“By definition”, I begin
“Alternative Medicine”, I continue
“Has either not been proved to work,
Or been proved not to work.
You know what they call “alternative medicine”
That’s been proved to work?
- Tim Minchin, "Storm"
Ancient arts that hold the secret of a long, healthy life, and relief from all that ails you. Herbal remedies for everything from headaches to cancer. Magnetic bracelets that make you faster, stronger, smarter, and more energetic. Treatments that "big pharma" doesn't want you to know about, because they can't make money on them: order now for three easy payments of $29.95. Many of the purveyors of alternative medicine and alternative therapies may very well believe their own claims, but, good intentions or not, they're usually making a profit from the desperate and the gullible.
This in itself would be good reason be vocally skeptical of the claims made by alternative practitioners. But there's much more at stake than a few people being parted from their money: by preventing people with real health problems from seeking real medical attention, alternative medicine kills.
The root of the problem: The Placebo Effect
Credit: Tim and Selena Middleton, Flickr.comThe placebo effect is a well known but little understood phenomenon wherein some patients treated with fake medicine - a sugar pill is the common example - and it has positive effects on their health outcome. It's reasonable to hypothesize that one's belief that the pill they're taking will cure them might cause biochemical reactions in the brain that help the body's systems to react and adapt; something as simple as a reduction in stress might help a person heal faster. But the placebo effect is even weirder than that: sometimes it seems to work even when the patient doesn't believe it will.
One of the criteria for measuring the viability of new treatments in medical trials is that they provide substantially better results than could be has through the use of a placebo. Alternative medicines have either not yet been investigated for such effectiveness or, more likely, have either succeeded and become actual medicine, or failed this test. The apparent successes of some alt therapies are almost always comparable to the predicted effects of placebos.
Further, the widespread awareness - and often misunderstanding - of the placebo effect and its implications for the effect of one's mental state on one's health has fed into pseudo-mystical "mind/body" mumbo-jumbo that goes well beyond any medically justified assertions.
It's also worth noting that the validity of the placebo effect itself has come under fire in recent years. A number of controversial studies beginning in the late 1990s have called into question some of the long-held assumptions about this phenomenon. They call into question measurement methods in previous placebo trials, criticizing the lack of adequate methods to separate the effects of the placebos themselves from other possible causes and effects, such as "Spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment, conditional switching of placebo treatment, scaling bias, irrelevant response variables, answers of politeness, experimental subordination, conditioned answers, neurotic or psychotic misjudgment, psychosomatic phenomena, misquotation, etc."
The Usual Suspects
Here are a few of the popular forms of questionable alternative medicine commonly practiced today.
That's the basic tenet that homeopaths would have you believe. When a drop of water comes in contact with even trace amounts of some substance that might have benefits for the body, it learns from that substance and takes on its beneficial properties (though apparently this doesn't happen for poisons or disease-carrying substances the same water comes into contact with). Once you've established your magical healing dewdrop, you can then proceed to make it stronger by diluting it with even more water. Then you can sell it in liquid form or soak it into a sugar pill and sell that, if you want to get fancy about it.
Let's put aside for a moment how ludicrous the very idea of selective "water memory" is, and how contrary to all our experience in the real world is the concept of making a medicine stronger by adding water to it. Let's pretend, just for a moment, that these claims are true.
All of the water that we drink is connected. Through our oceans, rivers, lakes, aquifers, and atmosphere, it's all been mixing and re-mixing for the billions of years since the earth cooled enough for two atoms of H to stay linked up with an atom of O. Every possible beneficial herb, vitamin, mineral, or medicine ever to exist on the planet has at one time been in contact with water which was later diluted with other water. So if there's any truth to the claims of homeopaths, it would be entirely reasonable to accept that a few sips of tap water a day would leave us in perfect health, all the time.
I haven't found that to be the case.
Skeptic James Randi frequently gives public talks that touch on alternative medicines. To demonstrate his point, he'll often bring along a full bottle of homeopathic sleeping pills and crunch on handfuls of them all through his talk. Randi is thin and in his 80s - and so far the massive homeopathic doses haven't slowed him down. (Though they might have elevated his blood sugar level.)
Credit: Wikimedia commonsSure, it's been around for a long time. From AIDs to erectile dysfunction to stroke, acupuncture has been used to treat just about any affliction. It's even gone high-tech, with some practitioners replacing needles with low-intensity lasers. But is there any evidence that this ancient art, involving the jabbing of pins into the body to manipulate alleged invisible energy fields, actually works?
Well, the good old placebo effect gets in our way here again. There have been some apparent successes with acupuncture, that seem to suggest it works, to a limited degree, in some situations. (Lots of studies in the far east have "proved" its effectiveness, but try finding one that was done under properly controlled double-blind conditions.) But here's where the arguments for acupuncture truly fall apart: fake acupuncture works as well as "real" acupuncture. That means if you laid down on a table and I, with no mastery of any ancient Chinese Art of Anything, started poking you in the buttocks with pointy things, I would statistically have an equal chance of curing your headache as would the wizened guru who interrupted his mountaintop meditation to see to your needs. Maybe better, because I'd slip you an aspirin afterward.
Credit: Wikimedia commonsThe chiropractic industry is a large, powerful, and wealthy one, owing much of its success to having the financial resources to lobby government regulators and sue its detractors (as the American Medical Association found out after its "Committee on Quackery" dismissed chiropractic in the 70s, and as journalist Simon Singh found out recently in the UK).
Chiropractors claim that most ailments are caused by misalignment of the spine called "subluxations", and thus can be cured through proper spinal alignment. They'll site numerous studies they claim point to successful medical outcomes through their intervention, but opponents argue that none of these studies has shown any significant statistical advantage over other forms of treatment, including such radical steps as weight loss, exercise, resting, or doing nothing.
They're right, though, that the spine is kind of important. That's why manipulating it, especially with tools, can be dangerous. Chiropractic techniques have been blamed for stroke, paralysis, and fractures; there's even a support group for its victims.
There are, in fact, herbal solutions that can improve your health. There are vitamin and mineral supplements that can help to address health problems. Their effectiveness varies widely, is sometimes poorly understood, overestimated, or, often, the evidence gathered so far is conflicting or inconclusive. But there are many items in this broad category that probably actually work, to one degree or another, and depending on what form and what concentration they're delivered in.
Unfortunately, there's a huge industry that wants to sell you this stuff whether it works or not, and which counts on the average consumer's difficulty in getting unbiased information about the various claims made for its products. Profit margins and propaganda are a dangerous combination. So how can you protect yourself from getting medical advice based more on economics than science?
One way to try to verify a product's health claims is to look for studies about the efficacy of whatever substance is being advertised as beneficial. Not studies conducted by the vendor, either - you're looking for research done by real universities or hospitals, and ideally both short and long term studies. Often there will be helpful (somewhat) plain-language summaries of these studies available at various places on the internet. Another step is to become familiar with internet resources like The Skeptic's Dictionary, Quackwatch, and others. There's an amazing herbal/supplement interactive infographic at InformationIsBeautiful, though it's not clear how often it gets updated. Be aware of some of the buzzwords that are often used to lend a scientific air to what would otherwise easily be written off as nonsense.
Above all, approach any medical claim with a healthy but open-minded skepticism. Look for evidence, not anecdote, and be aware that miracle cures seldom are, no matter how much you'd like them to be. Keep in mind that for all its shortcomings and all that it has yet to figure out, modern medicine has a far better track record than any other method when it comes to sending people home alive and well.