Respectful Insolence

Homeopathy is what I like to call The One Quackery To Rule Them All. Depending upon my mood, I’ll use more or less of J.R.R. Tolkien’s famous poem about the One Ring from The Lord of the Rings, but the point is usually made. Homeopathy is major quackery.

And it is, too. On the off chance that there’s a newbie reading this who hasn’t been a regular reader of this blog or other skeptical blogs and doesn’t know what homeopathy is. (Regulars can skip this paragraph if they wish, but I wouldn’t. It’s entertaining.) Basically, homeopathy is a system of magical medicine thought up over 200 years ago by a guy named Samuel Hahnemann. Basically, Hahnemann came up with two main concepts. The first is “like cures like,” which in practice meant that Hahnemann advocated using substances that caused the symptoms in healthy individuals in order to treat those same symptoms. Of course, there’s no real scientific rationale for this principle, but Hahnemann went even further off the deep end by further proposing that those remedies had to be diluted and that serial dilutions (with vigorous shaking, or succussion between each dilution step—homeopaths will tell us that this is essential) and that the potency of the remedy would increase with increasing dilutions. Of course, this alone is totally ridiculous based on some very basic principles of chemistry and pharmacology, but violating principles of chemistry and pharmacology isn’t enough for homeopaths. Oh, no, they have to violate the laws of physics by diluting their starting remedies to nonexistence. For example, a 1C homeopathic dilution is a 1:100 dilution, and a typical homeopathic dilution is 30 C, which equals 10030, or 1060. There’s just one problem. Avagadro’s number (the number of molecules in a mole) is 6.023 x 1023, or, just for the sake of ease, around 1 x 1024 rounded up. That means that a 30C homeopathic dilution is roughly 1036-fold more than Avagadro’s number. That means that the odds of even a single molecule of remedy being left after a 30C dilution is infinitesimal. In fact, any dilution greater than around 12C is unlikely to have more than one molecule of starting remedy in it, and even “weaker” homeopathic dilutions (less than 12C, which means they have more starting remedy in them) tend to fall into concentration ranges so dilute that even they’re unlikely to do anything.

In other words, homeopathy is nonsense, pure pseudoscience. What does that make homeopaths? I think you know the answer to that. They’re quacks. What else would you call practitioners of The One Quackery To Rule Them All?

Apparently, a general practitioner in Glasgow named Des Spence agrees that homeopathy is nonsense, so much so that he even said so in an editorial in the BMJ. Unfortunately, somehow he still manages to entitle his editorial (which he’s published on his very own blog as well), Good Medicine: Homeopathy. In it, as he states clearly and bluntly that homeopathic remedies don’t have any remedy in them (for presumably the same reason I just explained above). Unfortunately, he doesn’t just stop there. Unfortunately, what he writes makes me wonder what Fiona Godlee and the editors of the BMJ were thinking when they allowed this drivel to appear in the same pages that Brian Deer’s fantastic deconstruction of Andrew Wakefield’s antivaccine pseudoscience and scientific fraud appeared:

It was an intentional overdose. To prove a point I poured about 30 tiny tablets into my mouth and crunched them down. Because scientifically, I do not believe that these homeopathic pills have any active ingredient.⇑

Today, homeopathy is medicine’s whipping boy, repeatedly and systematically beaten to the ground. Yet despite explaining that the tablets are just placebos, homeopathy always gets up to take another beating. Some homeopathy is funded by the NHS, through general practice, and in the few homeopathic hospitals. This fact enrages the growling commissars of evidenced based medicine who want homeopathy purged from the NHS.

The “growling commissars of evidence-based medicine”? Is Dr. Spence for real? At least, with that one phrase alone, Dr. Spence has made it very clear what he thinks of science- and evidence-based medicine; he has utter contempt for it and those who try to promote it and who point out that homeopathy is quackery because, well, if there is a quackery more quacky than homeopathy, I’m hard-pressed to think of it right now. Yes, Dr. Spence. Homeopathy is medicine’s whipping boy for a reason. Actually, it’s medicine’s whipping boy for many reasons, not the least of which because, for homeopathy to work, more than one law of physics and chemistry would have to be proven to be not just wrong but spectacularly wrong. Now, normally, although it’s high implausible that we could have gotten the laws of physics that fantastically wrong, I suppose that, strictly speaking, it’s not impossible. However, to demonstrate that so much science supported by so many decades of careful experimentation and observations from multiple scientific disciplines would require more than some equivocal clinical trials whose results are entirely consistent with homeopathy being nothing more than placebo. Apparently Dr. Spence agrees that homeopathy is quackery but doesn’t agree with the conclusion that follows from that premise, namely that homeopathy shouldn’t be used and homeopaths are quacks:

So does homeopathy work? This depends what you measure. Does it cure infection, degenerative conditions, and cancer? It most certainly does not. And if any such claims are made they must be vigorously denounced. But homeopathy is most commonly used for medically unexplained symptoms in patients dismissed as neurotic; the so called “worried well.” These patients have passed from specialist to specialist, enduring repeated invasive and needless negative investigations. Or homeopathy is used in addition to, but not instead of, conventional treatments.

Let this sink in. Dr. Spence has just said that he thinks it’s acceptable to give something to patients and tell them that it will help them when it certainly will not. Homeopathic remedies are, after all, nothing more than water or whatever solvent is used to dilute the original remedy into nonexistence. (Sometimes ethanol is used.) Dr. Spence knows that. Dr. Spence agrees that that’s what homeopathy is. That’s why what I find even more disturbing is the level of contempt for the “worried well” that Dr. Spence’s post about homeopaths demonstrates. Oh, sure, he isn’t open about it. He disguises it quite well as compassion. But in reality what he is doing is saying, in essence, “I know homeopathy is quackery. I know there’s nothing to it. But homeopaths are such caring people and these worried well are so hard to deal with. Might as well give them water disguised as real medicine, all packed up into little sugar pills, tell them it will cure what ails them, and maybe things will be OK.” The subtext is, of course, that it will also get the “worried well” out of the doctor’s hair.

Of course, Dr. Spence would strenuously disagree with my characterization of his viewpoint, namely that he is advocating lying to patients and implying that what homeopaths do is good even though they are quacks because they seem so very, very caring, but that’s what he’s doing, and he’s deluding himself if he thinks otherwise. To him apparently it’s all good because medicine is controlled by big pharma pushing drugs and homeopaths aren’t. In fact, Dr. Spence makes an explicit argument for placebo medicine, but then he completely overestimates placebo responses, claiming that they might be as high as 80%, which is much higher than any estimate of placebo responses, even for subjective measures, that I have seen. But that’s OK to Dr. Spence. He doesn’t mind, because:

The homeopathic doctors I know are caring people, disillusioned with the crudeness of conventional medicine, not your typical aggressive alpha medical type. They are not in the pay of big pharma, whose drugs potentially kill 100 000 people a year in the United States alone.1 They listen, spend time, and offer some explanation for the unexplainable—and their patients like them. The effect of homeopathy is the positive effect of a therapeutic relationship that is reassuring, accepting, and supportive. Society should never underestimate the healing effect of a kind word or the value of a holistic approach.

This may surprise you, but in one aspect I agree with Dr. Spence. No, I don’t agree with him regarding the oft-cited and exaggerated estimate that drugs kill 100,000 people a year in the US. I am, however, relieved that he didn’t trot out Gary Null’s estimate of 780,000 deaths per year, which, if it were true, would make iatrogenic deaths the number one cause of death in the U.S. by far at approximately one-third of all yearly deaths. (I’m thankful for small favors in that.) No, I don’t agree that “conventional” medicine is “crude.” If you want crude, actually, you should go for homeopathy. It is, after all, incredibly crude in that it uses long-discredited methods thought up over 200 years ago, long before doctors even accepted the germ theory of disease. Back in those days, bloodletting was still considered a science-based treatment. So was purging with toxic metals, and diseases were thought to be due to either an imbalance of humors or the influence of miasmas. Indeed, back then, homeopathy looked good to some because doing nothing was better than the medicine of the time. Medicine has progressed a lot in 200 years, though. These days, giving patients water, patting them on the head an saying that everything will be OK is no longer acceptable. In fact, the only thing that is shocking is how long the paternalistic attitude that it’s OK to tell patients that something will work in order to get them to believe that it will (even though it’s obvious that it won’t) is OK. This sort of paternalism held out until the 1960s, 1970s, and even 1980s. Fortunately, however, this paternalism no longer holds sway, at least not as much as it used to, and it’s continuing to weaken. Be that as it may, I agree with Dr. Spence that the therapeutic relationship with a patient is important. I just don’t agree that it’s acceptable to lie to a patient or to feed him nonsense (whether I myself believe it or not) in the service of that relationship. Doing so poisons the relationship with unrealistic expectations.

