The Public's Doubts About "Western Medicine"

[firstyearstudent]

Someone I known mentioned that she had dropped out of nursing school because she didn't believe in Western medicine. I'm trying to get a handle on what this is all about and I just started reading this book Denialism by Michael Spector. Personally, I don't blindly put my faith in Western medicine, and I realize that many things are done without solid rationales or evidence or for liability reasons, but certainly there is more scientific evidence for these practices than for alternative medicine. And let's face it, I'm not going to a chiro if I've got leukemia and I don't think acupuncture is going to help with a severed arms. What's up with this the haters? Does anyone have insight into this? Your opinions?

[elkpark]

Its a joke when I hear people claim "I dont trust big pharma companies" but then go to a natural supplement store and spend hundreds or thousands on herbs that go to a "big herb company" instead of big pharma.

Do these people really believe that all these alternative medicine companies are in it just for altruistic reasons? Talk about being gullible/naive.

Alternative medicine is just as big a business as "big pharma" is. Alternative medicine companies pay their CEOs millions of dollars and have public stock ownership the same way the regular pharma industry works. So dont give me this BS about how you "trust" alternative medicine companies but dont trust big pharma. Its the SAME industry!

Not only that, but the "regular" pharmaceutical companies are required to conduct testing and document to the FDA that their products are "safe and effective." The companies that make "supplements" can just slap a label on a bottle and see how many suckers will bite. The FDA and its approval process are certainly not perfect, but at least they are something.

My problem with all the "supplements" and "alternative" treatments is not that they have nothing to offer, but that, because of the lack of any regulation/oversight/etc., you really have no idea what you're getting when you buy a bottle of something. It might contain what the label says, it might not, it might contain something entirely different ... CSPI, Consumer's Union, and other public advocacy groups periodically conduct and publish studies where they buy a bunch of supplements and analyze them in their own labs, and the results are always the same -- you buy three or four different brands of (for example) St. John's wort, and one bottle will contain only half the amount of St. John's wort per tablet that the label says, another might contain twice as much per tablet, another contains none at all but has something else in it that could be dangerous, etc. You have no way of knowing when you purchase the product (unless you have your own analytical chem lab at home in your basement ...) -- it's completely a matter of "buyer beware."

[zahryia, LPN]

Not only that, but the "regular" pharmaceutical companies are required to conduct testing and document to the FDA that their products are "safe and effective." The companies that make "supplements" can just slap a label on a bottle and see how many suckers will bite. The FDA and its approval process are certainly not perfect, but at least they are something.

My problem with all the "supplements" and "alternative" treatments is not that they have nothing to offer, but that, because of the lack of any regulation/oversight/etc., you really have no idea what you're getting when you buy a bottle of something. It might contain what the label says, it might not, it might contain something entirely different ... CSPI, Consumer's Union, and other public advocacy groups periodically conduct and publish studies where they buy a bunch of supplements and analyze them in their own labs, and the results are always the same -- you buy three or four different brands of (for example) St. John's wort, and one bottle will contain only half the amount of St. John's wort per tablet that the label says, another might contain twice as much per tablet, another contains none at all but has something else in it that could be dangerous, etc. You have no way of knowing when you purchase the product (unless you have your own analytical chem lab at home in your basement ...) -- it's completely a matter of "buyer beware."

Elk,

I agree somewhat with your second point/paragraph, but the your first point, while well taken, is a joke. It's no secret that the FDA is in bed with these companies. Does Avandia ring a bell? That's one example of many.

Again, even the IOM-well respected, no?-says that thousands and thousands of people DIE when they take their medications as prescribed. Let's not even talk about people who have to take medications for the side effects of their primary medications.

No lie, I know a girl who has Lupus who takes four medications. The first medication is for her condition and the three others are for the side effects of the primary and secondary medication:eek:. If she looked heathly and vigorous it'd be one thing, but the poor girl never feels well. And half the time it's not because of the lupus, it's because of the meds.

[CuriousMe]

Elk,

I agree somewhat with your second point/paragraph, but the your first point, while well taken, is a joke. It's no secret that the FDA is in bed with these companies. Does Avandia ring a bell? That's one example of many.

Again, even the IOM-well respected, no?-says that thousands and thousands of people DIE when they take their medications as prescribed. Let's not even talk about people who have to take medications for the side effects of their primary medications.

No lie, I know a girl who has Lupus who takes four medications. The first medication is for her condition and the three others are for the side effects of the primary and secondary medication:eek:. If she looked heathly and vigorous it'd be one thing, but the poor girl never feels well. And half the time it's not because of the lupus, it's because of the meds.

