Several years ago, during a lecture on Science-Based Medicine, I noted that if there were one medical pseudoscience that was vulnerable to extinction it was homeopathy. Homeopathy is perhaps the most obviously absurd medical pseudoscience. It is also widely studied, and has been clearly shown to not work. Further, there is a huge gap in the public understanding of what homeopathy is; it therefore seems plausible that the popularity of homeopathy can take a huge hit just by telling the public what it actually is.

Further, homeopathy is in a precarious regulatory position. Homeopathic products are presented and regulated as drugs, but clearly they are not, and they are also not supplements, herbal drugs, nutrition-based, or natural products. They are simply fraudulent drugs riding a wave of ignorance.

In the last few years homeopathy has had a rough time. While the industry is still growing, there are signs of clear trouble on the horizon. Let’s review:

Some Background

Homeopathy is a 200 year old pre-scientific system of medicine based upon magical thinking. It is mostly based on two notions, the first of which is that like cures like. In other words, a substance that causes a symptom can cure that symptom in extremely low doses. There is no scientific basis for this, despite the desperate attempts by homeopaths to invoke vaccine-like analogies, or their new favorite, hormesis.

The second notion is that you make a remedy more powerful by diluting it to extreme degrees. People have fun making comparisons, such as the need to drink a solar-system’s worth of water to have a 50% chance of getting a single molecule of active ingredient. No problem, say the homeopaths, homeopathic potions contain the magical “essence” of what was previously diluted in them. It’s turtles all the way down.

Homeopaths are also hoist with their own petard when it comes to the evidence. Rigorous clinical trials of homeopathy are frustratingly (but not surprisingly) negative. Homeopaths explain this away by saying that double-blind placebo controlled trials are not really appropriate for homeopathic treatments. Such studies take a cookie-cutter approach to treatment, while real homeopathy individualizes the treatment to the patient. This argument, however, just creates two even more serious problems.

The first is that whenever homeopaths use this argument they throw the entire homeopathic industry under the bus. They are essentially saying that all over the counter (OTC) homeopathic products are useless, and even fraudulent. I would be happy to stipulate to this, and erase the entire OTC homeopathic product industry. We can then deal with homeopathic practitioners separately.

The second problem is the manner in which homeopathic treatments are individualized. This also is not based on any scientific principle or set of reliable empirical data. It’s all magic and witchcraft. Quirky traits, like whether someone is weepy, are used to determine their optimal treatment. There is also no consistency among homeopaths – see ten different homeopaths and you may get ten different treatments. This has more in common with an astrological reading than medicine. It is an elaborate system of utter nonsense.

Troubled Waters

Word that homeopathy is complete bollocks is starting to get out. In 2010 the UK House of Commons Science and Technology Committee completed a full report on homeopathy in which they concluded it is witchcraft – that it cannot work, it does not work, and support for homeopathy in the national health service should be completely eliminated. In 2015 the Australian government completed its own review, concluding that there is no evidence that homeopathy works for anything. Homeopathy is a placebo.

Homeopaths like to point to the favorable Swiss government review. However, as I have explained in detail previously, even the biased Swiss report, which was packed with homeopaths specifically to give a favorable review, could not conclude that there is rigorous evidence showing homeopathy works. They had to resort to arguing for lower quality evidence.

This was all just the beginning. The FDA and the FTC in the United States are now both receiving testimony, questioning their current regulation of homeopathy. Currently the FDA essentially doesn’t regulate homeopathy, even though the law tasks them to do so. They let the homeopathic industry regulate itself, but they are questioning this in light of the exploding OTC homeopathic product industry. This is a good thing. Any change is likely to be an improvement. Likewise, the FTC is accepting comments on how it can better regulate the advertising of homeopathic products.

There is even a possibility that the FDA will decide to do their actual job – require testing of homeopathic products to demonstrate efficacy before allowing them on the market. If they do this simple and obvious thing, the homeopathic industry in the US will vanish over night, because there is no evidence to support any homeopathic product for any indication. They will have to endure the outrage of quacks, charlatans, and the deluded, but hey, that’s their job. Suck it up.

While I hold out a sliver of hope, I am realistic about the political realities here. Doing the right thing because it is right, even when bold and courageous action is required, is a rarity in politics. Further, Congress may quickly take away any victory, even before they are enacted, by changing the law and taking away the FDAs power to regulate homeopathy. That is a fight I would love to have, however. At least it’s a fight.

Another outcome that is less than total victory but at least is an improvement is truth in labeling and advertising. Homeopathic products should be labeled so it is absolutely clear what they are – what the actual ingredients are in plain language, and in what amounts. Also, if the labels could not pretend to be real medicine, and make claims not supported by evidence, that would be a good thing.

Maybe then we could put pressure on pharmacies to stop selling them. This is also happening. The Royal Pharmaceutical Society’s chief scientist just wrote an editorial in which she writes:

The public have a right to expect pharmacists and other health professionals to be open and honest about the effectiveness and limitations of treatments. Surely it is now the time for pharmacists to cast homeopathy from the shelves and focus on scientifically based treatments backed by clear clinical evidence.

Some individual pharmacists at taking a stand, and throwing away their homeopathic products.

Conclusion

Homeopathy is obvious pseudoscience and magic that has no place in a modern society. It cannot work and it does not work. It is simply an expensive placebo.

All we need now is the political will to acknowledge these clear facts and regulate homeopathic products as they should be – essentially by banning them as fraudulent. Nothing short of that is honest or fulfills our duty to the public.

I would, however, welcome any partial victories that are a clear improvement over the current situation. Right now we have a clear window, with the FDA and FTC reviews. This is a good time to push public awareness of what nonsense homeopathy actually is.