Alternative medicine

In the early 19th century, a satirical cartoon depicted a man promising that taking 1000 pills at night would transform him into a completely different person by morning. This image mocked Morison's Vegetable Pills, a popular alternative remedy of the time that promised miraculous cures without scientific backing. Today, the landscape of alternative medicine remains strikingly similar, with billions of dollars flowing into practices that lack biological plausibility, testability, or repeatability. Unlike modern medicine, which relies on the scientific method to produce repeatable evidence of effect or no effect, alternative therapies often reside outside mainstream medicine, drawing their authority from testimonials, anecdotes, religion, tradition, superstition, and belief in supernatural energies. The term alternative medicine refers to a set of products, practices, and theories that are believed by their users to have healing effects, yet whose effectiveness has not been established using scientific methods. Some practices contradict established science on how the human body works, while others appeal to the supernatural to explain their effects. Research into these therapies frequently fails to follow proper research protocols, such as placebo-controlled trials or blind experiments, leading to invalid results. History has shown that if a method is proven to work, it eventually ceases to be alternative and becomes mainstream medicine. However, the vast majority of alternative therapies have been thoroughly disproven, yet they continue to thrive in a highly profitable industry with strong lobbying power and far less regulation than conventional medicine.

The Placebo Paradox

A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect, though later reassessments found the study to have flawed methodology. Despite this, the placebo effect remains one of the strangest phenomena in medicine, where patients perceive improvement after being treated with an inert treatment. Alternative therapies often rely on this psychological phenomenon to create the illusion of effectiveness. When patients believe a treatment will work, they are more likely to report improvements, even if the treatment itself has no physical effect on the disease. This is further exacerbated by the natural course of disease, where conditions may resolve on their own, leading patients to attribute recovery to the alternative therapy. In the absence of this bias, especially for diseases that are not expected to get better by themselves such as cancer or HIV infection, multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. Some alternative therapies are actively harmful, such as cyanide poisoning from amygdalin or the intentional ingestion of hydrogen peroxide. The nocebo effect, the opposite of the placebo effect, occurs when patients expect a treatment to be harmful and perceive harmful effects after taking it. Distrust of conventional medicine may lead patients to experience the nocebo effect when taking effective medication, further complicating the landscape of alternative medicine. Researchers, such as epidemiologists, clinical statisticians, and pharmacologists, use clinical trials to reveal such effects, allowing physicians to offer a therapeutic solution best known to work. Alternative treatments often refuse to use trials or make it deliberately hard to do so, leaving patients vulnerable to ineffective or harmful practices.

Common questions

What is alternative medicine and how does it differ from modern medicine?

Alternative medicine refers to a set of products, practices, and theories that are believed by their users to have healing effects, yet whose effectiveness has not been established using scientific methods. Unlike modern medicine, which relies on the scientific method to produce repeatable evidence of effect or no effect, alternative therapies often reside outside mainstream medicine and draw their authority from testimonials, anecdotes, religion, tradition, superstition, and belief in supernatural energies.

Why do alternative therapies often fail to show effectiveness in clinical trials?

Research into these therapies frequently fails to follow proper research protocols, such as placebo-controlled trials or blind experiments, leading to invalid results. Alternative therapies often rely on the placebo effect to create the illusion of effectiveness, where patients perceive improvement after being treated with an inert treatment, and this is further exacerbated by the natural course of disease where conditions may resolve on their own.

How much money has the United States government spent on alternative medicine research before 2009?

In the United States, the National Institutes of Health has spent more than US$2.5 billion on investigating alternative therapies prior to 2009, with none being found to be effective. This funding has been criticized for diverting research time, money, and other resources from more fruitful lines of investigation.

What specific dangers did four children face in Australia between 2001 and 2003?

How does the alternative medicine industry impact healthcare access in developing nations and minority communities?

In developing nations, traditional remedies may comprise primary healthcare or be integrated into the healthcare system, with 80% of primary healthcare in Africa relying on traditional medicine. In Latin America, inequities against BIPOC communities keep them tied to their traditional practices, and it is often these communities that constitute the majority of users of alternative medicine.

The Profit of Pseudoscience

The alternative medicine sector is a highly profitable industry with a strong lobby, and faces far less regulation over the use and marketing of unproven treatments. In the United States, the National Institutes of Health has spent more than US$2.5 billion on investigating alternative therapies prior to 2009, with none being found to be effective. This funding has been criticized for diverting research time, money, and other resources from more fruitful lines of investigation. The industry markets alternative practices as more natural or holistic than methods offered by medical science, which is sometimes derogatorily called Big Pharma by supporters of alternative medicine. Marketing strategies often include friendly and colorful images of herbal treatments that look less threatening or dangerous when compared to conventional medicine. This intentional marketing strategy takes advantage of the least fortunate members of society, who may lack access to contemporary medicine due to a lack of private or public health insurance. In developing nations, traditional remedies may comprise primary healthcare or be integrated into the healthcare system, with 80% of primary healthcare in Africa relying on traditional medicine. In Latin America, inequities against BIPOC communities keep them tied to their traditional practices, and it is often these communities that constitute the majority of users of alternative medicine. Racist attitudes towards certain communities disable them from accessing more urbanized modes of care, exacerbating the inequities that minorities in Latin America already face. The alternative medicine lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine, allowing practitioners to promote treatments without proof of efficacy. This has led to a situation where even the safest alternative medicines can indirectly produce negative outcomes by delaying appropriate treatment.

The Death of Delay

Between 2001 and 2003, four children died in Australia because their parents chose ineffective naturopathic, homeopathic, or other alternative medicines and diets rather than conventional therapies. This tragic outcome highlights the dangers of treatment delay, where alternative medicine may discourage people from getting the best possible treatment. Those having experienced or perceived success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness. Critics argue that therapies that rely on the placebo effect to define success are very dangerous, as they can lead individuals to forgo effective treatments. In short, even innocuous treatments can indirectly produce negative outcomes. The Institute of Medicine has identified several types of harm resulting from the use of alternative medical techniques, including direct harm, economic harm, and indirect harm. Direct harm results in adverse patient outcomes, while economic harm results in monetary loss but presents no health hazard. Indirect harm results in a delay of appropriate treatment, or in unreasonable expectations that discourage patients and their families from accepting and dealing effectively with their medical conditions. Interactions with conventional pharmaceuticals can also be dangerous, with some herbal remedies causing dangerous interactions with chemotherapy drugs, radiation therapy, or anesthetics during surgery. An example of these dangers was reported by Associate Professor Alastair MacLennan of Adelaide University, Australia, regarding a patient who almost bled to death on the operating table after neglecting to mention that she had been taking natural potions to build up her strength before the operation, including a powerful anticoagulant that nearly caused her death. The rejection of science-based medicine in favor of alternative therapies has led to a situation where even the safest alternative medicines can indirectly produce negative outcomes, making it a critical public health issue.