Consumers are often critical, and even distrusting, of the pharmaceutical industry and the medical profession at large. In turn, they sometimes gravitate toward alternative medicines such as herbal remedies, essential oils and homeopathic remedies. These trends continue despite the fact that the overwhelming body of scientific evidence suggests this $34 billion American industry not only offers few, if any, health solutions, but can even harm consumers.
The complete lack of scientific evidence substantiating any health benefits is especially true of the homeopathic medicine industry. The sector itself suggests that its annual revenues range anywhere from $3 billion to $6 billion annually. Backed by powerful forces, including a congressional Dietary Supplement Caucus in Washington, D.C., this industry continues to reap profits at the expense of public health.
Companies marketing homeopathic remedies have been particularly successful in landing shelf space at drugstores and big-box chains across the U.S., despite the overwhelming evidence that these products often do not work, lack any stringent oversight, are often untested by regulators or the industry and, in fact, have even been proven to endanger the health and lives of young children.
The popularity of homeopathic remedies endures, even as overall interest in the sciences surges -- evident in the popularity of social media channels such as the “I f---ing love science” Facebook page, which has over 25 million “likes.” But are there instances when these remedies can work? And are there cases when the treatment of ailments at home is a viable alternative to the purchase of conventional over-the-counter medicines, or even visiting a physician?
A quick background on homeopathic remedies
TriplePundit spoke with Jann Bellamy, who helped established and is now on the board of the nonprofit Society for Science-Based Medicine, by telephone from her office in Tallahassee, Florida, to gain insight on this discussion.
Credible medical researchers have long dismissed homeopathic medicine as pseudo-science. First conceptualized by a German physician in 1796, it surged in popularity in the U.S. and Europe during the 19th century before falling out of favor due to relentless criticism by mainstream scientists. In the years before World War II, homeopathy enjoyed renewed interest in Nazi Germany and across the Atlantic in the U.S. When New York Sen. Royal Copeland, a homeopathic physician, authored the 1938 Federal Food, Drug and Cosmetic Act, he included special protections for homeopathic remedies. By the 1970s, the homeopathic remedy industry increased tenfold, largely due to the New Age movement which emphasized healing and spirituality when the time came to treat health ailments.
For almost 80 years, the Food and Drug Administration had jurisdiction over homeopathic remedies, but the agency let the industry grow with almost no oversight. “Unfortunately, the FDA just never has caught up with the times,” Bellamy told us. “It has the authority to regulate, but it has pretty much defaulted to the homeopathic industry and allowed it to regulate itself.”
Should the homeopathic industry be allowed to regulate itself?
Homeopathic remedy companies such as Hyland’s say their remedies are regulated by the FDA, but Bellamy argues that the FDA has eschewed its responsibility to monitor this sector. “Yes, one could argue that technically the FDA regulates this industry. But, in addition to requiring good manufacturing practices, all FDA has really done in terms of regulating is the issuance of a compliance guide, which is only a manual on how to label products,” she explained.
These same companies often point to a body of research and a 200-year history that demonstrates these remedies are effective. But Bellamy urged strong caution.
“There are no well-conducted trials of homeopathy that proves it works,” Bellamy insisted. She pointed to an extensive Australian government review that came out last year, which concluded: “There are no health conditions for which there is reliable evidence that homeopathy is effective.” A report commissioned by the United Kingdom’s parliament several years ago gave a scathing assessment of homeopathy, concluded the practice is nothing more than treating patients with a placebo, and urged the nation’s National Health Service to stop funding any such medical care.
“Really, in my view, we should not be able to sell these products,” Bellamy told 3p. “We know they don’t work. They don’t adhere to the basic principles of science. So, why should they be sold at all?”
She pointed to the fundamental rules of homeopathy, such as “like cures like,” which posits that a substance which causes illness symptoms in healthy people would remediate similar symptoms in sick people. Furthermore, Bellamy explained that the concept of “potentiation,” or homeopathic dilution, in which ingredients are diluted and vigorously shaken (or, as the industry says, “succussed”) to the point that no molecules of the original substance even exist in the solution, is contrary to the basic principles of chemistry and physics.