Sadly, doctors like Dr. Spence don’t understand that. Their version of the “therapeutic relationship” is not a relationship in which the health practitioner must tell patients the truth, even when it’s an unpleasant truth. Oh, no. His version demands that the practitioner either believe nonsense and pseudoscience and communicate that belief to patients, all in the name of the “therapeutic relationship that is reassuring, accepting, and supportive,” or that he lie to the patient. Take your pick. Either way, it equates the “therapeutic relationship” to the power of the physician, though the awesome power of his presence alone, to invoke placebo responses. Think I’m exaggerating? Think I’m invoking a straw man? Think again. Take a look at Dr. Spence’s last paragraph. Not only is it a a complete false dichotomy, but it’s an insult to the intelligence and dedication of any physician who supports science-based medicine:

There is no hard evidence for homeopathy. But likewise the more you understand of research evidence the more you understand it is mere modern marketing quackery. There may be some dangerous homeopathic charlatans, but there are plenty in mainstream medicine too. We need to accept that patients will still use homeopathy, and having access to it through the NHS means it is regulated and safe. As for the cost to the NHS, this is roughly the same as a single week of antidepressants,2 3 medications that are little better than placebo.4 Modern medicine has real capacity to do harm but often minimal good; homeopathy has minimal capacity to do harm but real capacity to do good. Homeopathy is an easy target; we would be better to focus on the failings of conventional medicine. Homeopathy is bad science but good medicine.

As a medical researcher myself, I have a simple message for Dr. Spence in response to his apparent belief that research evidence is “modern marketing quackery.” That response is: Screw you, Dr. Spence. You know nothing. You demonstrate it in the false dichotomy between science, which has its shortcomings but is responsible for an incredible increase in life expectancy and decrease in suffering, and homeopathy, which Dr. Spence equates to scientific medicine, even though it’s pure quackery. But to him it’s all good because homeopaths care so very, very much, apparently.

Dr. Spence may not realize it, but he’s just advocated lying to patients, foisting what he knows to be pseudoscience on them, all because it’s cheaper, because the people doing the foisting are allegedly so caring, and because he thinks placebo medicine is acceptable. I do not, and I think Dr. Spence is an idiot.

Comments

  1. #1 Grant
    September 18, 2012

    “Dr. Spense has just said that it’s OK to give something to patients and tell them that it will help them when it certainly will not.”

    An extreme example of local counterpart of this line of reasoning was a naturopath who ‘acquiesced’ to her patient’s wishes and treated her scalp tumour anyway. Apparently, “Mrs Nelson acknowledged that Mrs Maine needed to see a doctor, but said her [Mrs Nelson’s] philosophy was to put patients’ wishes first.” – rather than refer the patient on in their best interests.

    (The tumour eventually ate into the patient’s skull. The patient had surgery, but died a year later. I’m waiting to hear if, or not, further action will be taken against the practitioner. FWIW, I can recall spotting that one of the many, many remedies used on the patient was a local homeopathic product.)

  2. #2 dingo199
    September 18, 2012

    What a lot of mixed up thinking. Des Spence is clearly a very intelligent chap, but becomes quite muddled in his focus.

    Modern medicine has real capacity to do harm but often minimal good; homeopathy has minimal capacity to do harm but real capacity to do good.

    Did he really say that? Cursory reading makes that seem that he says modern medicine causes more harm than good, but homeopathy can only do good. certainly that is the inference many will draw from that.

    But what about indirect harms? What about all the unquantified damage that is done because deluded people resort to homeopathy when they should be taking something that actually works instead? Spence fails to consider any of that.

    And what’s this about wanting to keep homeopathy in the NHS? The fact that it may cost less than other interventions, or make him feel all warm and fuzzy inside because patients might like it is not a reason to divert scarce NHS resources to it. By all means the NHS needs to make sure conventional medicine is as effective and safe as possible, but don’t allow it to waste taxpayers money on magic water.

    The homeopathic doctors I know are caring people, disillusioned with the crudeness of conventional medicine, not your typical aggressive alpha medical type. They are not in the pay of big pharma, whose drugs potentially kill 100 000 people a year in the United States alone.

    So are the NHS doctors in the pay of bigPharma? Not that I am aware of. Does Spence not know any NHS doctors who are caring or unaggressive? He must have a tiny professional and social circle.

    What on earth is the NHS like in Scotland? Is it some fairy tale land atop of the Enid Blyton Faraway tree, where if you are ill, along will come a kind, caring homeopath who will cure your cancer, or treat your myocardial infarction (since the NHS would merely kill you)? Spence makes it sound like that. Hope I don’t visit and get sick there.

    We need to accept that patients will still use homeopathy, and having access to it through the NHS means it is regulated and safe.

    Ahhh, he means that the NHS should prescribe cigarettes, whiskey and heroin to the smokers, drinkers and drug addicts, so that it is “regulated and safe”. There is a school of thought that suggests this, but I never thought Spence would be going down that line. And why stop there? Some people will always use weapons like knives and guns, so let’s allow them on the NHS too. Makes sense to Spence, makes sense to me.

  3. #3 Tom Griffiths
    September 18, 2012

    >>Ahhh, he means that the NHS should prescribe cigarettes, whiskey and heroin to the smokers, drinkers and drug addicts, so that it is “regulated and safe”. <<

    I don't think he does mean that and I don't see the point or need to ascribe dafter things to people who are already daft enough.

  4. #4 Michael Edmonds
    New Zealand
    September 18, 2012

    I agree with Dingo199 – Dr Spense’s “reasoning” is all over the place and includes some glaring inaccuracies.

    “research evidence the more you understand it is mere modern marketing quackery.”
    Obviously he has no idea of what research really is

    “They are not in the pay of big pharma”
    Big red flag – invoking conspiracy with Big Pharma

    Given that there is now evidence that placebos work even when the patient knows they are being given a placebo, there is no justification for a doctor to lie to a patient.

  5. #5 elburto
    September 18, 2012

    As a Brit who’s chronically ill, and therefore a frequent flyer, I’ve experienced first-hand the impact of the recent NHS budget cuts.

    To think that anyone would advocate p¡ssing money up the wall in order to placate the bloody middle-class woo-loving worried well? I’m infuriated.

    There’s barely enough money around to keep hospitals open, and this idiot wants to waste more of it on placebo pushers.

  6. #6 nz sceptic
    September 18, 2012

    It doesn’t help that we have a ‘news series’ running in our most prominent local paper this week, based upon the ‘deaths in hospitals’ scenario. Basically it goes that if anyone dies in hospital (and forgetting most people go there when they’re ill), they’re a victim of the system, and by implication, no doubt, a victim of conventional ‘big pharma’ too!

  7. #7 herr doktor bimler
    September 18, 2012

    having access to [homeopathy] through the NHS means it is regulated and safe.

    Struth. Has not the man just argued that homeopathy is intrinsically, necessarily safe — by dint of its lack of effect — whether it is accessed through the NHS or any other means?

    drugs potentially kill 100 000 people a year in the United States alone.

    Yes, I suppose many therapeutic drugs do have the potential to kill 100 000 people a year, if taken as overdoses; the question, Dr Weasel-Word, is how many people they *actually* kill.

    Homeopathy is medicine’s whipping boy for a reason.

    I disagree with this choice of words. A whipping boy served a genuine purpose in the economy of a medieval castle; his employer *wanted* him there to receive occasional thrashings. Conversely, homeopathy serves no purpose and if it were to vanish tomorrow, Medicine would incur no inconvenience from the loss.

  8. #8 Krebiozen
    September 18, 2012

    “They are not in the pay of big pharma [...]”
    No, they do it all out of the goodness of their hearts (hoeopathic giant Boiron has an annual turnover of at least € 313 million).

    [...] whose drugs potentially kill 100,000 people a year in the United States alone.

    But how many lives do they save, and how many people do they allow a quality of life that would be impossible without them? As I have pointed out many times, the drugs that kill more people than any others are anticoagulants, NSAIDs and narcotic painkillers. Perhaps Des Spence knows of an effective homeopathic treatment for clotting disorders, arthritis and chronic pain (I’m not denying that addiction to opiates is a problem).

    Also, being in a similar situation to elburto, I am similarly annoyed at precious NHS resources being spent on this nonsense.

  9. #9 dingo199
    September 18, 2012

    Tom, you wrote:

    >>Ahhh, he means that the NHS should prescribe cigarettes, whiskey and heroin to the smokers, drinkers and drug addicts, so that it is “regulated and safe”. <<

    I don't think he does mean that and I don't see the point or need to ascribe dafter things to people who are already daft enough.

