Every homeopathic eye drop should be pulled off the market, FDA says
arstechnica.com
arstechnica.com
And although placebo is a scientifically proven effect, it is not a label for quackery to hide behind.
Some people make the stuff themselves and drink it, which over time can give one argyria (https://en.wikipedia.org/wiki/Argyria). Definitely not a good idea to do that, but I suspect for putting on minor wounds this might be more a case of "there are better solutions".
Every medicine/supplement/remedy makes 3 claims:
1. Features ('What' it is - ingredient identity, potency, purity, quality) 2. Advantages ('How' it works and how it is different - the 'mechanism of action') 3. Benefits ('Why' the consumer cares - pain avoiders and gain creators)
So, there are 3 distinct categories:
1. regulated Pharmaceuticals should have good evidence for Features, Advantages, and Benefits
2. Unregulated 'Nutraceuticals/dietary supplements' often have good evidence for Features and Advantages, that is they have SOME mechanism of action that does something, but sometimes they fail to deliver on Benefits (especially big marketing claims).
3. Homeopathic remedies and similar do not deliver on Advantages or Benefits. Sometimes they don't even deliver on Features (they have different ingredients than what they claim). These do not have a mechanism of action that makes any sense whatsoever. You couldn't even run a good Randomized double blind placebo controlled study if you wanted to because the proposed mechanism makes almost zero sense.
'pharmaceuticals' and 'nutraceuticals/dietary supplements' can both have legitimate mechanism of actions for them with good studies. Fish oil, Creatine, Protein Powder, and similar supplements all have very well-studied mechanisms of action (Advantages) for the benefits they provide.
I understand that there are tons of scammy supplements, but they need to be treated differently than homeopathic remedies by consumers. One should be taken seriously, but treated skeptically, and the other should be dismissed from first principles.
I think homeopathy is nonsense really, has no scientific evidence in its support, and makes no physical or biological sense.
At the same time, I believe if someone wants to place such products on their shelves, they should be able to. In my opinion it doesn't matter if there is any placebo effect, or any effect of any kind, as long as the contents are correctly labeled and are uncontaminated.
The lead-up in this piece is misleading. Yes, there have been problems with a number of eye drop products. But — and this is critical — those products were not homeopathic, and still had problems. That is, the homeopathic nature of the products was irrelevant to their safety.
So now we're in a situation where, instead of aggressively pursuing eyedrop contamination in general, the FDA is focusing on the putative purpose of the eyedrops, which has nothing to do with the underlying problem.
Meanwhile, we're facing ongoing problems with contaminated generic medications, that have been going on for years or even the scale of decades even (it's turned into an interesting exercise, Google "Indian generic medication" at any random time of any year and see what the latest scandal is; e.g., https://www.bloomberg.com/opinion/articles/2023-04-04/big-ph...). These scandals, in contrast to homeopathy, seem to get slaps on the wrist from the FDA without any dramatic calls for complete market removal, because they somehow fit in the schema for science-based medicine. Homeopathic products with no evidence of active harm must be removed from the market because they have no efficacy, but tainted medications that are killing people or landing them in the hospital year after year are ok.
Homeopathy and the FDA is an odd topic for me, because although I think homeopathy is completely unscientific nonsense, by the same token I also suspect it shouldn't be actively harmful unless there's a different problem, which should really be the focus. I guess I have problems with an agency regulating with reference to intended purpose rather than purity and safety, because for me there's a direct line from that to a failed drug wars, lack of access to needed medications due to overregulation, treatment protocols lacking in scientific or ethical rigor that become de facto standards, and inequities in medical care.
I was expecting an article about how the FDA found homeopathic eye drops in particular as a class of eye drops to be systemically contaminated, and how they were going to pull them off the market until manufacturers complied with safety inspections. But that's not what I found at all.
Put it a different way: what is the actual safety concern about these eyedrops? Is it about the homeopathy, or contamination? Is it possible for homeopathy per se to be unsafe? Which, then, should be the real focus of the FDA?
