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Comment by MarkusWandel | Hacker News Reader

My local pharmacy (in Canada, not the above) has this too. I asked the pharmacist and got a shrug... people ask for the stuff so they stock it.

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The customer is always right, or so they say. But it's the manufacturer who decides to package it in the same shape and color as popular FDA-approved medicines. And it's the retailer who decides to intermingle the different types of product on the same shelf. Practices which are sure to result in someone who intends to buy a familiar medicine to instead pick up the imitation and not realize they're getting something completely different.

It's also governments who choose to allow this to be legally done. Nobody allows homeopathic gas stations that look like the real ones.

Gasoline is immediately verifiable as being effective or not. The problem with homeopathic medicine is that people can't tell whether it works or not. Placebo is a hell of a drug.

Nearly every market where the quality or efficacy of the product isn't readily verifiable by the purchaser is a hotbed for scams and snake oil.

If people are buying a placebo drug, and the placebo effect is making them feel better… mission accomplished?

Fooling someone into believing that you've done something you haven't is fraud even if you're successful in your trickery.

In this case you might as well put sugar in the tablets and charge a lot less

Of course not! Diluting homeopathic gas with water would make it so potent that it could rival nuclear arms.

They don't look like "real" medications though because they are clearly labeled with "This product is not intended to diagnose, treat, cure, or prevent any disease."

We allow gas stations to have diesel pumps right next to gasoline ones. We just require that they be labeled appropriately and its expected that people read the label and not make assumptions based off proximity.

Yes, but is there also a pump with Purple Koolaid - that can't be used to fuel any known vehicle - right next to both of those pumps?

If they thought they could sell it, I'm sure there would be.

There is a one way incompatibility for them. You can't put a diesel nozzle in a gas port.

https://vehq.com/are-diesel-nozzles-bigger-than-gas/

The packaging looks super similar to real medicine to me (see: oscillococcinum). The gas pump analogy would be a pump selling <85 octane or even water instead of gas right beside the 87+ octane people want.

The gas station example is a bad one. Diesel nozzles are larger in diameter than gas nozzles to prevent people from putting diesel into a gas vehicle.

Attempt to prevent. As I recall, leaded had nozzles that were also larger than no lead but that didn’t stop people from using it and slaughtering their converters. People are ingenious in both good and bad ways - funnels and screwdrivers.

OTC medical matter isn’t regulated anywhere as tightly as active drugs. They’re supplements or food additives or other such things. Whole lot of that shelf space goes to stuff that’s not as useful or desirable as people think. And any ambiguity is naturally exploited to the max.

We know that homeopathic medicines are complete fraud (ie no better than placebo). This has been shown over and over again in thousands of studies. What you are saying is that your car stopping because of bad gas is worse than your asthma not being treated.

> Customer is always right … unless he wants contacts or prescription glasses

That depends on the country.

Also, even in America I think you can order contacts and glasses online without a prescription; you just have to know your numbers.

Can you really? Last I tried, online sellers wanted a prescription scan before processing my order

I really don't know actually; I never tried when I was in America because it was cheaper to buy contacts through my optometrist using my vision insurance. So you're probably right. I was told that you could buy prescription glasses offshore without a real prescription (you just had to input the numbers), but that wasn't an American site obviously.

Here in Japan, you do not need a prescription to buy contacts; you can just write down your numbers on a form and buy them over-the-counter.

Blaming the pharmacy is a little disingenuous. Consumers should be able to buy medication without the same shelf being sprinkled with fraudulent placebos. This is something that needs to be regulated with warning labels or similar.

I think the pharmacy has part of the blame. They know which of the products are homeopathic. To mix them with other medicine or to put them separately is their choice. They can do better, they just don't care enough to invest the minimal effort.

To some degree yes. On the other hand, they'll optimize profit within the bounds of regulation, that's kind of their job. I wouldn't be surprised if margins on homeopathics were higher than margins on effective meds.

I mean, most if not all homeopathic remedies label themselves as homeopathic.

But usually not obviously so.

If the consumers want it I have no problem with a section of homoeopathic stuff. I do have a problem with it being mixed in.

I'm not a supporter of homeopathic medicine, but I'd be curious to know the research on half the other stuff in the medical aisle. OTC pain medicines have famously little power vs placebo for instance.