    Fair enough, I accept he didn’t really mean that, but what really is his view?

    The idea that homeopathy should remain within the NHS so that it is “regulated and safe” to me implies that it is a dangerous thing when used outside the NHS, and is inherently unsafe when being dispensed by private homeopaths or bought over the counter.

    There is really no other interpretation, so why does Spence contradict himself here (having earlier said homeopathy has “minimal capacity to do harm but real capacity to do good”)? If that is the case, why does he argue for regulation?

    This is just another example of his muddled thinking. Someone needs to show him how to join the dots without upending the entire ink bottle into his lap.

  10. #10 Krebiozen
    September 18, 2012

    HDB,

    Has not the man just argued that homeopathy is intrinsically, necessarily safe — by dint of its lack of effect — whether it is accessed through the NHS or any other means?

    Maybe he is aware that homeopathic medicines are sometimes counterfeit [derisive snort] and/or contaminated with active and poisonous ingredients. Luckily the NHS has a special lab they use to test whether homeopathic remedies are genuine, using a revolutionary machine that runs on pixie dust.

  11. #11 dingo199
    September 18, 2012

    Clearly Spence is not advocating homeopathy for anything remotely medically serious and which needs conventional treatment. He thinks it is “good medicine” because all the “heartsink” patients, the chronically worried well and chronically ill for whom he has no conventional treatment can be fobbed off with a referral to his homeopath friends. This relieves him of the burden of having to keep seeing them, and making them happy now they are on a magic sugar pill.

    I’ve said it before and I’ll say it again now. If making patients “feel better” is the reason for the existence of the NHS, then why are holidays in Barbados not prescribable? They work out cheaper than those antidepressants Spence doesn’t like, and leave the patients well rapped.

  12. #12 Dangerous Bacon
    September 18, 2012

    Everybody knows that being nice to patients means offering them sugar pills and lying to them. That’s how you build a relationship founded on trust and respect.

  13. #13 Krebiozen
    September 18, 2012

    Ahhh, he means that the NHS should prescribe cigarettes, whiskey and heroin to the smokers, drinkers and drug addicts, so that it is “regulated and safe”.

    A controversial statement perhaps, but IMO the arguments for prescribing heroin on the NHS are far more convincing that those for prescribing homeopathy.

  14. #14 Sean Jungian
    September 18, 2012

    I’m a recent reader of your blog, and therefore don’t really have any right to comment. And while I agree with your takedown of Spence for the most part – that he is granting unwarranted legitimacy to what is essentially snake-oil – one (really minor) thing bothered me about your post, and that is this:

    ” it’s OK to tell patients that something will work in order to get them to believe that it will (even though it’s obvious that it won’t)”

    I don’t think even traditional “Western” medical doctors ever tell a patient that something will definitely work, do they? Every doctor or health professional I’ve ever interacted with (and yes, my experience doesn’t mean it’s a universal one) has always made it very clear to me that something *MIGHT* work. I assumed even homeopaths give that caveat.

    I don’t disagree with your assessment. I’m one of those people who likes to read opinions (especially when I think I probably agree with them). I just think that when you’re trying to debunk charlatans that maybe its misguided to use the same overstating techniques they use in arguments. But like I said, it’s a minor quibble.

  15. #15 Todd W.
    http://harpocratesspeaks.com
    September 18, 2012

    @Sean Jungian

    Welcome to RI! Stick around, and feel free to comment about anything.

    I do, however, disagree with your take on things. Whether the doctor says, “This will work” or “This might work”, there is implicit in the doctor’s prescription that there is at least a chance of it working. In the case of homeopathy, there is no chance that it will objectively work. So Orac’s point is still on target. The honest doctor would tell the patient, “This is a tic-tac. It will do absolutely nothing for you other than, perhaps, leave a sweet taste in your mouth and make you think that it’s actually doing something even though it’s not.” Anything short of that, even a lie by omission, is dishonest and shows a lack of respect for the patient.

  16. #16 Beamup
    September 18, 2012

    @ Sean:

    Welcome!

    Your assumption is unfortunately unfounded. Homeopaths routinely do claim that their sugar pills ALWAYS work. Just have to find the right remedy for your specific set of symptoms. So we’ll try this one, and that one, and this other one, and then when your cold goes away in seven days instead of a week, we’ll credit the last remedy tried with the cure.

    All too easy to manufacture situations where, no matter what happens, the woo “worked.”

  17. #17 johnV
    September 18, 2012

    “So does homeopathy work? This depends what you measure.”

    (insert picard and riker double face palm image)

  18. #18 T.
    September 18, 2012

    Peraphs people WANT to be paternalized. It would explain a lot of quackery.

  19. #19 Prak
    September 18, 2012

    I can agree with Dr. Spense at one point:

    Homeopathic medicine is well suited for patients with imaginary diseases.

    People are strange…

  20. #20 Den!s
    September 18, 2012

    hahaha “Growling commisars” … I’m stealing that for possible later use, I love it. Orac nailed it, this guy is an idiot.

  21. #21 Sean Jungian
    September 18, 2012

    @Todd W.

    Thank you, and you make a good point about the fact that a homeopathic remedy has NO objective chance of working, thus the lie. Thanks for pointing that out, I hadn’t considered it.

    @Beamup: Thank you for the welcome! I understand what you’re saying, although believing that homeopaths present it like that is something I’m still skeptical of and I’d need more evidence of before I believed it. Regardless, as I said before it’s really a minor point, and Todd W. made a good case for why it is, indeed, a lie as Orac posits.

    I’ve enjoyed Orac’s writing very much and also the comments. I am always wondering how/why people get involved in these kinds of fringe/anti-rational groups (Truthers, Anti-Vaxers, etc. etc. etc.), I always wonder what the payoff is for them.

    I actually got to this blog via a circuitous route that began with researching the current hot health topic in the US of “The Obesity Epidemic” and it’s (seems to me) malignant offspring, the “Childhood Obesity Epidemic”. I am starting to think that it, too, might be one of those true-believer faith-based movements, although I’m still trying to figure that out. And I wouldn’t have even been chasing down THAT specious topic if I hadn’t been at a recent PTA meeting where we were told (by state Nutritional Education rep, no less) that “Over 400,000 children die in the US every year due to obesity”. That little gem was outrageous enough to make me look for the source of that claim (since the reps, when asked, did not know).

    Anyway, I’ve taken up enough space, all this is to say that, I hope that if the Anti-Obesity cause turns out to be a crank cause after all, that Orac will post about it. Meanwhile I’ll keep going through the fascinating and disturbing archives.

  22. #22 Comrade Carter
    September 18, 2012

    I’m heading off to buy some homeopathic medicines. Can somebody here tell me what I should get and what I should use it for? I have a sink the needs draining.

  23. #23 Tonylurker
    September 18, 2012

    I have one quibble with the statement:

    ” Back in those days, bloodletting was still considered a science-based treatment. So was purging with toxic metals, and diseases were thought to be due to either an imbalance of humors or the influence of miasmas. ”

    Back in those days there was no science-based medicine. There was Philosophy-based medicine. The scientific method was still being formed, the germ theory was not yet accepted, and science was distinctly not being applied to medicine. The standard western medicine of the day was based on Greek philosophy about balancing bodily humors. (It was a traditional system of medicine that had been practiced for thousands of years!)

  24. #24 kruuth
    September 18, 2012

    So by his reasoning we should just do what we think will make the patient “fell” good disregarding the actual consequences?

    Isn’t hypochondria something that should be addressed and not coddled? Imagine people being scheduled for unnecessary, but more or less harmless procedures that don’t harm that patient…..but the operating theatre and time is now consumed, time and an operating room that could be used to treat a genuinely sick patient.

  25. #25 Denice Walter
    September 18, 2012

    @ nz sceptic:
    One of the idiots I survey has been spreading the crazy idea that doctors and hospitals *cause* illness and death of patients. They left something out, I venture. ( Similarly, there’s a meme that ARVs *cause* hiv/aids). His seminal work** is called *Death by Medicine* which has had diverse incarnations as an article, book and so-called documentary film. Someone should really report him ( and his enablers- including a struck-off Canadian doctor, Carolyn Dean) for the way they mercilessly torture numbers. Harriet Hall and James Laidler have both written about it.

    @ T.
    You have something there. Woo-meisters radiate a sense of omnipotence that might be more comforting to frightened people than telling them the truth. I unfortunately have heard scared people seek out these prevarciating minstrations. It’s not pleasant.

    ** of wankery

  26. #26 Bronze Dog
    September 18, 2012

    T.:

    Peraphs people WANT to be paternalized. It would explain a lot of quackery.