I agree with you that 'scams' that target the Features (like the fake/counterfeit generics example) are terrible and we should aggressively go after this type of scam. However, had those Features been real, the Advantages and Benefits of those generics probably had good evidence/support. Just because you got fake pills, doesn't mean that the real ones don't work well.
But Homeopathic medicines ALWAYS have Advantages and Benefits problems. Even if the Features are okay, and you get exactly what you expected, the mechanism of action will never work and you will never get the benefits more than a placebo. If any marketing convinces you otherwise (like the label or having shelf space at CVS in the 'eye care' aisle), then you are a victim of another type of 'scam'. Homeopathic products, as far as an rigorous research is concerned, always have Advantages/Benefits problems.
On one hand, regulating Features is maybe easier for a government to do and that is an argument for limiting the scope to Features issues. However, the health and monetary costs of products with fake Advantages/Benefits is undoubtedly many years of life and billions of dollars, so there will be pressure to regulate. (maybe you disagree with the costs/externalities here)
It's definitely an interesting discussion. Hopefully smart people are working on getting real data about the pros and cons!
If a sugar pill makes a lot of people feel better they should by every means have access to it. Within scientifically proven and “understood” mechanisms of action there are a litany of misunderstandings and MoA’s that are total guesses that folks seem so eager to dismiss in hindsight relative to homeopathy in particular. Every exception to the rule gets pulled out of the book when it comes to misrepresenting safety and efficacy for the newest juice big pharma’s pushing, like there was some sort of update to the collective consciousness rather than cheap lies and misrepresentations.
It’s silly how polarized and fixated people and western administrations are on this large quadrant of “relatively harmless, many people think it does some good”. Like it’s some low hanging fruit always there to punch down to.
Regardless, the vast majority of folks I know using homeopathy don’t actively ignore other options or deny other forms of treatment at all– if anything they respect it more and approach powerful drugs with a prudence I believe is important to preserve.
Along with the likes of osteopathy, homeopathy is one of the forgotten forms of medicine. Allopathy, in this day and age, is criminal. Lots of elective surgeries that do nothing more than line pockets of medical device manufacturers, fleece the elderly, and bring prestige to aristocrat wannabes (certain doctors). That is saying nothing about the endemic of overprescription of psychoactive drugs like stimulants, and the rest.
Though that’s not to say homeopathy or osteopathy is any better. Once a field with research and experimentation, now relegated to fraudulent shamanism.
There’s a lot of lost knowledge from the 19th century that hasn’t been passed down, nor digitized. Some of it remains in libraries here and there.
Allopathic medicine, I would argue, is pseudoscientific because research where placebo does better or negative results are achieved are thrown out and never published. Instead, it’s p-hacked and methodologically-massaged (knowingly and unknowingly) to achieve the results the grants paid for. And even when published, practice does not keep up with the research.
Double blind studies on spinal surgeries are a great example where placebo, stemming from the belief of the patient that he received treatment, is just as effective in alleviating subjective pain. In the placebo case, simply putting the patient under anaesthesia and having him believe he had surgery is enough to resolve spinal pain. Or how about where common spinal surgeries stem from?: surgical experimentation with only flimsy research integrity. The first spinal fusions were essentially no different than lobotomies with how reckless and unethical the practice of experimenting based on loose evidence is. Not even in a research context, but a surgical, and informal one.
And yet, the same results can be found with less drastic and life-changing means. Instead of fusing your spine with titanium screws, you could go to a chiropractor for unexplained back pain. Or better yet, figure out the psychosomatic and physical causes (stress, poor muscle tone, etc.), instead of band-aiding the problem. What a thought!
Homeopathy, chiropractic, osteopathy, “holistic medicine,” etc. are better when they achieve the same results, for less cost (monetary, physical, what have you), when they work, and do not do further harm to the patient.
That doesn’t mean they’re both not scams. But one scam is less harmful en masse than the other. Both use “woo” to achieve the same ends, but neither are honest about it.
