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Integrative Medicine Invades the U.S. Military: Part Three

Nobody seems to know exactly how to define “integrative medicine” (“IM”) or to demonstrate what it does that is superior to the “conventional” kind. There is a lot of talk about addressing the “whole person” and not just the disease, patient-centeredness and the like, all of which are already aspects of conventional medicine. But, however defined, the central idea seems to be that if you incorporate complementary and alternative (CAM) into conventional medicine the practice of medicine will improve tremendously.

Despite not having any clear idea of what IM is, or does, the military, prestigious medical institutions, hospitals, and individuals practitioners are eager to imprint the integrative medicine brand firmly on their public images. Hence the Consortium of Academic Medical Centers for Integrative Medicine, a newly minted medical specialty in integrative medicine, societies devoted to integrative medicine practitioners, CME courses, conferences, and so on.

But – whoops! – proponents, in their overblown hype for IM, apparently didn’t give enough thought to the fact that there isn’t much of an evidence base for this loosely-defined but supposedly superior system. And – whoops again! – you can’t really research something unless you know what it is you are researching. These little oversights have brought about efforts to decide which of the competing definitions of integrative medicine should prevail and, whatever it is, whether there is any evidence of benefit for the patient. (more…)

Posted in: Acupuncture, Clinical Trials, Homeopathy, Legal, Politics and Regulation

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The difference between science-based medicine and CAM

“Alternative medicine,” so-called “complementary and alternative medicine” (CAM), or, as it’s become fashionable to call it, “integrative medicine” is a set of medical practices that are far more based on belief than science. As Mark Crislip so pointedly reminded us last week, CAM is far more akin to religion than science-based medicine (SBM). However, as I’ve discussed more times than I can remember over the years, both here and at my not-so-super-secret-other blog, CAM practitioners and advocates, despite practicing what is in reality mostly pseudoscience-based medicine, crave the imprimatur that science can provide, the respect that science has. That is why, no matter how scientifically implausible the treatment, CAM practitioners try to tart it up with science. I say “tart it up” because they aren’t really providing a scientific basis for their favored quackery. In reality, what they are doing is choosing science-y words and using them as explanations without actually demonstrating that these words have anything to do with how their favored CAM works.

A more important fundamental difference between CAM and real medicine is that CAM practices are not rejected based on evidence. Basically, they never go away. Take homeopathy, for example. (Please!) It’s the ultimate chameleon. Even 160 years ago, it was obvious from a scientific point of view that homeopathy was nonsense and that diluting something doesn’t make it stronger. When it became undeniable that this was the case, through the power of actually knowing Avogadro’s number, homeopaths were undeterred. They concocted amazing explanations of how homeopathy “works” by claiming that water has “memory.” It supposedly “remembers” the substances with which it’s been in contact and transmits that “information” to the patient. No one’s ever been able to explain to me why transmitting the “information” from a supposed memory of water is better than the information from the real drug or substance itself, but that’s just my old, nasty, dogmatic, reductionist, scientific nature being old, nasty, dogmatic, reductionist, and scientific. Then, of course, there’s the term “quantum,” which has been so widely abused by Deepak Chopra, his acolytes, and the CAM community in general, while the new CAM buzzword these days to explain why quackery “works” is epigenetics. Basically, whenever a proponent of alternative medicine uses the word “epigenetics” or “quantum” to explain how an alternative medicine treatment “works,” what he really means is, “It’s magic.” This is a near-universal truth, and even the most superficial probing of such justifications will virtually always reveal magical thinking combined with an utter ignorance of the science of quantum mechanics or epigenetics.
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Posted in: Clinical Trials, Homeopathy, Medical Academia

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ASA Smacks Down Homeopathy

It is always gratifying to see regulatory agencies actually do their job. If those regulatory agencies whose job it is to protect the public from false or harmful medical advertising, products, or services thoroughly did their job, so-called “alternative medicine” would cease to exist.