    Very, very yes. That’s one of the themes I see in a lot of woo, especially quackery. They want absolute authority figures who can make pronouncements from on high, quite often because they can’t handle the fact that we live in an uncertain world where experts can make mistakes.

    Sometimes I worry about humanity on a psychological level. There are a lot of people who can’t seem to break out of hierarchical, authoritarian mindsets, and my inner pessimist often worries that it’s hardwired, not just caused by ignorance. Can’t give up the good fight, though, since I know there are people who can change for the better.

    @Sean Jungian: My general assessment is that widespread obesity is a real problem, but unfortunately there’s always some people who lie, exaggerate, and pass on plausible-sounding lies to ramp up the urgency. The 400,000 figure sounds pretty outrageous to me as well, so good for you for working to track down the source. I’d like to cut down on child obesity, but I wouldn’t want to lie to achieve that end or let others get away with lying for an otherwise good cause.

  27. #27 Laura
    Ithaca NY
    September 18, 2012

    I think Dr. Spence is trying to be a nice guy by accommodating homeopathy. Being funded by the NHS means that homeopathy is entrenched in Britain, and someone with a certain mindset will try to be inclusive of something that is popular. Especially if they’re in clinical practice and their patients often bring it up, maintaining a hardline anti-bogosity stance is too much conflict for some people.
    I think a lot of the supposedly “worried well” who turn to alternative medicine, are suffering from immune system problems. Especially since immune system problems can cause vague and common symptoms like “brain fog”, joint pain, back pain, fatigue, and people can have allergies that don’t show up on the standard skin and blood tests (look up “local allergic rhinitis” and “entopy” for more info). Such problems might be part of the explanation for CFS, fibromyalgia, toxic mold syndrome, delayed food allergies, “candida overgrowth”, etc.
    I call them the “supposedly” worried well because without positive lab tests, doctors may consider someone to be basically well – yet they can be very sick.
    Yes, many of these “alternative” people are quite nice – “people people” who believe their feelings give them good guidance.

  28. #28 Krebiozen
    September 18, 2012

    Sean,

    “Over 400,000 children die in the US every year due to obesity”

    As you suspected, since only about 10,000 children aged from 1-14 die every year in the US from all causes, and only around 50,00 from 0-19 (from another source I won’t link to to avoid moderation) this is clearly nonsense.

    I was similarly annoyed by claims, repeated by people who should know better, that, “this is the first generation of children that will die before their parents”. I tracked this down to a gross misinterpretation of a slight decrease (by about 0.1 of a year) in life expectancy at birth between 2004 and 2005. Not the same thing at all. Life expectancy has increased by at least four years since then (see Table 22 here).

  29. #29 Heliantus
    September 18, 2012

    The effect of homeopathy is the positive effect of a therapeutic relationship that is reassuring, accepting, and supportive.

    I wish supporters of alt-med would make up their frelling mind.

    On one hand, they accuse mainstream medicine to only address symptoms, not the underlying cause of diseases.
    And on the other hand, like Dr Spence, it’s suddenly perfectly OK to lie to the patient to make him/her feel better (in other words, it’s OK to mask/relieve the symptoms while not curing the disease itself).

    To be fair, Dr Spence doesn’t seem to bring on the first meme (although, if he uses “holistic”…)
    To be more fair, his point is based on reality, in that generally patients want doctors to spend more time with them.

    But, if you need some sort of counselling, go for the real thing, not to someone who is going to tell you that popping sugar pills is going to solve your problems.

  30. #30 Krebiozen
    September 18, 2012

    Typo – should read, “Life expectancy has increased by at least a year since then”.

  31. #31 Narad
    September 18, 2012

    And on the other hand, like Dr Spence, it’s suddenly perfectly OK to lie to the patient to make him/her feel better (in other words, it’s OK to mask/relieve the symptoms while not curing the disease itself).

    Even were homeopathy to work as advertised, it would still, by definition, only treat symptoms, since these are just different manifestations of disruption of the Vital Energy. No symptoms, no disruption. Poof!

  32. #32 Sean Jungian
    September 18, 2012

    @Krebiozen – yes, the line about the lower life expectancy was also trotted out at the same meeting – and when I asked about the source of that stat, I was again told “I don’t know”. I did track down all the published literature I could find, including the death statistics for children in the U.S., and wrote to both the presenters and to the local newspaper who quoted them.

    It’s like @Bronze Dog says, too. I think it very likely that there may be a problem with obesity in this country. But when officials (and media outlets as well, though I don’t hold them as highly accountable as the officials who are supposed to know) give misleading and outright made-up “facts” to support their conclusions, that makes me question EVERYTHING they are saying. This was all done to support some changes we had int he school lunch program, changes I actually do agree with. But its a red flag to me when they choose to use such inflammatory and dishonest information to support their position, when there is plenty of real information they could use. That doesn’t give them the shock factor, though.

    The sad thing is, no one else at the meeting batted an eye. I did point out that I didn’t think nearly a half million children in the U.S. were dying every year in ANY case, and that I thought we’d have noticed something like that. Everyone looked at me like I was just being cantakerously rude and contrary.

  33. #33 BrerScientist
    September 18, 2012

    @Sean Jungian
    The idea that 400,000 children die each year due to obesity is ridiculous. According to the CDC stats for 2009 (http://www.cdc.gov/nchs/fastats/children.htm), there were 48,033 deaths from all causes for children aged 0-19. If you include everybody up to age 59, you get close to 400,000, for deaths from all causes.

    Obviously, this statistic was pulled from some bodily orifice, and passed from person to person, growing in the telling each time.

  34. #34 Krebiozen
    September 18, 2012

    Sean,

    This was all done to support some changes we had int he school lunch program, changes I actually do agree with.

    That’s where I came across it, specifically from Jamie Oliver, who is the person who should know better I was referring to. To his credit he has abandoned it more recently, presumably as a result of people pointing out it’s not even remotely close to being true.

    I also think the obesity epidemic has been overhyped, though it is a real concern, as is the (probably related) increase in type 2 diabetes in young people. Facts, not hyperbole, are what we need to make real changes. There was an interesting article in a newspaper I read recently but have misplaced, suggesting that inactivity may be a result of, not a cause of, obesity. It’s easy to jump to the conclusion that inactivity and junk food are to blame, but it’s possible there may be something else going on. It’s probably the vaccines [/sarcasm].

    Everyone looked at me like I was just being cantakerously rude and contrary.

    Challenging people’s prejudices and preconceptions often elicits that reaction for some reason ;-)

  35. #35 Sean Jungian
    September 18, 2012

    @BrerScientist – yes I used that very link to find the actual number of deaths. And of those, more than half (27,000+) were infants whom, I assume, did not live long enough to become obese.

    I suppose that people just don’t have any clear idea how many deaths take place in the country, and I suppose that shouldn’t be surprising. But still, you’d think a number like 400,000 children would at least raise an eyebrow, or, conversely, that they could use the real numbers and not really hurt their case (since people don’t have a real concept of the numbers anyway).

    Besides all that, though, I couldn’t find any studies attributing obesity as a determining factor in CHILD deaths, only that overweight and obesity in children tends to predict the same in adulthood.

  36. #36 lilady
    September 18, 2012

    @ Sean: Welcome aboard.

    Now your statement about doctors saying a medicine *definitely* or *might* work…

    Doctors just don’t conjure up the type of antibiotics to prescribe for a bacterial infection, they have the literature from drug manufacturers and actual studies to refer to, that provides specific information about bacteria *sensitivities* and *resistance* to the various types of antibiotics. They also have methods of culturing/growing the bacterium specimen to determine if it responds to the first line narrow spectrum antibiotic…and if it doesn’t.

    It is the same process that is developed for the treatment of primary hypertension with or without coronary artery disease and all of the diseases/disorders that a GP/internist is likely to encounter in his/her practice.

    http://www.aafp.org/afp/2008/0715/p270.html

    Just because physicians are busy and they don’t have the time to chat up a patient, doesn’t mean that we should hand over the care of any patient who needs *stroking* or who is a hypochondriac, to the care of these *oh-so-kind* snake oil salesmen.

  37. #37 JBC
    September 18, 2012

    @Laura

    What is entopy? I could only fine entRopy–as in the second law of thermodynamics.
    ———–
    The thing with childhood obesity might be that there is the POTENTIAL (if the epidemic is not addressed) of this huge number of premature deaths. I don’t think there is any question about there being an actual childhood obesity problem–although the word epidemic is probably misunderstood in common parlance.

  38. #38 Sean Jungian
    September 18, 2012

    @lilady – Hi and thank you.

