Homeopathy and the NHS…

So the NHS may finally be clearing its shelves of homeopathic practice and remedies.  To address the current funding crisis, the NHS has announced that a number of remedies which are either ineffective, frankly dangerous or both will no longer be available.  Homeopathy is one of them and rightly so.   No doubt some, perhaps Prince Charles a strong advocate for homeopathy, will protest that this move will adversely affect the health of the nation but they will be in the minority and frankly, if they really believe this, then it is they who need therapy.

Some year back I was forced to seriously consider the formation of a new professional body “Pharmacists for Science” with a single aim of promoting science among colleagues.  Like “Vicars for God”, “Police for the Law” and “Teachers for Education” there should be no need for such a professional grouping but given the passion for the promotion of rubbish remedies such as homeopathy I really feared that pharmacy was in serious danger of losing science as the bedrock for the profession.

At that time a London based pharmacy was supplying homoeopathic “Swine Flu Formula” but it was the complete failure of government agencies to regulate effectively in this case that was of greatest concern.  This was frankly a dangerous practice but regulators struggled to close it down.     Other examples included homoeopathic remedies for mental block; the “Berlin Wall” in C30 dilutions.  The logic seemed to be that the blockade of Berlin was overcome by the fall of the wall therefore a dilution of the wall (fallen down bits) might help to overcome mental and emotional blockades.

My discovery of these unsavoury episodes was quickly followed by the appearance of Paul Burnett, then the Superintendent of Boots the Chemists now CEO of the Pharmacy Professional body RPS in GB, in front of a parliamentary committee.  MPs were seeking an answer to the question why our cash strapped NHS was paying for homoeopathy. Paul stood firmly by homoeopathic remedies and his customers’ right to choose.  Customer choice it seems is paramount to Boots policies and principles. I would disagree; rather “informed patient choice” should be king and if pharmacists, pharmacy staff and shelf barkers fail to clearly inform customers in any pharmacy that homoeopathic remedies are no more effective than placebo then we act, in my view, unethically.

Indeed Boots, perhaps alarmed by a number of protests outside stores, got the message and their websites now reflects a better, more scientific approach to homeopathy stating that the practice is poorly regulated and there is no evidence of efficacy beyond a placebo effect.   They also seem to have modified their range and offering of homeopathic remedies.

Homeopathic remedies are still sold in pharmacies only because they make a profit.  Homeopathy is just nonsense and it goes like this.  The first principle of homeopathy is what they call the “law of similars”.   Homeopaths look for a chemical that produces a similar symptom to the disease they aim to treat. For example, caffeine keeps you awake, so homeopaths use this to treat insomnia.  Similarly Hay Fever causes runny eyes and so do onions – so some homeopaths will treat hay fever with a preparation of onions.  Turning a chemical such as onion juice into a homeopathic preparation involves a process of “dilution” and “succussion”.  To create the centesimal or “C” remedies the homeopath takes one drop of the chemical and mixes it with 99 drops of water (dilution).

A 6C remedy will contain about 0.0000000001% “active” ingredient – which works out at about 1.7 billion molecules of active ingredient.

By the time you get to 10C, there are only 17 molecules of active ingredient left. And at 11C, you only have about a one chance in six of finding a single molecule in the remedy. By the time you get to 30C, you have more chance of winning the National Lottery jackpot five weeks in a row than you do of finding a single molecule of active ingredient.

Cochrane Library articles – the gold standard of medical science – contain reviews of homeopathy treatment of dementia, asthma and attention deficit/hyperactivity disorder and they confirm the placebo effect.   Some might argue that placebo – or suggestion – is effective therapy so why not use it but we must question the ethics of this.

I did not form the professional body “Pharmacists for Science” as I found that all pharmacists when asked appreciate that homeopathy is unscientific and merely placebo.  I sincerely hope that following the current consultation the NHS will finally rid itself for good of this expensive hocus pocus.

I am a pharmacist in Belfast.

  • Korhomme

    Jeremy Hunt, the Secretary of State for health in England, is keen on homeopathy.

