I still don't understand why these can be sold in American pharmacies.
A friend of mine is an orthopedic surgeon, and they explained to me that for mild problems, which would normally heal on their own, it's cheaper to cover a placebo rather than real medication.
If you have "mild problems, which would normally heal on their own", buying no medication at all would be even cheaper.
And from an ethical point of view, the idea of financing a whole (homeopathic) industry that uses your money to produce fake science, even with a single cent, should make one shudder, shouldn't it?
But placebos actually outperform no intervention.
But then, why prescribe the most expensive placebos where you co-finance societal harmful behavior, rather than just prescribing the "harmless" placebos that are not homeopathy, which are usually even cheaper and don't have any ideological overhead?
It's a psychological effect, so things like price or flavor or packaging likely affect its strength.
Color matters: placebo colored pills work better than white pills.
Delivery mechanism matters: placebo injections work better than pills.
Idk about price, packaging, or flavor specifically. But delivery mechanism, color, number of pills, etc I remember from a study.
[0] https://en.wikipedia.org/wiki/List_of_Ig_Nobel_Prize_winners...
No medication is even cheaper, but the placebo effect works, so if people were to take something, might as well have them take something cheap and harmless. In my opinion, it doesn't justify supporting homeopathy, but health insurances may see it differently.
Placebos are an interesting ethical issue. Doctors are not supposed to deceive you, they are people you trust with your life and very personal issues and they are therefore held to very high standards. But even if it is for your own good, the placebo effect is based on deception, so is it ethical for a doctor to give you a placebo? And is fake science that still help people ethical? The consensus seems to be "no" for both and I tend to agree, but I still think it is worth debating.
https://www.health.harvard.edu/blog/placebo-can-work-even-kn...
American culture loathes the idea of not treating a disease. Problems are expected to be dealt with, even if it harms society (see overprescribing antibiotics or opioids).
When confronted with people that don't understand the impacts of medicine, it's easier for an insurance company to give them fake medication than nothing at all.
The Chinese Communist Party had billions being raised out of incredible poverty and that populace started demanding medical care. There was no possible way to supply enough clinics, doctors, nurses, etc - and not just because Mao whipped the Red Guard into an anti-intellectual froth than then slaughtered much of China's academic/scientific community.
So Mao waved his hands and invented TCM, which basically said "oh yeah, most of these traditional Chinese medicines work. We did some research and figured out which ones and how to apply them!"
Hilariously people argue TCM doesn't work not because it's complete bullshit, but because it's a modified, corrupted version of actual Chinese medicine...
"If you get into a car accident in China," I say, "an ambulance will take you to a hospital where they will treat you with western medicine. Why do you think that is?"
This is the dominant harm, yeah. As we know from infosec, few things are more dangerous than a false sense of security, and that's exactly what ineffective drugs provide.
https://www.beckershospitalreview.com/pharmacy/walgreens-tes...
> "The safety of our patients is very important, but we also have to do what our customers are requiring us to do," Walgreens CEO Stefano Pessina told the WSJ. "We see that when we don’t sell tobacco, we have a lot of [negative] reactions."
They need to avoid making claims that they can treat or diagnose some condition. They do their best to hint at it without crossing the line, and frequently blatantly do cross it. The FDA does not have anywhere near the manpower to enforce it. And when they do finally get around to it, the brand vanishes, and a new one appears with exactly the same product lineup.
The sector has long lost any entitlement to benefit of the doubt. They are knowingly making illegal claims and using a disclaimer as a fig leaf even though everything else on the package contradicts it.
It's not a manpower issue, it's not a legal issue. It's not against the law because they wrote the law. There is no line they try to avoid crossing because that line was erased by lobbyists in 1994.
The reason that these get to make health claims and stuff without regulation, and get special treatment, is lobbying resulting in that act. Otherwise they would have been regulated.
It works even when you know it's a placebo.
This is why clinical studies don't tell neither group (neither the treated group nor the control group) who is in which group, to not spoil the results.
And also, this is why homeopathy puts so much effort into spreading the belief they are effective despite all odds, up to the point of trying to convince people to abandon basic scientific principles.
