Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

We wrote this book because we wanted to provide people with the most important research about alternative medicine, in the hope that readers would be in a better position to make informed decisions about their own healthcare. But what about those people who have not read this book? What about the millions of patients who have only been exposed to the media hype in the newspapers, exaggerated claims on the internet and misleading adverts in shop windows? Is it fair that they may waste their money and risk their health by using alternative medicine?

One of the greatest problems is that patients have virtually no protection when they enter the world of alternative medicine. Homeopathic remedies, for instance, are available on the internet, in high-street pharmacies and from anyone who claims to be a homeopath — in each case the vendors are selling treatments under false pretences, as homeopathic remedies are disproven and illogical. Similarly, couples seeking fertility treatment can waste large amounts of money on herbal treatments when there is no proper evidence or reason why they should be effective. Meanwhile, chiropractors expose their patients to large doses of X-ray radiation, manipulate the fragile bones of infants and apply heavy forces to adult necks, even though these treatments, in many cases, are totally in effective. And so the story continues, with acupuncturists, reiki healers, psychic healers, shiatsu therapists and many other alternative practitioners making totally unfounded, yet hugely enticing, claims.

Notably, if any conventional doctor made such ludicrous promises and offered similarly unproven and even risky remedies, then he or she would be struck off or would perhaps end up in the dock.

Conventional medicine and alternative medicine both have the same ambition, namely to cure the sick, and yet one is tightly regulated and the other operates in the medical equivalent of the Wild West. This means that patients who venture towards alternative medicine are at risk of being exploited, losing their money and damaging their health.

The solution, surely, would be to create a level playing field, whereby alternative medicine has to maintain the same high standards required of conventional medicine. Regulation across the board would provide protection to all patients seeking any form of medical treatment.

In particular, this would mean that each alternative treatment would have to be tested, and only if it were proved that it generated more good than harm would it be permitted. Most patients are unaware of the immense amount of testing undergone by conventional treatments, so it is worth quickly summarizing how pharmaceuticals are assessed and investigated in order to see the sort of scrutiny that we are also proposing for alternative treatments.

Regulation and associated testing procedures vary across the world, but America is home to the biggest pharmaceutical industry, and its regulations are fairly typical of those found in many developed countries. The road from early-stage research to drugs available to patients can be broken down into six stages:

Preclinical Research. Scientists test different chemicals to see if they might have a role in medicine. This is likely to involve preliminary testing on animals to see if the chemical is likely to be sufficiently safe and effective. It will also take into consideration how the chemical might be mass produced if it turns out to be useful. This takes at least five years.

Clinical Studies, Phase I. The potential drug is given to between 10 and 100 volunteers to investigate safety in humans. The main goal of Phase I clinical studies is to identify a safe range of dosage. This takes between one and two years and costs roughly $10 million.

Clinical Studies, Phase II. The drug is given to between 50 and 500 patients with a relevant disease. The main goal is to gauge the effectiveness of the drug in humans. At the same time it is important to establish the optimum dosage and duration of treatment for the next stage of testing. Phase II takes two years and may cost a further $20 million.

Clinical Studies, Phase III. The drug is given to hundreds or thousands of patients to determine its effectiveness and any side-effects. This usually involves randomized clinical trials and the drug is tested against a control group receiving a placebo or the best existing drug. For thoroughness, Phase III may involve two independent studies. It might generate a further stage of research if the drug seems to be effective only for a subset of patients, such as those in the early stages of the disease. Phase III takes three to four years and may cost $45 million.