Is homeopathy good for society?

November 21, 2006 4:42 AM

Is homeopathy good for society? How should it be regulated? Are there any good studies to this effect?

Possible pros: placebo, reduction of burden on healthcare system, economic benefits of the industry.

Possible cons: rejection of conventional medicine and science, exacerbation of untreated medical problems, scope for "fraud", reduction of money spent on conventional medicine.

How do these things balance out in real life? What are your experiences?

posted by Arcaz Ino to health (24 comments total)

Also, my natural instinct is that the general public be educated against homeopathy. Is this a bad idea that will undermine the benefits of placebo?
posted by Arcaz Ino at 4:46 AM on November 21, 2006

Strenuous regulation of health claims should be a necessary part of oversight.
posted by biffa at 4:50 AM on November 21, 2006

How do these things balance out in real life?
People who might not of died, die.

What are your experiences?
People close to me who might not of died, die.

Is homeopathy good for society?
No.
posted by public at 5:02 AM on November 21, 2006

Many members of my family are homeopaths, doctors and, sometimes, homeopathIC doctors. So I've kind of grown up around it. Personally I'm ambivalent about it, leaning towards the sceptical. It's never worked for me and, scientifically, I don't understand how it would. But I do admire their wish to help people.

Please correct me if I'm wrong, but are you starting from the assumption that homeopathy is an alternative to conventional treatment?

Because the two rules that all the homeopaths I know (or maybe they're just particularly scrupulous ones) swear by are:

1) Homeopathy is a complementary medicine - no homeopath should ask you to stop taking whatever the doctor has prescribed. Any that do are quacks and you must report them immediately!

2) Your doctor should be fully aware of any complementary therapies you are undergoing and should, preferably, be in direct contact with your homeopath.

As for studies, have a look at the Cochrane Library.
posted by unmusic at 5:32 AM on November 21, 2006

As a general principle, it ought to be illegal to make some kinds of health claims that can't be backed up. Even if the maker of the claims believes them.

When you set yourself up in a fiduciary relationship, however undeserved, you are held to a higher standard. You can commit fraud without meaning to, based not on what you know, but on what you should know.

I wish someone like public who has suffered real harm would sue a few alternative medicine quacks into the ground.
posted by yesno at 5:39 AM on November 21, 2006 [2 favorites]

It's worth checking out the archives of the Skeptic's Guide podcasts for discussions on homeopathy (and other hocum).
posted by the cuban at 6:00 AM on November 21, 2006 [1 favorite]

There is a debate on this subject in the UK right now (and I assume that is what prompted this question). Sense About Science has a campaign on alternative medicine which is opposing the new regulations, which allow homeopathic "remedies" to make health claims with a lower burden of proof than other medical products. They have lots of good, easy-to-understand information on their site.

I think a big problem is the use of exceptions for homeopathy to excuse any sort of medical product from the normal level of scrutiny. Take, for example, Zicam. It is marketed as a "homeopathic remedy" and therefore escapes the FDA drug approval process. But it cannot be described as homeopathic as the term has traditionally been used. In 2003 users sued for damaging side-effects.
posted by grouse at 6:05 AM on November 21, 2006

Possible pros: placebo, reduction of burden on healthcare system, economic benefits of the industry.

These aren't pros.

"Placebo" means that people who need effective medical treatments instead receive distilled water, or pills purely of starch.

This is ineffective, so any reduced burden on the healthcare system is only because people who need treatment are not receiving it.

And the economic benefits are pure misallocation of resources towards people and an industry that effectively provide no good whatsoever.

Like other quackery, it is purely harmful. It should be required to demonstrate replicable results or regulated out of existence, at least at the commercial level.
posted by ROU_Xenophobe at 6:38 AM on November 21, 2006 [2 favorites]

Is homeopathy good for society?
No.

How should it be regulated?
Medical fraud laws should be enforced.

How do these things balance out in real life?
They don't balance out:

• Sick, desperate people in vulnerable positions have their life savings stolen by medical fraud profiteers.


• Intellectually lazy (and ethically bankrupt) doctors take advantage of their special relationship with patients and their respected position in society to make a profit selling snake oil.


• Society suffers because diseases that could have been cured using modern medicine are allowed to run their course adding unnecessary burden to our already overburdened healthcare infrastructure.


• Mankind in general regresses several centuries in terms of scientific thought and medical advances.

Suggestions:

• A doctor who takes money for a treatment that has no basis in peer-reviewed, evidence-based medicine should have his/her license revoked for life and practice sued out of existence.


• If a doctor wants to experiment in untested or unproven treatments, he should take no money from patients* or, preferably, pay them to be his/her guinea pigs.