The problem about homeopathy isn't that it is a placebo or a the result of a study that had shit methodology. The problem with homeopathy is that it is made up bullshit that remains in the health space despite clear evidence it does not work.
Just like with horoscopes, the problem isn't what it does in itself, but where the unchallenged believes lead to. My neighbour died with cancer at the age of 50 as she only wanted "natural" medicine and homeopathy to treat it. A chemo therapy would have likely saved her life her heartbroken kids told me.
So sure, we can pretend there are no side effects of accepting bogus medicine, and even then it is an obvious cash grab, because homeopathy is not cheap. But it being bogus is the main problem.
From my point of view, longevity is not up and neither is quality of life due to modern medicine. Aside from some of the most fundamental medicines (penicillin, insulin, setting bones, etc.), it has yet to be proven that most forms of healthcare are not parasitic in nature. I.e. that whatever increases in longevity and quality of life are not due to modern medicine, but confounded because both have increased at the same time.
What is your evidence?
So what are the increases caused by? And what does it mean exactly for something to be parasitic? What is "both" referring to in your comment? Do you mean the relationship between lifespan and healthcare is correlation, not causation?
Also, what kind of research do you think we should be doing instead of pouring more resources into "modern" medicine?
If I had a philanthropic vehicle with unlimited funds, I would put out grants for further research into psychosomatic (and somatopsychic) disorders -- as well as the placebo effect. But I don't; and to ask others to do so where no incentive exists for them is foolish.
I think useful tools are being left on the table for the treatment of illness, because everyone involved is uninterested in anything more than self-interest.
That’s a tautology. “X is better than Y when it’s better than Y.” Show us evidence that they are better. But you won’t be able to. Alternative medicines do not generally outperform conventional medicine because they “…do not originate from using the scientific method, but instead rely on testimonials, anecdotes, religion, tradition, superstition, belief in supernatural ‘energies,’ pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources.”
The evidence will be anecdotal at best.
"As of 2021 many thousands of papers had been published on the efficacy of acupuncture for the treatment of various adult health conditions, but there was no robust evidence it was beneficial for anything, except shoulder pain and fibromyalgia.[17] For Science-Based Medicine, Steven Novella wrote that the overall pattern of evidence was reminiscent of that for homeopathy, compatible with the hypothesis that most, if not all, benefits were due to the placebo effect, and strongly suggestive that acupuncture had no beneficial therapeutic effects at all.[18]"
I'm not arguing for equal efficacy. I'm arguing that the complete disregard of sham practices, mediated by placebo, is not rational; and that not taking placebo into account as a possible treatment for certain conditions is short-sighted (if not harmful).
The real challenge is taking something that does work, but isn’t economically worth while, through the phased trial process. However even those studies regularly get published - “X appears to be effective deserves further research,” which is probably the sadder side of medical research as that’s code for “never going to be researched.”
They're over-prescribed, in my opinion, when more fine-grained therapy and lifestyle changes can elicit similar benefits.
And placebo even work for some if they know it.
Which means we can easily give recommendations for modern placebo which is actually cheap to buy and produce.
But the homeopatie shit is for sure also responsible for the people not believing in corona etc.
Except, doesn’t the placebo effect have something like a 50% efficacy rate for many ills? I always felt like that can’t be right. Is it?
I had figured that this was how homeopathy “worked.”
https://www.dcscience.net/2015/12/11/placebo-effects-are-wea...
There have been natural cures to many illnesses, like using witch Hazel for ear infections, that should not be simply thrown out, as those cures work much better, and with far less side effects, than taking pills. Big industry loves to suppress information about affordable cures, because it cuts into their profits.
I think regulating the profitability and effectiveness of both homeopathy and big pharma is the best move to make sure that cures are valid, but I also think both sciences/practices should be allowed to exist when they are proven, because ultimately, we as humans stand to benefit from having the option of either for our best life/health outcomes overall.
Naturopathic medicine use natureceuticals/supplements all the time. These contain active ingredients in usable dosages that have research about their mechanism of actions and many of them work quite well. (Witch Hazel may be one! Vitamins and minerals are also common. Fish oil too.)
