UNPOPULAR OPINION ALERT

[tim]

Something that I hear a lot in my peer group is "homeopathic medicines are dangerous because people use them instead of effective medicines."

I have no doubt that there's a small sector of the population that thinks clouds are chemtrails and ignores effective medicine out of spite. There's probably not much we can do about that sector of the population.

For the most part, though, I suspect people turn to things like homeopathy for problems that they've already sought advice from a real doctor for, and not gotten effective treatment. So who is being harmed, exactly? I mean... we're living in a world where it's legal for "real" pharmaceutical manufacturers to sell generics that don't actually do anything, and the FDA doesn't do anything about it (source: my former psychiatrist, who said, "I complained to the FDA [about a medication I was taking that a pharmacy tried to hand me a placebo generic "equivalent" for], but I might as well go home and play video games, since it does as much good and is more fun.")

So if you want to improve access to health care, why not... you know, work for a single-payer system and stop making access contingent on having money? (If you live in the US, anyway; if you're in another country, maybe your priorities are fine :-) Somehow I suspect that that's stopping a hell of a lot more people from getting health care that would improve their lives than homeopathy is. Or would that be no fun because you wouldn't get to laugh at "stupid people" and feel smarter than them?

I mean, yeah, businesses (both non-drug makers and regular pharmacies like CVS and Walgreens) make plenty of money off selling homeopathic crap, and that's irritating and all, but you know who makes a lot more money doing everything except making sure people get health care? Health insurance companies.

(I feel like I've said all this before, but meh, there's nothing new under the sun anyway :-)

Comments

[juli]

And even with single-payer, there's still going to be people who look like "stupid people" because they can't get help within the medical system, but for whom the medical system is actually the source of the problem. Doctors know this and even exploit it, like my doctor firing me because he put someone else's notes in my file and couldn't admit to failure for fear of litigation. Even if we removed the fear of litigation, I bet we'd still find that a lot of people who choose to be doctors also don't feel very much like admitting when they're wrong. So I'm the stupid person for not taking drugs I need, and that's how I'll look to my next doctor when I explain to him that I've been off them for months, because my previous doctor abandoned me. And that's how doctors want it, and that's how the medical system wants it.

At least with homeopathy I might have felt cared-for and supported through this difficult time, or whatever.

[tim]

Oh, absolutely. I also agree that just feeling cared for and supported counts for a lot, as much as the aspiring-robot types would like to discount it.

[azurelunatic]

Sadly, I have to disagree with you on the point that there are not people who mean to go for real medicine but end up with homeopathic bullshit because of two conversations I've had with people close to me.

The first one was the otherwise pretty savvy but terrifyingly under-educated (and from a poor background with correspondingly bad schools) former roommate who in ~2001 (before the non-functional antidepressant generic scandal hit) believed that generics had to be exactly the same, not even a change in filler, or the FDA would not allow them to be sold, and therefore had to be effective because they were the same. Having been around the internet more, I had heard that the fillers were allowed to be different, and that some people experienced differences when on the original and on the generic. It came to a screaming fight, and she was still not convinced.

The second one was the very trusting although reasonably well educated friend who has for the past several years been in the sort of scrimping-and-saving position where you only go to the doctor if you have to, you use the over-the-counter remedy when you can, and when there are two over-the-counter remedies, you go with the cheaper option. She also prefers to go with natural remedies if at all possible. So when one of her cats got sick at not quite the worst possible time, she was debating whether to try a homeopathic remedy or take the cat to the vet. I was quite taken aback because she certainly had not seemed like the sort of person who would believe that sort of thing, so I very delicately asked her whether she was acquainted with the various scientifically valid examinations of homeopathy, and thus I was the one to break it to her that scientifically speaking, they were the same as a placebo, and while I was generally okay with well-informed adults managing their own situations as they saw fit, the placebo effect is probably not effective on cats and would furthermore waste her immensely scarce money. She was shocked because she had assumed some sort of minimum standard of medical effectiveness for things sold in actual reputable stores.

All of these would be most improved by better access to health care, and secondarily improved by better access to quality education, but the FDA also ought to be hammered into actually ensuring effectiveness for things which are sold packaged as medicine -- human or animal.

[redbird]

Part of the problem, I think, is that a lot of people think "homeopathic" means "herbal," and it's worth telling them that no, it means "there's no actual medicine in here." (Well, not usually: the rules are so loose that actual medicines, or poisons, can be called "homeopathic" with a label like 1X.)

I don't think that other people are stupid: I think they are ignorant, in some cases because they've been lied to. the person who can't get health insurance, or whose insurance won't pay for what she needs, generally knows this. the person who sees three different things labeled "cough medicine" on the same shelf may not realize that one of them is essentially distilled water. or they may believe "they wouldn't be allowed to see it if it didn't work," not knowing that the law says that you can sell any old thing if you first convince the other homeopaths to add it to the official homeopathic pharmacopeia. i figure telling friends and acquaintances this is at least as good a use of my time as doing sudoku puzzles or rereading brain candy, both of which i also do.

[lindseykuper]

a lot of people think "homeopathic" means "herbal,"

Yeah, this is why the people I know who've used homeopathic stuff have used it. I thought so myself until well past college, and so did other smart people I know.

I know another smart person who just grabs a bunch of stuff from the shelf when he's sick, in the hopes that something will work, and so he's got homeopathic stuff in his medicine cabinet along with the rest. I don't think his strategy is unreasonable; sure, he ends with some duds, but it's worth it to him to not spend ages standing there puzzling over the minute differences between brands like I've been known to do.

[puzzlement]

It seems to me that, if one really wanted to focus on beneficial skeptical inquiry for some reason (and I don't believe that's necessarily a bad thing, for the same reason that I don't believe geek feminism needs to stop and wait for poverty to be solved, but in practice actual skepticism is indeed a lot of sneering at folks) it would be on a few things. One is non-evidence based providers attempting to displace somewhat-more-evidence-based primary care (as apparently some chiropractic practitioners are attempting in the US?), another is where non-evidence based care is actually very invasive and painful (as some late stage allegedly-curative cancer treatments are, involving, eg, ozone infusions and whatnot), another is where evidence-based care is being systemically subverted at a high level (as Ben Goldacre documented in South African approaches to HIV treatment) and another is where there is evidence of harm (as, apparently, there is with routine vitamin E supplementation?) Unsurprisingly, these often coincide with very powerful actors, including pharma companies, on the side of alternative medicine.

I do see some of this among some skeptical activists I follow, but selection bias is involved, because I don't enjoy sneeryness.

It would probably behoove many skeptics to regard themselves as activists and to make a statement of principles. Are they attempting to improve individual health? Public health? Save people money? What political beliefs and evidence do they have that make them thing that other people need their activism? What unique insights do they bring to the table? (I tend to be more sympathetic to working scientists or doctors than random computer geeks opining on medical skepticism, for example.) What other causes (eg health care funding reform) do they regard themselves as aligned with or supportive of?

[lorena]

http://blog.placeboeffect.com/placebo-research/

[someonefromthewater]

Something that I hear a lot in my peer group is "homeopathic medicines are dangerous because people use them instead of effective medicines."

And "effective" medicines are dangerous because they can be abused or prescribed purely to make the patient feel like they are Doing Something about an illness that isn't likely to go away. Or to make a caregiver feel better about themselves. Plus, you know, side effects.