I don't think that's terribly fair. There will always be risks associated with medicine. People die from taking aspirin! But how well would this young lady be without medication? The medications might not make her feel great, but have they inhibited the immune response that's destroying her body?

My asthma can be really severe, I can go from zero to pneumonia in a matter of just a couple days when flared up. Because of this I need to start on high-dose oral steroids right away, and there have been seasons of my life that I've had to stay on them for more than 6 months. Between the beta agonists and the steroids, I feel lousy. I'm grouchy, totally devoid of energy, shaking with fine tremors and have insomnia for days after I finally stop the meds. I need to take sleeping pills (generally ativan) to sleep. Do the side effects suck? Of course they do, but they're better than not breathing.

It's true that people have unexpected severe reactions to medication.....but it's also true that far more people's lived are saved by medication. Before any medication is given to anyone (that includes, prescription, OTC, and even natural herbs and supplements) the risk/benefit ratio needs to be looked at. Because no matter what you ingest, there will always be a risk

[elkpark]

Elk,

I agree somewhat with your second point/paragraph, but the your first point, while well taken, is a joke. It's no secret that the FDA is in bed with these companies. Does Avandia ring a bell? That's one example of many.

Again, even the IOM-well respected, no?-says that thousands and thousands of people DIE when they take their medications as prescribed. Let's not even talk about people who have to take medications for the side effects of their primary medications.

No lie, I know a girl who has Lupus who takes four medications. The first medication is for her condition and the three others are for the side effects of the primary and secondary medication:eek:. If she looked heathly and vigorous it'd be one thing, but the poor girl never feels well. And half the time it's not because of the lupus, it's because of the meds.

I'm well aware of the problems with the FDA and their approval process (while the GOP controlled everything during the Shrub administration, they pushed through a new "fast-track" approval process through which pharmaceutical companies can basically buy FDA approval of new drugs, and we are now starting to see the dangerous results of that process) -- which is why I qualified my statement to begin with. However, the FDA approval process is, at least, something. Alternative treatments and supplements have no approval process, no oversight, no regulation, no accountability whatsoever. And that's somehow better? Why, because the people hawking "natural" treatments are so pure of heart and trustworthy? Yeah, right. Sure, lots of people die from taking their medications as prescribed and intended. How many people die from "alternative," "natural" treatments? Does laetrile ring a bell? That's one example of many. But, of course, we don't really have any idea what the real number might be, because there's no mandate or system for reporting deaths and adverse effects with alternative treatments.

[zahryia, LPN]

I don't think that's terribly fair. There will always be risks associated with medicine. People die from taking aspirin! But how well would this young lady be without medication? The medications might not make her feel great, but have they inhibited the immune response that's destroying her body?

Glad you asked:D. I know know of a few people with lupus are doing very well with acupuncture and herbs. I've tried to get my girlfriend who's taking all those meds to consider alternatives, but like many on this thread, she doesn't trust herbs or other modalities. And that's fine. although sometimes I do wish she would be more open and at least investigate it and do her own research. I really hate to see her suffer.

But I'm not going to force the issue.

My biggest gripe is thata large number of people who are opposed to alternative med don't even understand it or have never studied it. And you can understand it outside of clinical trials. I can't tell you the number of doctors I've come across who get excited about it once they start learning about it. In the beginning, all they want are clinical trials too, but as they learn more, they become a lot more open.

It's all about education. I'm blessed to be educated in both fields. BUt I'm still always learning.

[firstyearstudent]

The marketers of supplements, herbal remedies and the like have no accountability at all because there is a disclaimer on the label that says they are not intended to treat disease.

[firstyearstudent]

zahryia -- You seem to be saying, in regard to alternative treatments, that once you believe in them, then you believe they work. I want evidence to believe they work. I generally don't just believe in things. For instance, I don't believe in ghosts or aliens. There's no scientific proof that they exist.

[CuriousMe]

Glad you asked:D. I know know of a few people with lupus are doing very well with acupuncture and herbs. I've tried to get my girlfriend who's taking all those meds to consider alternatives, but like many on this thread, she doesn't trust herbs or other modalities. And that's fine. although sometimes I do wish she would be more open and at least investigate it and do her own research. I really hate to see her suffer.

But I'm not going to force the issue.

My biggest gripe is thata large number of people who are opposed to alternative med don't even understand it or have never studied it. And you can understand it outside of clinical trials. I can't tell you the number of doctors I've come across who get excited about it once they start learning about it. In the beginning, all they want are clinical trials too, but as they learn more, they become a lot more open.

