AWA: Academic Writing at Auckland

In an article; Vicki Hyde, a former chair-entity of New Zealand skeptics disputed that homeopathic remedies have no effect, thereby pharmacies should ditch stocking treatments (Sachdeva, 2010). With further research into the topic, the arguments made throughout this essay will be against selling homeopathic remedies in community pharmacies, therefore supporting the anti-homeopathy campaign. Firstly, this essay will examine how homeopathy is valued as a placebo-based therapy due to its most controversial principal of potentization. Secondly, it will discuss how the distribution of ineffective homeopathic remedies in healthcare is ethically indefensible. Thirdly, with little evidence that homeopathy truly enables people to attain better health, it seems that continued stocks in pharmacies are a waste of healthcare resource. Lastly, the essay will examine the safety issues surrounding the preparation of homeopathic remedies from raw materials.

Homeopathy is a regulatory therapy (Bornhoft & Matthiessen, 2011) that has been viewed with skepticism by medical doctors’ due to failing on the grounds of scientific plausibility (Smith, 2011). Developed by Samuel Hahnemann at the end of the 18th century, homeopathy has persisted for more than 200 years (Bornhoft & Matthiessen, 2011) and its principal differs from conventional medicine in several ways (Milgrom, 2006). The most controversial and unique to homeopathy is potentization: the process where homeopathic remedies are prepared through a serial-dilution and shaking stage, which proponents claim to make medicine more potent (Jonas, Kaptchuck, & Linde, 2003). 

One reason for my arguments against homeopathic remedies further being sold in pharmacies was highly influenced by this process of potentization because it's difficult to understand how diluting an agent could make a medicine more effective, which in return improves a patient’s well-being. Moreover, the principal of potentization was the most controversial because homeopathy later became valued as being a placebo-based therapy (Hyland, 2005). The homeopathic medicine was diluted to a degree where a few or no molecules of the original substance remain (Hyland, 2005), which remarkably resembled those of a placebo. Considered as a mechanism, placebos trigger physiological processes starting in the cortex that can involve the releasing of neurotransmitters (Milgrom, 2006). Placebos are often used in pharmacological studies as controls which is able to produce remarkable effects in medicine (Zimmermann-Viehoff & Meissner, 2007). Milgrom (2006, p. 186) stated that the reason why homeopathy fails; “is because they do not rely on any real mechanism other than the placebo effect.” Therefore, medical doctors do not believe in homeopathic medicines because there is no mechanism whereby a few molecules of any original substance could have any therapeutic effects (Milgrom, 2006). It was further stated that a treatment with ineffective agents is equivalent to no treatment (Hyland, 2005). Thus, any reported beneficial effects of homeopathic remedies are most likely to be attributed to the placebo effect. An attempt to prove this placebo theory, a skeptic, James Randi took a fatal dose of homeopathic sleeping pills during his talk at an official TED conference, to only show that the medicine had no effects (Randi, 2007). He reassured that the pills were “equivalent to taking one 325 milligram aspirin tablet, throwing it into the middle of Lake Tahoe [and then drinking it]” (Randi, 2007, 12:25).

Furthermore, homeopathic differs from that of conventional medicine in terms of the examination process (Jonas, Kaptchuck & Linde, 2003). Treatments are determined by the clinical diagnosis which involves case-taking sessions that can last several hours, depending on which homeopathic approach best suits the individual’s symptoms and the complexity of the problem (Jonas, Kaptchuck & Linde, 2003). Homeopathic consultation adopts a holistic approach, whereby the time and effort is spent largely on talking and viewing the patient in his or her emotional, familial and societal context (Smith, 2011). However, this holistic approach does not uniquely differ homeopathy to that of a conventional healthcare, as holism often is (and can be) built in the same way (Smith, 2011). Upon assessing the patient’s medical situation, a decisive factor would be made around the choice of ingredients used in the treatment of over 5000 raw materials originating from plants, animals and disease origins (Milgrom, 2006). This means that the dosage and administration of medicine are extremely important, therefore the second argument made towards why I am against homeopathy is due to concerns about the risk of giving ineffective medicines to patients. With very few claims made for homeopathy having any clinical effects and given the possibility that medicines have a direct placebo effect, it seems ethically indefensible for a practitioner to offer homeopathy to patients instead of effective medicine. An article by Smith (2011) stated that World Organization of Health (WHO) has recently warned the use of homeopathic remedies for serious diseases such as influenza because patients will suffer harm through omission if they opt for homeopathy when they could have benefited from conventional medicine. Moreover, in a number of cases it has been documented that individuals have died from being treated with alternative forms of ineffective medicine, including homeopathy; despite the availability of conventional medicine which is effective (Hyland, 2005). From an ethical perspective, I think that further promotions of homeopathy in pharmacies as a supposed treatment for health disorders is deplorable. As drug experts, pharmacist should be able to consult patients on medicine based on scientific theories with supporting evidence rather than on ineffective medicine that currently has no plausible mechanism of action.

