SCIENCE-ISH

Labeling homeopathic drugs “unscientific” only makes them more attractive to people who want them

Earlier this month, the US Federal Trade Commission made a decision that was a true triumph for science.

The agency ruled (PDF) that the makers of homeopathic medicines must add a disclaimer to their products clarifying two things: “There is no scientific evidence that the product works” and “the product’s claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts.”

This is the first time that the FTC has taken the industry to task for false advertising. As the agency’s report accompanying the decision makes clear, numerous studies in the US and around the world have been unable to demonstrate any significant benefit from taking homeopathic remedies, even though companies and practitioners have for years touted their efficacy for serious conditions, including diabetes, cancer, and Parkinson’s, and everyday health concerns, such as cold sores and the flu.

Top-selling homeopathic medicines are shrewdly marketed—Latin and Greek root words are used to give homeopathy an air of scientific legitimacy (an ingredient like rock rose flowers will typically be labeled “Helianthemum” for example)—and poorly regulated: natural supplements do not need Food and Drug Administration approval to be marketed, and can only be pulled from shelves if proven harmful.

 Homeopathy’s basic premise is so nonscientific that it gives scientists little to work with or debunk. Homeopathy’s basic premise is so bizarre and nonscientific that it gives reasonable scientists little to work with or debunk. The system was invented by the German doctor Samuel Hahnemann, who first published his quackery in 1814. His two main arguments were that “like cures like,” and that the less of medicinal ingredient in something, the greater its effect. To treat anxiety, for instance, one might be prescribed a minuscule dose of arsenicum, a.k.a. arsenic, a toxic substance with a long history as a murder weapon of choice. According to homeopathic theory, arsenic causes anxiety and fear of death in its poisoned victims, meaning it would calm those same symptoms in a homeopathic prescription, which would be diluted to such a high degree that there would be virtually no trace of the arsenic in the pill (typically made from things like lactose, gelatin, or sucrose) or tincture (water, alcohol or glycerin) used as a delivery system.

This is not to say all alternative treatments are a scam. There’s a crucial difference, for example, between herbal supplements and homeopathic treatments: Herbal remedies contain detectable herbs whose medicinal benefits may or may not be supported by science. Herbs usually can have some effect on the body, which is why consumers are asked to tell their doctors when they’re taking something like Echinacea. Sure, the evidence that it can shorten the duration of a common cold is mixed, but there’s no doubt that the herb can interact with certain drugs, especially blood thinners, and pose some safety concerns.

The vast majority of homeopathic remedies, on the other hand, are safe—because they contain no active ingredient, only the “essence” or “vital force” of what was once there. In other words, nothing. (To be sure, a few homeopathic dosages may be potent enough to be hazardous, and some are combined with herbal remedies. Experts advise consulting your doctor about any supplements you plan to take.)

 By 2012 the total number of Americans reporting using homeopathic treatments broke 5 million. Nevertheless, some high-profile and high-achieving people have professed their faith in homeopathy, and consumers share tales of homeopathic pills healing disorders that conventional drugs couldn’t resolve. Government data from a 2007 National Health Initiative Survey estimated that about 4 million Americans spend over $3 billion annually on the remedies, and by 2012 the total number of Americans reporting using homeopathic treatments broke 5 million.

It remains to be seen whether the FTC’s new strategy can darken homeopathy’s reputation. Rebecca Tushnet, a law professor at Georgetown University who specializes in the relationship between false advertising laws and the First Amendment, tells Quartz that whether the disclaimers will dissuade people from buying homeopathic products depends on how consumers think about these claims generally, and the specific characteristics of people who buy homeopathic medicines. “I don’t think we have enough information about them to predict how they’ll behave,” she explains.

“It may be that they distrust modern science,” Tushnet adds. “The FTC says that as long as [consumers] understand that modern science doesn’t think these things work, that’s the most we can ask of a disclaimer, and people may go buy it anyway.” Cigarette warnings tell people that the product can kill them and people still smoke, she points out.

 Saying that “most” medical doctors do not support homeopathy will only signal to believers that “some” do. Indeed, some studies have shown that disclaimers are largely ineffective. Worse, as Alan Levinovitz at Slate reports, according to a Food and Drug Administration study in 2007, when a “qualified claim” of a health effect is placed on food packaging, consumers sometimes are more likely to believe the purported health effect is scientifically sound. In other words, perhaps saying that “most” medical doctors do not support homeopathy will only signal to believers that “some” do.

In addition, one scientist reported to the FDA in 2007 that consumers who see an unqualified statement on a package have such a strong emotional response that, paradoxically, they believe the exact opposite of the statement. “If people think a claim is inappropriate and is stated too strongly, trying to influence them, they may have a negative reaction rather than positive when they see that claim.” It’s possible then that the new homeopathy warnings declaring that “no scientific evidence” supports the products could backfire.

The psychology of conspiracy theory suggests that those who believe government agencies and Big Pharma are in cahoots to suppress information about natural remedies—and this is a fairly popular world view—might only have their suspicions confirmed by the FTC actively rejecting ideas “based only on theories of homeopathy from the 1700s.” Others may take comfort in knowing the theories have survived and maintained a following for so long, as if a sham medicine couldn’t survive a few centuries.

Scientists believe confirmation bias, the same fuel that keeps conspiracy theories burning, or the placebo effect, or both, may also explain why otherwise rational people believe homeopathy “works.” So, if you’re prone to fall under the spell of these powerful influences, you may yet feel pulled to the homeopathic products sitting next to the checkout at your pharmacy or organic grocery, disclaimer and all.

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