Homeopathy Part Two: The Secret Placebo Experiment

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If you suffer from low blood pressure or an inability to get bent out of shape, I recommend an evening of fine dining and finding yourself backed into a serious conversation about homeopathy.

Difficulty: you’ve been instructed by your spouse to “keep your science in your pants” because it’s a social occasion with extended family, not Thunderdome.

It wasn’t easy, but I kept my cool in the face of “I just don’t trust Western medicine”. Remained placid throughout the mansplanation of how dilution increases potency. But then I made the mistake of trying to get cute: I asked why tap water, which must contain an enormous variety of ultra-diluted compounds, doesn’t give you a massive coronary with the first sip. The explanation, accompanied by withering scorn, is that today’s tap water is obviously too polluted.

I got told.

The episode got me thinking about something that’s puzzled me about the UK since I moved here five years ago: the country’s (largely) uncritical acceptance of homeopathy. It’s so at odds with our default state of grumpy skepticism. The UK is just not the kind of place you’d expect “woo” to flourish, and yet the National Health Service may be spending as much as £5 million on homeopathic treatments.

Homeopathy is available in some of our hospitals – in fact, we have a homeopathic hospital. I used to walk by it every day on my way to work, and I regret to inform you that it is not an open field containing a lone brick that once had limited contact with a doctor. “Homeopathy is used for an extremely wide range of health conditions,” says the NHS on its page about homeopathy. “Many practitioners believe that homeopathy can help with any condition.” We also have a fine selection of homeopathic pharmacies (see joke, above). And even at the standard regular NHS pharmacies on every corner, the shelvea are stocked with loads of homeopathic remedies.

What do all these things do? For the majority of homeopathy users – who turn to the treatments for relief from things like asthma, skin conditions, and insomnia – the key seems to be “hair of the dog”. So for example, if you’re an insomniac, get a little tiny bit of insomnia, mix it with some water, dilute it to nothing, and take your potion.

The key, of course, is to figure out what “a little bit of insomnia” looks like. Oh, of course – owl.

Not impressed
Owl: not impressed.

Aw, bless your heart. You think that was a joke. While I’d love to be that funny, this homeopathic insomnia remedy is indeed made from owl. Sorry, the vague memory of an owl, mixed with water, and diluted.

Who’s going to explain to the nice homeopath that that there’s a difference between nocturnal behaviour and insomnia? I mean I suppose it stands to reason that there might exist some owls that are insomniacs? Popping Ambien and cursing the daylight. Going to the homeopathic owl pharmacy to get some tincture of human, since we are diurnal creatures and are therefore proven to get them back on track. (And at least owl is a better ingredient than Stonehenge. Also not a joke.)

So far, so ridiculous, but these guys at least deserve some credit for being up front about their ingredients (or lack thereof). Not everyone is so forthcoming. Some sugar pills and potions are cleverly packaged to hide the homeopathy. Browsing the pharmacy shelves, you might come across a treatment simply labelled “Chamomile. An herbal concoction.” Sure, why not? Isn’t aspirin derived from the bark of the willow tree? Could work.

What it doesn’t say on the package: no chamomile is involved. Just water that “remembers” a brief, long-ago encounter with chamomile.

Not impressed.
Chamomile: also not impressed.

I used to think it was because of our nation’s strong libel laws that homeopathic products are peddled without too much controversy. Science writer Simon Singh got his pants sued off for saying these sorts of things, so when it comes to the topic of quackery, we British journalists get pretty nervous.

But that can’t be the whole story. After all, journalists gave wide coverage to a blistering report (PDF) released in 2010 by UK House of Commons Science and Technology Committee that concluded: “Homeopathy is no better than placebo.”

No better than placebo. Which leads me to that conspiracy theory Erik was talking about. It’s also my newest way of deflecting conversations with extended family. Homeopathy is a giant secret clinical trial run by the government to test the placebo effect.

