I previously blogged an editorial by NBC medical correspondent Robert Bazell, where he told scientists to “quit whining” about intelligent design and instead work on teaching “values.” While I agreed with him there on the science (he made it clear he gave no respect to “intelligent design” and other types of creationism), his suggestion that teachers and scientists spend more time worrying (and teaching) about more “practical” things such as biotechnology and medical ethics was just, in my opinion, wrong. Luckily, his new editorial on alternative medicine contains no such red herrings.
Bazell focuses on the National Center for Complementary and Alternative Medicine (NCCAM). The core of Bazell’s argument is that, even though testing of all kinds of alternative medicines has been done over the last 15 years (at a cost of over $100 million annually), the results have all been negative–but no one cares, and because of regulatory laws that don’t require many “alternative” medicines and drugs to actually, y’know, work, it makes no difference anyway.
Last week’s study showing that the widely touted and sold supplement DHEA does nothing to slow the effects of aging was only the latest major piece of research with powerfully negative results from the National Institutes of Health Center for Complimentary and Alternative Medicine. Previous placebo-controlled trials proved the uselessness of St. John’s Wort and saw palmetto for enlarged prostates, shark cartilage for cancer, echinacea for the common cold and glucosamine plus chondroitin sulphate for arthritis.
But it doesn’t matter much — few seem to care.
A problem, he notes, is that too few people actually care about what the research says. Instead, they rely on “well, this worked for my friend” types of rationalizations, and dish out their money on quackery:
The powerful industry that sells these products ignores the results and often finds allies who believe in them because of an anecdote or advertisement.
After the chondroitin results appeared, Jane Brody, the longtime health columnist for the New York Times who has always prided herself in offering advice based on scientific research, wrote that she would continue taking chondroitin for her knee pain because “it transformed my 11-year-old spaniel from an arthritic wreck into a companion with puppylike agility, giving him nearly six more active years.”
It’s hard to argue with anecdotes like that, and people taking these types of supplements in spite of the research, rather than because of it. Ironically, of course (as Orac can tell you), many who take these alternative meds do so because of a distaste for “big pharma” or “corporate medicine,” despite the fact that alternative medicine is just as much (if not more) of a moneymaker:
Marketers often sell them under the guise of a mom-and-pop alternative to big pharma. Yet the $29 billion-a-year dietary supplement industry wields such power that it got Congress to pass a law in 1994 that basically frees it to peddle almost anything that doesn’t kill people with claims of medical benefit that need not be proven.
No doubt some of the thousands of products sold as dietary supplements work well, but the industry that sells them has neither motivation nor desire to know which ones work and which don’t.
And this is the crux of the problem. There’s no reason for those who sell these supplements to prove they work, because it’s not a condition of their sale. They can just slap on the small-print disclaimer that their product hasn’t been proven effective in laboratory tests, or isn’t approved to treat such-and-such condition, and they can still market it. Nice work if you can get it. Even worse are the credentialed people they get to push it, and lend an air of credibility:
On [Dr. Andrew Weil’s] Web site someone recently inquired if a supplement called NT was useful for fatigue. “I’m not convinced by the scant literature on the subject that there’s anything to recommend taking NT Factor for fatigue,” Dr. Weil replied, in a surprisingly forthright response.
But, then he added that the fatigue sufferer might want to try “Siberian ginseng (Eleutherococcus senticosus), coenzyme Q10, the Ayurvedic herb ashwaganda or cordyceps, a traditional Chinese medicinal mushroom that may help fight fatigue and boost energy levels.”
I can find no evidence that any of these relieve fatigue any better than NT.
It gets better.
Dr. Weill concluded his answer by advising that a better-studied treatment might be something called Juvenon. At the bottom of the Web page appeared an ad from the manufacturer of Juvenon with the quote “I take Juvenon every day — Dr. Andrew Weil.”
Such crass commercialism would put most big drug companies to shame.
…and I’d add profit in general is a major target of many who oppose mainstream drug companies, but the commercialism displayed by “alternative” companies is somehow overlooked.
Unfortunately, what Bazell leaves out are suggestions about what to do now. Close down NCCAM altogether and immediately? We have a serious catch-22 here. We do want studies done on these “alternative” medicines, so we can justify saying they’re crap (or, be surprised when they actually work). But the problem is, as mentioned, that for the companies that make them, it doesn’t matter if they work–they can market them anyway, even if they’re no better than a sugar pill placebo. This loophole needs to be closed before any serious reform can be made to NCCAM–and that’s not going to be a politically popular arena to step into.
[Edited to add: Abel has a post on this up today as well–check it out for further reading].