When I was in Hong Kong, I drove to the Literary Festival Dinner (a fantastic Chinese banquet) in a van with four educated, well-off, and well-traveled women who were on the Festival’s board of directors. Once on our way, they all proceeded to go after me for saying, in my conversation on faith versus science, that Chinese traditional medicine was largely bunk, as was acupuncture. They were incensed, maintaining that Chinese medicine had been scientifically tested many times (as had acupuncture), and that my statement was simply “ignorant.” I was shocked and taken aback, particularly because I was their guest. But I regrouped and tried to defend myself, citing the studies of acupuncture showing that it didn’t matter where the needles were inserted (there are specific points for specific ailments) or even whether the needles were inserted; sham and non-insertion acupuncture is no better than a placebo, which means the method doesn’t work as it’s supposed to. (Wikipedia gives a summary of the research with references; the upshot is that acupuncture is no better than a placebo, so the whole “system” with insertion points and so on is bogus.) The women said I was simply wrong.
Those ladies also told me that Western medicine is largely a sham, that it overtreats patients (sometimes true, but irrelevant when compared to TCM), and that Western (I prefer “scientific”) doctors ignore real cures that work (e.g. dubious cancer treatments) because those doctors are committed to enriching themselves, and don’t want to use cheap but effective treatments.
Further, as I mentioned in an earlier post, traditional Chinese medicine (TCM) was criticized by four young Hong Kong doctors in a conversation with me after my tale. The medics agreed that they often had to repair the damage caused by TCM because it was either harmful or (more often) delayed treatment, leading to the death of patients who could have been saved.
TCM involves all kinds of remedies that have not been tested and on first principles seem dumb, like using deer penises to remedy male sexual disorders, snake soup, the “cooling versus warming” effects of foods, and other products that are not only useless, but harmful to wildlife (bear paws, tiger parts, rhino horn, and so on). There may be some TCM remedies that do work (after all, a goodly percentage of scientifically tested drugs are derived from plants), but I know of none that have been tested the right way: double-blind research on patients. Even the National Center for Complementary and Integrative Health—the woo-laden branch of the National Institutes of Health whose job is to test “alternative medicine”—and has not, so far as I know, found any of it useful—describes TCM like this (read the whole page):
Is It Effective?
- For most conditions, there is not enough rigorous scientific evidence to know whether TCM methods work for the conditions for which they are used.
What I learned from that brief ride between bookstore and restaurant was that educated, cosmopolitan, and affluent Chinese people (I count Hong Kong residents as Chinese) can nevertheless fall prey to a form of faith: faith-based and untested medicine. This is something I didn’t deal with in Faith Versus Fact, and should have, for it’s another one of the dangers of faith—even if that faith isn’t religious.
This is all an introduction to another form of ineffective medicine: homeopathy. Most of us know the theoretical basis for this treatment (treat symptoms of illness with a substance whose ingestion can mimic the symptoms) and the “remedies” it inspires (pure water, said to contain some property inspired by the homeopathic substance, which has been diluted out completely). Both of these, as well as empirical tests, show that, like acupuncture, homeopathy is at best a placebo, and at worst can hurt people by delaying proper science-based treatment. Yet homeopathic medicines are sold in many places, including Whole Foods and Target, which should be ashamed of themselves. The Davis Food Coop in California, where I used to shop, is loaded with expensive, dumb, and useless homeopathic remedies. And, I’m told, you can even find some at CVS, though I haven’t seen them there.
Now, in a great move, the Federal Trade Commission (FTC) has issued a statement on homeopathic remedies, an enforcement policy for how to deal with those remedies (see overview of enforcement policy here), and a 24-page brochure describing how homeopathic drugs are advertised and how consumers perceive this advertising. The upshot: homeopathic remedies, to be advertised and sold as useful for a condition, must have been scientifically tested, just like regular pharmaceuticals, to determine their efficacy. Here are a few statements from the overviews (emphases are mine):
The Federal Trade Commission today announced a new “Enforcement Policy Statement on Marketing Claims for Over-the-Counter (OTC) Homeopathic Drugs.” The policy statement was informed by an FTC workshop held last year to examine how such drugs are marketed to consumers. The FTC also released its staff report on the workshop, which summarizes the panel presentations and related public comments in addition to describing consumer research commissioned by the FTC.
