Weekend Reading

An example of #badpharmacy

An example of #badpharmacy

The photo above is from a pharmacy in Toronto. Acid base nonsense? Check? Cancer quackery? Check. Endorsed by a pharmacist? Check. Send me your own pictures of ludicrous pseudoscience and quackery for sale in a pharmacy, and I may feature it in a future post.

Here’s today’s updates to engage, inspire and possibly infuriate you…

This is appalling: Homeopathy: Pharmacists dispense with professional guidance:

There are people who swear by homeopathic remedies, and everyone’s entitled to their opinion. However, if you ask your pharmacist whether a homeopathic remedy works you’d expect their response to be based on scientific evidence. This is the Royal Pharmaceutical Society’s (RPS) official advice: ‘The pharmacist should advise on the lack of evidence on the efficacy of homeopathic products… and provide advice relevant to the patient’s condition.’ However, in our snapshot investigation, 13 out of the 20 pharmacies our trained mystery shoppers visited failed to follow this guidance.

On a much more positive note, here’s some positive pharmacist action, from Professor Kelly Grindrod: How the threat of antibiotic apocalypse helped a pharmacist find her voice:

I also learned that, all those years ago, when the physician criticized me for questioning an antibiotic prescription, I should have been angry. Not humiliated. The prescription may have been appropriate but her criticism of me was not. As a student pharmacist and antibiotic steward, it was my responsibility to question every prescription. I should have walked away determined to improve my approach to physicians, not determined to look the other way. I have worked with enough caring and collegial physicians to recognize that now.

Pharmacists have the right and, yes, the invidious responsibility to question unnecessary antibiotic prescriptions. It is our job and our professional obligation. When I was still in pharmacy school, research by David Latif21,22 found that pharmacists who have worked in community practice for many years have lower moral reasoning than students or pharmacists new to practice. We fill prescriptions with no indication and sell medications with no proven benefit and the moral conflict shapes us as practitioners. My early experiences showed me the constant ethical struggles I would face and I looked for a way out.

Evening primrose oil is ineffective for eczema: a fascinating tale of mischief:

The very wide-spread notion that EPO is effective for eczema and a range of other conditions was originally promoted by the researcher turned entrepreneur, D F Horrobin, who claimed that several human diseases, including eczema, were due to a lack of fatty acid precursors and could thus be effectively treated with EPO. In the 1980s, Horrobin began to sell EPO supplements without having conclusively demonstrated their safety and efficacy; this led to confiscations and felony indictments in the US. As chief executive of Scotia Pharmaceuticals, Horrobin obtained licences for several EPO-preparations which later were withdrawn for lack of efficacy. Charges of mismanagement and fraud led to Horrobin being ousted as CEO by the board of the company. Later, Horrobin published a positive meta-analysis of EPO for eczema where he excluded the negative results of the largest published trial, but included results of 7 of his own unpublished studies. When scientists asked to examine the data, Horrobin’s legal team convinced the journal to refuse the request.

It’s time to stop giving acupuncture a pass. Acupuncture is a theatrical placebo: the end of a myth:

Although it is commonly claimed that acupuncture has been around for thousands of years, it hasn’t always been popular even in China.  For almost 1000 years it was in decline and in 1822 Emperor Dao Guang issued an imperial edict stating that acupuncture and moxibustion should be banned forever from the Imperial Medical Academy. Acupuncture continued as a minor fringe activity in the 1950s.  After the Chinese Civil War, the Chinese Communist Party ridiculed traditional Chinese medicine, including acupuncture, as superstitious.  Chairman Mao Zedong later revived traditional Chinese Medicine as part of the Great Proletarian Cultural Revolution of 1966 (Atwood, 2009).  The revival was a convenient response to the dearth of medically-trained people in post-war China, and a useful way to increase Chinese nationalism.  It is said that Chairman Mao himself preferred Western medicine. His personal physician quotes him as saying “Even though I believe we should promote Chinese medicine, I personally do not believe in it. I don’t take Chinese medicine”

This is absolutely fascinating: The German Granddaddy of Crystal Meth, with links back to Nazi Germany. And this idea of drug-induced super soldiers continues today: There’s a military arms race to build soldiers who fight without fatigue.

This is a good read on the pharmaceutical industry, debunking a widely-perpetuated myth: Another Look At Marketing Vs. R&D In Pharma:

So let me take a stronger line: Big Pharma does not spend more on marketing than it does on R&D. This is a canard; it’s not supported by the data. And let me reiterate a point that’s been made here several times: no matter what the amount spent on marketing, it’s supposed to bring in more money than is spent. That’s the whole point of marketing. Even if the marketing budget was the same as the R&D, even if it were more, it still wouldn’t get rid of that point: the money that’s being spent in the labs is money that came in because of marketing. Companies aren’t just hosing away billions of dollars on marketing because they enjoy it; they’re doing it to bring in a profit (you know, that more-money-than-you-spend thing), and if some marketing strategy doesn’t look like it’s performing, it gets ditched.

Food, Diet, Science, and GMOs:

When asked what she would tell people who wished to pursue a true paleolithic diet, Dr. Hoyes laughed harshly before replying. ”You really want to be paleo? Then don’t buy anything from a store. Gather and kill what you need to eat. Wild grasses and tubers, acorns, gophers, crickets- They all provide a lot of nutrition. You’ll spend a lot of energy gathering the stuff, of course, and you’re going to be hungry, but that’ll help you maintain that lean physique you’re after. And hunting down the neighbor’s cats for dinner because you’ve already eaten your way through the local squirrel population will probably give you all the exercise you’ll ever need.”

Why Rational People Buy Into Conspiracy Theories

Dr. Oz’s not-so-sweet artificial sweetener recommendations

So much for “Never Harmed Anyone”: Supplements and herbal meds result in calls to poison control centers

I’ve had questions about this product, and this helps with the risk assessment: E-cigarettes – the unanswered questions.

Causes of death in the 20th Century, Visualized.

Dr. Paul Offit argues it’s time to end religious exemptions from vaccines. And from Respectful Insolence, The legacy of Andrew Wakefield continues.

Blood Purity: How a Bizarre Obsession Advanced Science. This belief continues to manifest today in quack “blood type diets” you see promoted.

Coconut Oil: Health or Hype? You get one guess. And another take, from Harriet Hall.

Australian Government Cracks Down on Bogus Claims for “Black Salve”

Anti-scientific beliefs are just as prevalent on the left as they are on the right: Progressive Mythology.

Other must-reads

My Wife Looks Nervous: A Drunk Driver Killed My Family

Fascinating and infuriating: Senseless: Bicycle helmets do an outstanding job of keeping our skulls intact in a major crash. But they do almost nothing to prevent concussions and other significant brain injuries.

Cocaine Incorporated. Unbelievable story of the Mexican cocaine trade.

These 31 charts will destroy your faith in humanity. Actually, no, not really.

Continuing Education!

Stanford School of Medicine is offering a free “Statistics in Medicine” course, starting June 11. I’m registered.