Recently the Advertising Standards Authority (ASA) in the UK issued a judgment about advertising for homeopathy, specifically by the Society of Homeopaths. They had been receiving a number of complaints. After thorough investigation, and considering the response from the homeopaths, they came to two basic conclusions: homeopaths are engaging in false advertising by claiming that homeopathy is a proven treatment for specific indications when the evidence does not support those claims, and homeopaths sometimes “discourage essential medical treatment for conditions for which medical supervision should be sought.”

The ASA specifically investigated the following advertising and claims: (more…)

Posted in: Homeopathy, Politics and Regulation

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Homeopathy Ramblings

There needs to be a SCAM index, some quantitative tool, a formula for ranking the SCAMs, so one SCAM could reign supreme, to be definitely declared the the goofiest of all SCAMs. Perhaps (number of adherents)x(number of Pubmed publications)x(age of SCAM) all divided by a plausibility factor.

Homeopathy would win and any SCAM index that did not rank homeopathy at number one would have to put up a very convincing argument indeed that their formula was not somehow fundamentally flawed.1

For first time readers, homeopathy is based on several fictions, totally divorced from reality, made up in the 1800′s.

The first law,2 with less reality than Joe Abercrombie’s, is, “similia similibus curentur,” or “let like be cured by like”. Substances which cause specific symptoms can be used to cure diseases which cause the same symptoms.  If like cures like, I am uncertain what moonlight, one of many fanciful homeopathic nostrums, would cure. Lycanthropy? (more…)

Posted in: Clinical Trials, Homeopathy

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Six reasons CAM practitioners should not be licensed

States license “complementary and alternative” (CAM) practitioners (chiropractors, naturopaths, acupuncturists/TCM practitioners and homeopaths) via the magic of “legislative alchemy.” Ironically, licensing statutes are enacted based on the states’ constitutional power to protect the health, safety and welfare of the public. Yet these CAM practice acts actually increase public vulnerability to unsafe and ineffective health care practices.  It is, in short, a bad idea.  (A point we’ve discussed many times on SBM.) Here are six reasons why.  Feel free to add to the list.

1. Practice acts grant CAM practitioners a broad scope of practice, including legalization of scientifically implausible and unproven (or disproven) diagnostic methods, diagnoses and treatments.

Like medical doctors, dentists and nurses, CAM practitioners must practice under licensing legislation, also referred to as a practice act. Otherwise, they risk prosecution for the unlicensed practice of medicine or other licensed profession unless they are exempted by one of the so-called “health freedom” laws, which basically give everyone the right to practice medicine.

Chiropractic practice acts incorporate the absurd notion that patients are suffering from “subluxations” that adversely affect their (or their children’s) health. Acupuncture practice acts are based on the equally absurd notion that the body contains “meridians” which, when blocked, cause ill health, but can be relieved by sticking people with needles. Naturopaths can diagnose and treat conditions they invented out of whole cloth, such as chronic yeast overgrowth, ubiquitous “food sensitivities,” and adrenal fatigue. Homeopaths can treat patients with expensive little bottles of water. (You can find out much more about these CAM practices in the pull-down menu accessed via the “Categories” tab to the right of this post.)

Although there are exceptions, most practice acts grant CAM providers the right to diagnose and treat any patient, no matter what age or physical condition, suffering from any disease or condition, as long as the disease or condition is described in the terms of the practice act and the treatment is within the scope of practice. This is perhaps best illustrated by examples. Suppose a patient sees a chiropractor for vertigo. The chiropractor is legally allowed to diagnose the cause of vertigo as one or more subluxations of the spine and to treat the patient with adjustments. What if the patient sees an acupuncturist? If the acupuncturist diagnoses blockage of “qi” as the cause of vertigo and performs acupuncture to unblock the “qi,” the acupuncturist has done nothing outside his scope of practice. And if the patient sees a naturopath? The naturopath is free to diagnose, for example, “toxins” as the cause of the vertigo and proceed to treat these toxins with colonic irrigation. How about a homeopath? Same result: the patient is treated with what is essentially water. None of this will address the patient’s vertigo but it is all perfectly legal. (more…)

Posted in: Acupuncture, Chiropractic, Health Fraud, Homeopathy, Legal, Naturopathy, Politics and Regulation, Traditional Chinese Medicine

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Tag Away

Skin tags

Skin tags

Skin tags (acrochordon) are benign growths, often raised on a pedicle with a tiny stem. 46% of the population has one or more of them.  They are usually ignored, but some people think they are ugly and want to get rid of them, and sometimes the lesions rub on clothing and become irritated. Never fear! Tag Away is here!