    As I stated, I was only giving anecdotal (and admittedly not universal) information about my own interactions with health professionals. My doctors have always used phrases like, “we can try this…” and “let’s give this a try and if you’re still having problems…” My point was only that even (my own) medical personnel don’t ever say “this WILL (definitely, positively, absolutely, no question) work”. And I realize that using my personal experience doesn’t mean it is universal or even common.

    In any case, @Todd W. already pointed out that, even if a homeopath DOES use this kind of language, it’s still a lie (since the practitioner knows it has no chance of working). I realize that most traditional doctors do have a basis for thinking that something may work in a given course of treatment.

    @JBC from what I’ve found just in accidentally looking into the obesity epidemic, there might indeed be a question whether there is one or not. I have only questioned it in light of inaccurate facts being presented in support of halting it (when accurate facts would just as easily serve that purpose). I never doubted it prior to this. In any case, there is no doubt that we would want to give children the best nutrition we can and teach them to live as healthily as possible.

  39. #39 elburto
    September 18, 2012

    Welcome Sean!

    Krebiozen – after my work in the NHS I firmly believe that prescription heroin would save a lot of money, especially compared to the failure that is “liquid handcuffs”, methadone. The dentistry bills alone would be slashed. In primary care I’d speak to users with mouths full of rotting stumps, who ironically needed to top their methadone up with heroin because of debilitating dental pain.

    Laura – I actually believe a lot of the Woo-sers have functional disorders. It would certainly explain a dramatic “recovery” due to a sugar pill and a smile.

    Finally, Orac (and the rest of Team RI!) Have you seen this? –

    http://www.thetwentyfirstfloor.com/?p=4914

    It’s about. our old friend Burzynski. You know those magic disappearing brain tumours? Stan prescribes dexamethasone to his patients. What does that do on imaging? Makes it look like the tumours are receding, or gone.

    If he actually is aware of this, then he’s even sicker than I thought possible.

  40. #40 lilady
    September 18, 2012

    @ Sean Jungian: Your debut here and your excellent posts are the start of a brilliant career as a *Big Pharma Shill*. (You’ll know you have *arrived*, when our resident trolls come out to play and accuse you of joining our international cabal).

    Be assured that your posts are being watched by our beneficent Lord Draconis Zeneca and shortly your *good works* here, will be *rewarded*. :-)

  41. #41 Calli Arcale
    September 18, 2012

    Sean Jungian:
    Welcome, and great screen name!

    @Beamup: Thank you for the welcome! I understand what you’re saying, although believing that homeopaths present it like that is something I’m still skeptical of and I’d need more evidence of before I believed it. Regardless, as I said before it’s really a minor point, and Todd W. made a good case for why it is, indeed, a lie as Orac posits.

    Well, stick around — maybe Dana Ullman will pop by. ;-) He shows up sometimes on sciencebasedmedicine.org as well. He’s a bona-fide homeopath, and frequent apologist for homeopathy. He usually tries to argue it really works, then disappears abruptly. He’s a fairly high profile person on the topic, actually.

    Regarding lunch programs and obesity . . .

    Here in the Twin Cities, we’ve run into something interesting. A lot of school districts are overhauling their lunch menus, and at one school, students are protesting by brown-bagging their lunches — because the caloric content is inadequate for them. We’re talking teenaged male athletes being fed a diet that might be adequate for a first grader’s caloric requirements. I also have a serious worry about the kids whose only good meal every day is a subsidized or free lunch at school. Some of them are actually pocketing part of the lunch for their preschool-age siblings. Reducing the size of the meal is brutal to them, but of course nobody pays much attention to that part of the population anyway, the part that’s starving. And I seriously doubt that *anybody* was ever getting fat on school lunch. I mean really; it’s not like it’s the most awesome food you’ve ever seen. It’s one meal out of the day. If kids are getting fat, it’s not likely the fault of school lunch.

  42. #42 Sean Jungian
    September 18, 2012

    @lilady – I can’t wait to see those Big Pharma dollars and gift baskets start rolling in!

    @Calli Arcale – I haven’t run into Mr. Ullman but I look forward to seeing the commenters in action. I’m usually of the opinion “whatever gets ya through the night” when it comes to individuals choices, but my line is drawn deep at the point where it begins harming others. And I believe turning people to bogus therapies (especially when it is a concerted mass effort involving wholesale deceit), is where that line is crossed.

    We’re nearly neighbors, although we’re worlds away in some ways. I’m over in rural eastern ND, and we have had the same thing happen here – again, mainly speaking of high school athletes who, without supplemental food from home, just plain run out of gas before they even get to practice. But many parents of our elementary-school-aged kids are also packing, in essence, a second lunch for them to take with them.

    But above all, I wholeheartedly share your concern for our lower-income kids. I have occasion to work with several charities in our area, and the demand for assistance has skyrocketed just in the last 8 months, while at the same time budget cuts have been made to nearly all local services. In my letter to the local paper, I pointed out that nearly 15% of the children in our county live in poverty (and that percentage goes up when we have migrant farm workers) and that the school-provided breakfast and/or lunch may indeed be their ONLY complete, full meal for the day. Add to that the fact that this is an area with only a single (high-priced, low selection) grocery store within 30 miles. People in this part of the country tend to only acknowledge what directly affects them and people just like them, and turn blinders to anyone else. If you are not a married, white, well-to-do farmer (or farmer’s spouse), with the time and resources to travel 50 miles each way to get to a reasonable grocery store, they just do not think you matter.

    I do think the caloric requirements are unnecessarily restrictive in our new plan. While we were told that the changes were made, in part, because they saw the complete failure of trying to control weight by focusing on fat content, they still insist on having a very very low fat content.

    I also am beginning to question what is being counted as “overweight” and “obese” among our children. Granted, I am in an isolated, rural area; we have a total of maybe 500 school-age children. Still, (anecdotally), I am not seeing 1 out of every 3 children here as obese or overweight. I know the scale and way of measuring was overhauled; I do not know if this is indeed more accurate, or less. But I question it. I also wonder about encouraging eating disorders by focusing so much on diet; at the same time, while physical activity is shown to be one of the larger factors in determining good health, this is undermined by reducing physical education classes, cutting recess times, and keeping kids immobile during class. I just question all of it.

    All right, I’ve inadvertently hijacked this thread, and I apologize for that. Not an auspicious start for a newbie, and I thank you all for being so patient.

  43. #43 Sean Jungian
    September 18, 2012

    @ elburto – thank you!
    @Krebiozen – I agree with everything you posted. I do think there may be something to the obesity epidemic, particularly wrt diabetes becoming so prevalent, but my cantankerously rude nature forces me to resent having disingenuous hyperbole shoved down my throat. I prefer facts, please, real ones. You don’t have to scare me into compliance. When the message is delivered with such wild-eyed panic, my bullspit radar goes up.

    I agree that we don’t want to saddle a generation with potential health problems. But let’s figure this out, not hit the panic button. It reminds me of the unintended consequences we’re burdened with now from the famous “No Child Left Behind” initiatives. And above all, ignoring the very real social and economic factors that promote obesity is a guarantee that this attempt to slim down our kids will fail.

  44. #44 herr doktor bimler
    September 18, 2012

    the arguments for prescribing heroin on the NHS are far more convincing that those for prescribing homeopathy.
    after my work in the NHS I firmly believe that prescription heroin would save a lot of money, especially compared to the failure that is “liquid handcuffs”, methadone.

    Heroine is still prescribed through the NHS, and becoming more widely so, though the hurdles are still daunting:
    http://en.wikipedia.org/wiki/Heroin_maintenance

    The less-restrictive prescription policy up until the 1960s (when the US put pressure on the UK government to fall into line with the War on Drugs) was far more successful.

  45. #45 Edith Prickly
    September 18, 2012

    I’d like to know where Dr. Spence gets off dismissing anti-depressants as “little better than placebo.” They’ve made an immeasurable improvement in my quality of life. I wonder what he gives his depressed patients – bad advice?

    Sean – welcome! I can recommend a couple of resources for science-based information on obesity. Dr. Arya Sharma, the Chair of Obesity Research and Management at the University of Alberta, writes an excellent blog about his work at http://www.drsharma.ca. Dr. Yoni Freedhoff of Ottawa’s Bariatric Medical Institute also writes a blog called Weighty Matters – he often writes about children and obesity prevention programs, so you may find some useful information in his archives.

  46. #46 Edith Prickly
    September 18, 2012

    hmmm, not sure I did those links right — my HTML-fu is weak. The blog addresses are http://www.drsharma.ca and http://www.weightymatters.ca.

  47. #47 Edith Prickly
    September 18, 2012

    I apologize in advance if I’m spamming up the thread, but I thought Sean might find this interesting. Dr Sharma recently wrote about a study done at Yale’s Rudd Centre for Food Policy that looked at whether public health messages about obesity are helpful or just further stigmatize the obese: http://www.ncbi.nlm.nih.gov/pubmed/22964792 (look Ma! my first PubMed reference!!)