* Beta software is distributed for free. Why should beta medicine be any different?
posted by cup at 6:39 AM on November 21, 2006 [1 favorite]

My experience with homeopaths comforms with unmusic's comment. My family doctor was a homeopath, and also an MD. She was a wonderful doctor, and I always felt in good hands. She tried to avoid antibiotics whenever possible, but resorted to them when she deemed it necessary. She conducted extensive examinations - it was common to spend over an hour with her during an annual physical - and consquently knew her patients intimately. She also ordered way lab work than any doctor I've seen since, and went out of her way to make a thoughtful diagnosis. From what I understand, that sort of care is not unusual among homeopaths, and I consider it a very good thing. Consequently, I think a true homeopath/MD combo can result in excellent care.

Since Americans take too many antibiotics - and often misuse them or take them when they are unnecessary - I think it's a good thing to focus on alternatives to antibiotics, whenever that makes sense. My doctor was also vigilant about us taking acidophilus after taking antibiotics, which no other doctor has since even suggested to me.

As for the efficacy of homeopathic remedies - I can't imagine how they would work, but I really wouldn't know one way or the other. I took many "remedies" - bottles of sugar tablets soaked in the particular remedy - over the years growing up, and I never noticed that they were working.

I think there's a great misconception in the US about what homeopathy really is. If you're referring in general to herbal medicines, then you're mis-using the term. I can't tell from the OP's post whether the term is being used correctly. I was always skeptical, and I took the remedies more as a first option, in fairly minor situations, and then if that wasn't working we would try something else. There is also the concept of the constitutional remedy - a remedy you take regularly in order to improve your health holistically and strengthen your immune system. I have no idea of those worked or not - hard to tell. I doubt they work, but I can't say I'm positive they don't.

As for placebo - I do believe that sometimes people over-medicate, and if they can take a sugar tablet and feel better, and there isn't an underlying condicine that needs treatment, than I think the placebo affect is ok.

It is interesting how many people in Europe use homeopathic treatments.

Also, while I highly doubt the sugar tablets work, there are products like Calendula cream (for cuts), Arnica lotion (for bruises, sore muscles), combuduron (for insect bites), and eucalyptus chest rub (like Vicks) - especially when prepared by Weleda - that in my experience really do work. I'm suspicious of the chemicals in some of the more maintstream equivalents, and so I'm happy to use these products, since I find them to be quite effective. Whether they're really "homeopathic" in the traditional sense, I don't know. I do know that my homepath/MD did recommend these products, unlike the recent "homeopathic" fad, echinacea.
posted by Amizu at 7:40 AM on November 21, 2006

In response to Amizu, I'd point out that:
a) if doctors don't spend enough time with patients then that's an argument to fix things so that they do, not an argument to introduce homeopathy
b) those products aren't homeopathic. Homeopathic treatments are all dilute, and are supposed to be based on substances that when not dilute induce similar symptoms. A cream like that chest rub which is several percent essential oils amongst other things is not in the slightest bit homeopathic and it's entirely reasonable that they might actually do something.

In short, if a homeopath gets a few things right that does not mean that homeopathy is effective or in any way a good thing.
posted by edd at 9:09 AM on November 21, 2006

Okay, so here's my short(er) answer:

Actual clearly defined homeopathic remedies, so long as they are in addition to, NOT instead of conventional treatment - they can't harm you, only your pocket. I'm not convinced of their effectiveness though.

Pseudo-homeopathic "herbal" alternative therapies that persuade you to buy dodgy "herbal compounds" from Nicaragua over the internet, or go to a "clinic" in Mexico and part with $severalK and stop taking your conventional treatment - BAD BAD BAD BAD BAD BAD BAD BAD stay away.
posted by unmusic at 10:27 AM on November 21, 2006

HOMOEOPATHIST, n.
The humorist of the medical profession.
HOMOEOPATHY, n.
A school of medicine midway between Allopathy and Christian Science. To the last both the others are distinctly inferior, for Christian Science will cure imaginary diseases, and they can not.
(from the Devil's dictionary)
posted by hortense at 10:35 AM on November 21, 2006

unmusic, homeopathy is certainly less harmful as a complementary medicine than as a replacement, but many people do see homeopathy as an alternative, and in some cases feel able to treat themselves by reading the packaging and promotional material, rather than see a doctor. If false efficacy claims are made, that may be a bad thing.

grouse, Zicam is very interesting. If they can get away with calling their medicine homeopathic, then it would seem anyone can. (Interesting to note that they settled the side-effects issue out of court.)

