Pharmacies Targeted in Mass Homeopathy Overdose

Hundreds of protesters will gather outside Boots pharmacies on January 30 to swallow entire bottles of  homeopathic remedies and embarrass a profession that sells them in the absence of any evidence of efficacy.

A few weeks ago, I blogged about the 10:23 protest which was gathering momentum in the United Kingdom. Recall that in late 2009, a senior executive from Alliance Boots, a UK pharmacy chain, admitted that there is no clinical evidence to support homeopathic products, yet Boots sells these products strictly because of consumer demand.

Homeopathy is an elaborate placebo system of “remedies” with no active ingredients.  Based on the absurd notion of “like cures like”, proponents of homeopathy believe that any substance can be an effective remedy if it’s diluted enough: raccoon fur, the sunlight reflecting off Saturn, even pieces of the Berlin Wall are all part of the homeopathic pharmacopeia.  And when I say dilute, I mean dilute. The 30C “potency” is common – it’s a ratio of 10-60.  You would have to give two billion doses per second, to six billion people, for 4 billion years, to deliver a single molecule of the original material. That’s dilute. Continue reading

On Mentors and Memes

As we meander through life, there are inflection points – decisions and events that dramatically affect our future. It may take years to recognize them.  In 1993, I found out I’d been selected for a hospital pharmacy residency at Victoria Hospital in London, Ontario. I didn’t realize it until years later, but this was one of those events. In London, I had the privilege to spend a year learning from Dr. Charles (Charlie) Bayliff, the residency coordinator. I’ve been reflecting on Charlie’s impact on my life over the past few days. On Sunday evening, Charlie passed away after a battle with cancer.  I’m proud to call Charlie a mentor and a huge influence on my career, and philosophy towards pharmacy practice. Continue reading

Unapproved Natural Health Products Banned from Ontario Pharmacies

In a stunning move, the Ontario College of Pharmacists has prohibited Ontario pharmacies from selling health products that are not approved for safety and efficacy by Health Canada. This directive, which takes effect immediately, banishes some of the most questionable “alternative” health products from pharmacy shelves. This message was sent to all pharmacies and pharmacists on January 20, 2010: Continue reading

New UK Campaign: “Homeopathy: There’s nothing in it”

A few weeks ago I blogged about some very public criticism of pharmacy practice in the United Kingdom. I noted that pharmacies were being publicly criticized for selling homeopathy, and this was causing a public relations disaster for Boots, one of the UK’s leading pharmacy chains, and a proud vendor of homeopathy.  The mockery of Boots has continued. And there’s now a new public campaign to raise awareness of the fact that homeopathy is an elaborate placebo system, and has no place in pharmacies.

Cleverly (but somewhat confusingly) called “10:23”  (Remember what that number means?) the campaign has the following goals:

The 10:23 campaign aims to raise awareness of the reality of homeopathy – how it can be proven not to work, how it can be shown to be impossible, and why it’s important to give patients the right information to allow them to make an informed decision on their healthcare.

The campaign starts in a few weeks – and they’ve already posted their open letter to Boots – here’s an excerpt:

We call upon Boots to withdraw all homeopathic products from your shelves. You should not be involved in the sale of ineffective products, because your customers trust you to do what is right for their health. Surely you agree that your commitment to excellent patient care is better served by supplying only those products whose claims can be substantiated by rigorous scientific research? Or do you really believe that Boots should be in the business of selling placebos to the sick and the injured?

The support lent by Boots to this quack therapy contributes directly to its acceptance as a valid medical treatment by the British public, acceptance it does not warrant and support it does not deserve. Please do the right thing, and remove this bogus therapy from your shelves.

If you’re interested in the campaign, you can sign up and find out more.  And follow the chatter on Twitter.  I suspect the PR problems for homeopathy-selling pharmacies may be just beginning.

Forget to take your Ginkgo biloba? Turns out, it doesn’t matter

Among the natural products on pharmacy shelves, I was rooting for Ginkgo biloba for the prevention of dementia. For one, dementia is a horrible illness. Secondly, currently available drugs for Alzheimer’s disease (AD) have little meaningful effect. Thirdly, preliminary data with ginkgo for AD looked encouraging. I recall reading this systematic review back in 2000. One sentence jumped out at me (the bolding is mine):

We conclude that for selegiline, vitamin E, lecithin, linopirdine, and propentofylline the published data do not provide support for efficacy. Based on the evidence we reviewed, it is our conclusion that donepezil, metrifonate and rivastigmine, however, all provide statistically significant modest benefit on cognitive performance and global functioning to the elderly with probable AD who are eligible for inclusion in clinical trials. The magnitude of the effect is similar for all of the medications. The results from the trials of ginkgo biloba are promising but the effects are smaller than those from the above mentioned therapies.

So the effect, while weak, was just about as bad as the prescription alternatives. For a “natural” remedy, that’s pretty good. But as with most small clinical trials, what appears to be clinically and statistically significant usually disappears when larger, more rigorous trials are conducted. And that seems to be the case now, with a publication in the December 23, 2009 issue of the Journal of the American Medical Association. But before we dive into the trial, let’s look at why ginkgo is even being studied at all. Continue reading