The Pod Delusion - 10:23 campaign

Just a note to say that I've got a bit on The Pod Delusion this week (see above or download from here) blethering about homeopathic labelling and registration. (I know, pretty raunchy, huh?)

Please don't leave any comments about my voice making me sound like a dick - that is already an established fact.

The last two words on my bit were in response to Skeptic's With A K podcast - episode in question here. Please add SWAK podcast to your list of weekly podcast downloads here.

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Why homeopaths should support the 10:23 campaign.

You may have already come across the 10:23 campaign, a project that aims to raise awareness about the reality of homeopathy coordinated by the Merseyside Skeptics Society.

At 10:23am on January 30th 2010, more than three hundred homeopathy skeptics nationwide will be taking part in a mass homeopathic 'overdose' in protest at Boots' continued endorsement and sale of homeopathic remedies, and to raise public awareness about the fact that homeopathic remedies have nothing in them.

The campaign has been picked up by a number of media outlets - The Independent here and here, The Telegraph, The Times, The Observer, and, hilariously, the Daily Mail. (The Daily Mail got so confused with the big numbers associated with homeopathy, that they managed to inflate the NHS homeopathy budget by a factor of 1000. Basic editing has never been the Daily Mail's strong point).

There has been a backlash (of sorts) from the homeopathic community regarding the campaign, along with the standard name-calling that comes from proponents of alternative medicine any time it is criticised.

But why?

The campaign centres around Boots, the high street pharmacist. Boots is selling homeopathic products (own brand and branded) of varying dilutions, from various mother tinctures, with no restriction on amount to any old Horace, Jocasta or Gyles.

One thing that skeptics and homeopaths can surely agree on, is that this is not how homeopathy should be available.

Some skeptics would say that it shouldn't be available at all, whilst others would say that buying sugar pills isn't illegal and providing homeopaths don't make any claims as to its (lack of) effects, then caveat emptor.

Both sets of skeptics would agree that Boots should be propounding evidence-based medicine and selling pharmacy and health products which have a proven efficacy and safety record. Selling magic sugar pills based on 18th century silliness is not what a respectable Pharmacist should be indulging in.

Homeopaths, on the other hand, like to espouse the benefits of homeopathy as a 'holistic' philosophy, treating each person as a unique individual. The symptoms of having a cold are nothing to do with the cold virus that settled in your shnoz and reproduced at a rate of knots. No. It's to do with dis-ease and having an imbalanced immune system, and perhaps a poor mental state. For instance, see this on the Alliance of Registered Homeopaths' website:

Homeopathic medicines are chosen to treat the whole person, because homeopaths believe the mind and body operate as one, and you cannot treat one part of the body without affecting the whole. Medicines are chosen to fit all the characteristics of the patient, so physical disorders are considered in relation to the individual’s mental and emotional state.

The HMC:21 website states that:

It should be emphasised, however, that homeopaths base treatment on the totality of the symptoms of the patient, not on a general disease definition.

The Society of Homeopaths' website states:

Homeopathy treats all your symptoms - mental, emotional and physical.

Boots *own* website has a .pdf to download on alternative therapies. It states that homeopathic assessment takes in to account the following:

stress levels
lifestyle
level of exercise
diet
food preferences
family medical history
other factors such as weather

Indeed. The weather. This is the origin of the phrase "feeling under the weather". No, you're right, it isn't.

So, if a homeopathic assessment is of vital importance and the patient requires a highly trained homeopath to use their knowledge of symptoms, simillima, and remedies, in order to put the patient back on the road to recovery (for the meagre sum of £100/hour), how on earth are Boots able to sell the remedies to any old misguided dabbler?

(Sharp-eyed readers will remember the same argument being posed in a previous TiD blogpost when Napier's were holding a Homeopathy for Families workshop, which provided the attendants with a free vial of Arnica 30c. Individualised, my arse).

I am genuinely surprised that homeopaths have not complained that this accessability to homeopathic medicine is dangerous and can't be given to those without the secret knowledge; otherwise, of what value is the secret knowledge?

(Results of self-diagnosis are undoubtedly as good as homeopath-diagnosed patients, as the actual remedies given will have been identical - just sugar pills - and the placebo will probably have been similar in each case).

For this reason, I'm calling on all homeopaths to stand up for what you believe and to complain to Boots about how they are making homeopathy accessible to untrained patients. Homeopaths should be calling on Boots to remove homeopathic products from their shelves, lest these terribly potent homeopathic medicines get in the wrong hands.

I look forward to seeing armies of homeopaths outside various branches of Boots on 30th Jan 2010 demanding that Big Pharmacy has no right selling homeopathic products and that the livelihood of the highly trained homeopath should be respected.

Whether or not you are a homeopath but would like to help get homeopathic products removed from Boots shelves, then join up at 1023.org.uk.

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Help beat the gag on the BBC!

