The fox would be delighted to guard the hen house

John Tozzi at Bloomberg is also on the homeopathy story.

On a recent afternoon in midtown Manhattan, I popped into a chain drug store and picked up some $12 sleep tablets whose label promises both “courage and peace of mind” and “focus when ungrounded.” I also got a $17 tube of cream offering “rapid, soothing relief of pain” from conditions as varied as arthritis, carpal tunnel syndrome, and bug bites. Both products sat on shelves alongside familiar drugs such as Tylenol and Claritin, which regulators have carefully scrutinized for safety and effectiveness. The half- dozen products I bought—labelled as “homeopathic”—aren’t vetted for either.

Tablets that give you courage and peace of mind – that’s funny. I suppose it wouldn’t have sounded spiritual enough to say “calms you the fuck down” – not that it does that either.

About 3.3 million Americans spent $2.9 billion on homeopathic treatments in 2007, according to the latest estimates from the Centers for Disease Control (CDC), though private industry research suggests a smaller market. The industry has “mushroomed” since the early 1980s, when homeopathic sales were just $1.5 million a year, says Bill Nychis, who worked at the FDA for 39 years in compliance and enforcement. At the time, the agency was midway through a decades-long process reviewing older over-the-counter drugs for safety and efficacy. The FDA had the authority to regulate homeopathic remedies, but because sales were so small, the agency opted to outsource much of that job to the industry itself. “Risk is always depending upon the number of products on the market and the sales volume of the products,” says Nychis, who now advises importers at

In 1988, the FDA issued a policy guide “where we basically allow these drugs to come to the market without premarket approval,” says Cynthia Schnedar, director of compliance for the agency’s Center for Drug Evaluation and Research. Federal regulators allow the sale of any substance listed in the Homeopathic Pharmacopeia, a document published since the 1800s and maintained by a nonprofit industry association. The remedies need to meet certain FDA manufacturing guidelines and can be marketed over the counter only for “self-limiting” conditions, meaning illnesses like colds that go away on their own.

Oh? Is that right? Then why are homeopathic asthma “treatments” sitting on the shelf at the chain drugstore less than a mile from where I am at this moment? Sitting on the shelf with the real asthma medications?

Critics of homeopathy say FDA action is overdue. Stephen Barrett, a retired North Carolina psychiatrist who operates the fraud-busting site Quackwatch, petitioned the agency in 1994 to require that homeopathic remedies meet the same standards for safety and effectiveness as other drugs. The agency has cracked down on claims that homeopathic products can treat cancer or substitute for flu vaccines, but Barrett says it hasn’t done enough to warn consumers about common over-the-counter remedies. “You can’t separate safety from effectiveness,” he says. “If it’s not effective, it’s not safe.”

And there are homeopathic asthma “treatments” out there. I can’t emphasize this enough. It’s not just for headaches and other things that can be hard to treat and aren’t fatal. Asthma.

Manufacturers of homeopathic products argue that the consumer should be the judge. “Millions of Americans use homeopathic medicines and want access to them,” says John P. Borneman, chief executive of Hyland’s Homeopathic and president of the industry association that publishes the Homeopathic Pharmacopeia. “These medicines are very effective, people like using them, [and] it’s part of consumer choice in the United States.”

No. Medicine is a technical subject. People can’t evaluate medicines on their own, and manufacturers can’t (and shouldn’t and mustn’t) be trusted to give all the necessary information on the package. Manufacturers of homeopathic products are doing it to make money, and they’re not going to say on the label “THIS IS FAKE MEDICINE.” It has to be an outside body that does that, one with no financial stake in the outcome – a disinterested party.

In the U.S., homeopathic remedies have become more common at national pharmacy chains, says Yale historian Naomi Rogers, who has studied the history of medicine and homeopathy. “Homeopathic drugs didn’t disappear, but they moved from prescription drugs to all over-the-counter drugs,” she says. “They start to be seen as—or even packaged as—the equivalent of special vitamins, special kinds of extra things you can take to stay healthy, or to get healthy, or to treat something that you have that you don’t want to go to a doctor for.”