Amizu, I am referring to genuine homeopathy rather than herbal medicine, which I am sure is often effective.

Thank you for your answers.
posted by Arcaz Ino at 11:29 AM on November 21, 2006

Here's a short history of medicine:

Long ago, lots of different people practiced medical care according to their spiritual and social traditions. Then, coinciding with the industrial revolution and the move towards urban living, a group of upper class men began professionalizing and standardizing certain medical practices. They set up a system that intentionally shut out women, poor people, and people of color. This standardized system eliminated many forms of medical practice that were popular at the time. However, these new 'doctors' were not necissarily more compitent or safe than their competetors/adversaries who practiced other forms of medicine. There were major problems related to a lack of understanding of germ theory and overenthusiastic use of surgical instruments that led to quite a lot of deaths. (For example, childbed fever was unheard of when midwives administered to women during births but when births moved into hospitals, and doctors started going straight from working in the morgues to delivering babies, without washing their hands in between, suddenly lots of women started to die).

Anyway, at the time when this one particular branch of medicine that has evolved into the type of medicine now practiced by most MDs was being pushed into prominence - there were other - competing types of medicine that were also being promoted. These branches were not 'traditional' medicine in the sense that midwifery and herbal medicine are - they were theoretical forms of practice, performed by rich white guys trying to professionalize their fields, that were simply competing with the surgery based model that has mostly prevailed today. These branches of practice include Osteopathy and Homeopathy. Homeopathy was very respected at it's first peak, and in fact, one of our countries prominent teaching hospitals is named for homeopathy's founder.

The homeopathists and Osteopaths fought pitched legislative battles in order to maintain their legally protected status, and actually won. Their are laws for example that allow homeopathic medicines carry labels that specifically describe what they are ment to treat. Herbal remedies by contrast can not say, for example "Use this Valarian to sleep at night". Marketers tend to use language like "to enhance relaxation". And even that vague kind of language has been challenged by the FDA.

As for Homeopathy's efficacy: there have been a number of studies on the subject. A medline search reveals that in most cases, it may have some effect. Nothing stellar though. This pro-homeopathy site details some positive studies. They claim that the studies that have been done aren't great because they don't use appropriate dosing. This is a valid critique - basically, there hasn't been adequite testing to know for sure. That's because most large medical studies are funded by drug companies. THese drug companies have no money to make off of homeopathic remedies - so why study it? The governement is not out funding many studies on 'alternative' treatments just for the public good.

For more on the history of medicine, here's a great early Barbara Ehrenreich pamphlet on the subject. Scan down about half way to the section called Women and the Rise of the American Medical Profession for more on the period when homeopathy and 'mainstream' (now) medicine were professionalizing here.

This page has a more specific history of homeopathy that discusses the issue of market competition in relation to types of medical practice.

So, in answer to your question:

No one knows for sure, but homeopathy is probably not outstandingly effective for many conditions. It probably is helpful for somethings, and that isn't accounted for solely by the placebo effect (which, overall, is about 30% - so we shouldn't blow off the importance of that!).

Also, the marginalization of homeopathy has as much or more to do with capitalism than with efficacy.
posted by serazin at 12:13 PM on November 21, 2006

Have a read of this account of a homeopathic suicide.

Why exactly should my money - whether collected privately or by government - be spent on unproven bunk like homeopathy?
posted by tommorris at 12:25 PM on November 21, 2006

That's because most large medical studies are funded by drug companies. THese drug companies have no money to make off of homeopathic remedies - so why study it?

This doesn't make any sense at all. There's nothing stopping the drug companies from entering the homeopathy business. If they felt that water-with-2-molecules-of-strychnine-in-it had any potential as an actual medicine, I'm sure they'd be happy to pay for studies.
posted by equalpants at 12:46 PM on November 21, 2006

Two issues are at play:

1) as I aknowledged, homeopathy is probably not remarkably effective for treating most disorders. The research that is currently available is mixed, but doesn't seem to indicate that homeopathy is the best treatment in most cases. Drug company execs know this, and this would impact their interest in researching these treatments.

2) But, even if homeopathy were 100% effective, drug companies would not be motivated to produce these medicines because there is very little money to be made off of them.

There are plenty of diseases out there that could be treated, but no one is working on figuring out how. Drug companies can make much more money off of Rogain or Lexapro than they can finding treatments for diarrheal disease, the second biggest killer of children in the world, so they refuse to research new meds for diarrheal disease. This is a well known problem.

Homeopathics, which are inexpensive and available over the counter and only appeal to a small niche market (and possibly can't be patented at this point? I don't know the details here) aren't a good market, so drug companies have no motivation to research them.