  48. #48 tim gueguen
    September 18, 2012

    I wouldn’t be surprised if there are “homepathic” remedies that are anythiing but. I suspect a lot of people think the term homeopathic is just a synonym for natural or herbal, and that could include people makikng alternative medicine products. If more people actually understood that a homepathic preparation contains nothing but solvent they’d probably reject the idea.

  49. #49 Denice Walter
    September 18, 2012

    @ Sean Jungian-
    (Who knows, perhaps my Shadow is Jungian)

    The woo-meisters I survey often ridicule the standard western diet as causing obesity and THEN present madly orthorexic regimes that wildly restrict calories, fats, carbohydrates or proteins ( e.g. vegan, Weston Price or Paleolithic, GFCF). These nutritionists scoff at what SB dieticians promote. I have seen bizarre ritualised meal plans prescribed that often include fasts and handfuls of supplement washed down with green juice ‘smoothies’ and other raw food/ powdered vegetable/ fruit concoctions..

    Perhaps people fall prey to their simplistic solutions and sales pitch because they are overweight or fear obesity for themselves or their children. I can relate how 10 and 15% body fat are recommended for men and women, respectively ( not a good idea) by fellows who parade their leanness and brag about their athlethic prowess and hint about other ‘ability’. I met one live: 3% body fat is not attractive.
    These charlatans promote odd ideas about health that harshly characterise overweight people as being self-indulgent whereas their own regimes smack of eating disorders and narcissistic self-worship.

    Unfortunately, I have to leave for a while but welcome aboard.

  50. #50 Sean Jungian
    September 18, 2012

    @Edith Prickly – thank you, and thanks for taking the time to look up the links for me (the second post has them right).

  51. #51 Sean Jungian
    September 18, 2012

    @Denice Walter – thank you. But would you even know your Jungian Shadow if you saw it? heh

    The groups you mention, the avid and/or fanatical devotion to a particular food philosophy, this is exactly the kind of true-believer (or “woo” as y’all say here) group I find so fascinating (like flat-earthers, Creationists, Anti-Vax, etc. etc.). I wonder what component they possess that draws them together around a (usually) anti-intellectual, anti-science ideal. With the internet it seems like it’s easier than ever for fringe groups like these to coalesce and mobilize.

  52. #52 dingo199
    September 18, 2012

    Edith,
    Antidepressants should be reserved for moderate to severe depression, (and only when other strategies have failed perhaps). They do have a long list of undesireable side effects.
    Some are even worse at fixing depression than placebos.
    http://blogs.scientificamerican.com/guest-blog/2010/11/30/the-antidepressant-reboxetine-a-headdesk-moment-in-science/

  53. #53 lilady
    I'm not in Kansas, Dorothy...but still under a tornado watch
    September 18, 2012

    Sean Jungian: Some more statistics for the triad of childhood obesity, high blood glucose/Type II diabetes, and hypercholesterolemia:

    http://www.cdc.gov/healthyyouth/obesity/facts.htm

    BTW Sean, our overlord, the wise and beneficent Lord Draconis Zeneca, sometimes *honors* special requests. One of the *beloved posters* here, receives her filthy lucre remuneration in Proof Krugerrands.

    @ Laura:

    “I think a lot of the supposedly “worried well” who turn to alternative medicine, are suffering from immune system problems. Especially since immune system problems can cause vague and common symptoms like “brain fog”, joint pain, back pain, fatigue, and people can have allergies that don’t show up on the standard skin and blood tests (look up “local allergic rhinitis” and “entopy” for more info). Such problems might be part of the explanation for CFS, fibromyalgia, toxic mold syndrome, delayed food allergies, “candida overgrowth”, etc.
    I call them the “supposedly” worried well because without positive lab tests, doctors may consider someone to be basically well – yet they can be very sick.
    Yes, many of these “alternative” people are quite nice – “people people” who believe their feelings give them good guidance.”

    Linky, linky, linky for all your statements, Laura.

  54. #54 HeidiK
    September 18, 2012

    I’m reminded of an article,”The Triumph of New-Age Medicine,” that appeared in the “Atlantic Monthly” last year. It makes many of the same arguments:

    http://www.theatlantic.com/magazine/archive/2011/07/the-triumph-of-new-age-medicine/308554/

    (FWIW, I”m a librarian, not a scientist, but I was still disturbed by it.)

    (FWIW, I”m a librarian, not a scientist, but I was still disturbed by it.)

  55. #55 Krebiozen
    September 18, 2012

    elburto and HDB,
    Methadone? Madness IMO. Junkies don’t like it so they sell it to buy heroin, putting more opiates n the street, and it’s packaged up in a syrup that might be deliberately designed for children to accidentally overdose on. I firmly believe that education and abstinence programs, with prescribed heroin as a stopgap, are the only way we can defeat this horrible problem. It could be funded if necessary by buying opium from farmers, cutting out the organized criminals, and selling clean pure heroin (without crap like anthrax in it) to addicts. Surely that couldn’t be worse than the current mess? I watched an interesting documentary on the subject recently by Russell Brand, unlikely as that may seem, but he is a recovering heroin addict and knows of what he speaks.

  56. #56 Mephistopheles O'Brien
    September 18, 2012

    The Growling Commissars would be a killer name for a rock band. Just sayin’.

  57. #57 Vasha
    September 18, 2012

    @dingo1999, I’m another one whose life has been greatly improved by antidepressants — it took 10 years to get my depression under control, but 8 years ago I finally found the right medication, and haven’t had a single major mood dip since! I wouldn’t consider stopping the meds, at this point. This in spite of the fact that they do raise my blood pressure, and cardiovascular problems run in my family to begin with. Consider that if I was crippled by depression, I wouldn’t be able to sensibly think about solutions for my cardiovascular health.

  58. #58 Vasha
    September 18, 2012

    Addendum: however, you’re certainly right about some physicians having altogether too casual an attitude about prescribing antidepressants when not needed. I recall (I know, citation needed) someone prescribing them for a woman who was distressed because her husband had died the day before. Madness!

  59. #59 dingo199
    September 18, 2012

    @Heidi……Yeah…. quite.

    Then Lao had explained how acupuncture would open blocked “energy pathways” in his body, allowing a more normal flow of energy

    http://www.theatlantic.com/magazine/archive/2011/07/the-triumph-of-new-age-medicine/308554/

    Garbage.

  60. #60 Denice Walter
    September 18, 2012

    @ Sean Jungian:

    I certainly would know my Shadow because I WOULDN’T like her at all! The Shadow is supposed to be the same sex so I need to imagine what type of women I don’t like ( wouldn’t identify with)…

    At any rate, those I survey have been spreading their message ( which is not limited to health mis-information) using internet print and broadcast ( internet ‘radio” /’ tv”/ film) and here’s some ‘food’ for thought:
    they try to influence school children through parents and teachers. MIke Adams ( Natural News) gives ‘grants’ of 1000 USD to schools who spread his gospel; Gary Null is trying to get charter schools/ church groups to initiate his vegan programming. Both of these guys get their followers to spread the word via social media and to barrage legislators whenever a political issue is voted on.
    So this is more than just a business for them.

  61. #61 Denice Walter
    September 18, 2012

    @ Vasha:

    Anti-depressants- esp SSRIs- are often decried by alt med prevaricators who mention side effects multiplied to the nth power ( “They CAUSE suicide and mass shootings!”) whilst failing to mention the relief they provide- often enabling depressed people to live relatively normal lives. Alt med never fails to discourage people from taking meds.

    They are difficult to ‘get right': while I don’t counsel people who are depressed, I do know ( in my personal life) quite a few people who do suffer from depression with variable success with meds. I have a tendency toward dysthymia myself which I manage without meds BUT if it ever ‘got worse’ or I couldn’t function well I would certainly take meds.

    Best wishes to you.

  62. #62 Sastra
    September 18, 2012

    T. wrote:

    Peraphs people WANT to be paternalized. It would explain a lot of quackery.

    After listening to my alt-med friends wax lyrical about the Magical Placebo and the power of belief in response to my science-based criticisms, I jokingly asked them if they went to their naturopaths wearing t-shirts saying “Lie To Me.” They didn’t seem to quite want to reject the idea.

    I don’t think the advocates of the placebo see it as “paternal medicine.” Paternal medicine is when your doctor tells you your problems are all in your head — or gives you a strong drug and refuses to tell you what it is. Authoritarian, brusk. No, what they want is “maternal medicine.”