    Edzard Ernst, who was the foundation professor of complementary medicine at Exeter, investigated this. No effect beyond placebo has ever been found. The placebo effect is surprisingly strong.

    There is also a vogue for homeopathic vaccines. These are useless and engender dangerous complacency.

  • Brian O’Neill

    While I agree that Homeopathy is nonsense I see no harm in it for minor conditions.

    Lots of patients demand a prescription from the doctor even though most minor conditions will heal themselves. Why should a doctor not be able to prescribe arnica for muscle pain or rescue remedy for anxiety? They are a lot less harmful than traditional prescriptions.

    The placebo effect is very real. have a look at over 400 5 star reviews for Arnica
    https://www.amazon.co.uk/Nelsons-Homeopathic-Indicated-Arnica-30c/dp/B002R5HH98/ref=sr_1_1_a_it?ie=UTF8&qid=1513157289&sr=8-1&keywords=arnica+tablets

    People like the stuff, it costs a fraction of the cost of normal drugs, it has less side effects. I vote for more useless sugar pills 🙂

  • runnymede

    Long overdue this.

  • Korhomme

    Should these placebos be paid for by the NHS?

  • Neiltoo

    I would also agree that homeopathy is nonsense but what is the ethical problem with a placebo?

    Some might argue that placebo – or suggestion – is effective therapy so why not use it but we must question the ethics of this.

  • David Crookes

    Let me not speak carelessly about serious illness, but are there such things as homeopathic hospitals which treat cancer successfully, and if not, why not?

  • hgreen

    I’m in shock that the NHS was actually paying for this nonsense.

  • Conchúr

  • Brian O’Neill

    Well why not if its cheaper?

  • David Crookes

    That was BRILLIANT! Many thanks.

  • Aodh Morrison

    Never underestimate the credulity of the human mind.

    Yet in defence of homeopathy there is at least a swig of water or some flowery concoction on offer. In other instances the ‘cure’ amounts to nothing more than a touch of someone’s hand or a cantation offered to some imagined supernatural being.

  • WindowLean

    “Homeopathic remedies are still sold in pharmacies only because they make a profit”

    Terry, it’s good to know that pharmacies sell perfume and Pampers for altruistic reasons. I’ve often wondered why healthcare professionals do that.

  • mickfealty

    Aodh, far be it from me to defend something which science has demonstrated has no physical cause or effect, but we are finding out all sorts of new things about the power of the human mind through neuroscience. I suspect we will look back at this period of medicine as a “chemical hammer and nail” era.

    Put the Christmas lectures on your list of viewing over the holiday period?

  • Korhomme

    Don’t confuse herbal remedies with homeopathy.
    There are herbal remedies that work; homeopathy doesn’t.

  • Aodh Morrison

    I’ll certainly check out the RI lectures.

    You are of course correct when you look forward in time to those who will look back on our time and perhaps shake their heads at our stumbling attempts to understand the human mind. Hopefully they will regard us with a degree of understanding.

    Perhaps the discussion on homeopathy should be more tightly focused on its funding within the NHS rather than an opportunity to ridicule it more generally (guilty as charged). Although homeopathy strikes me as anti-science if it works for some as a placebo good luck to them.

    Of course science does not have all the answers and its advocates need to be cautious not to present their arguments in superior tones. I listened to an interesting programme on BBC Radio 4 that discussed REM sleep. It posed the question what was REM sleep for: to reboot the brain; to organise the day’s memories or something quite different. The presenter was clear that we do not actually know, and, like you, looked to the future in the hope that the answers would be discovered.

  • hurdy gurdy man

    Surely you mean “sledgehammer and nut”?

  • Reader

    Neiltoo: I would also agree that homeopathy is nonsense but what is the ethical problem with a placebo?
    None at all, so long as they aren’t ridiculously expensive. After all, in a placebo the active ingredient is free.

  • Korhomme

    AFAIK there are (were) two homeopathic hospitals in the UK, in London and in Bath. Both however use a combination of conventional medicine and homeopathy.

    I cannot accept that homeopathy can be used in any meaningful way to ‘treat’ any form of cancer.