I saw it advertised on TV.  They said it is “not available in stores.” But they only meant their special TV offer is not available in stores. You can buy Tag Away on Amazon.com, at Walgreens, at Walmart, and elsewhere. Tag Away is an all-natural product that promises to remove unsightly skin tags painlessly. It comes in a 15 cc bottle and is applied with a cotton swab 3 times daily for 3-8 weeks. One website claims:

One of the secrets of this product’s amazing success rate is Thuka [sic] Occidentalis, which is world-renowned for its ability to eradicate even the largest, most unsightly skin tags.

That’s not true. It doesn’t have an amazing success rate, it’s not world-renowned, and there’s no evidence that it can actually remove skin tags of any size. (more…)

Posted in: Herbs & Supplements, Homeopathy

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Naturopathic organ repositioning coming soon to Pennsylvania?

Pennsylvania legislators need to know only one thing about House Bill 612 (licensure of naturopathic “doctors”) to vote against it: As a means of “naturopathic musculoskeletal therapy” the bill would allow naturopaths to “reposition body tissues and organs.”

This is impossible. You cannot “reposition” tissues and organs of the human body by external manipulation.

Why does this tell us everything we need to know about these naturopathic doctors and why they shouldn’t be licensed in Pennsylvania? For one thing, this is no mistake a bill draftsman made in understanding what naturopathic practice includes. House Bill 612 was obviously drafted by naturopaths. That means naturopathic doctors actually believe they can “reposition” your body’s tissues and organs. And that speaks to their poor education and training. They don’t even understand basic anatomy.

For another, it tells us naturopathic doctors reject evidence-based medicine as a standard of practice. There is no evidence that this “repositioning” of organs and tissues is beneficial for any condition or disease, even if they could do it in the first place, which they can’t.

And for yet another, this certainly calls into question their understanding of the disease process and their diagnostic skills. One has to wonder exactly what health problems they think these purportedly out-of-place organs are causing. And how do they go about determining which organs are out of place and where they should go? Or when they have been successfully returned to their proper position? Again, this should raise alarming questions in the legislators’ minds about their education and training. (more…)

Posted in: Herbs & Supplements, Homeopathy, Legal, Naturopathy, Politics and Regulation, Vaccines

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The deceptive rebranding of aspects of science-based medicine as “alternative” by naturopaths continues apace

That naturopathy is a veritable cornucopia of quackery mixed with the odd sensible, science-based suggestion here and there is not in doubt, at least not to supporters of science-based medicine (SBM). However, what naturopaths are very good at doing is representing their pseudoscience as somehow being scientific and thus on par with conventional SBM. So how do they accomplish this? Certainly, it’s not through the validation of any of the cornucopia of pseudoscience and quackery that naturopaths apply to their patients as though picking “one from column A and one from column B” from a proverbial Chinese menu of woo. Naturopaths’ favored modalities include homeopathy (which remains to this day an integral part of naturopathy that all naturopaths are taught), acupuncture and traditional Chinese medicine (TCM), “detoxification” practices (a key precept of a lot of naturopathy) such as juicing, enemas, and chelation therapy, and the various other quack modalities that make up the practice of naturopathy. Treatments like these (especially homeopathy, whose precepts would require a massive rewriting of the laws of physics and chemistry for it to work) have not been and almost certainly cannot ever be scientifically validated with an evidence base of the quality and quantity supporting SBM.