    Mommy is caring and kind and can put herself in your place in a very respectful way. Her “fibs” aren’t really fibs if they work. Kisses to make it better — what could be wrong with that? She’s going to get down on your level and make you feel special. Believe in yourself: she does.

    People want to be maternalized.

  63. #63 Narad
    September 18, 2012

    I firmly believe that education and abstinence programs, with prescribed heroin as a stopgap, are the only way we can defeat this horrible problem.

    I’ve been starting and abandoning comments on this subject, but here goes again. I should preface the comment by stating that I’m in the U.S., so the social safety net is of a substantially looser weave. Anyway, I have a close relative who managed to get very close to the bottom of the heroin potential well. Twice, really, but the second time around was the catastrophic one: $350 a day for two individuals. This person has been clean for over a year, but this is due at least in part to being subject to probation-based drug testing that is the result of an unrelated (well, mostly; I feel compelled to be somewhat vague) and subsequent incident. Stick. The new, different compatriot, once through the same channel, has the carrot of possibly regaining a professional license.

    I imagine that it’s possible for some opiate addicts to function reasonably well with maintenance doses. Methadone also seems to be a fruitless attempt at a middle path. But I just don’t know that stopgap “tastes” are promising in any way at all, whether they be the real thing or being strung along with a substitute. I think I may be tilting toward a form of carrot-based encouragement of abstinence with ongoing monitoring as a condition. And I don’t really know who would want to pay for that sort of thing when labor is cheap.

  64. #64 al kimeea
    September 18, 2012

    @ Sean Jungian – My experiences through two clinical studies were very like yours. Nothing certain, just various possibilities with some greater than others.

    Never promised a cure or told side effects were anything other than a possible list. And please let us know of any effects not currently listed.

    And I was treated as more than a numbered patient, contrary to how “House” portrayed studies.

  65. #65 Denice Walter
    September 18, 2012

    @ Sastra:

    I always think of woo as being either ‘spa’ medicine or ‘grandmother’ medicine, respectively,
    either someone strokes your body with lotions or a person pats you on the head and gives you tea.

  66. #66 Edith Prickly
    running for the shelter of her mother's little helper
    September 18, 2012

    @dingo199

    Antidepressants should be reserved for moderate to severe depression, (and only when other strategies have failed perhaps). They do have a long list of undesireable side effects.

    I am quite aware of that, but I also think there is still a stigma against taking meds for mental illness – I certainly used to think that way – and comments like Dr. Spence’s don’t help.

    When my doctor first suggested I go on antidepressants I was resistant at first too, because I’d had episodes of situational depression in the past that resolved on their own. However, at the point I went to see her it had been several years and had gotten to the point where it was affecting my relationships and work situation – but I was still in denial about it. I figured that since I could still get out of bed every day (with difficulty) and appear functional to the people who mattered, it couldn’t be that bad but in fact, I was an empty shell of my former self and completely miserable. I had tried like hell to “will” myself out of it, but it was too entrenched by that point.

    My doctor was really good about it — she did all the things alties like to claim doctors never do, like listen to my concerns, answer my questions, and have me come back regularly for checkups. Going on the pills certainly wasn’t a cure-all. I’m still doing a lot of work on myself to recognize the dysfunctional thought patterns and behaviour that got me stuck there, but without the pills I wouldn’t have the energy or desire to do that.

    I did read the link in your comment – that is unfortunate, but developing and testing mental health drugs is a complicated process. I know a little bit about the history of treating mental illness with drugs, and there is very good reason to be cautious, but I also think we shouldn’t be too quick to dismiss all psychiatric drugs because one turned out to be ineffective. Sorry that I’ve taken up a lot of space with what’s essentially a long anecdote, but I’ve become rather sensitive lately to people who say cavalier things about depression (meaning Spence, not you.) :)

  67. #67 Grant
    Procrastinating tackling more of the garden in my break...
    September 18, 2012

    Denice Walter

    “@ nz sceptic: One of the idiots I survey has been spreading the crazy idea that doctors and hospitals *cause* illness and death of patients.”

    Reminds me of terribly-done graph by a “risk analyst” [sic] whose efforts are on a number of natural-health sites and claims to show that ‘natural’ remedies are the safest and hospital intervention the worse in terms of death. (Said RA is, amazingly, still trying to have the last word over on the ‘sad premature death’ thread.)

    Of course the base-lines are different as you say (hospitals cater for the seriously ill) and there’s no consideration of indirect effect in the ‘natural’ remedies, that giving, say, homeopathic treatment can delay sound treatment by which time the illness is more difficult to treat.

    Anyway, ’nuff said, etc. :-)

  68. #68 Cath of Canberra
    September 19, 2012

    My doctor also never tells me a drug will definitely work. His style is more: “Let’s try this one; it will probably work.” Or “This one might not work, but has few side effects so we’ll try it first.” I’ve made it pretty clear that I’m the science-based type, and he seemed very happy about that.

  69. #69 Denice Walter
    September 19, 2012

    @ Grant:

    Believe me, I’ve been to the land of Bad Graphs: amongst the all-time standouts are the ones that supposedly show that VPDs were already declining prior to the introduction of vaccines. I should find that: it is a precious example of lying in a pictorial format.

  70. #70 Politicalguineapig
    September 19, 2012

    Edith Prickly: I’ve been off and on anti-depressants, and I think it’s very variable from person-to-person, and it also depends on the anti-depressant. I never saw very much improvement, though my family thinks otherwise. I’m currently off anti-depressants, but considering going back on the ADD meds; that’s much more of a problem right now.

    Calli Arcale: Linkies, please? I live in the Twin Cities too, and I never heard a whisper of this. Of course, all of my siblings are out of high school now.

    Sean Jungian: Oh, good god do I hate this ‘obesity epidemic’ meme. It reminds me of how much sh*t I got as a chunky unathletic kid. I’m still chunky, but I get loads of exercise, eat a balanced diet, and I’m in good health. I’m a fan of Michelle Obama, but I really wish she’d shut up about obesity.

    Though if Romney wins, I will probably have to aquire an eating disorder, just to ensure I never get pregnant. (Yes, I am aware that is a terrible idea.I don’t have time for surgery.)

  71. #71 TLorquin
    the lurker cave
    September 19, 2012

    @Sean Jungian
    This may provide you with some other ways to look at obesity. (sorry, first time poster, no hyper-linky from me)

    http://www.haescommunity.org/

  72. #72 TLorquin
    September 19, 2012

    oh hey, it worked!

  73. #73 Edith Prickly
    September 20, 2012

    @Politicalguineapig

    I’ve been off and on anti-depressants, and I think it’s very variable from person-to-person, and it also depends on the anti-depressant. I never saw very much improvement, though my family thinks otherwise. I’m currently off anti-depressants, but considering going back on the ADD meds; that’s much more of a problem right now.

    I agree, from what I’ve read there does seem to be a wide variety of responses to anti-depressants and I imagine that having other conditions present (like ADD) would complicate matters. I feel very lucky that I found one that worked on the first try. I hope you eventually find something that works for you.

  74. #74 Calli Arcale
    September 20, 2012

    Politicalguineapig

    Calli Arcale: Linkies, please? I live in the Twin Cities too, and I never heard a whisper of this. Of course, all of my siblings are out of high school now.

    Link in moderation. Short version: I saw it reported on the TV, and a quick web search shows the protest is actually over the border in SW Wisconsin.

  75. #75 Sean Jungian
    September 20, 2012

    @TLorquin – thanks for coming out of lurkerdom to get me a link!

  76. #76 JustNuts
    September 20, 2012

    @ Denice Walter:

    Yes, that VPD graph – I’ve seen various forms of it flaunted a number of times on anti-vax forums. But it’s DEATHS, not INCIDENCE. And from about the 1930s to present, advances in medications and care is the principal reason for the drop in death incidence. Vaccinations just add to that drop – precipitously!

  77. #77 Glaxxon PharmaCOM Terrabase DIA
    Just over there . . . no, not there, there by the shiny thing.
    September 20, 2012

    MESSAGE BEGINS———————————

    Shills and Minions:

    There’s nothing quite like that “new shill smell,” is there? The new recruit is always so fresh faced and eager to start receiving filthy PharmaLucre™. I’m sure young Jungian will make a mark for himself our our happy, avaricious, little cadre. Times like this make my schaden just that much more freude.

    And minion Jungian, we know that you have your choice of marauding alien species and grasping cabals to whom you might give your loyalty, so we at PharmaCOM would like to thank you for making the Glaxxon Empire your subjugator of choice.

    Lord Draconis Zeneca VH7iHL

    Foreward Mavoon of the Great Fleet, Subjugator General of Terra, Monkey Master of Mars

    Glaxxon PharmaCOM Terrabase DIA
    00010111001111101011111

    ———————————-MESSAGE ENDS

  78. #78 lilady
    September 20, 2012

    See Sean, I told you that your auspicious debut here, would be noticed by our magnificent and beneficent overlord, Lord Draconis Zeneca. Congratulations!!!