It's all about education. I'm blessed to be educated in both fields. BUt I'm still always learning.

I'm so glad your friends are doing so well with their lupus.....but we both know that there are lots of folks out there who are doing well with pharmaceuticals. As well as lots who are doing well without any treatment since SLE is an autoimmune disease characterized by periods of remissions and exacerbations with an acuity along a spectrum, so some folks have a more mild form of the disease while other's have a much more severe form. Which, by the way, is why clinical trials are so important! We can't know if acupuncture and herbs are working for your friends because they have a mild form of Lupus, or maybe are in remission, or a thousand other things without looking at what the experience is of a lot of people.

I guess that's one of my problems with alternative treatments, I have done a lot research in an attempt to educate myself, but how do you get educated without clinical trials? I know there are books and resources, but how do they know what they say is true without evidence.... that's faith, not science. I need evidence beyond anecdotal stories. How do we know if those herbs have side effects, how do we know that some people won't have a very adverse effect from the herbs? We wouldn't think of taking a drug without looking at clinical trials first...any practitioner prescribing a drug that wasn't tested at all would be practicing malpractice. I guess I don't see the difference with herbs.

That doesn't begin to get into the issue of knowing how much potency you're getting in the herbs.

So, it's not a lack of openness. I want herbs to work! But, I won't take it on faith. The consequences could be to dire.

That's not a lack of openness, that's just looking at evidenced based science.

[zahryia, LPN]

zahryia -- You seem to be saying, in regard to alternative treatments, that once you believe in them, then you believe they work. I want evidence to believe they work. I generally don't just believe in things. For instance, I don't believe in ghosts or aliens. There's no scientific proof that they exist.

Don't put words in my mouth. I didn't even come close to saying that. What I AM saying is that I put stock in people's experience. I don't need a clinical trial to substantiate a claim. And let's be real, when we give our patients medications, we don't have the results of the clinical trials nor do we refer to them. We refer to a med book, which is totally different.

And if everyone was REALLY gung ho on clinical trials, we would NEVER use drugs for off label purposes. That's done all the time.

What I AM interested in is patient's experience with their provider. I'm interested in who the patient is as a person and ALL the factors that affect their health. And maybe this is because my first career was in public health. We use a biopyschosocial model. And western medicine doesn't always honor that.

As for drugs, I can run circles around many who are against non-western medicine. I understand the pharmokinetics and pharmadynamics of many major constituents. I know how to use a pharmacopeia. I've read the USP. So a lot of my education has been 'scientific' and a lot of it has been from traditional texts.

I hope you don't discourage your patients from praying. After all, there's no scientific proof that God exists. Oh but wait, if there's a clinical trial that shows praying to a non-scientific being (therefore non-existent in your eyes), then you'd go for it.

[zahryia, LPN]

I'm so glad your friends are doing so well with their lupus.....but we both know that there are lots of folks out there who are doing well with pharmaceuticals. As well as lots who are doing well without any treatment since SLE is an autoimmune disease characterized by periods of remissions and exacerbations with an acuity along a spectrum, so some folks have a more mild form of the disease while other's have a much more severe form. Which, by the way, is why clinical trials are so important! We can't know if acupuncture and herbs are working for your friends because they have a mild form of Lupus, or maybe are in remission, or a thousand other things without looking at what the experience is of a lot of people.

I guess that's one of my problems with alternative treatments, I have done a lot research in an attempt to educate myself, but how do you get educated without clinical trials? I know there are books and resources, but how do they know what they say is true without evidence.... that's faith, not science. I need evidence beyond anecdotal stories. How do we know if those herbs have side effects, how do we know that some people won't have a very adverse effect from the herbs? We wouldn't think of taking a drug without looking at clinical trials first...any practitioner prescribing a drug that wasn't tested at all would be practicing malpractice. I guess I don't see the difference with herbs.

That doesn't begin to get into the issue of knowing how much potency you're getting in the herbs.

So, it's not a lack of openness. I want herbs to work! But, I won't take it on faith. The consequences could be to dire.

That's not a lack of openness, that's just looking at evidenced based science.

Curious,

Who is going to fund these clinical trials? Are you willing to fund it? You said the consequences could be dire. Based on what? Where are you getting this evidence based science from that it could be dire?

And just for the record (not referring to you, Curious), I've never said people in the alternative medicine field are not trying to make a profit. Of course there's a business, but let's not compare an idustry that sells pills for $300 each tablet to the alternative medicine industry. That's a joke.