Yes, but they don't include that homeopathic remedies are fake medicine and not everyone will necessarily know that.

Sadly, I don't think that will change any opinions, particularly of people suspicious of "the man". May ironically make it worse.

At Whole Foods, I cannot buy a freaking Aspirin! What in actual hell? The remedies section is mostly bullshit plus some actual vitamins.

I thought supplements were treated different than, you know, actual medicine. That's probably why. But I've wondered that myself, too.

What I don't understand is that on the one hand they want to sell their customers wholesome foods --on the other hand-- they sell charlataney stuff, products of dubious efficacy.

If freaking 7-11 stores can sell me Aspirin tablets, I don't see how Whole Foods can't.

There’s an unfortunate crossover between people who want whole food and people who follow Gwyneth Paltrow, believe in Sedona vortex fruit cocktail crystal magnet medicinal woo, and have had their catalytic converter stolen 7 times for reasons they could never possibly comprehend.

What, pray tell, does having your catalytic convertor stolen have to do with believing in Goop? Last time I heard of one being stolen, the thieves didn’t bother to do an interview.

driving a prius ?

Arguably, Goop customers can afford a nicer car than a Prius

I've wasted much more time than I should have reading HN today but somehow this comment made it all totally worthwhile. Thank you!

I bet a different license is needed to sell "medicines".

I wandered into a "Pharmacy" that was completely homeopathic. I had the runs and urgently needed some immodium or something. It was like a nightmare.

Immodium is one of my "always have it stocked" things now. A few years ago, I had a bad case of the runs where Friday was "ok, that's uncomfortable" and Friday night was "this isn't good". Saturday was "I don't have enough energy to be able to safely drive a few blocks and back." I was able to call up a relative and they got some and dropped it off at my house.

So that's always in my drug cabinet now so that I won't have that situation again.

The chemistry part of it is neat:

> It is an opioid with no significant absorption from the gut and does not cross the blood–brain barrier when used at normal doses.

The "morphine giving you constipation" thing... this is the same, except that's all it does.

I'll also note the WHO Model List of Essential Medicines - https://en.wikipedia.org/wiki/WHO_Model_List_of_Essential_Me... - its under "Medicines for other common symptoms in palliative care" as Loperamide.

You almost certainly know this, but I feel compelled to add that Immodium does have downsides.

The most intuitive is prolonged use can stop all waste leaving your system for a while. As you can imagine, when the system finally starts going again it's initially uncomfortable, and can also be long-term damaging.

Yeah I think it probably has some kind of warning on the box. I keep it around. Once in a blue moon something I eat hits me wrong. I don't really want to go out and find a pharmacy in that state.

"palliative care" by the WHO is underselling it. In countries that struggle with basic sanitation, being able to prevent someone from literally shitting themselves to death with dysentery and other diseases that specifically suck the water out of your body into your intestines, it's downright lifesaving. "Shitting yourself to death" was a regular concern for average people for most of human history.

I've heard of people using it to manage withdrawals when kicking opioid/opiate addictions. Indeed it would at least help with the diarrhea symptom when withdrawing. No idea how well it works.

Thus the "normal doses" part. The "unapproved use" section gets into that - https://en.wikipedia.org/wiki/Loperamide#Off-label/unapprove...

> The primary intent of users has been to manage symptoms of opioid withdrawal such as diarrhea, although a small portion derive psychoactive effects at these higher doses. At these higher doses central nervous system penetration occurs and long term use may lead to tolerance, dependence, and withdrawal on abrupt cessation. Dubbing it "the poor man's methadone", clinicians warned that increased restrictions on the availability of prescription opioids passed in response to the opioid epidemic were prompting recreational users to turn to loperamide as an over-the-counter treatment for withdrawal symptoms.

Oh man thanks, I had no idea that that had made its way into studies/academia/that kind of thing. Yeah no matter what withdrawals mean you're gonna end up paying painfully whether its all at once or on the installment plan.

It would be easy to reconcile it - just have a separate shelf clearly marked "Homeopathic remedies" and people who asked for it would have the easiest time finding it, while people asking for the real thing would not be confused.

The fact that it doesn't happen suggests that either they don't care - or they have some interest in maintaining the confusion.

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