  79. #79 Chris
    September 21, 2012

    Perhaps you should actually spend a month with a homeopath and see the evidence for yourself rather than reading an opinion of another and then recycling it, which is what everyone on the internet essentially does.

    You won’t find the true knowledge on the internet, unless you come across a website from someone who has first hand experience. Much stuff on the internet is just opinions, much like yours. However, you have no clinical experience and don’t have the first clue about compartmentalization based upon some of your other posts.

    It’s amazing all the placebo effects people “have” with homeopathy. They walk into the clinic with notes from allopaths which have failed them, but yet they eventually leave cured, and remain cured. Perhaps we should do a study on the “extended placebo effect.” Or perhaps, the “indefinite” placebo effect.

    Could you imagine what would happen if homeopathy killed a million people a year? Talk about a feast being had by all the beleivers in the incompetent field of allopathy. But that is what you have. 1 million people die at the hands of allopathic medicine each year. Where is your article on that? How about writing an article on the side effects of Lipitor and why they still prescribe it. Better yet, why don’t you write an article illustrating how lipitor affects the electron transport chain and ubiquinone. Oh shoot, you mean get into the biochemistry of it? Ahh, well…you can’t do that can you? But you can write an article based on…an opinion. I once had many opinions that I thought were correct, but that was in 6th graded when I didn’t know any better. However, you are either still completely arrogant and delusional, or you are a person who is paid to misinform people much like Stephen Barrett, who actually emailed me telling me that a build up of toxins doesn’t cause disease. The irony is that he runs a quackwatch site. He’s the biggest quack of them all. And you are nipping at his heels.

  80. #80 Grant
    September 21, 2012

    “1 million people die at the hands of allopathic medicine each year.”

    This is the same crankery I referred to in my previous comment.

  81. #81 Narad
    September 21, 2012

    1 million people die at the hands of allopathic medicine each year.

    Perhaps you’d like to break out which of these homeopathy is going to take care of.

    However, you are either still completely arrogant and delusional, or you are a person who is paid to misinform people much like Stephen Barrett, who actually emailed me telling me that a build up of toxins doesn’t cause disease.

    By definition, homeopathy cannot address a “build up of toxins,” as speculation about the cause of symptoms is not on the table. There is only One Disease.

  82. #82 Sean Jungian
    September 21, 2012

    @Lord Draconis

    I await my instructions….and my Introductory Gift Basket.

    I almost snorted my coffee through my nose when I read this. Thank you!

  83. #83 Chris
    Neither here nor there...
    September 21, 2012

    So, Chris, just give us the case report of homeopathy actually curing Type 1 diabetes, syphilis, or hypertrophic cardiomyopathy that does not involve any other form of treatment. Like the septal myectomy my kid had earlier this year, or the betablockers that he takes to decrease the probability of tachicardia, which landed him in the emergency room.

    Make sure you cite using the title, journal and date of the properly evaluated PubMed indexed case report.

  84. #84 herr doktor bimler
    September 21, 2012

    However, you have no clinical experience

    I take it that this is addressed to Orac.

    However, you are either still completely arrogant and delusional, or you are a person who is paid to misinform people

    Can’t he be both?

  85. #85 bad poet
    September 22, 2012

    @Sean, welcome!

    Seems to me that homeopaths (and naturopaths for that matter) derive whatever “success” they have with their patients (or should that be victims?) from the talk therapy, not the sugar pills, water/alcohol potions and other stuff they sell.

    WRT antidepressants, my shrink and I have agreed to stick with newish generic stuff after a couple of disastrous tries of new products being sampled. We’ll stick to science over marketing. (I’ve got ADD and BPII, so that just makes it a little more time-consuming….)

  86. #86 Politicalguineapig
    September 24, 2012

    Edith: Thanks!
    Callie: Link appears to have been gobbled by the moderating software. I’ll run a search for it..someday.

    Bad Poet: My condolences. I’ve had a few bad experiences myself with meds. They either don’t work, or they have side effects that are humdingers. Odd ones too; did you know there’s an ADD med that thins blood? Combine it with a bad winter and you get crime-scene level nose-bleeds.

  87. #87 Krebiozen
    September 24, 2012

    I still find it slightly startling that someone like Chris can complain about Orac making “uninformed” comments about homeopathy, and then come out with a smorgasbord of completely nonsensical and easily refuted claims, such as:

    It’s amazing all the placebo effects people “have” with homeopathy.

    Not really. Study after study shows that homeopathy has no more effect than placebos. Homeopathy has never, ever, been shown to have cured anyone of anything anywhere. You disagree? Please provide some evidence.

    1 million people die at the hands of allopathic medicine each year.

    Out of kindness, I will let you know that if you use the word “allopathic” without irony on a science blog, most people will assume you are an ignoramus. Anyway, where is your evidence for this? Do you mean globally? Just in the US? Even Gary Null’s execrable ‘Death By Medicine’, doesn’t claim 1 million deaths each year. That travesty is based on a few deaths several decades ago extrapolated to the entire population, counts the same deaths multiple times, counts patients with bedsores who die as having been killed by medicine and has several other serious problems that render it completely useless as a source of information. Many people who die are very sick and in the hospital where they are likely to be on drugs that have some serious side-effects. Homeopathy, on the other hand, has no effects at all, apart from encouraging people to reject real medicine.

    How about writing an article on the side effects of Lipitor and why they still prescribe it.

    Maybe because its benefits greatly outweigh its risks in high-risk patients, with a 12% reduction in all-cause mortality? Of course that hardly compares to the effect of homeopathy on all-cause mortality in cardiovascular patients, or any patients come to that, which is non-existent. Any comment on that Chris?

    Better yet, why don’t you write an article illustrating how lipitor affects the electron transport chain and ubiquinone. Oh shoot, you mean get into the biochemistry of it? Ahh, well…you can’t do that can you?

    I’m sure Orac could and would if he thought it was of interest, since he is a research scientist. The effects of statins on ubiquinone synthesis are well-known, but there appears to be little clinical significance, as supplementation with CoQ10 has little or no effect on myopathy in statin patients. It was a plausible hypothesis that inhibition of ubiquinone synthesis might be responsible for myopathy in statin patients. It was tested scientifically, found to be false and abandoned.

    I once had many opinions that I thought were correct, but that was in 6th graded when I didn’t know any better.

    Guess what Chris; not much has changed.

    Stephen Barrett [...] actually emailed me telling me that a build up of toxins doesn’t cause disease.

    It’s true that if you expose people to more toxins than their bodies can excrete, that can cause disease. It’s also true that people with impaired kidney or liver function can accumulate toxins that can cause illness. I’m sure that Dr. Barrett is well aware of this.

    However I suspect that’s not what you mean, and that you are suggesting that people with normal kidney and liver function, continuously accumulate toxins from their food, drink and environment that eventually cause specific diseases. This is a common belief that has infested the internet, but there’s very little evidence that it is true.

    Why do you believe this? What evidence have you seen that supports this idea? What specific toxins are you referring to and which specific disease? If they were real chemicals, we would be able to identify them, show that their concentration increases in people as they get older, and demonstrate that there is a correlation with disease.

  88. #88 Chris
    Not that "Chris"...
    September 24, 2012

    … just to be clear. ;-)

  89. #89 dingo199
    September 25, 2012

    Oh My oh my! I’ve bin lookin at the responses in the BMJ to Spence’s article.
    http://www.bmj.com/content/345/bmj.e6184?tab=responses

    What a rambling, incoherent rant from “Dr” Vera Scheibner, retired paeleontologist.

    It reminds me of that Worms Armageddon game, but her selection of argumental “weapons” have been dredged up from the slimy bottom of the antiscience cesspit.

    Perhaps her piece could qualify as an instruction manual in “logical fallacy” bingo?

  90. #90 Jon
    October 5, 2012

    It gets worse. For the non-scientifically-minded here, Avogadro’s number is the number of hydrogen atoms in a gram. The most releevant atoms here are hydrogen, carbon (12 times the mass of hydrogen), nitrogen (14 times the mass of hydrogen), and oxygen (16 times the mass of hydrogen). The molar mass of water, therefore, is around 18 g/mol. (I say “around” because the number of neutrons varies. All numbers refer to the most common isotope for simplicity)

    This wouldn’t be so bad, but consider histamine, or C5H9N3. Its molar mass would be 111 g/mol. Seriously. A homeopathic remedy for allergies would thus, perforce, be already dilluted to the point of not having one molecule of histamine per gram at about C21.

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