At Science-Based Medicine, David Gorski details the  disturbing integration pseudoscience into the care of American veterans:

Today’s topic is the Veterans Health Administration (VHA) and its embrace of pseudoscience. VA Medical Centers (VAMCs) provide care for over 8 million veterans, ranging from the dwindling number of World War II and Korean War veterans to soldiers coming home now from our wars in Iraq and Afghanistan. Although there have been problems over the years with VAMCs and the quality of care they provide, including a recent scandal over hiding veterans’ inability to get timely doctor’s appointments at VAMCs, a concerted effort to improve that quality of care over the last couple of decades has yielded fruit so that today the quality of care in VA facilities compares favorably to the private sector. Unfortunately, like the private sector, the VA is also embracing alternative medicine in the form of CAM, or, as its proponents like to call it these days, “integrative medicine,” in order to put a happy label on the “integration” of pseudoscience and quackery with conventional medicine.

Of course, I (and others at SBM) have discussed the intrusion of woo into the military before. For instance, a post I wrote in SBM’s first year of existence discussed Col. (Dr.) Richard Niemtzow, a radiation oncologist by training but also one of the Department of Defense doctors trained as certified acupuncturists, and his advocacy for “battlefield acupuncture.” The form of acupuncture that Col. Niemtzow advocated was auricular acupuncture, which involves inserting tiny needles into the ear and leaving them there until they fall out. He even pioneered a program to train physicians in “battlefield acupuncture” and deploying them to combat zones. Not surprisingly, the evidence base cited in support of such a program was—how do I put this?—underwhelming, but that hasn’t dampened enthusiasm for the idea and other alternative medicine in the military. Given that my last post on battlefield acupuncture was in 2009, I thought I’d take a look again at the infiltration of “integrative medicine,” including battlefield acupuncture, into the military and the VHA. Unfortunately, unlike Clay Jones’ satirical—or…is it?—piece about robotic acupuncture, this is no joke. It’s really happening.

You can read Gorski’s full post here.

The Independent reports on a heartbreaking story out of Spain that could put renewed pressure on the alternative medicine industry in Spain:

A Spanish father has launched a court case against a homeopath he accuses of telling his son his cancer could be cured with “fungi and alcohol”.

Julián Rodríguez’s son, Mario Rodríguez, died after shunning conventional medical advice to treat his leukaemia in favour of alternative remedies.

The landmark case, which Julián hopes will result in stronger regulation on homeopathic practitioners, is expected to bring renewed pressure on Spain’s burgeoning alternative remedies industry.

The Provincial Court of Valencia, which initially dismissed Julián’s case, has now accepted it on the basis that José Ramón Llorente – who is not a medical doctor – should be held accountable for his claims that he could cure cancer, on the grounds of ‘professional intrusion’.

If convicted, Mr Llorente could face two years in prison, according to La Vanguardia.

You can read the full article here.

The Australian National Health and Medical Research Council recently released a review of 176 studies on homeopathic treatments for 61 illnesses, concluding that homeopathy “should not be used to treat health conditions that are chronic, serious, or could become serious.”

As the San Francisco Chronicle reports:

The study was threefold: first, it included an overview of published reviews by an outside, independent contractor; next, it did an independent evaluation of “information provided by homeopathy interest groups and the public”; last, it considered clinical practice guidelines, and how official international governments view homeopathy.

The result? Unsurprising.

“There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health conditions considered: no…studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment,” the official statement reads. “For some health conditions, studies reported that homeopathy was not more effective than placebo.”

Keep reading here.

As reported in today’s Daily Mail:

The National Health Service (NHS) could ban homeopathy on prescription, ministers announced today.

It is thought the health service spends £4m a year on the controversial alternative treatment – and there are homeopathic hospitals and GPs around the country.

But Life Sciences Minister George Freeman said today that cash should only be spent on the most effective medicines.

You can read the full article here.

After decades of non-regulation, federal agencies are finally taking a closer at homeopathy,reports BuzzFeed’s Dan Vergano:

The FDA is taking aim at homeopathic remedies — pills and preparations sold over-the-counter that claim to cure diseases with tiny doses of stuff that makes people sick.

