Post No.: 0810
Although the definition of complementary and alternative medicine (CAM) is a bit nebulous, they’re considered to be treatments that fall outside of mainstream healthcare. They include the likes of homeopathy, aromatherapy, acupuncture, naturopathy, Ayurveda, meditation, hypnosis, Reiki, colonic irrigation, chiropractic, and herbal medicines.
Technically, complementary medicine is used alongside conventional medicine, whereas alternative medicine is used instead of conventional medicine. But they’re frequently grouped together as one category.
One could argue that remedies that have been clinically proven to work as intended are simply called ‘medicines’ rather than ‘complementary and alternative medicines’! CAMs therefore typically fall under pseudoscience; although we should take each complementary or alternative medicine on a case-by-case basis. For instance, there’s evidence that shows acupuncture helps with pain relief, and certain kinds of meditation can be beneficial for our mental well-being.
Some people try complementary and alternative medicines because they’re in a desperate situation – they seek a treatment for a serious health problem they have that either mainstream medicine doesn’t provide or they don’t trust in what mainstream medicine has to offer for one reason or another. When it comes to the former, public health services might even help patients find CAM services in a limited number of cases – as something they could try if they feel it’s psychologically better than nothing at all.
Some others try complementary and alternative medicines not because they are actually ill or infirm but because they want some kind of shortcut or ‘elixir’ to achieving perhaps increased vitality, youthfulness or libido. They believe in complementary and alternative medicine because of their wishful thinking for a simple, effortless/low effort and/or side-effect-free treatment. Sometimes there is a simple and side-effect-free treatment but it requires copious amounts of effort, self-discipline and persistence to implement (e.g. eating more vegetables, quitting smoking or doing more exercise) but they don’t want that sort of solution, even in cases where it would eventually work.
Well lots of people believe in a god(s) because of their faith that someone or something is guiding them and protecting them. Lots of people believe in spirits and afterlives because of their belief that death isn’t the end of their mental continuity and that justice can be dealt to people’s souls in another life. Cryonics can give wealthy people hope that they or their loved ones can be reanimated someday despite the current severe lack of evidence that this can be achieved, at least through freezing. Wishful thinking could be considered more delusional than optimism or hope but these wishes or desires fall across the spectrum of belief or faith because they’re not based on the present empirical evidence. And beliefs or faith can be an effective psychological coping strategy and so sometimes they can improve well-being (the placebo effect) – they won’t cure or treat the actual ailment or injury itself but can help one in mentally dealing with it.
However, desperate or delusional beliefs in particular can be exploited and lead to harms. If there is no hard evidence that these complementary and alternative medicines work as claimed then they’re essentially shams.
Some may argue though that if the sham products, along with their rituals or ceremonies for delivery, work as placebos, then they work to some degree – just like the threat of Santa Claus not giving presents to children who misbehave (a ‘noble myth’). But one must ask if it’s necessary or if there’s a better, non-deceptive way to achieve the same result?
Placebo explanations can help people ‘understand’ their illnesses or problems in ways that seem magical and involving esoteric forces, which, as a result, if they can tap into these forces, can give people a sense of what to do to get better (e.g. having low ‘chi’ and therefore the need to cultivate more ‘chi’ or ‘life force’).
But there’s a risk of medicalising responses to social or behavioural problems or reinforcing destructive beliefs regarding having an illness by virtue of using placebo pills, placebo rituals and placebo explanations. For example, by giving the impression that only pills can solve a particular social or behavioural problem, or that one won’t be able to cope without these pills, or that an illness is caused by a demon possession that only a special ritual can ward off. More critically – placebo peddlers can often encourage people to turn away from more efficacious mainstream medicines.
If something is for sale and isn’t illegal then some people will read this as it being approved or it works. But anecdotes are not reliable data. Several (alleged) success stories don’t tell us how many failures there have been too, especially because dead people cannot give their testimonies to say, “This alternative cancer treatment is a scam because I took it and then died from cancer!” Deceased people in every kind of context can no longer personally share their sides of the stories, from those who died due to extreme poverty to civilian casualties of war.
Conventional therapies will physically treat or cure a disease; although we must understand that very few even proven therapeutics work 100% of the time because of individual factors such as comorbidities, a person’s age or how far a disease has progressed. Complementary (as in when used alongside with rather than as an alternative to conventional) therapies might be able to further help a patient’s mental well-being while they’re unwell, as long as these complementary therapies cause no harm themselves and don’t interfere with the conventional medicines. Yet they can still be expensive (in fact, placebos generally work better if they’re charged more for or overpriced because of the assumption that ‘you get what you pay for’!) and therefore can be exploitative of people in a desperate and vulnerable position.