Allow me to explain. Placebo is an effect that has undergone a massive reputational transformation, from nuisance to an intriguing way the body can heal itself without drug intervention. The medical world is just starting to work out how to integrate its unpredictable and strange power in mainstream medicine.

It’s looking like the placebo effect works by turning on your body’s natural healing mechanisms – powerful enough to address not just psychosomatic conditions, but even amping up your immune system. So where’s the switch? Part of the effect seems to be down to the expectations we have been conditioned to have during an encounter with medicine. Or something that carries the trappings of medicine.

These conclusions come from a handful of intriguing but small studies. What we really need is to confirm them is a longitudinal study of the placebo effect on a massive sample.

Well, I think our government is far cannier than anyone suspected, and they have been using the infrastructure of homeopathy as a way to secretly test the placebo effect.

And let’s not forget the homeopaths – they have done scientists an immense favour. It takes money and time to build a brand and following to make a sugar pill become a convincing prop in the placebo effect. You need a vast network of people including graphic designers, salespeople, NHS copywriters (“Many practitioners believe that homeopathy can help with any condition”) and pharmacists, to credulously and earnestly market and sell Nothing like that’s not a completely insane thing to do.

And presto: highly convincing sugar pills ready to be deployed among people who have no idea they are taking part in a grand experiment.

It would explain why sane people swear that homeopathy is curing them of their eczema or asthma – homeopathy may be a whole lot of nothing, but under some anecdotal conditions, it seems to work. This would also explain why and when homeopathy doesn’t work. Maybe shaken-and-stirred chamomile can get your brain juices flowing, but owl is just one fucking bridge too far.

No scientific study, no matter how well replicated, could ever attend to so many details.

Now if they’d just tell us the results.

 

 

Photo credits:

Pharmacy: shutterstock

Homeopathic owl: shutterstock

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8 thoughts on “Homeopathy Part Two: The Secret Placebo Experiment

  1. Great article ! But compared with some of the twaddle that’s out there homeopathy is a model of rationality and evidence-based interventions. Bach flower remedies are water exposed to the vibrations of flowers, people pay money to have their pets’ ailments diagnosed and treated over the ether (or the internet for skeptical technophiles), putting a chunk of rose quartz in a horse’s water will improve its self esteem (I kid you not !).

    Apparently intelligence, unlike homeopathic remedies, does not become more potent in smaller quantities.

  2. I’ve always been in favor of a giant placebo experiment, but sorry that the U.K. one lacks a key element I’d add: This cure will only work if you stop smoking, drink and eat a little less, and exercise.

  3. Homeopathy is all over Italy too. Actually, you have to always keep on your toes when navigating medicine here because it’s kind of like an alternative medicine minefield. I’ve had MDs prescribe me some really bizarre herbal things that haven’t been trialed, and one even prescribed me what I discovered later to be a homeopathic remedy. Pharmacists, at normal pharmacies, will actively try to push it on you. And it’s everywhere. Once I accidentally bought homeopathic toothpaste – whatever that means.

  4. Did I miss something?

    The linked (pro homeopathy) article states this:

    The facts, it seems, are being ignored. By the end of 2009, 142 randomised control trials (the gold standard in medical research) comparing homeopathy with placebo or conventional treatment had been published in peer-reviewed journals – 74 were able to draw firm conclusions: 63 were positive for homeopathy and 11 were negative. Five major systematic reviews have also been carried out to analyse the balance of evidence from RCTs of homeopathy – four were positive (Kleijnen, J, et al; Linde, K, et al; Linde, K, et al; Cucherat, M, et al) and one was negative (Shang, A et al). It’s usual to get mixed results when you look at a wide range of research results on one subject, and if these results were from trials measuring the efficacy of “normal” conventional drugs, ratios of 63:11 and 4:1 in favour of a treatment working would be considered pretty persuasive.

    How does it relate to the rest of the article?

  5. Peter Apps: ” Apparently intelligence, unlike homeopathic remedies, does not become more potent in smaller quantities.” OUTSTANDING COMMENT!

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