Do pharmacy regulators “get” homeopathy?

Epic Facepalm

It’s on almost every pharmacy’s shelves. I’ve written at length about the problems with homeopathy in pharmacies. In fact, it was the subject of my very first post, over three years ago, where I described how homeopathy is an elaborate placebo system, with “remedies” that contain no active ingredients. Homeopathy was “invented” in the late 18th century, and is effectively a vitalistic belief system that rejects established facts about biochemistry, physics, and pharmacology. If homeopathy works, then real medicine as we know it cannot work. Over several posts, I’ve detailed the problems with the pharmacist provision of homeopathy:

  • The “principles” that underlie homeopathy have never been proven. There have been no scientific advances in homeopathy since it was invented. Attempts to explain how homeopathy works are either bizarre or laughable.
  • While the sale of homeopathy is permitted by Health Canada, the evidence standard for approval is effectively absent. Despite this, Health Canada grants individual approval numbers to indistinguishable sugar pill packages. It has led to products as ridiculous as homeopathic insect repellent.  Using fake products instead of real products have a real potential for harm.
  • Consumers generally have the expectation that products sold in pharmacies and sold as if they were medicine, actually have medicinal effects. That’s not the case with homeopathy. By allowing the sale in pharmacies, these products are given a veneer of legitimacy by virtue of their proximity to pharmacists.
  • From an ethical perspective, then, homeopathy serves as a disutility, wasting resources and redirecting patients away from valid treatments.
  • For placebos to work, patients must believe something that is untrue – that homeopathy has medicinal effects. From a patient autonomy perspective, patients have the right to make informed decisions about treatments. Withholding information from consumers is unethical and paternalistic.
  • Further to the points above, ethicist Dr. Chris MacDonald notes that pharmacists have an ethical obligation to not just be honest with customers about homeopathy, but to be candid about it. Just because consumers don’t ask, doesn’t make it ethically acceptable to sell homeopathy without disclosing information about its lack of effects.
  • In the United Kingdom in 2009, the parliamentary science and technology evaluated the evidence supporting the sale of homeopathy. In public hearings, pharmacy chain Boots admitted it sold homeopathy not because it worked, but because consumers wanted it. “However they sugar it, you’re swallowing a delusion” was the headline in the Times. Another was “Distrust me, I’m a pharmacist”. The awareness is rising is Canada, risking the reputation of the profession.
  • Some consumers and advocacy groups have had enough with this situation. In Canada, a class-action lawsuit has been launched against homeopathy manufacturer Boiron and Shoppers Drug Mart for selling the homeopathic product Oscillococcinum. The suit alleges that the firms have violated at least twelve consumer protection acts.

Homeopathy has no place in modern pharmacy practice, except perhaps as a case study in history, ethics or perhaps most appropriately, critical thinking. Despite the numerous problems that exist with the sale of these products, I’m unaware of any pharmacy regulator, worldwide, taking any voluntary action to limit or restrict their sale in pharmacies.

With all of this in mind, I was recently informed that I was required by my own pharmacy regulatory college to participate in the “Quality Assurance Program Practice Review”. As a registered pharmacist, I am required to maintain my professional competency to practice. It is my own responsibility to manage my professional development and life-long continuing education. My regulator has developed different tools to help pharmacists evaluate their own competency and to develop their own learning plans. It’s now a fairly elaborate process that must be completed every five years, and sections of analysis include standards of practice, communication, clinical knowledge, practice environment, and finally, an education action plan. In general, the assessment is fair – probing knowledge and understanding in a variety of areas, and helping pharmacists develop their own list for their personal development. Once you’ve completed the assessment, you’re required to document your learning plan for their review. Note one of the learning categories for pharmacists (click the image to enlarge):

Homeopathy? A category for learning? And “Herbals/Naturopathic Products”?  Naturopathy is a belief system with a similarly vitalistic, not scientific, philosophy. It is not a therapeutic category. And naturopathy is not a synonym for herbal. While naturopathy can include herbal products,the practice includes homeopathy.

If pharmacy regulators consider homeopathy to be a legitimate subject for professional development, then it’s probably unrealistic to expect pharmacy profession to ever address the ethical and professional issues I described above. Regulators have a responsibility to put the public interest first. Putting the public interest first should include committing the profession to meet science-based, professional standards.  And homeopathy is incompatible with a science-based practice standard.

Ironically, the Practice Review application shows me the learning goals I set back in 2008, and asks me to evaluated my progress against them. One of the objectives I set for myself, way back then?