How should pharmacists handle homeopathy?
Nevertheless, these remedies are readily available in neighborhood drugstores and, of course, through online retailers such as Amazon. On that point, Bellamy argued that retail companies are placing their pharmacists’ professional reputations at risk.
“Pharmacists, back in the day, used to own the pharmacy, but they don’t anymore as they are now an employee of a Walgreen’s or RiteAid,” Bellamy explained. The result is that their relationship with their employers puts them in an unfair dilemma as these companies stock their stores’ shelves with alternative remedies in order to meet consumer demand.
“We need a framework in place so that a pharmacist is bound to say, if asked, ‘Look, this product just does not work.’ But the fact is: These products are profitable for these retailers, bottom line.”
Retailers in turn look to the FDA to provide safety guidance. For example, CVS was quick to pull Hyland's teething tablets from shelves when the FDA issued a warning.
What should the FDA do?
Bellamy does not see the situation changing much unless the FDA steps up and takes its mandate to regulate these remedies seriously. “I think it’s not going to be resolved as long as the current regulatory system is in place,” she said. But she inferred that if the regulatory agency summarized the scientific evidence governing how these remedies work, you would see an immediate impact.
“If you had to put on a bottle’s label, ‘this doesn’t work for anything,’ that would obviously cut into these companies’ sales. They’d be finally telling the truth, as in fact, they should not be able to imply that what are in these bottles is going to do consumers any good.”
Another problem is that the FDA does not have sole authority over homeopathic and other alternative medicines. While the FDA is tasked with regulating how these medicines are made and labeled, the Federal Trade Commission (FTC) regulates how they are advertised.
“The FTC, in fact, has expressed concern to the FDA over its lack of regulation, which is indeed confusing to people,” Bellamy said. “The FTC, rightfully so, has told the FDA to do its job."
The FTC issued a policy that health claims for any product must be substantiated by evidence; yet the FDA’s current regulatory framework causes confusion. Many homeopathic remedy advertisers mistakenly believe that if their products comply with the FDA guidelines on homeopathy, then they do not have to comply with the FTC’s substantiation requirements. Last year, the FTC condemned the FDA for not taking stronger action on these remedies:
“The staff comment notes that the FDA’s regulatory framework for homeopathic drugs, set forth in a 1988 Compliance Policy Guide, does not require that over-the-counter (OTC) homeopathic drugs be approved by FDA as safe and effective if they satisfy certain conditions, including that the product’s label contains an indication for use. Yet the policy guide does not require sellers to have competent and reliable scientific evidence to support the indication for use.”
The stubborn fact is that the unregulated sale of homeopathic remedies is a scandal perpetuated by companies that care more about profit than healing, without being held accountable to accept the basic fundamentals of science. Most damning is these companies’ claims that their products, which are largely made of water and sugar, are effective because they contain the “memory” of these substances even if not a single molecule exists.
By that logic, drinking water in much of the U.S. -- which is largely reclaimed and recycled as it passes through sanitation systems and eventually back into municipal supplies -- would still be toxic from contaminants, giving the phrase "toilet to tap" a scary new meaning.
Image credit: Wellcome Images/Wiki Commons
Leon Kaye has written for 3p since 2010 and become executive editor in 2018. His previous work includes writing for the Guardian as well as other online and print publications. In addition, he's worked in sales executive roles within technology and financial research companies, as well as for a public relations firm, for which he consulted with one of the globe’s leading sustainability initiatives. Currently living in Central California, he’s traveled to 70-plus countries and has lived and worked in South Korea, the United Arab Emirates and Uruguay.
Leon’s an alum of Fresno State, the University of Maryland, Baltimore County and the University of Southern California's Marshall Business School. He enjoys traveling abroad as well as exploring California’s Central Coast and the Sierra Nevadas.