Also, contrast this with psychotherapy, which usually does work even better if the patient understands how it works, because it enables them to become an active and more effective part of the therapy.
1. Under the Federal Food, Drug, and Cosmetic Act, homeopathic products are subject to the same requirements related to approval, adulteration and misbranding as other drug products. https://www.fda.gov/drugs/information-drug-class/homeopathic...
2. Homeopathic products are "classified as either over-the-counter (OTC) or prescription medicines." https://www.chpa.org/about-consumer-healthcare/faqs/faqs-abo...
> There are no FDA-approved products labeled as homeopathic; this means that any product labeled as homeopathic is being marketed in the U.S. without FDA evaluation for safety or effectiveness.
At the end of the day, people are allowed to buy dumb shit. 50% of my local CVS is make-up, which is way more egregious than echinacea root extract.
But at the end of the day I feel like all medications should basically be handled like homeopathy products. They should be available to anyone, barring some kind of competency ruling or disagreement by the pharmacy over what they want to sell to whom, and the FDA should basically ensure that they are what they say they are on the label.
I'm glad there's skeptics out there calling BS on homeopathy but where I diverge from them is in somehow preventing it from being available. It's water, it's labeled accurately, so let people do what they're going to do. If they weren't doing this I doubt they'd be doing something more "mainstream" anyway, or complying with it. They might even be doing something even more actively harmful.
I guess I see it as a slippery slope from banning homeopathy to something much murkier where reasonable experts disagree. Real medical science can get very grey really fast and I'm not sure I trust regulatory authority figures to always make the best decisions about what to do. Better to leave it to the consumer and whichever provider they trust most.
Demand product purity, prevent health claims on the label, whatever, but I think my question is "why aren't more medications sold in American pharmacies?"
Honestly don't really see the economic or societal argument for deregulating medicine. If you want a system where to get an fda stamp you have to prove it works but can sell whatever otherwise with no consequences until you kill someone or destroy their gallbladders (https://www.foodsafetynews.com/2024/05/fda-determines-that-t...) - well that's what we already have now so given it hasn't changed in decades, even with recent attempts to do so after all the strip mall stem cell clinics and GRAS issues and all, I don't think your opinion is that out of the mainstream.
And in terms of why aren't more sold in pharmacies - no clue what you're talking about there lol. Have you not seen the A-Z supplement whatever aisles full of all this unregulated crap? You can buy whatever you want unless the DEA has an issue with it.
Over the counter? No, you can't. You can buy a lot of stuff that doesn't work over the counter. But, for example, if I want a decongestant that actually works (pseudoephedrine HCl), I have to go to the pharmacy and show them my driver's license and make a record of the purchase because the government is afraid I might start a meth lab.
And that doesn't even get into all the market failures with prescription drugs. What if I have the same bacterial infection for the umpteenth time and I know that antibiotic X will fix it? Can I just walk into the drugstore and get a course of antibiotic X? Of course not. (At least, not in the US. But in Mexico, I can.)
Even if the argument is that I might be misdiagosing my symptoms (which, if it's the umpteenth time I've had the same thing, is not a very good argument), why isn't there a machine in the drugstore that can check my diagnosis? It's already been shown that expert systems can outperform human doctors for many diagnostic tasks. In a functioning market for health care, we would see that technology in wide use. But we don't, because we don't have a functioning market for health care.
and you can buy the other stuff as reagents/third party suppliers etc, for 'research' use.
Ok. (Though there is still the question of whether it actualy makes sense for the DEA to care.) How about commonly used antibiotics?
> you can buy the other stuff as reagents/third party suppliers etc, for 'research' use.
Antibiotics? Please enlighten me.
In other words, no, I can't buy anything I want unless the DEA has a problem with it. I can buy stuff that doesn't work or that I can't trust, but I can't buy antibiotics (or many other things I might want) that I can trust. Which of course concedes my point.