How do I challenge the profession to stop the explicit and implicit support of non-evidence-based quackery such as homeopathy?

I’m marking that learning objective as “incomplete”. And I continue to wonder if the profession of pharmacy really “gets” the problems with homeopathy.

Pharmacists and other health professionals, what does your regulator think of homeopathy? Share your observations in the comments.

Photo from flickr user drtchock under a CC licence.

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18 thoughts on “Do pharmacy regulators “get” homeopathy?

  1. it is meaningless and biased arguments about natural remedies.
    your scientifically so called proven toxic chemical based medicines experimented on animals first , which cannot express its pain and agony it experiences during medication, just because of superficial action only on symptoms you fellows claim it as scientific. before releasing to market how many people doied , what negative reaction that had is never disclosed. just for the sake of commercial gains, real factors are hided.

    no doubt scientific advancemen5 in diagnosing is cery helpful, but medicines reactions are equally alaraming.

    you claim scentific, but incidence of diabetes and cancer cases are increasing day by day. why it so? why scientifically proven medicines cannot prevent it?

    Natural medicines do not need scientific evidence because it acts naturally, do not cause side-effects.

    only result is important and patient is certifier , not sceptic people.

    venkates cs

    Bangalore

    INDIA

    • Wow, Ok, one at a time…

      I’m going to be mentioning North America a lot, because that’s where I live, not because I think it’s better. I just don’t know how things are done in India at all.

      “so called proven toxic chemical based medicines experimented on animals first”

      Actually, in a petri dish first… Or in some cases, worked out on paper. We now understand diseases on a molecular level, and can diagnose, treat and in some cases cure them with this understanding. We move on to animal testing as a necessity, because (in general) we value animal life less than humans, that’s why we eat animals and not each other.

      “before releasing to market how many people doied , what negative reaction that had is never disclosed”

      If it’s never been disclosed, then how do you know it happened?

      There are plenty of cases where negative side effects are not hidden. In fact in the USA, every TV commercial selling prescription drugs lists every side effect, and references to independent studies are on the screen for all to see.

      “you claim scentific, but incidence of diabetes and cancer cases are increasing day by day. why it so?”

      Two things, population growth, and diet. In North America, there is a huge portion of the population that can only afford low-nutrition, high-calorie foods. As a result most people in North America are over weight. Obesity (or over weight) leads to a whole host of problems, mostly cancer and diabetes and cardiovascular issues.

      “Natural medicines do not need scientific evidence because it acts naturally, do not cause side-effects.”

      This is too vague. Aspirin is “natural”, it’s derived from the bark of a willow tree. Blowfish poison is also “natural” but will kill you if you ingest it. Crude oil is “natural”, and it’s byproducts are used in the production of almost everything… Actually, everything we use to diagnose and treat disease is “natural”, in that it’s made up of chemicals that have been tested and proven to work effectively to treat certain kinds of illness.

      A “Natural Medicine” that doesn’t require scientific evidence and is not chemical based is ‘Super-Natural Medicine’, and isn’t bound by the laws of logic that science based medicine follows. But there is a problem with this way of thinking:

      It means that anyone can make a claim about “natural medicine” and without testing it you have to accept that person’s word that it works. In North America, we call these people “Snake Oil Salesmen”.

      In the past there were people called ‘peddlers’ who went from town to town making all sorts of fantastic claims about the products they were selling, but when the townsfolk bought their products and they didn’t work, the peddler was long gone and didn’t have to answer to anyone for his con-job.

      Now-a-days, we ask people to prove it works, because a lot of us understand so much more about the natural world, and we’re able to spot a dishonest claim a lot sooner. That’s just a part of being “sceptical”. You can’t trust anyone who thrusts anything at you expecting you to buy it on face value. You need to investigate a little further to see if it’s right for you. The majority of people who take prescription medication in North America know the risks, because they’ve done their homework.

      • hi,

        so you yourself says prescription lists every side effects, that means it has side-effects all you agree. still you are left with no choice but to take such medicines. so one problem supressed, another problem crops-up. so u consider it as scientific.
        natural medicines like homoeopathy not used in crude form, it is potentized, only medicinal efficacy there which do not harm you any way. follow the law of nature then you will know it is curable or not
        venkatesh cs

      • There is no law in observable ‘nature’ that would allow homeopathy to work. It has no side effects, because it has no effect at all. (placebo effect notwithstanding) Often times, people get better on their own. But if you try to treat a serious but treatable disease like diabetes with homeopathy, it will get worse, and you will likely die.

