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Science vs. Homeopathy
Mr. E writes "Ars Technica has an interesting look at pseudoscience as it applies to homeopathy. While most discussions about what science is get derailed by the larger controversies surrounding them, Ars chose a relatively uncontroversial pseudo-science to examine so that they could examine the factors which make homeopathy a psuedo-science: ignoring settled issues in science, misapplication of real science, rejection of scientific standards, claims of suppression, large gaps between the conclusion and evidence, and a focus only on the fringes of what we currently understand."
Something few people seem to recognize is there are two separable elements to most of homeopathy. The first is the treatment itself, and the second is the explanation for how it works. For whatever reason people aren't satisfied to know that something works, they also need to know why it works. And unfortunately if there isn't a self-evident explanation one will be invented. And it doesn't end there, the invented rationale is then usually extended to develop other treatments (which don't work of course because what they are based on isn't true).
Take acupuncture. Twirling small needles in the top layer of the skin has a variety of benefits. But why? Traditions tell the story that it balances the energy flows, etc etc. A recent study examined three groups, one with no acupuncture, one with acupuncture in the traditionally prescribed locations, and one with acupuncture in random locations. Both of the latter two groups were better than the first (no treatment), but interestingly they weren't different from each other.
So yes acupuncture has some effect, but the traditional explanation has nothing to do with why it works.
So two of the big problems with homeopathy are first that most people get hung up on the far out explanations for why the treatments supposedly work and miss out on stuff that could actually help them. And second that lots of homeopathic treatments are developed that don't do anything to help because they are logical extensions of faulty premises.
Alternative medicine also suffers from the fact that once a treatment becomes well accepted and is supported by empirical research it magically leaves the realm of alternative medicine. So by definition alternative treatments will always be those that haven't yet been supported by scientific research, even though many of them do in fact work.
I've talked to a number of homeopaths and in my limited experience they seem to take it like an all or nothing religion, where you have to accept it all or none of it, and you have to accept the wacky explanations to the letter. It would be nice if they didn't feel so burned by the modern medical machine that they reject as a matter of principle empirically based testing.
The claim is that if you dilute a substance X to the ratio of one part X to 10***120 parts pure water, you will then have no X left in the pure water, only the memory of X, and this will now cure whatever illness X caused in the first place.
Now ask yourself, where did you get the pure water for the dilution, since all water has the memory of all substances that it has ever been in contact with?
How do you remove the memory of X from water so the water can become pure again and suitable for another round of dilution with substance Y?
Infuriate left and right
It's a shame that in most people's minds homeopathy has become mixed up with "natural remedies", some of which do contain useful compounds.
Herbalism and natural remedies aren't suitable for everything, but some of them can help and have been proven to. Some of them are the source of things like aspirin.
Homeopathy on the other hand is total quackery.
Placebo effect is very important, especially in things like depression, anxiety, and agitation (its a real clinical status, look it up!) where behavioral therapy may improve symptoms. I'll let it slide that homeopathy for these things is hard to justify, what with the "like cures like" and all (can we get a 100000x dilution of sad juice?), and stick to the placebo effect which I think is your main point.
..So, if you wake up and feel tired (who does that??), you are experiencing possible drug-related fatigue..
Also, we can pretty much write off Prozac because it has become the Ritalin of middle-age. By that I mean that a wide array of causes, behavioral, social, or chemical, are causing a problem, and instead of resolving it (through behavioral therapy or psychological analysis) the doc is just writing for the same treatment. Bobby is loud, give him Adderall. Bobby is sad, give him Prozac. Some people really need the chemically altering action of Prozac to be happy- some people just want to buy a month's worth of 10mg Problem Solver from CVS... i digress..
When administering or justifying a placebo as a treatment, take care not disregard the importance of real medicine. Placebo effect is significantly less present with things like hypertension, electrolyte imbalance, heart problems, diabetes, kidney and liver diseases, obesity, hypercholesterolemia, and other more corporal diseases. There is no "I think this will resolve my congestive heart failure" placebo effect that stands on its own.
As far as "sugar pills have no side effects" is concerned, look at and drug study that reports side effect profiles - placebos can have many of the same adverse effects as the "medicine" medicine. People will report dry mouth, sweating, fatigue, headaches, sleeping problems, and even sexual problems because ordinary people will have all of these things randomly on a day to day basis. The only thing thats different is that the FDA makes them report every single thing as a "possible side effect" if it occurs during a trial.
If you wanted to market sugar pills as an FDA approved drug, your drug monograph would be as bleak as that of any other drug with regard to side effects. I'm not trying to say that pharmaceutical compounds dont have side effects, but the same effect that makes people feel better regardless of drug action can also make them feel worse.
Homeopathic drugs will never be superior to prescriptions because they are just water. Literally, in some formulations there is actually NO drug - just the solvent, because they have diluted it to such a degree that you could have an entire lot without a single molecule of the effective chemical. It would be nice if all of our healthcare issues could be resolved by just "thinking and feeling as though one is receiving a cure," but almost every time, this is not the case. People who have needs for medicinal intervention can not afford to be distracted by things like this at a cost of delaying real medicine. Real medicine and real doctors and real pharmacists who make people better through real science.