bother to look up the meaning of "placebo" on the label. For instance, few people look up the ingredients of foods or cosmetics even though there's a good wikipedia entry for the majority of the common ones. Most legitimate medication on the market is far more effective than placebos. Because side effects have been sometimes under-reported in some studies, some people swing to the extreme of losing all faith in pharmaceutical companies and fall prey to quacks.
    Quite a lot of people use homeopathics here in Germany, especially a lot of highly educated people do so, not necessarily hard core scientists though. They do distrust classical pharmacy and do have good cause. Almost all of them will still rely on classical medicine in case of any serious illnesses.

    I would say most in people in Germany will understand the term placebo and very view physician will dare to prescribe a declared placebo, even if they belief, that no pharmaceutical treatment is required. As patients might, even if they don't know the term, be told by somebody else and would feel cheated and never see the physician again.

    The way to apply a placebo with any effect is by not telling the patient, what it is, otherwise the effect would be lost. And the effect can not be negligible or there wouldn't be double blind studies against a placebo.

    Many patients expect or will even demand prescriptions from their physician, when consulting him. As a result physicians prescribe unnecessary pharmaceutics and other treatments, leading to high costs for the health system and maybe even negative health effects. Probably physicians already use some kind of undeclared placebos in such cases, by using mild ineffective pharmaceutics, which they deem save.

    All rigorous studies and meta studies seem to come to the same conclusion, that homeopathics are in effect equal to placebos, this seem to be a well proven fact. The problem lies in the socio-political interpretation of this fact, which is not so clear. A broad long term study of pharmaceutics vs. homeopathics in applied medical use of not serious illnesses would be really interesting.

    Having >>faith<< in the pharmaceutical industry to do good, is misguided in my opinion, companies never look for the common good, but for their profits. Pharma will always overstate effectiveness and understate risks in their advertisements as that is in their best interest.

    You say "Most legitimate medication on the market is far more effective than placebos. " -- I am convinced you are right.
    But even where pharmaceutics are proven to be far better than a placebo, the studies only give a statistical averaged over the group of participants. Some patients might not benefit at all although the result is good on average. I am also sure pharmaceutics are not always correctly applied. So the benefits of pharmaceutics are not always clear. For serious illnesses I belief, they are state of the art nevertheless, and I would never recommend >>replacing<< powerfull pharmaceutics by any kind of placebo.

    Using them in addition to pharmaceutics will not hurt patients though, using them in situations, where other treatments have totally failed wont hurt either, nor when effective medication is not within financial reach like in 3. world countries. In these cases the placebo effect will still have a positive effect. Where to draw the line is a question of policy.

    But using placebos as a replacement of miss applied pharmaceutics for not serious illnesses can only be good thing. From a scientific standpoint, I see no need to fight alternative medicine. Most scientists will rightly disapprove the stated justification of the remedies, but why shouldn't they consider them as placebos.

    Is this a dilemma?

    As a rule products are free to state >>true<< positive effects and >>must<< state all negative effects and risks. As placebo have by definition no negative effects and all studies say they have positive effects, nobody is hurt if they are not classified as placebo, except for the pharmaceutical industry. There is no cause to state negative effects, while some positive effects can be truthfully advertised. An required disclaimer to not use the remedy for serious illnesses and to see a physician instead probably wont hurt, and should equally be used for freely traded pharmaceutics.

    Forbidding to advertise unproven effects of any product or treatment is something, that can be regulated by law and probably is already, making people and companies liable for resulting damages of falsely advertised effects of treatments will probably be effective concerning greedy quacks. A state regulated Alternative Medicine Sector, as we in Germany have, seems a good idea to me and is approved and supported to some extend by private and public health insurance companies as well as by a minority of physicians. This will prevent dangerous quackery more effectively than fighting all uses of alternative medicine.

    Would scientists betray/cheat/hurt people or the healt system, if they don't press the label placebo on alternative medicine?

    I don't think so.