Moreover, my third argument for being against homeopathic remedies further distributed in community pharmacy is because it’s a waste of healthcare resources. Due to its ineffectiveness, since they barely contain any active ingredients, expenditure on homeopathic services is represented as being a waste (Hyland, 2005) that could otherwise have been spent on more effective healthcare medicine (Smith, 2011). The cost of homeopathic therapy, in reality, does not come cheap when considering consultations and the provisions of clinics and specialist hospitals (Smith, 2011). Therefore, with lacking evidence of having any clinical benefits, patient’s will likely return to conventional medicine; in that sense, they would have paid twice (Smith, 2011). Firstly, patients would have to pay for the expense of their homeopathic treatments, which possibility did not work; and secondly for their conventional medications, which generally does work (Hyland, 2005).

Lastly, despite the growing use of homeopathic treatments worldwide, there are states that still regulate the type of medicines distributed (WHO, 2009). Reasons for the regulation is due to safety concerns for the production and manufacturing of homeopathic medicines and the large variety of raw materials used that may constitute potential harm to patients (WHO, 2009). As previously mentioned before, the choices of ingredients used in the remedies range from over 5000 raw materials including medicinal plants, animal, pathogens, mineral and disease origins (Milgrom, 2006). It is understandable that compared to conventional medicines, the hazard from homeopathic remedies are modest, however due to growing popularity appropriate vigilance is needed to ensure the quality and safety of products being available to consumers over-the-counter (Kirby, 2002). Although homeopathic medicines may generally appear to be safe because it largely contains organic ingredients compared to conventional medicines, I think the potential aspects of toxicology should not be neglected during the preparation of homeopathic remedies because there are always room for error. A possible risk could be the usage of unsafe starting agents (WHO, 2009). The quality of the starting agent used during the manufacturing of homeopathic medicines might employ materials from problematic sources (i.e. bacteria, parasites, fungi, ova, virus particles, disease particles etc.) that is restricted in conventional medicine (WHO, 2009). With no quality evidence to support the efficacy of homeopathic treatment (Smith, 2011), it is difficult to know whether ingredients have been correctly identified as being free of any contamination or that it has not been adulterated by other species (Kirby, 2002). Another potential risk could be failing to dilute the agents sufficiently (Kirby, 2002). Though the agents used in a homeopathic medicine is known to be diluted to an extremely high degree where few molecules of the original substance remain (Hyland, 2005), many people would be left with the uneasy feeling of the starting agent still being presented as a small hazard (Kirby, 2002). If there is a slight possibility of any of these risks being present, homeopathic treatments should not be proposed for sale in community pharmacies. 

In summary, the arguments I have made of homeopathy has been against future distribution of the homeopathic treatment in community pharmacies. I have argued that homeopathy has been valued as a placebo-therapy that shows no sign of any therapeutic effects. Moreover, continuous selling of homeopathic medicine is attributed to be ethnically indefensible because patients are given an ineffective medicine which does not work instead of conventional medicine which generally works. Additionally, pharmacies should discontinue the stock of homeopathic treatments because it is a waste of healthcare resources and money. Lastly, my final argument for supporting the anti-homeopathic campaign is due to the concerns for the risks surrounding the preparation of the medicines which included the potential hazard of using unsafe starting agents or failing to dilute the agents sufficiently. 

References

Bornhoft, G., & Matthiessen, P. (Ed.). (2011). Homeopathy in healthcare: Effectiveness, appropriate, safety, costs. Berlin, Germany: Springer-Verlag Berlin Heidelberg.

Bunge, M. (2004). How does it work? The search for explanatory mechanisms. Philosophy of Social Sciences, 34(2), 182-210. doi: 10.1177/0048393103262550

Hyland, M, E. (2005). Entanglement and some heretical thoughts about homeopathy. Homeopathy, 94(2), 105-106. https://doi.org/10.1016/j.homp.2005.02.008

Jonas, W, B. Kaptchuck, T, J., & Linde, K. (2003). A critical overview of homeopathy. Annals of Internal Medicine, 138(5), 393-400.

Kirby, B, J. (2002). Safety of homeopathic products. Journal of the Royal Society for Medicine, 95(5), 221-222.

Milgrom, L. R. (2006). Is homeopathy possible? The Journal of the Royal Society for the Promotion of Health, 126(5), 211-218. doi: 10.1177/1466424006068237

Randi, J. (2007, February). James Randi: Homeopathy, quackery and fraud [Video file]. Retrieved from https://www.ted.com/talks/james_randi/up-next

Sachdeva, S. (2010). Plea for pharmacists to ditch stock. Retrieved from http://www.stuff.co.nz/national/health/3277310/Plea-for-pharmacists-to-ditch-stock

Smith, K, R. (2011). Why homeopathy is unethical. Royal Pharmaceutical Society 16(3), 208-211. doi: 10.1111/j.2042-7166.2011.01109.x

World Health Organization. (2009). Safety issues in the preparation of homeopathic medicines. Geneva: World Health Organization.

Zimmermann-Viehoff, F., & Meissner, K. (2007). Homeopathy and placebo – Synonym, similar or different? Forsch Komplementramed 14, 247-248. doi: 10.1159/000103748