A friend of mine is an orthopedic surgeon, and they explained to me that for mild problems, which would normally heal on their own, it's cheaper to cover a placebo rather than real medication.
While I hear this argumentation a lot, I still struggle with this:
If you have "mild problems, which would normally heal on their own", buying no medication at all would be even cheaper.
And from an ethical point of view, the idea of financing a whole (homeopathic) industry that uses your money to produce fake science, even with a single cent, should make one shudder, shouldn't it?
But then, why prescribe the most expensive placebos where you co-finance societal harmful behavior, rather than just prescribing the "harmless" placebos that are not homeopathy, which are usually even cheaper and don't have any ideological overhead?
There is a lot of over-the-counter and even some prescription medicine that don't do much at all for what people take them for, and homeopathy is cheaper and less harmful for the same placebo effect. Cold medicine in particular is known for its dubious efficiency.
No medication is even cheaper, but the placebo effect works, so if people were to take something, might as well have them take something cheap and harmless. In my opinion, it doesn't justify supporting homeopathy, but health insurances may see it differently.
Placebos are an interesting ethical issue. Doctors are not supposed to deceive you, they are people you trust with your life and very personal issues and they are therefore held to very high standards. But even if it is for your own good, the placebo effect is based on deception, so is it ethical for a doctor to give you a placebo? And is fake science that still help people ethical? The consensus seems to be "no" for both and I tend to agree, but I still think it is worth debating.
> If you have "mild problems, which would normally heal on their own", buying no medication at all would be even cheaper.
American culture loathes the idea of not treating a disease. Problems are expected to be dealt with, even if it harms society (see overprescribing antibiotics or opioids).
When confronted with people that don't understand the impacts of medicine, it's easier for an insurance company to give them fake medication than nothing at all.
The Chinese Communist Party had billions being raised out of incredible poverty and that populace started demanding medical care. There was no possible way to supply enough clinics, doctors, nurses, etc - and not just because Mao whipped the Red Guard into an anti-intellectual froth than then slaughtered much of China's academic/scientific community.
So Mao waved his hands and invented TCM, which basically said "oh yeah, most of these traditional Chinese medicines work. We did some research and figured out which ones and how to apply them!"
Hilariously people argue TCM doesn't work not because it's complete bullshit, but because it's a modified, corrupted version of actual Chinese medicine...
Sometimes I get into conversations with TCM advocates.
"If you get into a car accident in China," I say, "an ambulance will take you to a hospital where they will treat you with western medicine. Why do you think that is?"
In France they were funded by the social security up to 15%, but luckily this stopped in 2021. I had some as a kid and my mom is still a strong "believer" in them. I don't see any harm in selling them IF and only if they don't prevent people from taking other "real" treatments. But other than this it's just placebo.
> and only if they don't prevent people from taking other "real" treatments
This is the dominant harm, yeah. As we know from infosec, few things are more dangerous than a false sense of security, and that's exactly what ineffective drugs provide.
Most of homeopathy usages target little aches and whatnots that require no treatment (beyond patience), so I guess it could also act as a buffer against overmedication.
Because every bottle is clearly labeled “The FDA has not evaluated this for treating any condition”. There are a great many products that the FDA hasn’t evaluated that are still sold, why should these be any different?
The reason that these get to make health claims and stuff without regulation, and get special treatment, is lobbying resulting in that act. Otherwise they would have been regulated.
Most pharmacies used to sell tobacco products (they only started to do so after a couple of states started banning the practice.) Walgreens still does (in states where it isn't banned from doing so).
> "The safety of our patients is very important, but we also have to do what our customers are requiring us to do," Walgreens CEO Stefano Pessina told the WSJ. "We see that when we don’t sell tobacco, we have a lot of [negative] reactions."
Because a lot of those bottles also make claims that are in violation of the FDA rules. The label is not sufficient.