        Natural medicines, like homeopathy may seem like they work because sometimes the best course of action is to let your body heal itself. Homeopathy just gives you something to do so you can put your mind at ease while you heal naturally. This would have the exact same outcome if you did nothing at all. So, how is that effective treatment? It seems like a waste of money to me.

      • A comment about the suffering of animals: Many homeopathic preps are made from animals. One such popular remedy is Poumon Histamin. This is made from the lungs of a guinea pig that has died from anaphylaxis. Did that animal not suffer horribly?

    • cs venkatesh

      Can you tell us what you believe ‘natural remedies’ are?

      If you believe that homeopathy falls into this category, can you explain what is natural about taking a plant/mineral/any other substance/non-substance, grinding it up in alcohol or ‘pure’ water, shaking it (or banging it against a bible), diluting some more, more banging, more diluting, yet more banging…

      If you believe it to be ‘natural’ because of the way it works ‘naturally’ with the body, please explain why all that diluting and banging are necessary.

  2. Let me get this straight, she thinks that the evidence is positive and consistent (which it certainly isn’t), is based on anecdote (no argument) and unfalsifiable.
    So, she doesn’t understand Science. That’s pretty evident.

    • I wonder if it’s not so much that she thinks they’re unfalsifiable as doesn’t know what “falsifiable” means. (Note: it does not mean “false”.)

  3. Scott, the regulator in my profession is the American Speech Language and Hearing Association and though they pay lip service to the principles of evidence-based practice, I think they often look the other way when members offer unproven treatments. As far as I know, there’s no one out there challenging them. I know they’re in a tough spot but in the end they’re just pandering to their members.

  4. I think that people who believe in a god (or goddess) are easily led down the alt med path. They have been primed for it. Since most of the world “believes” at one level or another, the task is enormous. Somehow, people need to realize that even if they choose to believe in an imaginary being, they don’t need to transfer that idea to science and medicine. Perhaps we will have to settle for trying to convince believers that their god(s) endowed scientists with the highest ability to understand the world–that they are our “prophets” and we should all strive to comprehend science (worship?).

    If we can fit rational thinking into the religious framework without directly challenging cherished beliefs, perhaps more people will learn more about science. I used to want everyone to become an atheist, but I’d settle for higher levels of critical thinking.

    • NATURE [ NATURAL] IS GOD , GOD IS NATURE. NATURE HAS REMEDIES FOR ANY DISEASE. NATURE IS MEDICINAL KIT. ONE NEED TO HAVE FAITH IN NATURE, BELIEF AND FOLLOWING IT AS PER LAW OF NATURE NOT AS PER MAN-MADE LAW ALWAYS. ONE NEED TO EXPERIENCE IT PERSONALLY, NOT JUST EXPERIMENT IT AND FORMING OPINION . THERE ARE MANY ASPECTS TO CONSIDER TO GET BENEFIT FROM NATURE. JUST EXPERIMENTING ON RATS, MONKEYS OR ON OTHER ANIMALS, AND FORMING OPINION THAT IT ACTS ON HUMAN ALSO MEANINGLESS AND MISLEADING.
      HOMEOPATHY FOUNDER HIMSELF WAS A SCIENTIST MEDICAL DOCTOR , HIGHLY QUALIFIED HIMSELF, HE WAS FRUSTRATED BECAUSE OF ALLOPATHIC MEDICINES SIDE EFFECTS AND ITS DAMAGING ACTION , HE RESORTED TO NATURE CURE THERAPY. HOMEOPATHY MEDICINES EXPERIMENTED ON HUMAN AND FINAL CONCLUSION TAKEN.
      WHEN NO SIDE EFFECTS, WHY DISPUTE?

      VENKATESH CS

      • What is your addiction to all caps? I’ve been debating (or trying to debate) with homeopaths for years and they all seem to use all-caps. Your appeal to the natural fallacy aside, you have presented no evidence to back up your claim. Please explain why, in over two centuries of testing, there is no robust evidence for any effect of homeopathy.

      • “HOMEOPATHY FOUNDER HIMSELF WAS A SCIENTIST MEDICAL DOCTOR , HIGHLY QUALIFIED HIMSELF,”

        Indeed. Problem is, a qualification from 1700s isn’t considered particularly current.

        Venkatesh, you are amusing.

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