MANAGEMENT INSIGHT – Homeopathy & Other Irrational Things People Believe
The ADE 651 was marketed by a UK company called ATSC as a bomb detector that worked on the principle of “electrostatic magnetic ion attraction.” It sold for $40,000 per unit. The Iraqi government spent $85 million on 2,125 of these tracker devices.
The ADE 651, it turns out, is a glorified dowsing rod. An “electrostatic magnetic ion attraction” is just a string of pseudoscientific nonsense that sounds good, but isn’t. The success ratio of the unit was the equivalent of a coin toss, yet it was used to make life or death decisions about a region’s safety. People died. Pseudoscience kills. And yet, so many people – even smart people like those in the military and government leaders –believe it. Why do smart people believe stupid things?
THE DANGERS OF HOMEOPATHY
Which leads me to homeopathy. To be clear, I’m not talking about herbalism, not today. Herbalism is a variation of homeopathy and has many red flags of its own, but at least it might contain something. Homeopathic remedies contain nothing. They are massive dilutions. Massive, in this context, is something of an understatement. As the Canadian Broadcast Corporation (CBC) colorfully pointed out, a tablet the size of the earth might contain a single molecule of the original substance (as quoted in the blog Science -based Medicine, “Homeopaths threaten public health selling sugar pills as vaccine alternatives,” Dec 4, 2015). How can such a dilution possibly do anything at all?
Homeopaths claim that the water in their tablets and vials has come into contact with an active ingredient and somehow magically retained a memory of it (while apparently forgetting all the other ingredients it has come into contact over the water’s 4-billion-year history).
Homeopathy is based on the idea that “like cures like.” On the surface, this sounds like vaccines, but with two differences. One is the amount of dilution, which reduces the presence of the active ingredient to zero, and the other is that many of the diluted homeopathic ingredients are unrelated to the cause of the disease. The belief is that any ingredient can be effective if it’s diluted enough: cancer, crude oil, and skim milk are examples. The Berlin Wall is my favorite, touted to cure feelings of being forsaken, separation, but also asthma, narcolepsy, and painlessness. Painlessness?
Target sells a homeopathic asthma spray under its brand name Up & Up. There are 15 “ingredients” listed in Latin with associated benefits. Aconitum Napellus is said to aid with shortness of breath. If you happened to have your Latin dictionary with you in Target, you might learn that its common name is aconite (it has never been associated with any medical benefit), and the only thing we do know about it is that it’s a toxic alkaloid and at high concentrations, a strong, fast-acting poison. Aconite comes from a Greek word meaning “without struggle.” It was once used to kill wolves, which is why one of the plants with this ingredient bears the nickname Wolf’s Bane. One other ingredient in the remedy is also a known poison. None of the 15 ingredients have any established efficacy. Target is effectively selling a water pump, and while the package does say it’s not a rescue inhaler, it is being sold as an alternative medication in the pharmacy aisle. Medication is a word that has meaning to people. Like you could use this spray instead of another (real) medication to treat life-threatening asthma symptoms.
Nosodes are the homeopathic answer to vaccines. They contain less (read none) of the active ingredient, and are therefore marketed as more natural and safer, leading parents to believe that after taking nosodes, their children are immune, without burdening parents with proof of scientific efficacy. Pseudoscience kills. So why do so many people believe these things?
CONSENSUS SCIENCE & CHIROPRACTORS PRESCRIBING DRUGS
Of course, everyone has the right to challenge the current way of doing things, and homeopaths often claim the right to challenge consensus science. They certainly have the right to do so, but the media also has the obligation not to take them too seriously. There’s a big difference between a Google education, and a medical degree with years of experience. It takes training and experience to evaluate medical reviews and put them in context. An article in a journal may or may not be taken seriously by the medical community; Google readers, if they understand it, lacks that perspective. Let’s face it, true expertise takes hard work.