They need to avoid making claims that they can treat or diagnose some condition. They do their best to hint at it without crossing the line, and frequently blatantly do cross it. The FDA does not have anywhere near the manpower to enforce it. And when they do finally get around to it, the brand vanishes, and a new one appears with exactly the same product lineup.
The sector has long lost any entitlement to benefit of the doubt. They are knowingly making illegal claims and using a disclaimer as a fig leaf even though everything else on the package contradicts it.
It's not a manpower issue, it's not a legal issue. It's not against the law because they wrote the law. There is no line they try to avoid crossing because that line was erased by lobbyists in 1994.
What should not be allowed to sold in pharmacy? Or should that even be asked. I think this is pretty relevant question. Should pharmacies have some extra regulation that limits them from selling anything but exactly approved products? Or specific models of such? Like only certain toothbrushes?
This is an incorrect summary of the placebo effect. The placebo effect does require the patient to either believe it is effective, or at least not knowing clearly it is ineffective.
This is why clinical studies don't tell neither group (neither the treated group nor the control group) who is in which group, to not spoil the results.
And also, this is why homeopathy puts so much effort into spreading the belief they are effective despite all odds, up to the point of trying to convince people to abandon basic scientific principles.
GP is actually correct according to Wikipedia[0] (for what that's worth): There seems to be evidence that "open-label placebos"—i.e. "where the patient is fully aware that the treatment is inert"—still have positive effects.
Contrast this with advertisement, which actually does work even when people know that it is ads, and which still does work on people how know how ads work.
Also, contrast this with psychotherapy, which usually does work even better if the patient understands how it works, because it enables them to become an active and more effective part of the therapy.
Placebos work even if users know it's a placebo. I don't for a second believe in any of homeopathy claims, but I still buy and use it, because placebo works. Especially so when price and all other medicine-looking rituals around it are maintained.
It's considered a dietary supplement, which is governed by the dietary supplement health enforcement act, which in turn classifies dietary supplements as a food product.
> There are no FDA-approved products labeled as homeopathic; this means that any product labeled as homeopathic is being marketed in the U.S. without FDA evaluation for safety or effectiveness.
Unless we want to make people accountable for running their own sophisticated clinical studies for every single product we buy, we should probably have some rules in place around false claims and false advertising.
Maybe we should also have some rules around false claims and false advertising around food in general. I think this causes more damage than homeopathic stuff ever can do.
I might be downvoted for this, but I tend to have a kind of libertarian take on this. I absolutely do not believe in homeopathy beyond placebo effects, and I understand the harm they do by opportunity costs in pursuing other treatments.
But at the end of the day I feel like all medications should basically be handled like homeopathy products. They should be available to anyone, barring some kind of competency ruling or disagreement by the pharmacy over what they want to sell to whom, and the FDA should basically ensure that they are what they say they are on the label.
I'm glad there's skeptics out there calling BS on homeopathy but where I diverge from them is in somehow preventing it from being available. It's water, it's labeled accurately, so let people do what they're going to do. If they weren't doing this I doubt they'd be doing something more "mainstream" anyway, or complying with it. They might even be doing something even more actively harmful.
I guess I see it as a slippery slope from banning homeopathy to something much murkier where reasonable experts disagree. Real medical science can get very grey really fast and I'm not sure I trust regulatory authority figures to always make the best decisions about what to do. Better to leave it to the consumer and whichever provider they trust most.
Demand product purity, prevent health claims on the label, whatever, but I think my question is "why aren't more medications sold in American pharmacies?"
its not about banning availability, its about making them required to prove the health claims theyre making. If you didn't have any requirements to prove your drug worked before selling it, youd take away a pretty huge market incentive to make drugs that work (health is about as far from a perfect full information free market as you can get -- homeopathy doesn't work at all and those companies are making plenty of money). These regulations also force research into and labeling of side effects, and skimping on that led to an opiod crisis.
