Paging Health Canada – Part 1

Hello? Anyone?

Skeptics are often accused of being dogmatic, closed-minded, and/or shills when they criticise particular industries or companies for dishonest, irresponsible, or ethically questionable practices. The natural health industry, with its general lack of oversight and use of science as shiny wrapping paper instead of an inherent foundation, is a veritable cornucopia of claims to be skeptically dismembered. But when skeptics criticise “Big Nature”, several counterpoints are common:

  • Attacks: Skeptics are against consumer choice. Skeptics are shills for Big Pharma.
  • Testimonials: I/my friend/my cat tried and it worked, so your evidence is wrong.
  • Anti-Science: Science has been wrong before. Science can’t test (insert misunderstanding of physics concepts, from simple (energy) to complex (quantum)).
  • Assumptions: Natural is better than synthetic. I know in my gut that this works.
  • Paranoia: Big Pharma is intentionally making us sick for profit, but herbal medicine is personal and small-business that cares about me.

Attacks are an attempt to discredit facts. Skeptics are defenders of informed personal choice and freedom. As much as alternative medicine advocates play the “freedom” card, they often don’t sufficiently back up their claims and/or dismiss evidence that something they believe in might not work. This cherry picking tends to coincide with accusations of “Western bias” or fetishism of Big Pharma products. So apparently freedom isn’t that important if the science-based opinion happens to be that Pharma constitutes the best available treatment…

The remaining counterpoints use “folk logic”. Without evidence, we have a tendency to rely on intuition and personal experiences/connections to make a decision. This feels like a completely reasonable way to make a decision, because that’s unfortunately how our brains work. But what happens when two people have opposite intuitions or when anecdotes oppose each other? Who is right? Skeptics advocate for an objective way to figure that out: science. In the case of health, the gold standard is to prevent experimenters/participants from knowing what treatment they’ve given/received so they can’t accidentally influence the results with their expectations and beliefs — this is the placebo-controlled double blind study. This isn’t perfect, because about 5% of the time there will be false positives to be cherry-picked, but eventually a clear picture comes into focus. This process and its results isn’t evidence of an agenda; it’s just a tool.

Scientific studies investigate questions in a way that hopefully eliminates as much error as possible. The limitations of science can be confusing to those unfamiliar with the process — for instance, confusing the bias of the experimenter (their perceptions and emotions) with bias in the scientific method itself. However, imperfections in method are no justification to allow snake oil to be sold alongside medicine. The solution to scientific imperfections should be to try to eliminate them as much as possible, not to discard the process entirely except during cherry picking season.

Facts: What are those?

Both Big Pharma and Big Nature are profit-driven industries. Each behave in a way to maximize profits by whatever means are legally allowed. In the process, both industries have strayed from the path of total honesty from time to time. The difference between the two is that Big Nature has successfully lobbied/marketed itself to 1) not have products be regulated as real drugs and 2) be considered science when it’s convenient (when studies agree with beliefs) and too advanced for science (when studies disagree) at the same time. Thanks to poor Canadian regulations, if health claims are vague enough and a product has “traditional use”, it can be sold alongside medicine at a comparable price in a real pharmacy or directly to the consumer.

Big Nature has also been successfully marketed as an underdog industry without enough money to prove that what they are saying is right, which Erik Davis has demonstrated is indefensible given their profit margin. The natural health industry has also managed to get Health Canada approving thousands of products for safety and efficacy, giving distinct license numbers to products such as chemically indistinguishable sugar pills, despite often having no credible supporting evidence. This program is now so back-logged that products are being exempted with a separate set of indecipherable numbers. Meaning for the consumer: Still no way to tell whether a “natural health” product is safe or effective. Big Pharma, despite the faults of an imperfect system, is held to much stricter standards. This is why Big Nature often gets more mentions in the skeptical community, even though there are problems in both industries — it’s a matter of proportion. Big Pharma already has plenty of scrutiny.