You can help beat Trafigura’s gag on the BBC by embedding this Youtube video on your website…

…and linking to this pdf! See here (full blogpost) as to why.






(H/T to Carmen Gets Around and Don't Get Fooled Again.)

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Merseyside Skeptics Society Stick the Boots in.

10:23pm on a Friday night - this is my rock and roll life. Due to moving house, I've had a month off blogging. Luckily nothing in the areas that I tend to blog about has happened in the last month.

Oh, apart from the UK Parliament having an evidence check session on homeopathy which is brilliantly on YouTube, so you can watch some governmental weaselling and squirming at your convenience. Lots of good blogs have been covering this such as Ben Goldacre's Bad Science, Lay Science and The Quackometer.

All this, and I missed it.....

The upshot of the session was a glut of anti-homeopathy pieces in the press, such as The Sun's Homeopathy is a Resources Drain. (Sadly, there are still plenty of people who think sugar pills may cure AIDS).

One of biggest gaffes from the session was by Paul Bennett, Chief Pharmacist of Boots who, despite selling homeopathic products in a manner contrary to MHRA regulations said he had seen no evidence for their efficacy, but sold them because "large numbers of [Boot's] customers thought they worked". This is nothing new in reality, the Quackometer blogged about this in 2006 and the Guardian ran a story on Boots & homeopathy in May 2008.

The Merseyside Skeptical Society wrote an open letter to Boots, reprinted below, outlining the ridiculous position Boots are placing themselves in. (MSS kindly discussed the Thinking is Dangerous blogpost on Boots removing homeopathic sulphur 30c in Episode 8 on their excellent "Skeptics with a K" podcast.)

Well said, MSS.

An Open Letter to Alliance Boots

The Boots brand is synonymous with health care in the United Kingdom. Your website speaks proudly about your role as a health care provider and your commitment to deliver exceptional patient care. For many people, you are their first resource for medical advice; and their chosen dispensary for prescription and non-prescription medicines. The British public trusts Boots.

However, in evidence given recently to the Commons Science and Technology Committee, you admitted that you do not believe homeopathy to be efficacious. Despite this, homeopathic products are offered for sale in Boots pharmacies – many of them bearing the trusted Boots brand.

Not only is this two-hundred-year-old pseudo-therapy implausible, it is scientifically absurd. The purported mechanisms of action fly in the face of our understanding of chemistry, physics, pharmacology and physiology. As you are aware, the best and most rigorous scientific research concludes that homeopathy offers no therapeutic effect beyond placebo, but you continue to sell these products regardless because “customers believe they work”. Is this the standard you set for yourselves?

The majority of people do not have the time or inclination to check whether the scientific literature supports the claims of efficacy made by products such as homeopathy. We trust brands such as Boots to check the facts for us, to provide sound medical advice that is in our interest and supply only those products with a demonstrable medical benefit.

We don’t expect to find products on the shelf at our local pharmacy which do not work.

Not only are these products ineffective, they can also be dangerous. Patients may delay seeking proper medical assistance because they believe homeopathy can treat their condition. Until recently, the Boots website even went so far as to tell patients that “after taking a homeopathic medicine your symptoms may become slightly worse,” and that this is “a sign that the body’s natural energies have started to counteract the illness”. Advice such as this directly encourages patients to wait before seeking real medical attention, even when their condition deteriorates.

We call upon Boots to withdraw all homeopathic products from your shelves. You should not be involved in the sale of ineffective products, because your customers trust you to do what is right for their health. Surely you agree that your commitment to excellent patient care is better served by supplying only those products whose claims can be substantiated by rigorous scientific research? Or do you really believe that Boots should be in the business of selling placebos to the sick and the injured?

The support lent by Boots to this quack therapy contributes directly to its acceptance as a valid medical treatment by the British public, acceptance it does not warrant and support it does not deserve. Please do the right thing, and remove this bogus therapy from your shelves.

Yours sincerely,
Merseyside Skeptics Society

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MHRA cause Boots to remove homeopathic product and update website

Back in July, Boots had been promoting Nelson's Sulphur 30c homeopathic remedies, alongside a pdf to download to help you choose which homeopathic product you thought you needed, complete with therapeutic indications. (I hate it when I forget to cache a website that's being complained about. Never mind...)

After a complaint from this site, the MHRA contacted Boots and instructed them to change their website, using only the phrase

Nelsons Sulphur 30c Pillules is a homeopathic medicinal product without approved therapeutic indications

according to the current legislation. Boots have since removed the product completely, however the Patient Guide to Homeopathy is still on the website. MHRA are now aware of this and so hopefully it too will disappear soon.

Not that it matters really, because Holland & Barrett are selling Nelson's Sulphur 30c pillules, complete with therapeutic indications, and completely contravening the law (original link to website here). The MHRA are now aware, and the offending site can be seen here.
Indeed, even Nelson's own site (original site here) deems itself above the law by claiming that the product is "known by homeopaths for its many skin benefits" which is woolly wording in my book, but we'll see what the MHRA do.
(Nelson's also promote the product with therapeutic indications on their Nelson's Homeopathy page here).


