Homeopathy has been taking a lot of hits for the last decade. I like to think this is at least partly due to our efforts. We did explicitly decide that homeopathy was the most vulnerable of the medical pseudosciences, and that we should keep up the pressure as much as possible.
Part of homeopathy’s vulnerability is that it thrives on ignorance. Many people simply do not know what it is – they think it is herbs and natural treatments. They are often doubtful, and then scandalized, when informed that it is based on silly notions of sympathetic magic and water remembering the “essence” of substances that have long been diluted out of existence. So all we really have to do to fight homeopathy is just explain to people exactly what it is.
Many governments have somewhat opened their eyes as well. There have now been multiple independent government-sponsored reviews of the homeopathy literature, all coming to roughly the same conclusion. In 2010, the UK’s House of Commons Science and Technology Committee published a withering report on homeopathy, dismissing it as witchcraft and recommending that the UK not waste another dime on this nonsense. In 2013 the Australian National Health and Medical Research Council (NHMRC) published their report, concluding that the scientific evidence shows homeopathy does not work for any indication. They later recommended that it be removed from pharmacies.
In the US the FTC reviewed their regulation of homeopathy, and in 2016 decided to tighten their regulation of homeopathic products by requiring actual evidence to support any clinical claims made. The FDA is still reviewing their homeopathy regulation. The Russian Academy of Science jumped on the bandwagon earlier this year.
The only outlier in terms of recent government-sponsored reviews is Switzerland. However, the Swiss report also reveals how vulnerable homeopathy is. Initially the Swiss also concluded that homeopathy does not work, but Swiss homeopaths were unhappy. They managed to engineer a follow up review, packed with homeopaths. A published analysis of the Swiss review concluded:
This paper analyses the report and concludes that it is scientifically, logically and ethically flawed. Specifically, it contains no new evidence and misinterprets studies previously exposed as weak; creates a new standard of evidence designed to make homeopathy appear effective; and attempts to discredit randomised controlled trials as the gold standard of evidence. Most importantly, almost all the authors have conflicts of interest, despite their claim that none exist. If anything, the report proves that homeopaths are willing to distort evidence in order to support their beliefs, and its authors appear to have breached Swiss Academies of Arts and Sciences principles governing scientific integrity.
Interestingly, even the highly biased Swiss report could not argue that the scientific evidence shows homeopathy works. So instead they desperately tried to redefine scientific evidence. This strategy is standard procedure for alternative medicine apologists, so it was not surprising.
As of this year we have one more review to add to the list – the European Academies Science Advisory Council. Here is a summary of their main conclusions:
Scientific mechanisms of action—where we conclude that the claims for homeopathy are implausible and inconsistent with established scientific concepts.
Clinical efficacy—we acknowledge that a placebo effect may appear in individual patients but we agree with previous extensive evaluations concluding that there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect. There are related concerns for patient-informed consent and for safety, the latter associated with poor quality control in preparing homeopathic remedies.
Promotion of homeopathy—we note that this may pose significant harm to the patient if incurring delay in seeking evidence-based medical care and that there is a more general risk of undermining public confidence in the nature and value of scientific evidence.
Translated into plainer language – homeopathy can’t work, homeopathy doesn’t work, and misleading patients about these simple facts can cause demonstrable harm. Essentially we can conclude with the highest degree of scientific confidence that homeopathy is utter nonsense and has no clinical efficacy. Any regulatory body that allows homeopathic products to be promoted as medicine is failing their citizens. Any health care professional who practices homeopathy is a quack.
Homeopathy and integrative medicine
Because of the obvious status of homeopathy as quackery, it presents a difficult problem for proponents of so-called “integrative” medicine. They desperately pretend to be science-based, but being based on science is fundamentally at odds with the very concept of integrative medicine. In other words, science-based (or even the weaker standard of being evidence-based) integrative medicine is an oxymoron.
As my colleagues and I have often pointed out – what are they integrating? They mostly rebrand diet and exercise as if it is alternative (it isn’t) and add a generous helping of outright quackery. Integrative medicine brings nothing new to the table that is not pseudoscience, which makes integrating pseudoscience into mainstream medicine their raison d’être.
But of course proponents desperately deny this. They insist that they are evidence-based, and simply want to expand the repertoire of options for patients. This is where homeopathy comes in. The claim of integrative medicine proponents of being evidence-based is on thin-ice to begin with. When it comes to homeopathy, they plunge into the frigid waters. They know they can’t maintain their facade of being scientific when it comes to homeopathy. The game is basically up. So what do they do?
Sometimes they sacrifice homeopathy on the altar of seeming scientific. The NCCAM did this – when we had a meeting with them in 2010, of course we asked them directly about their policy towards homeopathy. The director would only say that they are not currently funding any studies in homeopathy (but would not commit to never funding homeopathy going forward).
Sometimes they just try to hide their use of homeopathy from the public. The most recent example of this is the integrative medicine center at UC Irvine (which I wrote about just last week). The Samuelis, who are apparently big believers in homeopathy, donated $200 million to UC Irvine to establish and integrative medicine center there. UC Irvine insists this center will be evidence-based (no, no pseudoscience here). But right there on their website they mention that they offer homeopathy – which is blatant pseudoscience.
So they had a choice. They could try to defend homeopathy, which I guess they decided they could not do. They could declare homeopathy pseudoscience and not part of legitimate integrative medicine, which they apparently did not have the moral courage or scientific insight to do. Or they could quietly scrub the word “homeopathy” from their website, which is what they did.
The LA Times reports on this update – in the face of significant criticism of their new center for pseudoscience in medicine, UC Irvine made some cosmetic changes to their website to at least remove the quackery that currently has the worst PR. Of course, the internet remembers, and the prior listing of homeopathy is archived. It is unclear if they no longer offer homeopathy, or if they just did not want to advertise this fact. Further, they still incorporate naturopaths in their center, and homeopathy is central to naturopathic practice. You don’t have one without the other, and sure enough one of their naturopaths still advertises homeopathy on their page.
Homeopathy, however, represents more than just a PR inconvenience to proponents of integrative medicine – it undercuts their entire philosophy. Their real dilemma is that the scientific basis for anything they are trying to do is not really any better than homeopathy. How can they condemn homeopathy (even just by scrubbing any mention of it) while accepting acupuncture, energy medicine, worthless or harmful herbs, and other nonsense?
The scientific basis for acupuncture is no better than for homeopathy – after thousands of clinical studies it is very clear that acupuncture simply does not work. It just has better PR than homeopathy. I strongly suspect that acupuncture has been so successful in hoodwinking medical professionals who are not paying close attention because it has a better placebo effect. Sticking needles into the skin is more invasive, and more invasive interventions have a larger placebo effect than just taking pills. That is really the only advantage to acupuncture – it is harder to properly blind and easier to present a negative study as if it is positive. It is just as worthless as homeopathy, however.
We will have to continue to hold UC Irvine’s feet to the homeopathy fire. They should not be allowed to quietly hide from the truth that they have welcomed a center for quackery and pseudoscience into their medical school. Making cosmetic changes to their website will not be enough. Further, it takes more than just getting rid of homeopathy (if they are even really doing that) to be truly science-based.