It’s the time of year where if you’re not sick, someone you know probably is. The influenza season in the Northern hemisphere started out slowly, but seems to be accelerating and hasn’t peaked yet. Add that to cold viruses circulating, and you get the peak purchasing period for cough and cold remedies. John Snyder gave a nice summary of the evidence base for the common treatments a few weeks ago. In short, despite all the advertising, there is little evidence to suggest that most of the “tried and true” products we’ve used for decades have any effect on our symptoms. One of the most sensible developments that’s occurred over the past few years has been the discontinuation or relabeling (depending on your country) of cough and cold products for children. The rationale to pull these products is compelling: Cough and cold remedies have a long history of use, and were sold without prescriptions before current regulatory standards were in place. They were effectively grandfathered onto the marketplace. When it comes to their use in children, the data are even more limited. There are few published trials and the results are complicated by different age groups, irregular dosing, lack of placebo control, and very small patient numbers. What’s even harder to believe was that doses were based mainly on expert opinion, not data, and generally didn’t consider that children don’t handle drugs the way adults do. So why withdraw them from pediatric use, but not adult use? Like most regulation, it comes down to risk and benefit. Both are troubling for pediatric use. (more…)
There have been many cases now of big companies or organizations, or wealthy individuals, threatening to sue or actually suing a blogger for libel. The most famous case is that of Simon Singh who was sued by the British Chiropractic Association over comments he made in an article. Simon braved through the expensive and exhaustive legal process (which is especially onerous in England), but he is not just a lone blogger. He is a successful author and was writing for the Guardian. Eventually the BCA was forced to drop the case – but only after the blogging community rallied behind Simon, magnifying his criticisms of the BCA by orders of magnitude. By all accounts it was a PR disaster.
The blogging community as a whole is rather passionate about this issue. We exist on the premise of free and open public discourse about important issues. At SBM we take on many controversial issues and we don’t pull our punches when criticizing what we see as pseudoscience in medicine. So of course we take notice when a large company tries to bully a blogger to silence their legitimate criticism.
According to the BMJ this has happened yet again – this time the international homeopathy producer, Boiron, is threatening a lone Italian blogger because he dared to criticize their product, Oscillococcinum. The blogger, Samuele Riva, wrote two articles on his blog, blogzero.it, criticizing what our own Mark Crislip has called “oh-so-silly-coccinum.” The blog is entirely in Italian, but he is maintaining a page in English with updates on the Boiron vs Blogzero affair.
I keep half an eye on the medicine displays in stores when I shop, and this year is the first time I have seen Oscillococcinum being sold. Airborne as been a standard for years, but Airborne has been joined by Oscillococcinum on the shelves. Dumb and dumber. It may be a bad case of confirmation bias, but it seems I am seeing more iocane powder, I mean oscillococcinum, at the stores.
On a recent podcast I was listening to one of the hosts suggested a homeopathic remedy for flu symptoms, and then specifically suggested osillococcinum. This is a technology podcast, the 404, and the hosts are certainly bright, educated people. Why would he suggest osillococcinum? Probably because he unaware of how oh so silly the product is.
I am quite proud of my medical school. The dedicated faculty and dynamic curriculum produce graduates of excellent clinical skill with a strong sense of service. Initially I was too focused on coursework to pay much mind to the student-run interest group in “cross-cultural and integrative medicine” and the occasional extracurricular CAM event. More recently, however, I noticed that such events had become a highly-publicized, monthly occurrence. It was still very much outside the official curriculum, but the discussion was one-sided with no public debate.
In addition to the student group on my local campus, we have a “CAM institute” that boosts CAM across the wider university. The CAM institute is a major sponsor of events organized by the student group in addition to producing its own lecture series and publications. The events hosted by either group are of two types. The first kind is an activity for med students that essentially functions as stress management: a yoga instructor leads free sessions between lectures once a week, and free herbal tea or massages are offered during final exam week. Who can complain about that? The massages are quite popular. The second kind of event is a lecture or workshop on a particular CAM modality.