Fastest.Blogpost.Ever.

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Totally Hypothetical Remedy? - MHRA introduce certification mark for herbal remedies.

This is the new Traditional Herbal Registration certification mark. Well, it is apart from the 'Warning', which is what I think it is lacking.

According to the MHRA, this

indicates that the herbal medicine has been registered with the MHRA under the Traditional Herbal Registration (THR) scheme and meets the required standards relating to its quality, safety, evidence of traditional use and other criteria as set out under the Traditional Herbal Medicinal Products Directive (THMPD) 2004/24/EC.

There have been 92 applications since the scheme began in March 06.

The most important line is this one:

Under this scheme, the permitted indications for the medicine are based on traditional usage and not on evidence of effectiveness of the product.

My bold. So, as I wrote before with homeopathy, as long as the seller can demonstrate safety of the product and a history of use for the particular therapeutic indication, then it can receive the THR stamp and be sold legitimately, despite there being no investigation into whether it works or not.

[The MHRA guidance states:

European Directive 2004/24/EC on traditional herbal medicinal products was brought forward specifically in recognition of the position that for many herbal medicines it was difficult for companies to meet the full requirements for a marketing authorisation, particularly in relation to efficacy.

So, because it was difficult to prove they had any efficacy, it was deemed best to create a class of 'pseudo-medicines' that could pretend to be effective, but didn't have to prove it.]

On a positive note, any product with this mark on it will single it out clearly and obviously to me as snakeoil - if it were a *real* medicine that, you know, actually had some effect, then it would be marketed as such and would have some evidence to back it up.

So, perhaps we should look at this stamp as a victory for evidence-based medicine, as it singles out products without any provable efficacy for all to see.

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"We are all individuals!" - The Comedy of Homeopathy

Poking fun at homeopaths and those that follow the religion of homeopathy is an easy game: it's an 18th century quack medicine that requires laws of physics and chemistry to be binned in favour of a belief system based on anecdotes and a denial of evidence.

There is plenty to go at: the pills are nothing more than sugar and water, diluted to near infinity, the followers have an unwavering belief in the power of the magic pill and the theory of homeopathy is so topsy-turvy it requires a huge amount of hand-waving and circle-squaring to make any sense out of it.

Time and time again it has been shown to be no better than placebo, despite the homeopathic high priests trying to cure AIDS, malaria and other diseases, sometimes at the expense of proven medicines.

One of the huge paradoxes in the homeopathic theory is the need to offer the patient an individualised medicine - remember the Homepathic Mantra:

Homeopathy heals the person, not the dis-ease

and on the other hand, sell bottles of homepathic medicine for specific ailments.

The idea that the sugar pills need to be indivualised, but also can sold in a popular dilution for a specific ailment is one that I have yet to hear any homeopath explain coherently.

Take a look at the Alliance of Registered Homeopaths' website for instance:

Homeopathic medicines are chosen to treat the whole person, because homeopaths believe the mind and body operate as one, and you cannot treat one part of the body without affecting the whole

which is followed in the next paragraph by, and seemingly without a hint of cognitive dissonance,:

The onion - Allium cepa - can be used homeopathically to treat colds and hayfever where the main symptoms include runny eyes and nose.

Similarly, the Society of Homepaths' website gives the following mangled idea:

What can homeopathy treat?

Homeopathy treats the person, there is some evidence to suggest it can help a person manage the symptoms of acute fevers, sore throats and toothache, to chronic illnesses such as arthritis, eczema, asthma, anxiety and insomnia.

Note the modifiers "some evidence", "suggest", "help", "manage" and "symptoms" - even with these language modifiers in place, it's still stretching the truth.

The pinnacle of this confused comedy came last January, when Napiers Herb and Plant Remedies held a workshop called "Homeopathy for Families" workshop. The advert has since vanished but I blogged about it back in the day. The workshop cost £20, but delegates would receive

a complimentary bottle of the homeopathic remedy Arnica.

Imagine if Pfizer ran a similar scheme, giving away a bottle of Viagra to each delegate? It would be popular, sure, but wholly, wholly unethical, immoral, and illegal.

I made the MHRA aware of this - and was faced with another crazy dichotomy in the up-is-down world of homeopathy. MHRA decided that because the product isn't licensed as a medicine,

the restriction on the distribution of free samples therefore did not apply

.

Compare this with the Alliance of Homeopaths Website:

Homeopathy is one of the two most widely used forms of medicine in the world today

So it's a medicine but not registered as a medicine. Black is white.

There is a push from within the Church of Homeopathy to register some of these sugar pills under the EU Homeopathic Registration (MLX312) scheme.

This scheme allows specific homeopathic preparations to be licensed for sale for specific therapeutic indication - to a backdrop of "treat the person, not the disease".

After all, we are all individuals.

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