More consequences of calling sugar pills “safe and effective”

Leona

Are sugar pills effective substitutes for vaccines? That’s what some are asking about Health Canada’s decision to approve 82 homeopathic “nosodes” which are sold by homeopaths as vaccine alternatives. Homeopathy is an elaborate placebo system of sugar pills. Of all alternative medicine, homeopathy is the most implausible of them all.  Based on the absurd notion of “like cures like” (which is sympathetic magic, not science), proponents of homeopathy believe that any substance can be an effective remedy if it’s diluted enough: cancer, boar testicles, crude oil, oxygen, skim milk even pieces of the Berlin Wall are all homeopathic remedies. In the case of nosodes, it’s infectious material. But this isn’t attenuated viruses, or anything you’d find in a real vaccine. This is simply raw infectious material that’s diluted. And when I say dilute, I mean dilute. The 30C “potency” is common – that’s a dilution of 10-60.  You would have to give two billion doses per second, to six billion people, for 4 billion years, to deliver a single molecule of the original material. So nosodes are effectively and mathematically inert – they are pure placebo. Not surprisingly, there is no persuasive medical evidence that homeopathy has medicinal effects.

The Natural Health Product regulations, under Canada’s Food and Drugs Act, regulate homeopathic products as well as products like nutritional supplements, probiotics, traditional Chinese medicine, vitamins, and herbal remedies. They are a deliberate shadow of the regulations that govern drug products — requiring some manufacturing quality and safety standards, while effectively removing the standards for product efficacy claims. Yet Health Canada insists that this doesn’t compromise quality, safety, or efficacy:

Through the Natural Health Products Directorate, Health Canada ensures that all Canadians have ready access to natural health products that are safe, effective and of high quality, while respecting freedom of choice and philosophical and cultural diversity.

When used for self-limiting conditions, the risk of harm from homeopathy may be slight. But not if it makes people think they’re using medicine, when they’re actually doing nothing at all. And a framework that gives even a veneer of credibility to sugar pills increases the perception that homeopathy has legitimate medical uses. We’ve seen this worldwide with homeopaths descending on Haiti or treating HIV in Africa, illustrating that proponents lack any insight into the fact that these products are inert. You even get one one ethicist has called “one of the worst charities in the world“, Homeopaths Without Borders:

Homeopaths Without Borders (HWB) has provided homeopathic care and education in GuatemalaEl Salvadorthe Dominican Republic and Sri Lanka. Since the 2010 earthquake in Haiti, it has focused efforts there, too. Besides minor ailments, HWB also treats malaria, typhoid, cholera, dengue fever, advanced diabetes, and educates about the “beneficial effects” of these treatments.

Laugh or cry? I can’t decide. There’s something really wrong with a company that deludes the barely educated global poor with the false hope of a malaria treatment–when they could have been seeking assistance that might actually save their life. It’s even more wrong that it can get the tax exemption status known as 501(c)3 in the US.

What Health Canada does has very real consequences in the rest of the world. Just this week I noticed the following at the UK website, What Doctors Don’t Tell You:

wddty

Health Canada’s approval is being treated internationally as a stamp of legitimacy for these products.  From the BC Medical Journal, Health Canada licenses homeopathic vaccines:

Remarkably, at the same time as Health Canada focuses on influenza education, flu shots, and other proven prevention measures, that same body has licensed 10 products with a homeopathic preparation called “influenzinum.”[8] According to providers, in­fluenzinum is for “preventing the flu and its related symptoms.”[9] Homeopathic vaccines are available for other infectious diseases as well. Health Canada licenses homeopathic preparations purported to prevent polio,[10] measles,[11] and pertussis.[12] Health Canada continues to assure Canadians that it tests products for safety and efficacy before allowing them to enter the market. All approved homeopathic products are given a DIN-HM number. The website states, “A NPN or DIN-HM means that the product has been authorized for sale in Canada and is safe and effective when used according the instructions on the label.”[13]

Homeopathic vaccines are available for other infectious diseases as well. Health Canada licenses homeopathic preparations purported to prevent polio,[10] measles,[11] and pertussis.[12]

This week, Carly Weeks, writing in the Globe and Mail, gave her take on Health Canada’s actions:

Health Canada is responsible for protecting Canadians from unsafe or ineffective products. So why hasn’t the department done anything to stop the sale of nosodes, dubious homeopathic concoctions promoted by many naturopathic and homeopathic practitioners as being superior to traditional vaccines?

It’s a question a growing number of medical professionals are asking. As vaccination rates continue to fall and outbreaks of preventable illnesses, such as measles and whooping cough, are becoming increasingly common, doctors are worried that nosodes could divert more people from legitimate immunization campaigns and lead them to an alternative therapy that doesn’t work.

There are no shortage of proponents, she found:

Many naturopathic practitioners say nosodes are equally or more effective than regular vaccines and that the added bonus is they contain no additives or preservatives, which may be found in trace amounts in some vaccines.

Anna Sienicka, a homeopathic practitioner in Toronto, says she and her family use nosodes and believes they offer protection.

“There are no side effects,” she said. “There are no chemicals or anything else.”

