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Alternative Medicine

There are many remedies and therapies, both traditional and modern, which fit into the general category of alternative medicine. They can't all be bogus, can they? Not even a skeptic would believe that. Well actually that's true. There probably are some alternative methods which have a certain amount of effectiveness, but the vast majority don't work and on balance we would probably be better off without alternative medicine because the negative aspects of it (see note 1) probably outweigh the positive.

You might detect in this subject that I am slightly less negative than in some of the others in this skepticism section. While that is true, I am still basically skeptical about the whole subject. I'm sure some natural and herbal remedies work, after all many conventional drugs are based on herbs, plants and other natural sources. The point is that conventional medicine has refined the natural products and made them safer and more effective (see note 2).

Many alternative treatments have been scientifically studied and some have given interesting results. Unfortunately there have been several poorly designed and controlled experiments which have given misleading results when considered by themselves. The best example of this is probably homeopathy. Some earlier studies showed interesting results, but there was also studies which showed no effectiveness. A recent meta-analysis of the data showed homeopathy is probably completely ineffective (see note 3).

Unreliable Evidence

What about people who use alternative remedies and have found they work? Well that doesn't actually prove much. There are several factors which make this sort of evidence highly unreliable. I have described the main factors involved here...

First, there will always be people who recover from an illness even with no treatment. If this spontaneous recovery happens to coincide with taking a treatment of any sort they will naturally associate the recovery with the treatment.

Second, there is the infamous placebo affect (see note 4). In many cases people can make themselves feel better just because they are taking a remedy which they think will help. Studies show that people given pure water will recover in some cases as long as they think they are taking something which will be helpful. There is a fascinating relationship between heath and the mind which we don't fully understand.

Third is the fact that people feel a commitment to the plan they have chosen, especially if it is contrary to expert advice, which they might be rejecting. Studies have shown that people say they are getting better when by all objective measurements they aren't, just because that's what they want to believe to justify their decisions (see note 5).

Finally is the fact that people tend to report and remember positive results and ignore events which are less interesting. If someone takes an alternative remedy and seems to recover they will probably tell their friends and other people about it. If someone else takes the same remedy and it makes no difference they are unlikely to mention it. This creates a positive bias which makes alternative medicine look a lot more effective than it really is (see note 6).

Just to finish off this subject, here's a list of alternative medicine subjects and my appraisal of how likely they are to be effective. This is based on the type of criteria I have listed above but I don't have room here to go into each one in detail. Faith healing: highly unlikely to be effective. Some studies show negative effectiveness! Homeopathy. Highly unlikely to be effective. The better designed the study, the less effect it shows. Herbal medicine. Some herbs have a certain amount of efficacy but the majority don't. In most cases the effective component of herbs and other natural medicines has been isolated and used in conventional medicine anyway. Aromatherapy might have some small effect but largely useless. Chiropractic is more likely to be harmful than beneficial. Magnetic therapy seems to be total nonsense. Acupuncture is an interesting case superficially but seems to be less effective when examined critically.

Summary

So there you have it. In general there might be some isolated cases where alternative therapies are useful but because the vast majority are useless or harmful the best overall attitude is to assume they are all ineffective.

The vast majority of alternative medicine remedies do nothing, although occasionally there are some which might have some limited success. Some are actually dangerous and might prevent the use of real medicine. Therefore I give this a moderately high score on the crap-ometer!

Notes

1. Even if an alternative therapy has a certain amount of effectiveness that doesn't mean that a conventional response might not have more benefits. Also alternative therapies sometimes interfere with conventional drugs that might be being used at the same time. Some alternative therapies are actually dangerous. Being alternative, natural, etc doesn't mean they aren't potentially harmful. Finally, the billions of dollars involved in the alternative medicine industry might be better spent on research into conventional medicine.

2. For example, a traditional remedy for pain is chewing willow bark. This works because it contains acetylsalicylic acid, which is also know as aspirin, a refined version used in conventional medicine. But taking aspirin as a tablet is safer than chewing willow bark because its a measured dose, has had potentially harmful components removed. And its a lot more convenient.

3. A recent meta-analysis of homeopathy research, published in the Lancet concluded with "Biases are present in placebo-controlled trials of both homeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homeopathy are placebo effects." (Lancet. 2005 Aug 27-Sep 2;366(9487):726-32.)

4. The placebo effect is a well known, but not necessarily well understood phenomenon, where an effect will really happen just because the person involved thinks it should. Obviously there is a limit to how far this can go, but for some medical conditions the patient can make themselves better if they think they are taking something which is effective even when a totally ineffective alternative (for example, water) has been substituted. See Wikipedia, Placebo Effect for details.

5. Cognitive dissonance is a fascinating psychological phenomenon which occurs when an individual subconsciously tries to justify two conflicting cognitions. So if a person wants to believe a therapy works, but observes it doesn't, that person will modify his observation, or interpretation of the observation, to minimise the amount of conflict. In other words he'll believe something that isn't supported by the evidence.

6. This biased reporting of positive results while ignoring negative ones is responsible for many illogical beliefs. For example people visiting a psychic will be impressed with one correct prediction while ignoring 10 incorrect ones. The fact that the success rate might be at the same level as chance is conveniently ignored. Biased reporting is a major factor in many areas of the paranormal and one which is carefully controlled for in scientific studies.

Sources of Further Information

There are many web sites with information on this subject. Below I have shown some which present the information for both sides of the argument.