This Week in Alternative Medicine: "$2.5 billion spent, no ...

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First off: the most important news of the day is Iran. My thoughts -- and I'm sure all of our thoughts -- go out to the brave people in the streets there. So my topic here is just a diversion.

Last week, I wrote a diary calling alternative medicine "mumbo-jumbo".

In it -- particularly in the discussion -- I found fault with the National Center for Complementary and Alternative Medicine (NCCAM), a unit of the National Institutes of Health, and suggested that it was poorly-run, driven by ideology, and a waste of money.

There was some good discussion, but I was surprised to be accused of being everything from a "concern troll" to an "anti-tax Republican".

So I'm back today with an interesting article I missed. Meet you below the fold to discuss it.



Here's a rundown some of the comments from the earlier diary:

-- Trials using "alternative medicine" are not performed because there is no profit motive for testing non-patentable therapies.
-- The NIH isn't spending enough money on "alternative medicine" trials, and the amount they spend should be expanded.
-- Scientists (and people like me) aren't open-minded enough about such therapies, or how they might work.
-- Many of the effects "alternative medicine" may not be measurable by our standard ways of doing trials.
-- I must be a shill for big pharma, or a stockholder, to even raise the issue that the NIH shouldn't be funding trials based on the criteria of whether the therapies are alternative or not.

Well, an article from MSNBC entitled $2.5 billion spent, no alternative cures found addresses the first four of these. (The last one just isn't true. I'm not a stockholder/employee, or in any way related to big pharma.)

I don't know quite how much I can quote without going beyond fair use, so be sure to visit the article.

Here's the introduction:

Ten years ago the government set out to test herbal and other alternative health remedies to find the ones that work. After spending $2.5 billion, the disappointing answer seems to be that almost none of them do.

Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer. All proved no better than dummy pills in big studies funded by the National Center for Complementary and Alternative Medicine. The lone exception: ginger capsules may help chemotherapy nausea.

In the previous diary's comments, there seemed to be some disbelief, or misunderstanding, of how the NCCAM was run in a distinct fashion from other NIH insitutes, and how it is more susceptible than other institutes to ideological input. Here's one way:

Critics also say the federal center's research agenda is shaped by an advisory board loaded with alternative medicine practitioners. They account for at least nine of the board's 18 members, as required by its government charter. Many studies they approve for funding are done by alternative therapy providers; grants have gone to board members, too.

"It's the fox guarding the chicken coop," said Dr. Joseph Jacobs, who headed the Office of Alternative Medicine, a smaller federal agency that preceded the center's creation. "This is not science, it's ideology on the part of the advocates."

And here:

Congress created it after several powerful members claimed health benefits from their own use of alternative medicine and persuaded others that this enormously popular field needed more study. The new center was given $50 million in 1999 (its budget was $122 million last year) and ordered to research unconventional therapies and nostrums that Americans were using to see which ones had merit.

That is opposite how other National Institutes of Health agencies work, where scientific evidence or at least plausibility is required to justify studies, and treatments go into wide use after there is evidence they work - not before.

Once again, I'll ask you to please read the article before you begin commenting. Discussing "alternative medicine" is like discussing religion, I've found, but I'll hope that the article may provoke thoughtful commentary, and civilized discourse. (A person can dream, can't they?)

I'll close with an argument against the special nature of "alternative medicine" and against the case for exceptionalism in the study of it:

"Alternative Medicine", when proven to work, is simply called "medicine".

"Alternative medicine" is otherwise treatments that are either:

(a) unproven, in which case their supporters should seek definitive trials comparing them to standard treatments, or no treatments at all;

(b) proven not to work, in which case those who promote their use are at best uninformed or at worst quacks and frauds;

(c) unprovable, because they rely on some supernatural effect. (Often, in this last case, proponents invoke the word "quantum" in explaining the unobservable/unmeasurable effects.)

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