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MacDoctor last night wrote a post on the ethics of homeopathy: check it out.[1] As it’s a lazy sort of weekend a few off-the-cuff thoughts on a different aspect of the subject might fill the bill.

Source: Wikimedia Commons

Source: Wikimedia Commons

I’d like to offer suggestions as to what might be practical remedies to educate and curb use of homeopathy for weekend rumination. Readers are welcome to pitch in with their own suggestions.

Insist that the ingredients in the final product, and their amounts, be listed on the bottle. Take a look at the bottles of homeopathic remedies in your neighbourhood pharmacy. They don’t list what’s in the final product.[2] What homeopathic remedies list are the ingredients that are placed in the starting mixture, not what it’s in the resulting product. The diluted ingredients are not in the final remedy – they get eliminated in the repeated dilutions.[3] One rule for all remedies: all remedies must list what’s in the product. That homeopathic remedies can get away with not doing this is silly.

International standard measures should be used. It’s obvious, right? Use measures that can be compared directly with other remedies on offer and are generally understood, like those defined by IUPAC. That these producers can get away with not doing this is also silly.

Have products that lack sound evidence be marked ‘Untested remedy’. OK, this one will raise a few hackles and obviously a little less serious. But really, why not? It’s the nub of the thing after all; all this suggestion is asking is that it be made explicit and stated directly. When people talk about ‘complementary’ remedies or ‘alternative’ remedies, the key point isn’t that they are ‘complementary’ or ‘alternative’.[4] The key point is if they can be demonstrated to work. (Think: what are they complementary or alternative to, and why?) Sellers of homeopathic remedies not supposed to be able to make therapeutic claims[5] but it’s very obviously worked around, for example, with names that imply a therapeutic use. It’s possible that’s all that some customers read – the name of the remedy.

Mark products with a level of evidenced support. This is a little more complex variant on the same basic idea as in the previous suggestion. It harks back to on-line efforts (e.g. this one) that try to broadly indicate the level of support for particular ingredients for particular treatments. Perhaps a simple scale–1 – 5 stars, say; homeopathic remedies would get no stars–and an identifier or a short URL that can be used to look up a more detailed account on-line (think mobile phones with network access, etc.) To do this well is fairly tricky, but the idea is to convey the broad essence of the thing simply and concisely.

Insist that all medicines have the same licensing standards, or at least set stronger standards. Europe has being moving in this direction for herbal remedies, for example, as widely reported elsewhere with it’s Traditional Herbal Medicinal Products Directive[6] coming into force May 1st. Likewise the UK has it’s Traditional Herbal Medicines Registration Scheme. (New Zealand currently as a Natural Health Products Bill underway.) It’ll be interesting to watch the developments in Europe and the UK. For example this opinion piece (worth reading) from the Journal Of Chinese Medicine dated November 2010 notes that ’[…] a wide range of manufactured unlicensed Chinese medicines, including those supplied by external dispensaries, will, at a stroke become illegal’ and that

The vast majority of herbal medicines are unlicensed, in fact, a grand total of zero, yes zero Chinese medicine products are licensed and only one has been registered so far under the Traditional Herbal Registration scheme.

I hope that studies monitoring the use and understanding of these remedies by the general public are taking place in parallel to these legislature changes. It would be interesting and useful to examine what effect they have quantitatively.

Footnotes

1. See also the comments on his original forum.

2. There are exceptions where, for example, silver oxide is listed but not said to be an active ingredient, leaving a (false) implication that their high dilution of exotic herbs (or whatever) is the active ingredient and this is ‘other stuff’.

3. Often well before the dilution series is complete, in fact.

4. Don’t get some idea that I’m dissing everything; natural products have long been a source of sound remedies and there are good reasons for that. The thing is that you need to show that have some useful effect in a reliable manner, rather than spin a ‘hopeful story’ that they might.

5. My reading of the relevant regulations are that homeopathic remedies are forbidden from making claims for a therapeutic purpose.

6. The directive in all it’s glory (read: administrative language) can be found on the European Law website.


A sample of articles on ‘alternative’ remedies on Code for life:

Message to Otago Daily Times: homeopath is not a sound career option*

Homeopathic remedies in NZ pharmacies

In good health or not? — ’natural health’ advertising in newspapers, magazines

Have your say on the development of a Natural Health Products Bill

Pharmacists to say that homeopathy does not work?

Sources for medical information for non-medics and non-scientists

Medical DIY…

Popularity does not mean effectiveness or sensibility

Undiluted humour: If Homeopathy Beats Science

Homeopathy check-up: Not in the health system, disclaimers on labels