The consequences of legitimizing nonsense

Smarties: As effective as homeopathy

For a blog established to examine the role of science in pharmacy practice, I’ve given a disproportionate amount of attention to homeopathy. Which is frustrating, because homeopathy is not something that pharmacists, or the pharmacy profession, should even need to discuss. Unlike herbal remedies, and some supplements, there isn’t even any science to discuss. As pseudoscience goes, homeopathy is the worst of the worst – it is a belief system, nothing more. If homeopathy actually worked as claimed, it would mean that all we know about biology, biochemistry, pharmacology, and toxicology was wrong. Not a little wrong, but completely wrong. Which would then mean that all we know about science-based medicine is wrong.

In short, homeopathy is an elaborate placebo system, based on the idea that “like cures like” (which is simply a form of magical thinking) involving successive dilutions of products in water, like Berlin Wall, “Mobile Phone (900mHz)“, and even the light reflecting off Saturn. These substances are believed to have medicinal effects, and the dilutions are believed to increase, not decrease, the potency of the final product. But the dilutions in homeopathy are so great you’re not even getting any Berlin Wall. Think of putting one drop of a substance into a container of water. Only that container is 131 light-years in diameter. That’s the “30C” dilution. Homeopaths believe that the water molecules retains a “memory” of the original substance (while conveniently forgetting all the other products it has come in contact with.) The final remedy is diluted so so completely that most products on store shelves don’t contain a single molecule of the ingredient listed on the label. After all that dilution, the water is dripped on tablets of sucrose and lactose: They are, as a final product, sugar pills. Chemically indistinguishable, and as medicinal as a box of Smarties.

Not surprisingly, a review of clinical trials, when you control for biases, confirms what grade-school numeracy and scientific literacy would suggest – homeopathic products are no more effective than a comparable placebo. Yet frustratingly, regulators in Canada and in other countries have given legitimacy to homeopathy by registering both the medication and their purveyors – risking the perception that homeopathy may in fact offer medicinal value. And whether it’s due to ignorance of homeopathy, or indifference to the unfounded ideas of “alternative” health, legitimate health professionals continue to give a pass to homeopathy, taking a “What’s the harm” attitude. Yet harms can result:

Do pharmacy regulators “get” homeopathy?

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:

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:

Health Professionals or Retailers? Pharmacists, your customers are wondering

Recently, Australian Skeptics published an open letter to the pharmacists of Australia, asking consumers to take it to their “university trained seller of snake oil”.  Click on the link to see the full-sized PDF.

An Open Letter to Australian Pharmacists - click to enlarge PDF

Their letter makes several important points:

The Alternative that Isn’t: Bioidentical Hormones

The interest in bioidentical hormone therapy (BHT) has seemingly exploded of late, due in part to celebrity books and daytime television discussion. Suzanne Somers, author of multiple books on BHT, recently made her case for BHT on Oprah. According to Somers, BHT is a veritable “juice of life“; appropriate for women from their twenties right up to menopause and beyond. This article will look at the safety and effectiveness of BHT, and the responsibility of pharmacists and the pharmacy profession in its provision.

The Cognitive Dissonance of Homeopathy

A pharmacist’s education is rooted in the study of the natural sciences. It’s training that lends itself to sorting out novel, science-based therapies from implausible pseudoscience.  To the the chagrin of the science-based pharmacist, homeopathic products are widely available at pharmacies in Canada and around the world. Many pharmacists endorse homeopathy and see it as complementary to conventional (real) medicines.  Others argue that they’re simply responding to consumer demand.  Is homeopathy based on sound science, and should homeopathic products be sold in pharmacies?

Background

Homeopathy was invented in the early 1800s by a German physician, Samuel Hahnemann. At that time, illness was believed to be the result of imbalances in the four bodily “humors”, namely blood, phlegm, black bile and yellow bile. Typical medical treatments were crude and dangerous, and included bloodletting, blistering, laxatives and emetics, intended to bring balance to the humors. Hahnemann invented an alternative treatment system that he believed was less toxic and more effective at balancing the humors.

There are three key principles for homeopathy, and they’re fundamentally different from our current, science-based understanding of drugs and diseases.