November 21, 2013

“When Alternative Medicine Becomes Quackery”

Yesterday, I discussed how the placebo effect makes some alternative therapies "work." The post's title was "The Remarkably Powerful, Highly Underrated Placebo Response,” a chapter heading from Dr. Paul Offit's excellent new book, Do You Believe in Magic?

The title of today’s post is lifted from the final chapter of Offit’s book. After describing how the placebo response makes many alternative therapies valuable, Dr. Offit cautions that “a sharp line divides those who practice placebo medicine from those who practice quackery.” That line is crossed in the following four ways:

1) Recommending against conventional therapies that are helpful.
A wildly irresponsible example occurred when TV doctor Mehmet Oz publicized Dr. Issam Nemeh’s claim that faith healing can cure cancer. Here's another: in 1995, holistic promoter Andrew Weil said Chinese herbal therapy showed more promise to treat HIV than conventional medicine.

In Offit's view, top prize for irresponsibility goes to TV doctor Joe Mercola, who -- among other positions -- opposes the pasteurization of milk, claiming it compromises the product's nutrition. In fact, pasteurization doesn’t destroy milk's nutrients; instead, it destroys dangerous -- even deadly -- bacteria like salmonella, E. coli, and listeria.

Mercola also believes that vaccines are dangerous and should be avoided or delayed. He questions whether HIV causes AIDS. He suggests that cancer can be treated with baking soda and coffee enemas. He warns against mammography, offering his own special device to detect cancer. 

2) Promising potentially harmful therapies without adequate warning.
Andrew Weil writes that kava “relaxes muscles, promotes calm, and is non-addictive.” Seven years later, the FDA issued a warning that it could cause severe liver damage.

Offit writes about the risks from chiropractic manipulations. In 2010, Edward Ernst -- professor of complementary medicine at the University of Exeter in England -- reviewed the medical literature and found 26 deaths from chiropractic manipulation, almost all caused by ripping the vertebral artery in the neck.

3) By draining patients’ bank accounts.
Andrew Weil has his own brand of supplements. Products available for sale on his website include:
  • Memory Support Formula, containing ginkgo, for $56.10.
  • Joint Support Formula, containing glucosamine, for $72.
  • Energy Support Formula, containing large quantities of vitamins, for $72.60. 
Offit debunks claims for ginkgo, glucosamine, and mega-vitamins.

In 2003, Weil signed a deal with Drugstore.com that paid his company $3.9 million.

Deepak Chopra promotes ayurvedic supplements, oils, massages, and herbs under the brand name Chopra Center. He sells books, videos, clothes, aromatherapy, jewelry, and music. Customers can sign up for courses run by Chopra for fees of $1,000 - $5,000. You can participate in a sacrificial ceremony to please the Vedic gods for between $3,000 and $12,000. One year's worth of anti-aging medicine can cost as much as $10,000.

Joe Mercola is also a phenomenal salesman. Among his products for sale, which gross about $7M annually: 
  • The Mercola Vitality Home Tanning Bed for $2,977: an “Incredible Deal.” Of course, science shows that UV radiation causes cancer.
  • A pack of 16 “worry-free” organic cotton tampons for $7.99 to replace your tampon that "may be a ticking time bomb.”
  • A one-ounce bottle of Organic Sea Buckthorn Oil Anti-Aging Serum for $22.
My own experience: A few years ago, I made an appointment with a nutritionist recommended on my neighborhood listserv. He gave me a blood test. When I returned a week later, he shared the report showing deficiencies in many vitamin and minerals, some I’d never heard of before. Not to worry. He had special pills available from his mini-pharmacy in the next room. I actually played along with this scam for about a month.

4) By promoting magical thinking that “sadly is everywhere today.”
Offit cautions that magical thinking isn’t harmless. Encouragement of scientific illiteracy -- or scientific denialism -- can have a corrosive effect on patients’ perceptions of disease, making them susceptible to the worst kinds of quackery.

Robert Slack, writing for the Center for Inquiry, sums it up:
The gaps in medical knowledge we all dread are not likely to be filled by energy fields, meridians, and astrology but by the purposeful pursuit of knowledge under a single set of standards we call science. The way forward is through a careful and purposeful pursuit of scientific truth, even if it means leaving some of our most romantic fallacies behind.



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