The policy statement explains that the FTC will hold efficacy and safety claims for OTC homeopathic drugs to the same standard as other products making similar claims. That is, companies must have competent and reliable scientific evidence for health-related claims, including claims that a product can treat specific conditions. The statement describes the type of scientific evidence that the Commission requires of companies making such claims for their products.
. . . You’ll want to read the Enforcement Policy Statement for the full story – it’s short, but packed with detail – but it boils down to this: “Efficacy and safety claims for homeopathic drugs are held to the same standards as similar claims for non-homeopathic drugs” and there’s no basis for treating them differently under the FTC Act.
What are those standards? We’re thumbnailing it here, but according to the FTC’s Advertising Substantiation Policy Statement, if a company conveys that it has a certain level of proof, it must have “at least the advertised level of substantiation.”
If there’s no express or implied reference to a particular level of support, the FTC considers “the type of claim, the product, the consequences of a false claim, the benefits of a truthful claim, the cost of developing substantiation for the claim, and the amount of substantiation experts believe is reasonable.” For health, safety, or efficacy claims, companies need “competent and reliable scientific evidence,” a phrase defined in many recent cases. For claims that a product can treat a disease or its symptoms, that generally means well-designed human clinical testing.
For most OTC [over the counter] homeopathic drugs, the case for efficacy is based solely on traditional homeopathic theories, and not on studies applying current scientific methods. So claims that they have a therapeutic effect lack the reasonable basis required by FTC law, and therefore are likely misleading.
This, I think, is the death knell of homeopathic drugs, and perhaps we should start holding our pharmacies and ripoff companies like Whole Foods accountable if their homeopathic “remedies” are advertised as useful.
Is there any way out for the homeopaths? Can such remedies still be sold? The Enforcement Report gives only one way, but it requires severe qualification:
For the vast majority of OTC homeopathic drugs, the case for efficacy is based solely on traditional homeopathic theories and there are no valid studies using current scientific methods showing the product’s efficacy. Accordingly, marketing claims that such homeopathic products have a therapeutic effect lack a reasonable basis and are likely misleading in violation of Sections 5 and 12 of the FTC Act.14 However, the FTC has long recognized that marketing claims may include additional explanatory information in order to prevent the claims from being misleading. Accordingly, the promotion of an OTC homeopathic product for an indication that is not substantiated by competent and reliable scientific evidence may not be deceptive if that promotion effectively communicates to consumers that: (1) there is no scientific evidence that the product works and (2) the product’s claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts.15
But even that comes with restrictions—restrictions that may ultimately make the marketing of homeopathic remedies illegal. See especially the bit in bold below:
Perfunctory disclaimers are unlikely to successfully communicate the information necessary to make claims for OTC homeopathic drugs non-misleading. The Commission notes:
• Any disclosure should stand out and be in close proximity to the efficacy message; to be effective, it may actually need to be incorporated into the efficacy message.
• Marketers should not undercut such qualifications with additional positive statements or consumer endorsements reinforcing a product’s efficacy.
• In light of the inherent contradiction in asserting that a product is effective and also disclosing that there is no scientific evidence for such an assertion, it is possible that depending on how they are presented many of these disclosures will be insufficient to prevent consumer deception. Marketers are advised to develop extrinsic evidence, such as consumer surveys, to determine the net impressions communicated by their marketing materials.
• The Commission will carefully scrutinize the net impression of OTC homeopathic advertising or other marketing employing disclosures to ensure that it adequately conveys the extremely limited nature of the health claim being asserted. If, despite a marketer’s disclosures, an ad conveys more substantiation than the marketer has, the marketer will be in violation of the FTC Act.
I’m not sure when this enforcement policy will take effect, but I think we should start pointing out this stuff to the purveyors of these ridiculous remedies.
Here’s a homeopathic “pain remedy” sold at Target. This packaging will soon be illegal:
h/t: Stephen Barnard