You keep bringing up antibiotics but it's the category of drugs with the most widespread use (animal agriculture) with one of the strongest cases for being drastically under-regulated - they stop working if things become resistent to them and we spray them everywhere like candy. Also you keep acting as if getting a prescription is some sort of actual barrier or burden for non-prescription drugs, which is particularly funny after the whole fiasco with wegovy off label prescriptions before the active ingredient was approved for obesity/launched for obesity. These are not real barriers, even when they probably should be.
We're not talking about rights here. You claimed, and I quote, "You can buy whatever you want unless the DEA has an issue with it." I am simply pointing out that that is not true. Whether it should be true as a matter of right is irrelevant to that factual question.
> you keep acting as if getting a prescription is some sort of actual barrier or burden for non-prescription drugs
Um, no, I said no such thing. Obviously having to get a prescription is not a barrier or burden for non prescription drugs. But, as you yourself have pointed out, a huge number of those non-prescription drugs, for which there is no barrier or burden, don't work. And, as you have also pointed out, routing around things like prescriptions to get, for example, antibiotics means you can't trust the product. So there are barriers and burdens in the way of getting things that do work and can be trusted. Which was my point, and which contradicts your original claim that I responded to.
The question of whether there should be all these barriers and burdens in the way of buying things that work and can be trusted is a separate question. Your argument for why there should appears to be that without such barriers more harm would be done. Of course there will always be people who make stupid choices, and giving people more freedom by removing barriers and burdens will increase that. But you are not recognizing the other side of the barriers and burdens, which is that they prevent people from making good choices, choices that could save their lives. For example, look up the harm done in preventable deaths by the FDA's slowness in permitting beta blockers.
The post you responded to that advocated a libertarian approach was saying, in effect, that, on net, the harm done by regulation is greater than the harm done by individual people making bad choices in the absence of regulation. I happen to agree. You apparently do not. But I do not see that you have given any reason to believe that the opposite is true. I certainly don't see anything in what you've posted that makes the opposite claim the slam dunk that you appear to think it is.
And when i say the prescription not being a barrier, i'm not talking about not needing a prescription to get research grade antibiotics. I'm talking about how needing a prescription to get a non-controlled drug is literally a non-issue because of rampant off label prescribing and online prescription mills.
To call this area "under-regulated" is not accurate: the whole food production chain in the US, with all of its dysfunctionality, is a product of decades of regulation and government interference and mismanagement. The best way to stop antibiotic use with animals is for people to stop eating meat and other products from those animals, and if anything is going to facilitate that, it's going to be the market, which is already providing plenty of products in grocery stores that are from animals raised with no antibiotics, and will provide more the more people choose to buy them, as I do.
Many cold medicines have side effects, some are even abused recreationaly. Given that human bodies tend to recover with or without cold medicine (and given the shaky legs that Phenylephrine stands on), what is the issue with people using "fake medicine"?
Homeopathic remedies cannot be abused recreationaly. They aren't precursors to meth. They are better in every way (except the don't work better than a placebo). But, if all a patient needs is a placebo (people recover from the common cold just fine without medicine), homeopathic remedies are perfect.
Remember the hippocrattic oath: First of all, do no harm. Safe, well prepared homeopathic remedies shouldn't do harm. Many cold medicines do.
Because people are being tricked into thinking they’re taking medicine, preventing them from seeking out medical care.
over the counter cold medicine
vs
homeopathic "remedies".
Neither of these cure diseases. Neither of these prevent the seeking of medical care. Both of them may make people feel better (the placebo effect can be powerful). Only one of these is frequently abused by teenagers as a recreational drug.
I actually had someone at a pet store try to sell me homeopathic medication instead of dewormer because they were out of actual dewormer. Do you think that's harmless to someone who doesn't know the difference between giving their pet real medication vs. magic woo water?
True
But worse people use homeopathic remedies because they do not trust modern medicine
Harmless for cold cures, not harmless for infectious diseases
Your examples are cases where homeopathic remedies should not be marketed beside real medicine.
Sounds like a business plan
Of course having a "healer" present with a "prescription" may make people feel better. So maybe prescribing crystals is better than pharmacy homeopathic remedies.
However, none of this needs to cost $400. Given that these are all placebos, they should cheap and safe.