Honestly don't really see the economic or societal argument for deregulating medicine. If you want a system where to get an fda stamp you have to prove it works but can sell whatever otherwise with no consequences until you kill someone or destroy their gallbladders (https://www.foodsafetynews.com/2024/05/fda-determines-that-t...) - well that's what we already have now so given it hasn't changed in decades, even with recent attempts to do so after all the strip mall stem cell clinics and GRAS issues and all, I don't think your opinion is that out of the mainstream.
And in terms of why aren't more sold in pharmacies - no clue what you're talking about there lol. Have you not seen the A-Z supplement whatever aisles full of all this unregulated crap? You can buy whatever you want unless the DEA has an issue with it.
> You can buy whatever you want unless the DEA has an issue with it.
Over the counter? No, you can't. You can buy a lot of stuff that doesn't work over the counter. But, for example, if I want a decongestant that actually works (pseudoephedrine HCl), I have to go to the pharmacy and show them my driver's license and make a record of the purchase because the government is afraid I might start a meth lab.
And that doesn't even get into all the market failures with prescription drugs. What if I have the same bacterial infection for the umpteenth time and I know that antibiotic X will fix it? Can I just walk into the drugstore and get a course of antibiotic X? Of course not. (At least, not in the US. But in Mexico, I can.)
Even if the argument is that I might be misdiagosing my symptoms (which, if it's the umpteenth time I've had the same thing, is not a very good argument), why isn't there a machine in the drugstore that can check my diagnosis? It's already been shown that expert systems can outperform human doctors for many diagnostic tasks. In a functioning market for health care, we would see that technology in wide use. But we don't, because we don't have a functioning market for health care.
for cell culture lol it's not hard to find them, even though arguably it should be because of resistance. Also this isn't advice to take them - they aren't regulated and so you shouldn't trust them lol they're for research use only for a reason
If the homeopathic remedies don't harm anyone (I know that some have, this comment only references the remedies that don't), what is the problem with them being sold and used?
Many cold medicines have side effects, some are even abused recreationaly. Given that human bodies tend to recover with or without cold medicine (and given the shaky legs that Phenylephrine stands on), what is the issue with people using "fake medicine"?
Homeopathic remedies cannot be abused recreationaly. They aren't precursors to meth. They are better in every way (except the don't work better than a placebo). But, if all a patient needs is a placebo (people recover from the common cold just fine without medicine), homeopathic remedies are perfect.
Remember the hippocrattic oath: First of all, do no harm. Safe, well prepared homeopathic remedies shouldn't do harm. Many cold medicines do.
Why not just prescribe a crystal and some essential oils instead? Maybe have them sacrifice a chicken tomorrow evening at dusk? Actually, if they send me $400 in Bitcoin I will simply cure them with the power of prayer. Nobody is making meth off of my well wishes either.
Why a prescription? If the patient can get a placebo fix without a prescription, isn't that better?
Of course having a "healer" present with a "prescription" may make people feel better. So maybe prescribing crystals is better than pharmacy homeopathic remedies.
However, none of this needs to cost $400. Given that these are all placebos, they should cheap and safe.
Neither of these cure diseases. Neither of these prevent the seeking of medical care. Both of them may make people feel better (the placebo effect can be powerful). Only one of these is frequently abused by teenagers as a recreational drug.
There are plenty of people who take homeopathic and other alternative products instead of prescription products because they can't afford the prescription products, and fraudulent advertising makes them think the alternative is more or less equivalent.
I actually had someone at a pet store try to sell me homeopathic medication instead of dewormer because they were out of actual dewormer. Do you think that's harmless to someone who doesn't know the difference between giving their pet real medication vs. magic woo water?
> There are plenty of people who take homeopathic and other alternative products instead of prescription products because they can't afford the prescription products,
True
But worse people use homeopathic remedies because they do not trust modern medicine
Harmless for cold cures, not harmless for infectious diseases
A friend of mine is an orthopedic surgeon, and they explained to me that for mild problems, which would normally heal on their own, it's cheaper to cover a placebo rather than real medication.