  • Korhomme

    Not only is the placebo effect strong, it’s even present when the patient knows they are getting a sugar pill. It has been investigated; people were given a pill and told it was sugar and could not be expected to do anything. But many reported that it relieved symptoms.

    There’s no obvious physical cause when you get to quantum mechanics; you are hardly suggesting that this is the power of the human mind? 😉

  • lizmcneill

    Water would be cheaper still.

    Also, I’m not sure how effective arnica and rescue remedy are, but they both smell nasty enough that they aren’t homeopathy!

  • mickfealty

    I suspect neural coding is very powerful, even Shakespeare knew this: ‘nothing is good or bad but that thinking makes it so’. 😉

  • Devil Éire

    I suspect neural coding is very powerful…

    That’s a meaningless statement. Are you referring to anything other than the placebo effect? It would help communications vastly if you could refer to a long-handled digging implement by its actual name.

  • StevieG

    Ben Goldacre is the real hero here…http://www.badscience.net/2009/11/all-bow-before-the-mighty-power-of-the-nocebo-effect/
    …And of course the chapter on placebos in his book is fascinating.
    Homeopathy is nonsense in and of itself – just tell people to get their own sugar pills.

  • Neiltoo

    The author doesn’t agree apparently.

  • Reader

    Neiltoo: The author doesn’t agree apparently.
    Apparently homeopathic remedies involve lots of labour, diluting and shaking and what-not. (though how could anyone ever know?). The cost is not trivial.
    A proper placebo would be a chalk tablet with a bit of food-dye. Say 500 tablets for £1.00

  • William Kinmont

    Pampers hold in SH1t and perfume has a scent. Homeopathy cures nothing . If the bottle of perfume claimed all sorts on the lable but only had water within it is fraud why not the same rules for heomeopathy.

  • William Kinmont

    Proper effective medicines can even be boosted by placebo effect. The same medicine in different coloured tablets can have different outcomes for patients. I find giving very specific instructions with medicines can ensure better compliance and better perceived results . E.g. take twice daily v must be taken exactly 12 hours appart.

  • William Kinmont

    Very common perception some education on this would go a long way

  • William Kinmont

    A dangerous situation regulate to allow professionals to dispense meds they know don’t work. or allow amateurs to treat the I’ll with meds they wrongly believe to work.

  • William Kinmont

    Bens books should be in the school curriculum

  • Ben De Hellenbacque

    Isn’t it because it’s too hit and miss to be safe?

  • Ben De Hellenbacque

    As reassuring as touching the king’s cloth for our scrofula. At least the mystique and majesty of monarchy is being reinforced there.

  • Ben De Hellenbacque

    Arnica is not homeopathic per se. So called ‘natural’ remedies are also not necessarily homeopathic. Not all ‘complementary’ medicines are homeopathic. Most ‘conventional’ pharmaceuticals are derived from naturally occurring sources, be it snake venom or plants. So are they also homeopathic?
    Homeopathy is not some all encompassing term for new agey home treatments.
    Homeopathy is specifically based on the (spurious) principle of like curing like, diluted to the degree of molecular absence because water is alleged to have a memory.
    Given that all our mains water has passed through X number of people, that water therefore retains the memory of everything that they’ve ingested and every chemical contained within their digestive system as well the toilet cleaners and anything else flushed down the bog.
    As for Rescue Remedy: don’t get me started.
    I can recall a friend owning a book called something like “You too can heal your life” which claimed that mental attitude both caused and cured all ailments. Cancer was allegedly due to having ‘victim mentality’. Interesting that 3 month olds die of cancer but they could have been cured if they’d been given a pep talk.
    My point is that all snake oil salesmen should be inherently distrusted because they prey on the vulnerability of the desperate.

  • David Crookes

    BDH, I construe the unexistence of purely homeopathic hospitals which treat cancer successfully as a tacit admission by homeopaths that homeopathy doesn’t work.

  • Jaiecy

    NHS should not act against homeopathy as homeopathy really works and is not at all a placebo. one can refer to an article at http://adidarwinian.com/father-of-human-pharmacology/
    that clearly shows why homeopathy is not a placebo. I and my family members
    have been taking homeopathic remedies for almost a decade.