But that may change. This month, both the FDA, which oversees drug safety, and the Federal Trade Commission (FTC), which oversees drug ads, will end lengthy public comment periods that followed hearings on homeopathy. The FTC smacked its sister drug-safety agency in public comments in August, calling for the FDA to crack down on homeopathic products, which “may harm consumers.”

The Center for Inquiry has already filed comments with the FDA; they can be read here,

The article goes on to quote CFI’s Michael De Dora:

In 1938, before the advent of modern drug testing, the U.S. Congress added homeopathic remedies to the list of legal drugs nationwide. Homeopathy largely faded from medicine thereafter, dispensed in minute quantities from the cabinets of homeopathic doctors. That changed in 1988, when U.S. drug laws changed to allow these products on pharmacy shelves without a prescription, and without the efficacy evidence needed to sell other drugs. The same laws exempt homeopathic drugs from limits on alcohol, according to the FDA.

Regardless, a resurgence of interest in “natural” medical cures spurred the growth of a homeopathic remedy industry, Michael De Dora of the Center for Inquiry, a junk science watchdog group based in Washington, D.C., told BuzzFeed News.

By 2007, the CDC estimated that Americans were spending $34 billion a year on alternative medicine and doctor visits, including homeopathic products. The American Association of Homeopathic Pharmacists takes issue with market surveys that suggest homeopathic drug sales are around $6.4 billion yearly, instead claiming they are closer to $1 billion.

In any case, it’s a lot of money. “Especially with big box stores stocking homeopathic products on their shelves, the market has grown,” De Dora said. “They are on the shelves next to real medicine, they look like real medicine, and there is a lot evidence that people don’t know what they are buying.”

You can read the full article here.

This week, California Governor Jerry Brown vetoed a bill, AB 159, that would have allowed terminally ill patients to access experimental treatments that have not yet been approved by the FDA.

Although advocated for as allowing freedom and choice for individuals facing , so-called “right to try” bills allow patients access to dangerous drugs whose safety is not yet proven, and clear the way for profiteers and alternative medicine practitioners to wring money—often hundreds of thousands of dollars—out of the dying and their desperate families, all without any legal protection.

From the San Jose Mercury News:

“Patients with life threatening conditions should be able to try experimental drugs, and the United States Food and Drug Administration’s compassionate use program allows this to happen,” Brown wrote in a signing message to lawmakers. “Before authorizing an alternative state pathway, we should give this federal expedited process a chance to work.”

[…]

“The bill was opposed by the Association of Northern California Oncologists, who warned that providing unregulated treatments for people desperately trying to extend their lives takes advantage of their frailty.”

Lamenting the “cruel sham” that is “right to try” legislation, surgical oncologist David Gorski details the misunderstandings that sustain them:

Basically, right-to-try laws all follow the same template provided by a libertarian think tank, the Goldwater Institute. The idea is to make it easier for terminally ill patients to access experimental drugs and devices. The requirements are risibly low and betray a total lack of understanding of how drug development works in that they only require that the experimental drug (1) have passed phase I trials and (2) still be in clinical trials. Of course, phase I trials are not designed to test efficacy. Their purpose is to work out optimal dosage, identify the maximal tolerated dose, and identify major side effects. Worse, they usually only consist of a few tens of patients, often less than 30. To propose letting seriously ill patients drugs that have been tested in so few people and not demonstrated to be efficacious and safe is to invite disaster. In addition, they provide no financial support for patients, who are basically on their own when it comes to paying what can be the substantial financial charges. In addition, right-to-try laws strip away patient protections, making it virtually impossible for a patient injured using such a drug to sue either the drug company or the physician administering the drug. That’s even leaving aside the fact that drug approval is controlled by the federal government, and drug companies will be highly reluctant to offer such drugs without the approval of the FDA, and the FDA already has programs for single patient INDs, also known as compassionate use, to allow patients access to experimental drugs.