Or just as one of the several asthma treatments on the shelf, and one that is cheaper than the others.

At this week’s hearing, the FDA will consider whether its current approach is “appropriate to protect and promote public health in light of the tremendous growth of the homeopathic market.” Barrett says the answer is no, and he suggested a way 20 years ago to deal with it: “Hold homeopathic drugs to the same standards as other drugs.” Which would probably make them harder to find at your local pharmacy.

I sure as hell hope so. It horrified me to find homeopathic asthma “treatments” right there on the shelf.


  1. Randomfactor says

    I’ve seen those tablets recently…not at my usual drugstore, but when I chanced to visit a location of the pharmacy chain in a much lower-income neighborhood.

    Courage? I’d have laughed out loud had it not been so sad.

  2. Pliny the in Between says

    When discussing the decision making of one of our rather cantankerous colleagues, a mentor of mine said, “In his view, when science meets opinion, opinion always wins”. Unfortunately that could be the motto of many Americans. We see it in politics, science denialism, religion, quackery, etc. American exceptionalism is extended to the individual who doesn’t need anyone to tell them what they should think. And any group who claims authority (on the basis of education, training, or special knowledge) is suspect and no doubt part of that shadow conspiracy suppressing cancer cures and perpetual motion machines. Marketing capitalizes on this conceit. ‘Why take any of those nasty chemicals when you can have this natural cure’ (ignoring for a moment that cancer, nicotine, and strychnine are all natural too). Sadly, only when national store chains lose their shirts from litigation over somebody dying of this quackery, are they likely to stop selling it.

  3. Dave Ricks says

    Borneman’s argument for American consumer choice …

    These medicines are very effective, people like using them, [and] it’s part of consumer choice in the United States.

    … is the ice cream argument in Thank You For Smoking:

    NICK: Let’s say that you’re defending chocolate, and I’m defending vanilla. Now if I were to say to you: “Vanilla is the best flavor ice cream”, you’d say…

    JOEY: No, chocolate is.

    NICK: Exactly, but you can’t win that argument. So I’ll ask you: “So you think chocolate is the end-all and be-all of ice cream, do you?”

    JOEY: It’s the best ice cream, I wouldn’t order any other.

    NICK: Oh! So it’s all chocolate for you, is it?

    JOEY: Yes, chocolate is all I need.

    NICK: Well, I need more than chocolate, and for that matter, I need more than vanilla. I believe that we need freedom. And choice when it comes to our ice cream, and that, Joey Naylor, that is the definition of liberty.

    JOEY: But that’s not what we’re talking about.

    NICK: Ah! But that’s what I’m talking about.

    JOEY: But you didn’t prove that vanilla was the best.

    NICK: I didn’t have to. I proved that you’re wrong, and if you’re wrong I’m right.

    JOEY: But you still didn’t convince me.

    NICK: It’s that I’m not after you. I’m after them.

    [points into the crowd]

  4. johnthedrunkard says

    “Millions of Americans use homeopathic medicines and want access to them,”

    Millions of Americans use HEROIN and want access to it.

  5. footface says

    So, according to the CDC estimates, the Americans who bought homeopathic products in 2007 spent an average of $879 on them? Wow.

  6. RJW says

    “You can’t separate safety from effectiveness,” he says. “If it’s not effective, it’s not safe.”

    Yes, this is the the criteria that must be applied to all alternative ‘medicines’. i.e. ‘prove your claims scientifically’

    @3 Pliny the in Between

    “We see it in politics, science denialism, religion, quackery, etc.”
    The phenomenon certainly isn’t confined to the US.
    Journalists’ need to create controversy and provide ‘balance’ enables complete crackpots to given ‘equal time’ in the media, and there’s the Right Wing anti-science campaign because scientists keep pointing out inconvenient truths that threaten corporations’ ability to make money when, how and where they choose.
    I can understand the climate change denial campaign, it’s the usual rear guard action by the plutocracy to protect their investments.

    Of course science is difficult compared to quackery and religion and many people have the attention span of a goldfish.

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