So, instead naturopaths play a very clever game. In all fairness, naturopaths are not the only practitioners of so-called “complementary and alternative medicine” (CAM) or “integrative medicine” who play this game, but from my observations they appear to be the most talented at it. Their skill at obfuscating the line between SBM and naturopathy is evidenced by the success they have had in state legislatures in expanding their scope of practice, most recently in Colorado, where, if there is not a groundswell of support urging the Governor to veto SB-215 (or, as Jann Bellamy aptly called it, the quack full employment act), consumer protections against quackery in Colorado will be laid waste. At the same time, there is a naturopath licensing act (HB-1111) sitting on the Governor’s desk as well that would license naturopaths and give them the path to mandatory reimbursement from insurance companies. Instructions to write to the Governor opposing both bills can be found here and here; they would be disastrous for efforts to keep full vaccination in Colorado. A direct link to write the Governor can be found here.
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Posted in: Clinical Trials, Homeopathy, Naturopathy, Nutrition, Science and the Media

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The Quack Full Employment Act

Quacks, charlatans and snake oil salesmen are closely watching “The Colorado Natural Health Consumer Protection Act,” Senate Bill 13-215 (SB 215) as it wends its way through the Colorado Legislature. I imagine a few felons about to be released from prison are keeping tabs on the bill too, for reasons we’ll get to in a minute. SB 215 passed the Senate on Tuesday. It will now go on to the House, where it has the support of Rep. Joann Ginal, the mover and shaker behind a bill giving “naturopathic doctors” a right to practice, House Bill 13-1111 (HB 1111). That bill passed the House and is now parked in the Senate awaiting committee assignment.  Apparently, critical thinking skills have abandoned the state capital. Things are looking grim.

If the “Colorado Natural Health Consumer Protection Act” passes, Colorado will become one of a handful of states where anyone can practice medicine. Of course, these laws don’t come out and say that exactly. In fact, the Colorado bill states that if you don’t have a medical license you cannot practice medicine, which in Colorado is defined to include:

Holding out one’s self to the public within this state as being able to diagnose, treat, prescribe for, palliate, or prevent any human disease, ailment, pain, injury, deformity, or physical or mental condition, whether by the use of drugs, surgery, manipulation, electricity, telemedicine, the interpretation of tests, including primary diagnosis of pathology specimens, images, or photographs, or any physical, mechanical, or other means whatsoever; . . . Suggesting, recommending, prescribing, or administering any form of treatment, operation, or healing for the intended palliation, relief, or cure of any physical or mental disease, ailment, injury, condition, or defect of any person . . .

But, as we shall see, what SB 215 actually does is allow rank amateurs to diagnose and treat just about anyone for any disease or condition with means of no known safety or effectiveness. In other words, they can practice medicine, it’s just quack medicine. At the same time, the bill strips away important consumer protections. And guess who’s supporting it? The Colorado Medical Society, although I suppose we can be disappointed but not surprised. The Colorado Chapter of the American Academy of Pediatrics is remaining neutral. As I said, critical thinking skills have decamped from Denver.

Pay attention folks. Passage of this bill will energize the Health Freedom crowd. They’ll be in your state soon.

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Posted in: Energy Medicine, Health Fraud, Herbs & Supplements, Homeopathy, Legal, Naturopathy, Politics and Regulation

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Homeopathic regulation diluted until no substance left

Homeopathy is quackery but it is perfectly legal to prescribe homeopathic products and to sell them directly to consumers in the United States as well as other supposedly civilized countries such as the United Kingdom and Germany. This makes as much sense as allowing the sale of batteries that don’t produce electricity.

What makes this state of affairs even stranger is that homeopathic products are classified as drugs under U.S. law. Does this mean that they undergo the same pre-market approval process and are subject to the same post-market requirements as pharmaceutical drugs? No, not by a long shot. In fact, the federal government and the FDA have pretty much handed regulation of homeopathic products over to their manufacturers.

How did this happen?

In 1938, Congress passed the Food, Drugs and Cosmetics Act. The Act’s principle author was Senator Royal Copeland, a physician who practiced homeopathy. He managed to include all articles monographed in the Homeopathic Pharmacopeia of the United States (HPUS) in the definition of drugs within the FDCA, although why he did so remains in dispute. The HPUS is a source for monographs, identity, methods of manufacture, standards and controls and potency levels of homeopathic products, both prescription and OTC. (The vast majority of homeopathic products are OTC.) In short, if the product is in the HPUS, it’s legal.

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Posted in: History, Homeopathy, Legal, Naturopathy, Politics and Regulation

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