Over the last year and a half, state legislature after state legislature, believing, based on the dishonest propaganda of advocates who claim that the FDA is killing people and the Goldwater Institute cynically featuring the sympathetic stories of dying patients (particularly those with Lou Gehrig’s disease) to advance its agenda, has fallen under the spell of right-to-try. It passed in Michigan last year, sneakily pushed through the legislature. Over the last year, state after statepassed these ill-advised laws. Not surprisingly, several months ago and more than a year after the first of these laws passed, right-to-try advocates couldn’t point to a single patient helped by these laws, and even patients were starting to realize that they’ve been sold a bill of goods in the name of an antiregulatory fervor to weaken the FDA, which was the real reason all along for these laws. The Goldwater Institute just used terminally ill patients to lobby state legislatures, that and the fact that most people don’t understand drug development and think that the arguments for right-to-try sound reasonable because of it. It’s no wonder that patients feel betrayed and disappointed. Right-to-try laws, by their very design, create false expectation and false hope.

Because of the widespread misunderstanding of drug approval (specifically the primacy of the FDA over any state law) and the lack of attention paid to the patient-hostile provisions of the Goldwater Institute template for right-to-try laws that strip away legal protections and greatly weaken the right to legal recourse in the case of harm, these laws have passed 24 states. California would have been the 25th.

[…]

In actuality, given the small proportion of drugs that make it successfully through the whole regulatory process after phase I, patients with terminal illnesses are far more likely to be harmed then helped by releasing experimental drugs that have only passed phase I trials. The frequent retort is that these patients are terminally ill and things can’t get worse, but there is something worse than being terminally ill. It’s being terminally ill and exhausting the last of your finances and even going into debt. It’s being terminally ill and harming yourself so that your are less able to do what you want to do in your short remaining time. It’s being terminally ill and dying sooner than you have to.

Read his full post here.

From the Center for Inquiry’s Office of Public Policy:

The Center for Inquiry (CFI) was invited and today delivered oral testimony at the Food and Drug Administration’s first review of its policies regarding the regulation of homeopathic products in more than 25 years.

Michael De Dora, director of CFI’s Office of Public Policy, delivered CFI’s testimony during on the first of a two-day public hearing at the FDA’s White Oak Campus in Silver Spring, MD. His testimony, however, was presented not only behalf of CFI, “but also on behalf of dozens of doctors and scientists associated with CFI and its affiliate program, the Committee for Skeptical Inquiry, with whom we work on these matters.”

In his testimony, De Dora briefly reviewed the scientific evidence on homeopathy, illustrated the harm caused by homeopathy, and proposed actions the FDA should take to hold homeopathic products to the same standards as non-homeopathic drugs in order to fulfill its mandate to protect the American public.

You can read more, including the full testimony, here.

William Keener, a resident of North Carolina and member of the state chapter of the Secular Coalition for America, writes on a “modest” new bill that would enact stricter immunization requirements in the state:

We can only hope that this proposed legislation leads to a more rational, evidence-based public discussion about the true risks and benefits of vaccinations and better informed consent conversations between doctors and patients. Enacting stricter immunization requirements is necessary but not sufficient to save us from misinformed dissent against our best medical advice on immunizations.

Sens. Jeff Tarte (R-Mecklenburg), Tamara Barringer (R-Wake) and Terry Van Duyn (D-Buncombe) should be applauded for introducing this bill and starting an important conversation about immunizations and public health in North Carolina.

The HPV vaccine and the “home school loophole” still need to be addressed, but we should do so and pass a bill as quickly as possible based on the best medical knowledge and evidence – not on our fears.

When it comes to vaccinations, we’re all in the same herd and share in the responsibility for public health.

Reuters reports that the U.S. Food and Drug Administration will hold a public hearing seeking information and comments on the use of homeopathic products, as well as the agency’s framework for such products:

The hearing, scheduled for April 20-21, will discuss prescription drugs, biological products, and over-the-counter drugs labeled homeopathic, a market that has expanded to become a multimillion dollar industry in the United States.

The agency is set to evaluate its regulatory framework for homeopathic products after a quarter century.

You can read the FDA’s announcement here.