As for whether government money should be used on 'unproven bunk like homeopathy', well, in this case you might be right, but there is no reason to research anything this is proven. The point of research to prove or disprove whether something works.
posted by serazin at 1:51 PM on November 21, 2006

Sorry, I meant:

there is no reason to research anything THAT HAS ALREADY BEEN PROVEN.
posted by serazin at 2:06 PM on November 21, 2006

Sorry serazin, your link to "a medline search" does not include any search terms so we can't know what you are talking about when you claim that "in most cases, it may have some effect." You might as well link to www.google.com. In any case, the claim is wrong. There have been hundreds of studies on homeopathy so don't argue that it hasn't been tested due to drug companies and a conspiracy of the medical establishment. A 2002 peer-reviewed meta-review of other systematic reviews stated:

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.

The governement is not out funding many studies on 'alternative' treatments just for the public good.

The federal government provided $122,692,000 in funding this year for the National Center for Complementary and Alternative Medicine yet still can't find conclusive evidence for homeopathy's efficacy.

No one knows for sure, but homeopathy is probably not outstandingly effective for many conditions. It probably is helpful for somethings, and that isn't accounted for solely by the placebo effect (which, overall, is about 30% - so we shouldn't blow off the importance of that!).

Here's what we do know for sure. We know that we cannot conclude from the existing clinical evidence that homeopathy works. We know that there are many other treatments that are more promising and have been less studied. We know that there is no understandable physical basis for homeopathy to work.

While placebo effects are real, saying that the placebo effect "overall, is about 30%" is too meaningless to be a scientific statement.

With regard to capitalism, I think it is responsible for the continued existence of homeopathy—there are too many people who think they can still make money off of selling or prescribing snake oil and so they continue to push for its acceptance.
posted by grouse at 2:25 PM on November 21, 2006

Sorry about the MedLine link. The search value I had put in was just the word 'homeopathy'. Within the first couple links I found This article pointing to a significant effect from homeopathic treatment. I didn't read all of the links - obviously.

Federal spending on alternative medicine is miniscule compared to on on conventional medicine. I don't think anyone could reasonably claim differently. I wasn't able to find anything on that alternative medicine research site about how much was spent on homeopathic research, but I'll take your word for it. My point is, there is not a lot of high quality research on homeopathy - and that's why an organization like the one you link to was established. I bet you five bucks if you write to the authors of the peer reviewed review you link above, they will agree that there are not a lot of quality studies out there on this topic.

I'm not sure why we're arguing really. I don't think there is some vast conspiracy out there against homeopathy, although there was a historical one. I agree with you - there is not sufficient clinical evidence that homeopathy is the most promising treatment out there. I said as much in my original comment. I simply said that there haven't been enough good studies to say for sure, and gave some historical context about homeopathy.
posted by serazin at 3:10 PM on November 21, 2006

Here is what I think the disagreement is.

You say that "there is not sufficient clinical evidence that homeopathy is the most promising treatment" and that that there haven't been enough good studies to say for sure.

I say that there is insufficient clinical evidence that homeopathy is a useful treatment. There is insufficient physical evidence that the "remedies" are different from the diluents used, and indeed physical evidence that they are not. When there is such a lack of evidence even after testing (acknowledging that some of the testing has been poor), normally I think reasonable scientists would focus their efforts on something more promising rather than saying that it hasn't been proven either way.

I'm not sure how the story about how modern medicine started answers the question.
posted by grouse at 3:43 PM on November 21, 2006 [1 favorite]

One study isn't a lot. If there've been hundreds of studies you expect one, by chance, to get a significance at 1%.

grouse is quite right in my opinion. If you do studies and fail to find clearcut evidence then you have to start wondering how homeopaths claim they know it works when they've not been conducting things as a properly controlled study. Indeed, if homeopathy had been sufficiently bold to come out and lay down exactly what it could treat with what effectiveness I'd bet it'd have been thoroughly disproven.

I'd like to see this false dichotomy between alternative/complementary medicine and non-alternative medicine gone. As I think John Diamond said, there is only medicine that's been tested and works, and that which hasn't.

Returning to the original question, can you really claim it is good for society to invest even more money trying to show it works when it's repeatedly failed to demonstrate any effect? As grouse has stated, the US has managed to chuck $123 million down the drain on this. Not good for society.
posted by edd at 4:40 PM on November 21, 2006

To clarify, the $123 million is for research on all sorts of alternative medicine. But it is just for this year; more would have been spent in previous years, and more will be spent still.
posted by grouse at 4:59 PM on November 21, 2006