She said that ample research has backed the immunizing power of nosodes. One of the most cited studies, published in the journal Homeopathy, looked at the use of nosodes to prevent leptospirosis, a bacterial disease common in Cuba. After cases of the disease fell, the researchers attributed it to the use of nosodes. However, it’s worth noting that a sizable portion of the high-risk population had already received traditional vaccines, which would help reduce transmission. The study has several other flaws, such as the fact the homeopathic treatment was administered right before the peak of the disease outbreak, after which it would be expected that rates of infection would fall.

Weeks is correct. Contrary to what the homeopath says, nosodes haven’t been shown to prevent leptospirosis. There’s an extensive review of the study over at Science-Based Medicine, and also at Respectful Insolence which points out the numerous flaws in the paper.

Concern about the sale of nosodes has driven the launch of the Stop Nosodes campaign from Bad Science Watch. The campaign has been launched to accomplish a single goal:

Bad Science Watch is calling on Health Canada to stop approving nosodes for sale in Canada and revoke the licenses of all currently approved nosode products. This would include a mandatory recall of all existing nosode products.

Health Canada has essentially eliminated the scientific requirements for approving homeopathic remedies, so we should not be surprised to see products emerge that are promoted as vaccine alternatives. Homeopathic nosodes that are deemed “safe and effective” provides yet another example of the consequence of regulating pseudoscientific practices. This is a regulatory failure, not just for Canadians, but for public health endeavors worldwide. The minimum we should expect from a regulator is that when we’re told a product is “safe and effective” is that we have some assurance it actually works. There’s no societal or individual benefit by licensing homeopathic nosodes for sale. Bad Science Watch is inviting you to take action against nosodes. Join the campaign here.

 

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5 Responses to “More consequences of calling sugar pills “safe and effective””

  1. Zoltan says:

    First off, the only other comment on this blog needs to be removed as “whackjob spam”

    Scott, I wrote Leona Aglukkaq, M.P. and Health Minister, on this topic. I received a form letter with a link to this document:

    http://www.hc-sc.gc.ca/dhp-mps/prodnatur/legislation/docs/ehmg-nprh-eng.php#a1_3

    Section 1.3 says that evidence is required, and points to chapter 8 of the document as to what constitutes evidence. However,

    “For homeopathic medicines that already have a DIN (i.e. transitional DIN applications), further evidence to support the safety and efficacy of the product is not necessary as long as the product has not changed in any way from what was previously approved by Health Canada.”

    So, if HC said it was fine before, then fine, no evidence needed.

    In chapter 8 it says that,

    “Homeopathic materia medica and homeopathic provings are the most commonly available evidence, and are accepted as Level IV evidence.”

    And Level IV is defined as,

    “Peer-reviewed published articles, conclusions of other reputable regulatory agencies, previous marketing experience, expert opinion reports, textbooks, homeopathic materia medica, homeopathic pharmacopoeias, homeopathic provings, homeopathic repertories”

    So! For HC, homeopathic publications publishing the study is considered viable evidence that homeopathy works. Excellent.

    *sigh*

  2. Oliver Dowding says:

    Once again all you skeptics have forgotten to ask how animals recover so well when treated with homoeopathy!
    That must be an awkward one to deal with, especially when it is huge flocks of hens, dairy cattle or any animal on a farm. Hmmm.
    500 dairy cattle, massive success over 15 years – I don’t need no skeptic with a pre-convinced opinion to tell me it did not work or it was just “sugar”.
    That’s all.

    • Dianne Sousa says:

      Oliver,

      That’s the wrong question to ask. I would first ask: “do they recover?” You may think they do, and you may attribute their recovery to homeopathy, but unless you can repeatedly demonstrate this fact under controlled conditions you’ve got nothing.

      • Oliver Dowding says:

        Diane, yes they did, and yes we did repeat this time after time after time after time after time.
        As overseen by a number of sceptic veterinary surgeons. I never did work out why they never had an “Isaac Asimov” moment.
        As undertaken by a number of livestock staff, none of whom were into fabricating results or risking “their” animals which they cared for.
        I suggest you get yourself out onto a farm where its happening regularly and acquaint yourself with reality not perception.
        http://www.hawl.co.uk would be a good start – 3rd in the (very conventional) 2010 Farmers Weekly annual awards in the class “Livestock Advisor of the Year” category.

      • Scott Gavura says:

        @Oliver:
        Looks like you’re assuming that any observed effects in animals cannot be due to the placebo effect. This is a misconception of the placebo effect, which can be due to bias on the part of the observer who is not blinded. It can also be due to different levels of attention, or simply an observational effect – reversion to the mean. The bottom line is that we need good quality, randomized, observer blinded, placebo-controlled trials. Given homeopathy is simply sugar pills without any medicinal ingredients, it would take many well-designed, well-controlled studies to demonstrate an effect. But I’d be happy to review the best piece of evidence you have.

        For more: Is there a placebo effect for animals?

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  • Scott Gavura

    Scott is passionate about improving the way drugs are used. A pharmacist by background, Scott has a professional interest in improving the cost-effective use of drugs at the population level, while helping consumers make more informed decisions about their health. He blogs about pharmacy practice and questionable science at Science-Based Pharmacy and Science-Based Medicine. All views expressed by Scott are his personal views alone, and do not represent the opinions of any current or former employers, or any organizations or associations that he may be affiliated with. 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.