Homeopathy is a specific belief in homeopathic remedies, which as described in the article are pretty thoroughly debunked pseudoscience. They dilute things down, but the effects are no different than placebo.
In my opinion, this is a really unfortunate confusion that a lot of people have. Natural supplements are useful, and when they are proven useful, they often get turned into regulated medicines! However, homeopathic remedies are entirely different and get to 'free-ride' on the confusion created in the alternative health industry.
This Witch Hazel product at CVS is not homeopathic.[1] This is a normal Witch Hazel supplement that is pure distilled Witch Hazel. This is not homeopathic.
Most people think 'homeopathic' just means 'natural supplements/alternative medicines'.
That IS NOT what it is. Homeopathy is a specific 'ritual' that is done where the compound that 'causes illness' is diluted many, many, many times until there is effectively none of it left in the bottle. It is psuedoscience AND IT IS NOT NATURAL MEDICINE. [2]
It matters to understand this, because the homeopathic industry obviously uses this confusion to their advantage.
[1] https://www.cvs.com/shop/t-n-dickinson-s-witch-hazel-all-nat...
Yes, that is called real medicine though. That has nothing to do with homeopathy.
I'll throw this out into the ether... maybe someone else has experienced it.
Because I wore contacts too small in diameter the whites of my eyes now have extremely prominent red veins. There is no cure for this condition except a very expensive and barbaric procedure from a Beverly hills doctor. It's an extremely risky procedure that can cause all kinds of problems to the eye.
I'm quite surprised there isn't a cure for this, many people have these veins.
Anyway, I've tried every drop, supplement, and odd thing you can try to try and look like a person that isn't high or drunk 24/7.
You would be surprised how something so small can affect a persons confidence. If you have semi white eyes thank the Lord above and be careful wearing contacts.
Also if anyone has any suggestions I'm all ears.
These "principles" are actually true sometimes, to a certain extent in specific cases. Vaccines, for example, or hormesis. Similarly, bloodletting as practiced in the Middle Ages was actually the right treatment for a few specific diseases. But when these concepts become disconnected from empirical reality and turn into sacred doctrine, that's when the trouble starts.
> These "principles" are actually true sometimes, to a certain extent in specific cases. Vaccines, for example, or hormesis.
You're being too charitable with "true sometimes", in my opinion. I've unbent a paper clip into a nearly straight strip of aluminum before. The result was a "paper clip" in name and origin only. I would call it a "paper clip" for convenience, and I might jokingly consider it a paper clip "to a certain extent". But calling the strip a paper clip wouldn't be useful unless I were to describe it as "a paper clip if I bend it back into the original shape". The "law of similars" and the "law of infinitesimals" as described by the article are like the straightened "paper clip": understandable generalizations from a practical truth, but too far from the initial practical truth for "true sometimes" to be a useful rule of thumb. (It is useful, however, to find out how a useless "principle" came about.)
A vaccine is not a cure. It's training for the immune system. The response to small amounts of a harmful substance can prepare the body to respond more quickly and/or more correctly to a future exposure. Giving yourself a vaccine while you're already infected with the virus would have little benefit if any. I could call a vaccine a cure "to some extent" if I wanted to be broad with my definitions, but would it be useful to do so? Not to me, so I might as well not call a vaccine a cure at all.
Hormesis is less about "small amounts can be more potent than large amounts" than "small amounts can actually help you at all compared to large amounts".
Someone noticed that using “less concentrated medicine” resulted in healthier patients. Then obviously even less concentrated medicine “worked” better, and so on…
You can easily see how a simple logical extrapolation from there would result in ardent believers of homeopathy.
(To make matters worse: Simply hydrating patients with water is a fairly effective treatment all by itself!)
Some things may be slightly superficially similar by pure coincidence, because there's a large amount of things in the world and there's always something that's accidentally similar, but this kind of observation is meaningless and devoid of any value.