As you may know, a homeopathic concoction is almost nothing — mostly water — but its effects are far worse than nothing. The mere presence of a marketed alternative comes with unmeasurable opportunity cost. How many patients, caregivers, or parents have foregone actual interventions because of the existence and accessibility of homeopathic products? It chills me to the core.
I don’t even like talking about how homeopathy is purported to work. Explaining the process somehow makes it seem like a thoughtful treatment modality. It isn’t. I also don’t take pleasure from the humour in its absurdity — the joke is tired and can be mistaken for smugness. Long story short, homeopathic products are mostly water. There will be some additional counterintuitive component(s), but in quantities so infinitesimally small they’re either negligible and/or inert. Think that makes it a cheaper alternative? Guess again.
In 2021, the global homeopathic products market was nearly $18 billion. With projected 18 to 19 percent gains over the next several years, it’s expected to swell to $50 billion by 2028. Worse, it’s a problem close to home. North America dominates the market. Chances are, you know someone who has taken, is taking, or will take a homeopathic product. Maybe you have been duped. Do not be ashamed. Demand better of others.
There are many contributing factors to the market growth, such as soaring evidence-based medication costs (which we’re somewhat protected against here in Canada). Another is the legitimization of the industry. A deeply concerning development is increased spending and crackdowns on good manufacturing processes by regulators, such as the U.S. Food and Drug Administration. On the surface, this sounds like a good thing. However, the downstream effects mean the players in the manufacturing game will learn how to do this better and will ultimately be able to claim their product is “approved by X government organization.” Scary, and reminiscent of what we see with other “complementary” and “alternative” practices like chiropractic.
This level of attention from regulators and the increased market demand, while disturbing, may be the only path out of this. The spotlight will draw demands for actual demonstrations of effectiveness. What we know is that the evidence for homeopathy is incredibly poor.
Anyone with a search engine will be able to drum up some evidence — a systematic review and/or meta-analysis — but what isn’t immediately obvious in these reports is the publication bias. In short, if a study didn’t have a “positive finding” — meaning, it showed no or neutral effects — it’s less likely to be published. Therefore, when researchers pool the results from several studies — a meta-analysis — they’re pooling the cherry-picked positive studies. The non-positive studies sit in a drawer somewhere. Surprised there are any studies with positive effects? Don’t be. Those studies are often the result of chance at best, and research misconduct at worst. Thankfully, the counter-attack is building and recent reports are exposing the publication bias.
The problem will get a lot worse before it gets better. Make no mistake about it: People will suffer. As skeptics and critical thinkers, our role is to demand good evidence. We shouldn’t fear that homeopathy will be proven to be effective. It won’t, at least not in its current form. So when an acquaintance tells you they’re interested in homeopathy, help them ask good questions. When you see a business attempting to profit from homeopathy, ask them tough questions. When you have opportunities to influence homeopathic researchers, ensure they’re registering their studies (which serves to decrease future publication bias).
Science will get us through this. Let’s hope the hype-generated destruction along the way isn’t too bad.