So it isn’t about whether or not you can question the scientific consensus, it’s about how you do so. If argument uses misinformation and cherry-picked studies, it should be called out. Similarly, the media has a duty not to put years of scientific expertise and acquired bodies of knowledge head to head against this type of pseudoscience as if they were two equally credible adversaries in a battle for opinions. Sure, anyone has the right to challenge the scientific consensus. And anyone can slap a hockey puck: you, me, Wayne Gretzky, and Jenny McCarthy.
Speaking of credibility, the ACA (American Chiropractor’s Association) has created a College of Pharmacology and Toxicology. The ACA’s goal is to let chiropractors become full-scope practitioners, offering a range of physician services, including diagnoses and prescribing drugs. If the prescription course is anything like the Family Practice course, it would be in the range of 100 hours. In fairness, it could be more like the 300-hour course that apparently teaches students to diagnose using blood tests, electrocardiograms, spirometry, salivary assay hormonal and neurotransmitter tests, among others and awards a post-doctorate degree for 2 to 3 months of work.
WHERE’S THE FDA IN ALL THIS?
Clinical trials rate the efficacy of homeopathic treatments precisely on par with a placebo. They are a placebo. These results are not a coincidence. Homeopathy does, believe it or not, fall under the purview of the FDA. Honestly, it shouldn’t. This gives homeopathic remedies a legitimacy they don’t deserve, and puts the FDA in an awkward spot. It came about because of a homeopathic-friendly US Senator, Royal S. Copeland, who sponsored the 1938 Food, Drug and Cosmetic Act, which made it so that any product listed in the US Homeopathic Pharmacopoeia (USHP) would by definition be a drug to the FDA. There is a Compliance Policy Guide, which sets out labeling and manufacturing standards for homeopathic products, but that’s about it. Any product that finds its way into the USHP is a legal drug. Only a “homeopathic proving” is required, a type of evaluation that proves neither safety, nor efficacy.
By setting out regulatory standards and licensing these products as drugs, the FDA lends credence to them in the mind of the consumer. The FDA is an authority, “Protecting and Promoting your Health,” as its website says. FDA involvement in homeopathy leads consumers to believe that these products are being evaluated and tested, and allowing them to be placed side by side with the real drug on the pharmacy drug further entrenches the apples to apples comparison.
Because Congress considers them drugs, the FDA is in an awkward situation. The solution so far, other than a few labeling requirements, has been to add the disclaimer that the “FDA is not aware of scientific evidence to support homeopathy as effective” on packaging. But how does this get around the requirement that labels can’t make claims that can’t be proved? I ran out of time to figure this one out.
The last time a law was passed regarding homeopathy was 1938. It’s time to rethink this. Between the wars, homeopathic remedies were quaint concoctions doled out by a few alternative practitioners. Now, depending on your source, the industry is worth between $3 and $6 billion a year, and a lot of consumers – perhaps most – still have no idea what homeopathy really is.
The FDA has announced a public hearing to collect comments and information on homeopathic remedies from stakeholders. This is a good place to start. Here are my thoughts.
We need new legislation that clarifies that homeopathic remedies are not drugs and have passed none of the rigorous tests of drug development. They should not be regulated by the FDA. They are not drugs. This must come from Congress.
Homeopathic remedies should not be allowed to be placed side by side with real drugs on pharmacy shelves. If they want to be compared with pharmaceutical products as equals, they should be required to meet the same safety and efficacy standards as other medications.
If they can’t prove efficacy, they should not be sold as medications. It is unethical to sell a product that contains no active ingredient and shows no efficacy. If they are to be sold, they must be labeled appropriately. Current labels are obscure, using Latin to hide behind names like Anas Barbariae Hepatis et Cordis Extractum (duck liver and heart, sold as a flu medication) and dilutions like 10X and 30X, which have no meaning at all to consumers. Consumers have the right to know what the “ingredients” are, as well as that the dilution results in none of the ingredient being present in the bottle.