What’s also abominable is that if you follow a wellness diet or complementary medicine plan and your cancer or other major health problem isn’t improving then the influencers and businesses that promote them will likely blame you for not going far enough, or for not believing in them enough. There are always red flags when you buy or follow something and it doesn’t work but then you get blamed for the failures instead of those things you’ve purchased or joined. (Those at the bottom of pyramid schemes get treated in a similar fashion too.) Furthermore, if you get pushed into attempting ever more extreme behaviours then that’s harmful because nothing that’s ever truly healthy is extreme. Healthy is balanced, never extreme.
It’s also a flaw to assume that these wellness products must work just because the wellness industry is worth billions – scams make billions of dollars every year(!)
Yet there is a danger in elevating the stances of cranks and quacks by engaging with and challenging them and thus giving them some PR and exposure, because if they feel that their worldview (and source of income) is being attacked, they’ll work even harder to justify it even more (e.g. by conducting further confirmation-biased research and/or by searching for and congregating with others who share in the same worldviews). For people with an agenda, engaging with them could give them some extra publicity and raise their profile even more. On another paw however, we cannot just let these people mislead others for profit.
The markets don’t always self-correct to take the charlatans out of business because instead of accepting that a ‘wonder treatment’ doesn’t work – duped consumers can think that it’s only because they haven’t used it for long enough yet, or the seller will claim they’re not using it right (or some other excuse that’s not the seller or product’s fault). Plus there’ll always be new, vulnerable or insecure, people desperate or delusional enough to exploit with false promises. Wherever there’s desperation, there’s exploitation – from cheap labour to expensive cosmetic surgeries.
This is also why treatments are more preferably marketed than cures – if cures don’t work then it’ll be obvious, but if treatments don’t work then the placebo effect can still produce a temporary feeling of improvement in one’s mood and pain relief and so consumers may stick with believing in them and using them for far longer than they should.
With a mere treatment, the marketers haven’t oversold the product in the sense that if a consumer feels worse some days (people can naturally feel better or worse from one day to the next) or never ultimately gets better then they weren’t promised a lasting cure anyway. And if it doesn’t have an effect at all then consumers may again think that it’s only because they haven’t used enough of it or some other reason. So a cure has a definite and lasting outcome, whilst the effects of a treatment or ‘improvement’ can be more subjective and temporary. Moreover, if you don’t actually cure someone, you’ll be assured of their repeat business! (It’s like, in general, most customers would rather buy durable products that last, whereas businesses will make more money from constantly selling replacements or at least repairs or consumables.) This all means that many racketeers do make heaps of money before they’re found out and the present fad is replaced by another. People still do sell and buy different types of ‘snake oil’ – business is in fact booming in this Internet and influencer age.
Technically speaking, laws are passed by the legislature, whereas regulations are rules issued by authorised governmental organisations. Regardless, both must be obeyed. And we should be glad that there are laws and regulations to ensure that any clinical claims made by manufacturers when they say their products heal or treat specifically stated problems must match the independent science. However, manufacturers get around this via a careful choice of wording on their packaging and adverts (e.g. by claiming that their product ‘is a component of hair’ instead of saying it ‘is good for hair health’). Advertising regulations can be worked around by implying things that we’ll generally naturally assume, like that person in a white lab coat with a stethoscope around their neck is a qualified doctor, or that person rubbing their head and then feeling better after some treatment has just been cured from their headache. People frequently get scammed after assuming that they could automatically trust the reputation of someone just because they are (aiming to become, or merely said they are) a doctor.
Regulations evolve over time to intervene in the markets for good reasons. For instance to prevent people from being harmed without first being properly forewarned about the risks of something, and to give customers confidence when buying new products from unknown brands, which therefore helps new businesses to compete with established ones – you can trust them, not because of their history (because they’re new market entrants) but because they pass the required minimum regulations. And helping to encourage fresh competition is normally good for consumers. A problem though is that once certain regulations get taken for granted – those who feel that their profit-maximisation is being curtailed due to them ‘because they’re not needed anymore’ will lobby for deregulations, and politicians who treat GDP as the cardinal measure of economic health will oblige, which means that the old problems that those regulations were introduced in the first place to prevent from happening again, will happen again. This pattern arises in all kinds of sectors, especially in the financial sector.
Another major issue is that – when it comes to complementary and alternative medicine practitioners – there’s typically no statutory professional regulation for CAM practitioners i.e. anyone can legally practise the treatment even if they have no/limited formal qualifications or expurrience, and they aren’t legally required to join an association or adhere to any minimum standards of practice.
So these are the risks of complementary and alternative medicine. In my fluffy opinion, I would stick to clinically-researched and department-of-health-approved medicines.