For many, homeopathy is quackery based on unscientific principles, but those who regularly use homeopathic treatments have a very different view. So what’s going on?
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The debate over the effectiveness of homeopathy is not new. More recently, it made headlines after the Australian National Health and Medical Research Council released a draft information document on homeopathy which found that there were “no health problems for which there was reliable evidence of the effectiveness of homeopathy”.
Back in 2010 a report from the British House of Commons stated that the evidence failed to demonstrate a credible physiological mode of action for homeopathic products, and that the available data showed that homeopathic products were no better than placebo.
Yet many people turn to homeopathy to treat a range of health problems, including colds, coughs, ear infections, skin conditions, arthritis and headaches. There are no recent figures available on the use of homeopathy in Australia, but data collected by the Complementary Healthcare Council in 2008 showed that Australians spent at least $11 million that year on form of therapy that all available evidence suggests does not work.
So what’s going on? If Australians – and citizens of many other countries around the world, including Germany, France and India – are voting with their wallets, does that mean homeopathy must be doing something right?
“For me, the crux of the debate is a disjuncture between how the scientific and medical community perceives homeopathy and what many in our communities get from it,” says Professor Alex Broom, chair of the department of sociology at the University of Queensland.
“The really interesting question is how can we have something that people think works when for all intents and purposes, from a scientific point of view, it doesn’t?”
What is homeopathy?
Homeopathy is based on the theory of “like like” treatment and is supposed to work by giving you very small amounts of substances that, in higher doses, would cause the symptoms you want to cure.
The idea is that taking small doses of these substances – derived from plants, animals or minerals – will enhance the body’s healing ability and increase its resistance to disease or infection.
The amounts of these substances in homeopathic products are so small that they are generally undetectable, but they are still claimed to have a biological effect.
Homeopathy is used to treat a wide variety of conditions – coughs, colds, depression, headaches, asthma, arthritis – in fact the most common everyday ailments.
The relationship
Part of the appeal of homeopathy may lie in the nature of the patient-practitioner consultation. Unlike a traditional general practitioner consultation, which lasts on average around 15 minutes, a first homeopathy consultation can last an hour and a half.
“It’s a very important part of what homeopathy does because we’re not just looking at an individual symptom in itself – for us, that individual symptom is part of a person’s overall health.” , explains Greg Cope, spokesperson for the Australian Homeopathic Association.
“Often we have a consultation with someone and we find details that their GP simply didn’t have time to find in 10 minutes of consultation, which often leads them to return to their GP with more information than he had before.”
Writer Johanna Ashmore sees her homeopath once a month for an hour-long consultation, with a telephone check-up in between.
“The fact that your first date is a good hour and a half where she’s asking you about your history, what kind of child you were – the profiling that they’re doing – I feel like If I go to her and tell her I have this health problem, she’s going to treat my body to combat it rather than just treating the symptoms,” Ashmore explains.
She first saw a homeopath to treat a rash on her face that appeared after pregnancy. She was aware of the popularity of homeopathy, particularly through friends living in France, and decided to try it instead of following the medical route she thought her GP would recommend. The results impressed her and she now goes regularly, takes her children to treat minor ailments like worms and has even convinced her skeptical husband who also seems to benefit despite his reservations.
Alternative to medications
Most people see a homeopath after receiving a diagnosis from a “traditional” practitioner, often because they want an alternative choice to medication, Cope says.
“Generally speaking, for a homeopath, their preference is if someone has a diagnosis from a doctor before starting homeopathic treatment, so it is rare that someone comes to us with an undiagnosed illness and certainly If it comes undiagnosed, we would want to refer them and get that medical assessment before starting treatment,” he says.
Since homeopathic medicines are by nature incredibly diluted – and some would argue that they are diluted beyond any hope of effectiveness – they are unlikely to cause any adverse effects, so what’s the harm?
Professor Paul Glasziou, who chaired the NHMRC’s homeopathy working committee, says cost is harm, but the greater harm is the opportunity cost associated with not having effective treatments.
“If it’s just a cold, I’m not too worried. But if it’s a serious illness, you may not be taking basic treatments, and the most worrying thing is things like HIV, which affect not only you but also those around you.” says Glasziou, professor of evidence-based practice at Bond University.
This is a particular concern with homeopathic vaccines, he says, which endanger “herd immunity” – the immunity of a significant proportion of the population – which is necessary to contain epidemics of vaccine-preventable diseases.
As effective as a placebo
The question of a placebo effect inevitably arises, as studies showing that homeopathy is equivalent to placebo suggest that the resulting benefits are a product of the patient’s faith rather than an active ingredient in the medications.
However, Cope rejects the argument that homeopathy benefits disproportionately from the placebo effect, pointing out that homeopathy appears to benefit even skeptics.
“I definitely see in my practice, we usually see the kids first and then we can treat mom and after a few years of nagging, dad comes in and even though dad is only there because mom harassed him, we get wonderful results,” says Cope. .
“What a homeopath sees daily in his clinic cannot be explained by the placebo effect.”
“I don’t care how it works.”
Ashmore is aware that the scientific evidence does not support homeopathy, but she can nevertheless see the benefits.
“I think that if seeing my homeopath once a month improves my health from a psychosomatic point of view, I am happy,” she says.
“I don’t care how it works – I just know that for me it does.”
Wrong criteria?
Homeopathic practitioners vigorously deny the charge that homeopathic treatment does not work, arguing that it is judged by criteria that do not recognize the individualized nature of homeopathic therapy.
Cope says the recent NHMRC review only considered a certain type of evidence, such as the randomized controlled trial that has become the gold standard in Western medicine, putting homeopathy at a disadvantage.
“They’re used to the Western model of evidence that everyone has the same disease, everyone gets the same treatment, and that’s the standard by which they judge the quality of a trial, which doesn’t work for homeopathy because it is the exact opposite of how homeopathy prescribes in practice,” says Cope.
“We take around 100 people with headaches and they each get a different medication or a different prescribing technique depending on their individual situation, which makes it very difficult for people like the NHMRC.”
However, Glasziou says that while this may be a reasonable claim, it is also testable. He cites a trial conducted on Chinese herbal medicine, which compared personalized treatment and standard treatment with a placebo for the treatment of irritable bowel syndrome.
“Homeopathy could copy this trial format, they could test this theory,” Glasziou says, but he continues to argue that the principles of homeopathy make no scientific sense and has yet to find proof convincing of the effectiveness of the treatment.
Cope also points out that the NHRMC review only took into account articles published in English while many studies on homeopathy are published in other languages, notably German.
But if so many people around the world place their trust in homeopathy, despite the evidence against it, Broom questions why homeopathy seeks scientific validation.
“The problem is that if you want to dance with conventional medicine and say ‘we want to prove our effectiveness in treating discrete physiological conditions,’ then you actually have to demonstrate your effectiveness,” says Broom.
“In my view, this is not a question of broader credibility per se, but a question of scientific and medical credibility. There is in fact a lot of cultural credibility around homeopathy within the community, but this is not reproduced in the scientific literature.”
Published on 05/23/2014