Much as the health labels on tobacco, it should be required that every homeopathic product contain the declaration that no homeopathic product has ever been proven effective for any medical condition.
WHY DO PEOPLE BELIEVE IRRATIONAL THINGS?
All this leads me to wonder about bigger issues. If mankind’s intelligence rises three points every 10 years (Skeptic Magazine, “The future of intelligence,” by Robert Ehlich, Vol. 10, No. 2.), then why do people still believe stupid things?
The answer may be that evolution has hard-wired us to believe in things, says Michael Shermer, founding Publisher of Skeptic Magazine, in his TED Talk, The Pattern Behind Self-Deception. Belief is our natural default position.
We are pattern learners. We associate. Your mother always served ice cream out of a tall blue glass. You see a tall blue glass, and your heart leaps. Shermer uses the example of a pigeon with two buttons. When he presses a button, sometimes he gets a reward. There is no pattern. Still, whenever he gets a reward, he repeats what he did the last time to get the reward, even if it means two spins clockwise and one counterclockwise, followed by two pecks on a button. This is where superstitions come from.
Evolution has rewarded our pattern-seeking behavior and punished the opposite. Imagine that you are a cave dweller in Paleolithic times, Shermer asks us. Walking toward your sub-Saharan campsite, you hear a noise in the bushes. If you associate the rustling in the bushes with a lion, you will probably live. If you don’t think bushes + rustling = lion, your genetic line dies out.
We don’t question our pattern-seeking behavior. It’s too engrained. In a split-second decision, you don’t get time to think rationally. Evolution dealt with this by setting our default position to believe all patterns are real, says Shermer. Interestingly, the less we control things, the more likely we are to look for patterns. Baseball players are notorious for their superstitions, from rubbing the bat a certain way to wearing a gold thong (Jason Giambi, New York Yankees). Rituals are richest in batting because the less control we have, the more we look for patterns. The best batter fails 7 times in 10, whereas outfielders catch the ball 90% to 95% of the time.
I feel the pull of this type of pattern behavior. I consider myself a rational guy, but I have a lucky hockey jersey to wear to games. My wife has a lucky perfume, which she still insists single-handedly ended the Great Recession. Now she wears it every day, and Xcelience is doing very well.
Evolution has also taught us to infuse our patterns with intentional agents. Identifying predators kept us safe. Think of the cave dweller scenario again. The lion is the intentional agent. Invisible agents are everywhere today. From ghosts and aliens to government conspiracies, they are behind the scenes orchestrating. The Illuminati. The Truman Show. The X-files.
If you’re looking for pattern-seeking behavior, look no further than your nearest psychotic neighbor. I’m not bad-mouthing your neighbor, most of us have a little dab of psychosis in us; it doesn’t have to be full-blown schizophrenia. A UK study published in New Scientist on April 4, 2015, showed that 33.8% of respondents felt that someone was out to harm or discredit them. Some 44.3% thought they were not in control of some of their actions. Another 33.6% thought that some of their thoughts were not fully under their own control. You get the idea. Psychosis is pretty normal.
Dopamine is strongly associated with pattern-seeking behavior, and hence with psychosis. L-dopa, the drug form of dopamine, is given to Parkinson’s patients and has been shown to increase the tendency to see patterns (more specifically, delusions and paranoia). Similarly, psychosis is treated by blocking receptors for dopamine. Amphetamines and cocaine increase the tendency to see patterns associated with both creativity and hallucinations, says Shermer. Consider the fine balance that this takes. John Nash goes crazy and Richard Feynman gets a Nobel Physics Prize, as Shermer points out.
All this would make you believe that we need to tame our pattern-seeking minds in a modern world and go for purely rational thought, but that’s not entirely true. There is power in moderation. If you see patterns in everything, you’re delusional, but if you are too skeptical, you’ll miss the good ideas too. It’s best to seek a healthy balance that will keep you safe from lions but also open to creative possibilities.
Derek G. Hennecke, President & CEO, Xcelience
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