The problem with “Integrative” Pharmacy

 

pharmacy window

Imagine a retail pharmacy where some of the medicines on the shelves have been replaced with similar-looking packages that contain no active ingredients at all. There is no easy way to distinguish between the real and the fake.

Another section of the store offers a number of remedies with fantastic claims, such as “boosting” the immune system, “detoxifying” the body, or “cleansing” you of microscopic Candida. They look sciencey, unless you realize that they treat imaginary medical conditions.

A corner of the store offers unpurified drugs supplied as tinctures and teas. The active ingredients aren’t known, and the batch-to-batch consistency of the product is unclear. The store will suggest products for you based on your symptoms.

Walk past the enormous wall of vitamins and other supplements and you’ll find a nutritionist who will tell you what products you should be taking. You’ll also find a weight loss section. From a science-based perspective, this shouldn’t even exist, given no product has been shown to offer any meaningful benefit. But there are dozens of products for sale.

At the back of the store you’ll finally find the pharmacist. A sign on the counter offers blood- and saliva-based tests for food “intolerance” and adrenal “fatigue”, claiming to test for medical conditions that actually don’t exist or lack an evidence base. The pharmacy also offers a large compounding practice, advertising what it calls “personalized” approaches to hormone replacement with “bioidentical” hormones.

Welcome to the “integrative” pharmacy.

You may not see all of this in your local pharmacy, but they’re coming: claims of a new “integrative” way to provide health care that is changing the face of retail pharmacy. Unfortunately, it’s harkening back to the era of patent medicines and snake oil. It’s not good for the pharmacists and the profession of pharmacy, and it’s even worse for the patients we serve. Continue reading

Does Target sell the most irresponsible homeopathic remedy ever?

I can’t think of anything more appalling than selling water to someone and telling them it will treat their asthma. This pic via Ryan Melyon on Twitter, was taken at a Target pharmacy in Chicago:

Fake asthma remedy

I’ve said it before but it’s worth repeating: Homeopathy is an elaborate placebo system where the “remedies” are inert. It’s reckless endangerment of life to sell a product for treating the acute symptoms of asthma when there is no medication in the bottle, even if there is a caution on the front of the box. And it should be obvious, but placebo has no meaningful effects in the treatment of asthma.  The sale of homeopathy in pharmacies is not only misleading to consumers, it is fundamentally unethical behavior from a health professional. Target and its pharmacists have a ethical and moral responsibility to pull this product off the shelf immediately.

January 16: Here’s an update on Target’s fake asthma “remedy”. And a petition has been started asking Target to stop selling this product.

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… Continue reading

The Ethical Implications of Rexall’s Dubious Homeopathic Offerings

Main ingredient in homeopathy

From ethicist Dr. Chris MacDonald, a column on Rexall’s recent advertisements promoting homeopathy:

The problem, of course, is there’s no reliable evidence that homeopathy works, nor any plausible reason to think that it even could work. In commercial contexts, that’s pretty bad. And it’s worse still when the company selling the stuff is a company people rely on for competent health advice, and when that company leverages the credibility of a licensed health profession to promote bogus wares.

And importantly:

The commercial world is full of scams, and all too often people with something to sell have unwarranted faith in their products. Greed and ignorance are nothing new, but that doesn’t mean they are excusable. Companies that claim not just to provide a product, but to educate and take care of consumers, ought to do better. They should do their best to sell only those products that they, and their customers, are justified in believing in.

More here.

I’ve written about the ethics of selling homeopathy before.  As XKCD said about pharmacies selling homeopathy,

 Telling someone who trusts you that you’re giving them medicine, when you know you’re not, because you want their money, isn’t just lying–it’s like an example you’d make up if you had to illustrate for a child why lying is wrong.

How to boost homeopathy sales? Don’t tell the customer it’s homeopathy

Homeopathy Cartoon

The other day a parent asked me if she could give her 2-year-old Tylenol liquid along with some cough syrup she had purchased at the pharmacy. I was a bit surprised, as cough and cold products for young children have been pulled from pharmacy shelves for a few years given their lack of efficacy and spotty safety record.  “What product did you give?” I asked. “Stodal” she replied. I paused, then replied. “Well the good news is that you can give Tylenol and Stodal together. But you should know that Stodal is a homeopathic product – it contains no medicinal ingredients, so what you’re effectively giving is a sugar syrup.” I explained how homeopathy is permitted for sale in Canada, and sold in pharmacies, despite the fact it is an elaborate placebo system of sugar pills and liquids. The mother was furious – at the pharmacy for selling it, at the store staff for recommending it, and especially at the regulator, Health Canada. “How can they possibly permit this to be sold?” she asked me. I had no explanation – but encouraged her to return the product to the pharmacy and demand a refund. Continue reading