[CuriousMe]

Don't put words in my mouth. I didn't even come close to saying that. What I AM saying is that I put stock in people's experience. I don't need a clinical trial to substantiate a claim. And let's be real, when we give our patients medications, we don't have the results of the clinical trials nor do we refer to them. We refer to a med book, which is totally different.

And if everyone was REALLY gung ho on clinical trials, we would NEVER use drugs for off label purposes. That's done all the time.

Well of course we don't look up clinical trials every time we dispense meds. We consult the drug book, but....where do you think the information on adverse reactions and time of onset, peak, etc came from....clinical trials.

As far as the off label, no there aren't clinical trials about the effectiveness for the off label condition, but....the clinical trials that were done for the original indication are still valid regarding adverse effects, onset, peak, half-life, etc.

What I AM interested in is patient's experience with their provider. I'm interested in who the patient is as a person and ALL the factors that affect their health. And maybe this is because my first career was in public health. We use a biopyschosocial model. And western medicine doesn't always honor that.

Isn't considering the whole person part of nursing? It's what I'm being trained to do. I don't see how doing a hollistic assessment (your biopyschosocial model) is connected with either pharmaceuticals or alternative herbs and such. That just sounds like good nursing to me.

As for drugs, I can run circles around many who are against non-western medicine. I understand the pharmokinetics and pharmadynamics of many major constituents. I know how to use a pharmacopeia. I've read the USP. So a lot of my education has been 'scientific' and a lot of it has been from traditional texts.

That's fantastic, more education is always great. I'm sure you're an amazing resource to those fortunate enough to work around you. I just wish the information was available to scientifically evaluate non-western medicines as well.

I hope you discourage your patients from praying. After all, there's no scientific proof that God exists. Oh but wait, if there's a clinical trial that shows praying to a non-scientific being (therefore non-existent in your eyes), then you'd go for it.

Why would I interfere with their faith? That's my whole point. There's a difference between science and faith. The fact that there's a difference doesn't negate either one, they're just different. I have no problem with faith, I have my own beliefs and draw immense strength, peace and joy from my spiritual life and church family. That doesn't mean I'm going to make treatment decisions based on what my pastor says.

I have no problem at all praying for healing and as well as wisdom for the folks giving care; while following evidenced based treatments. My God gave me a brain to use as well as a soul.

Who is going to fund these clinical trials? Are you willing to fund it? You said the consequences could be dire. Based on what? Where are you getting this evidence based science from that it could be dire?

I have no idea who will fund those clinical trials. Someone or a foundation who believes that we should be using more non-western medicine likely. Maybe you could write a grant?

I'm a poor college student, I can barely fund me

As far as me saying the consequences of taking herbs/supplements, that aren't regulated at all being dire...well, that's common sense. We're talking about substances that have pharmaceutically active compounds. There's no way for a consumer to be able to know for sure how much of these compounds they're receiving, even if they take in the same amount of the herb. It's unlikely that anything that has pharmaceutically active compounds only acts on the body system we want it to.....that's just not how our bodies work. Of course the consequences for a bad reaction could be dire. Are you saying it's not possible for dire consequences?

If I had some clinical evidence, I could say there were dire consequences in XY% of the population who did ABC. I didn't say that, I said the consequences could be dire. I stand by that.

[zahryia, LPN]

I wish I could do the multiple quotes, but I can't.

The point of clinical trials is to determine if they are effective for a particular condition, so no, the information contained in med book doesn't all come from a clinical trial. The med book focuses on pharmokinetics and pharmadynamics. So information regarding the peak, onset, etc is known before a clinical trial is done. And just so you know, herbs have their own 'med' books (In fact there's an herbal med book from Mosby)

My point about the 'whole' person is that alternative medicine (in general) incorporates this moreso than western medicine. I'm not referring to nursing. Yes, I should hope that we as nurses see our patients as holistic beings. However, that's not to say other medical professionals do the same.

I was not referring to your post regarding the praying. I was being facetious given firstyear's alien/ghost comment.

I'm not going to waste my time searching for money to conduct herbal cliincal trials when A) I don't necessarily rely on them in the first place B) Even if the herbs do well, it will be dismissed as a placebo and C) It might not even be published.

NCCAM is doing some interesting stuff with acupuncture. I'd say of all the alternative modalites, it has the most respect. Even Hopkins has jumped on the bandwagon.

I think in time TCM and Ayurveda will be used more as an integrative method. The problem is there's not enough people who know and understand both western and non-western medicine. Only when you know both, can you truly compare and contrast.