It’s estimated that Australians spend $10 million per year on homeopathic remedies, including treatments for a variety of ailments including pain, addiction, insomnia, chronic fatigue, acne, burns, skin conditions, asthma, PMS, depression, dementia and ADHD. Is that money well spent?
In 2014, Australia's peak medical research agency, the National Health and Medical Research Council (NHMRC), reviewed the available research on a large number of homeopathic remedies and found that there was no evidence to support their efficacy.
The NHMRC's report, which was based on a complete review of all available, reliable data arising from trials of various homeopathic remedies, noted that many of the studies in favour of homeopathic medicine were poorly designed and conducted, saying that "the available evidence is not compelling and fails to demonstrate that homeopathy is an effective treatment for any of the reported clinical conditions in humans”.
Before finalising the report, the NHMRC also considered submissions from the public and homeopathic interest groups, including the Australian Homeopathic Association. Indeed, many patients have found relief from using homeopathic treatments, including former footballer Jim Stynes, who famously pursued a number of alternative treatments for his cancer in conjunction with traditional treatment under oncologists.
However, as former president of the Australian Medical Association (AMA), Dr Steve Hambleton pointed out:
“Observational studies might be a reason to do a proper study and not actually to conclude that something is cause and effect. What you really want to do is actually look, in particular, at the double-blind randomised control trials where you truly get rid of bias and you can truly test something against the placebo to see whether there is any difference to placebo treatment. That's where the NHMRC has gone. We hear lots of testimonials in which people say, ‘I tried it and it works for me’. Sometimes there's a string of testimonials, none of which are credible scientific evidence. When we look at animal studies, just because it works in a rat or another non-human animal doesn't necessarily mean it’ll work in a human.”
There have been a number of cases that have demonstrated the dangers of relying solely solely on homeopathic treatments. Tamar Stitt, aged 10, was diagnosed with liver cancer in August 2009. Her parents refused chemotherapy, instead choosing to pursue natural remedies such as daily clay wraps and drinking dandelion tea. Tamar's condition deteriorated and she finally started chemotherapy but she died in November 2009, three months after she was diagnosed. The Coroner heard evidence from experts who estimated that Tamar had a 60 per cent chance of survival had appropriate medical treatment, including chemotherapy, been delivered in a timely fashion.
In 2002, 13-month-old Isabella Denley died after her parents refused medication for her epilepsy and instead relied on alternative medicines.
The arguments for greater regulation
The NHMRC report has led to calls for tighter regulation of the homeopathic industry. Australia's health practitioners are regulated by the Australian Health Practitioner Regulation Authority (AHPRA), which manages the registration and renewal process for health professionals, along with the development of registration standards, codes and guidelines. Homeopathic medicine is not regulated by AHPRA and some of the treatments aren't registered with the Therapeutic Goods Administration.
At the time of the report's release, Dr Hambleton noted:
“Unconventional therapies are very poorly regulated in reality. We have health practitioners now fully registered. Chinese-medicine practitioners are now fully registered. There are minimum standards to be reached. There is a board whose job it is to protect the public from registered health practitioners who don’t do what the wider body of the profession believes is reasonable. The unregulated industries are very broad. We've got multiple forms of unconventional therapy for which there is very little credible evidence. Unless they're making outrageous claims those industries are clearly very successful.”
So, given the findings of the report, is it time for greater regulation of the homeopathy industry? Should we continue to take such a relaxed view to claims that may have no substantiated evidentiary basis? There are all kinds of restrictions on advertising and penalties for misleading and deceptive conduct that apply to any commercial product. Why should homeopathy be exempt?
More importantly, what happens when we are dealing with potentially life-threatening conditions? Should we take such a relaxed view to claims that may have no substantiated evidentiary basis? Mainstream medications have to go through rigorous testing to assess their safety and efficacy before they are put on the market. Again, should homeopathy be any different?
Supporters of homeopathic medicine would argue that there is evidence for the effectiveness of the treatments. However, if you are selling an evidence-based treatment for health problems, it is arguable that it should be subject to the same rules and regulations that every other health treatment in Australia is, and that it should be subject to the same advertising restrictions and penalties that apply to any other product.
While the vast majority of natural remedies are harmless, there are always exceptions; when people are dealing with serious, life threatening conditions, it is essential that they have access to accurate information about whether these treatments have any real scientific support. Without proper industry regulation, there is always potential for people to be given false hope and, when at their most vulnerable, they can easily be duped by misleading claims.
Tom Ballantyne is a senior associate in Maurice Blackburn’s Melbourne office.