  • WindowLean

    Emmm, not really the point I was making.

  • William Kinmont

    the article like honeopathy contains absolutely nothing of substance, just like your last sentance.
    My family have been keeping an eye out for yetis as last while

  • Jozzy

    Sorry for arriving late to the party. Whilst Terry here is trying to comment on UK prescribing, its clear he’s just having a go at a widely available item in chemists shops he finds irritating.
    I find the queues, strip lighting, smelk of cabbage and pref for hiring young ladies in chemists shops irritating, but unlike Term I’m not claiming they should be banned for offending my sensibilities.
    Big T’s slam dunk is fact that he has a “gold standard” report, all of which he has read, of course, including criticisms and limitations and decided hpathy is silly and has no place with tonic wine, chewable vitamins and Joop! on his shelves.
    However, T neglects to offer any evidence on his other (testable) assertions – such as that it is dangerous.
    How something can not have any effect and be dangerous is an interesting assertion. Im sure theres piles of stuff on that, but he ran out of room.
    As for dangerous placebos, no better and more fitting title for happy pills, as T’s own falls pharmacy is awash with benzos of every stripe and hue and greatly suffering for it, dispensed with a smile by a pharmacists in a poly blend suit.
    Rather than gnash his teeth over things he is suggesting the feeble minded obtain for aches in the false leg or cancer of the wig, I’d rather he aimed his satirical eye at that actual epidemic.
    Its also about whethet or not you should be allowed, as an adult, to buy homeopathy. He callously brushes this fundamental point aside. If I was T, I’d get booze and fags banned first, followed by Fry’s and 2 for £3 Pringles tubes, and if you’d rather we defeated the homeopathic menace instead, you’re either one of 12 militant atheists grinning as you walk past happy Christmas signs on way to the vape shop, or have a bit too much free time.

  • Jozzy

    Not really that funny. Google the “pigs with fangs” cartoon

  • Jozzy

    Have they seen u get out the bath? Sane thing as yeti 😉 also possibly hpathic remedy for attraction to men?? LOL

  • William Kinmont

    Dilution is the solution

  • Where?

  • Hunt recanted his belief in homeopathy some years ago: http://www.dcscience.net/in-memoriam/the-diary-june-2013-may-2014/#060813

  • There are now just two that apparently use homeopathy: the Royal London Hospital for Integrated Medicine and the Glasgow Homeopathic Hospital (rebranded the Glasgow Centre for Integrated Care) – the former doesn’t now even have a specific homeopathy service.

    The Bristol Homeopathic hospital closed a few years ago (and the Liverpool and Tunbridge Well ‘hospitals’ before that) and was replaced by a clinic that took NHS referrals. That will be subject to a consultation in the New Year.

  • Jaiecy said:

    “one can refer to an article at http://adidarwinian.com/fat
    that clearly shows why homeopathy is not a placebo”

    No. No it doesn’t.

  • Pellets of homeopathy are about five times the cost of paracetamol tablets.

    However, homeopathy is harmless if you only consider the specific effects of products that have been diluted sufficiently and manufactured correctly: there are many cases of adulterated, contaminated and downright dangerous homeopathic products, such as the infant teething tablets that contained dangerous amounts of atropine from the Belladonna ingredient.

    However, there are also non-specific effects from homeopathy, including the harm of delaying proper medical attention and the attitude of many homeopaths against conventional medicine, particularly their anti-vax views.

    Providing homeopathy on the NHS simply gives it credibility that endangers public health.

  • Rescue remedy and other similar flower-based products are not homeopathic and as not authorised or registered in the UK as medicinal products: they are simply food stuffs, and, because of their alcohol content, they are not permitted to make therapeutic claims.

    Most arnica creams are also not homeopathic: they are simply a herbal product with usually 7% to 10% arnuca montana plant in them.

  • Jozzy

    Evidence?? Again that’s a tesatbke assertion – no evidence base

  • Sorry, evidence for what? The cost? The non-specific harms? The Belladonna assays? The anti-vax and anti-conventional medicine views of homeopaths?