How we fail ourselves

Big Nature isn’t an hot topic for skeptics because we have it out for alternative medicine on the basis that it’s “different”. It’s a hot topic because we don’t feel that CAM is giving us our money’s worth. Big Nature (among other industries) discredits science when convenient because otherwise they wouldn’t be able to convince anyone to buy their products. At the same time, they recognize that many people still put stock in evidence (i.e., their critics) and attempt to use any positive research paper to bolster their claims with no critical appraisal of the research or appropriate context. We’re being manipulated. Not necessarily on purpose, but certainly by people who believe certain things to be true without evidence (and even in contrast to available evidence) and are preaching their views with convincing advertising – wait, when did this turn into a post about cults?

Imagine you are in the market for a supplement. You hear about a particular company and decide to look it up. A Google search for the company turns up product sites and a glowing review from the Better Business Bureau on the first few pages. This company has a large multi-national website and runs a mail-order supplement business that, according to the BBB, has been in business almost 40 years. The website itself is full of positive testimonials and individual products have glowing reviews from doctors. Does this company deserve your business? Sounds pretty good, right?

The information you might not have found is that this same company has had trouble in the past for including an undisclosed pharmaceutical drug in one of its products, resulting in a recall. The same company has also come under fire for selling products with controversial animal ingredients. Furthermore, many products do not have ingredients clearly disclosed in their online store, have associated claims that are not supportable by robust evidence, and do not have Health Canada registration status openly disclosed (making product safety distinctions effectively nil).

Upcoming…

The above example is a real company that is examined more closely in Part 2. This “case study” is an example of why skeptics speak out against the natural health industry and why proactive steps should be taken to protect Canadian citizens and our health care dollars.

7 Responses to “Paging Health Canada – Part 1”

  1. One other point on the profit component. I have found that most of the CAM practitioners sell the products they recommend. Here in Charlottetown, the largest ‘health food’ and supplement stores is owned by the largest naturopathic clinic. The office is directly above the store.

    It is not uncommon for pharmacies and medical clinics to occupy the same same building, but they fall under space lease agreements not direct ownership.

    • Iain says:

      This is an important point, where double standards are common. In most jurisdictions, the clear conflict of interest in having medical practitioners also sell the products they prescribe is addressed by prohibiting such arrangements. The CPSO, for example, bars Ontario physicians from profiting from pharmaceuticals. But the proposed regulations for the college of homeopaths do not contain such rules, which would cut heavily into the profits of practising homeopaths.

    • Kim Hebert says:

      Yes, good point. Thank you for bringing up that issue.

  2. daijiyobu says:

    @JohnUnderhay re. “I have found that most of the CAM practitioners sell the products they recommend”,

    I often hear that the naturopaths make half their income through their dispensaries.

    And what’s really interesting is that BIG HOMEOPATHY is funding, hugely, their new Elsevier textbook.

    -r.c.

  3. DR says:

    Let’s not also forget that some of the major Big Nature companies are actually owned by Big Pharma companies…

    • In discussions that get on the topic of Big PHARMA and “little nature”, I bring up that simple fact of pharmaceutical companies buying up the natural products companies. Instant conversation stopper. Their talking points haven’t evolved to the stage of dealing with such a concept.

      1. Shades of grey do not exist
      2. Everything Big Pharma does is evil
      3. Everything Big Nature does is good
      4. Big Pharma owns Big Nature
      5. Does not compute

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  • Kim Hebert

    Kim Hébert is an occupational therapist. She is interested in the promotion of science and reason, particularly regarding therapeutic health interventions. She blogs occasionally about occupational therapy and other health topics at Science-Based Therapy. Her hobbies are art and astronomy. **All views expressed by Kim are her personal views alone, and do not necessarily reflect the opinions of current or former employers, associations, or other affiliations. All information is provided for discussion purposes only, and should not be used as a replacement for consultation with a licensed and accredited health professional.