Is homeopathy really so bad?

Medical editor Jerome Burne (last month voted freelance consumer journalist of the year by his peers) thinks attacking homeopathy is misguided. In this post adapted from his blog, he claims the energy would be better spent on investigating dodgy prescription drugs

There is no shortage of villains in the world. Psychopaths (domestic and national), whalers, toxic waste dumpers, global eavesdroppers, billionaire tax avoiders and their army of accountants are all well worth campaigning against, with the aim of getting them banged up or forced to cough up.

There is also an infinite supply of people who are mildly irritating: who misplace apostrophes, wear Croc shoes, do crochet, litter their sentences with ‘you know’ and text using their middle finger.

However, most of us can tell the difference. Picketing shops that sell Crocs, for example, would put you in the mild-to-fairly-irritating and definitely-a-bit-potty class.

One might say the same of the anti-homeopathy lobby, which has picked on something that might, to some, be mildly irritating – homeopathy – and pumped up their dislike into a cause, with a vindictive campaign against homeopaths.

The placebo effect

Personally, I am agnostic about homeopathy. I appreciate the apparent absurdity of the mechanism but I know plenty of perfectly rational people who swear it has helped them.

Maybe it has a strong placebo element but so do anti-depressant SSRIs. The data on effectiveness may be mixed, and both sides can cite sheaves of negative and positive studies.

But unlike regular drugs, these trials are not all run by those selling the remedies; nor do they have vast marketing budgets to accentuate the positive and conceal the negative.

I bring all this up because, recently, H:MC21 (a charity that defends homeopathy) protested outside the offices of the Advertising Standards Authority, which regularly chastises homeopaths for making unsupported claims on websites. H:MC21 has in turn been ridiculed by the likes of Vice.

But I say well done, H:MC21. You see, homeopathy and other complementary and alternative medical (CAM) activities don’t exist in a vacuum. They are part of the healing options open to all of us.

Drugs driven by big pharma, not evidence

You can’t make a judgement about CAM without considering what may be involved in taking allopathic drugs for your ailments.

I won’t rehash all the evidence for pharma’s sometimes fraudulent practices and unreliability (Ben Goldacre’s latest book, Big Pharma, does that comprehensively). But it does seem useful and revealing to highlight the stories about the risks involved in taking drugs that were reported in just a single recent issue of the British Medical Journal (BMJ) on 22 June.

Take Alteplase, which is widely prescribed on the NHS for the treatment of acute stroke and recommended by NICE. An investigation has just found that only two of a dozen randomised trials of Alteplase showed benefit while five had to be stopped early because of “lack of benefit, higher mortality and a significant rise in brain haemorrhage”.

The investigation also found that the clinical guidelines (what doctors rely on to guide them) for Alteplase had been written by experts who nearly all had links with companies making or marketing the drug.

Meanwhile, a German study has just found that the use of anti-psychotic drugs – powerful tranquillisers with a nasty range of side effects – on children aged ten and older had increased in the past four years by 41 per cent “for no medical reason”. There is good reason for thinking the situation is similar in the UK.

What do these drugs do to a developing brain? We’ve no idea. Is this worrying and probably not in the children’s best interests? I think so.

The charges against homeopathy

Now, a central charge against homoeopathy is that there is no evidence it works. OK. But what about the missing evidence for the effectiveness of Tamiflu? For at least three years, researchers have been asking to see the full evidence that this flu drug, on which the NHS has spent £500 million, cuts infection risk or shortens the time you are sick.

The BMJ reported that its editor had told a Commons committee that only half of the Tamiflu trials had been published, and that a positive trial was twice as likely to be published as an unsuccessful one.

This is a long-running problem and possibly a little more dangerous than homoeopathy. So these are all examples of why it is perfectly rational to suspect you may not be told the entire truth about both the safety and the effectiveness of standard treatments and why it makes sense to try something else.

Members of the anti-homeopathy lobby, such as the Nightingale Collaboration, usually advance the following arguments for why homeopaths must be hounded: that any reported benefit is due to the placebo effect; that treatment claims therefore lack evidence and are fraudulent; and that homoeopathy distracts patients from getting a real treatment that works.

But all of these can be applied with equal force to one or more of the drug examples covered in the BMJ.

So, ultimately, what Nightingale is attacking is the intelligence and judgement of people who are trying to find an effective way to heal themselves.

If homeopathy, which even its most virulent critics cannot claim is remotely likely to be harmful, works for you, then someone needs to combine serious arrogance with real battiness to believe they have the right to stand in your way.

Jerome Burne won freelance journalist of the year at the Medical Journalists’ Association Awards in July 2013