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OT - Bit of a curly one - bringing herbs into Oz 11-Mar-2011 At 6:19:20 PM Andrew_M

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Bloody hell, here’s what’s turned into a long and dull essay...good if you have insomnia

Much “alternative” medicine is an obvious crock of sh!t, but just because it isn’t conventional doesn’t necessarily mean that it doesn’t “work”. There are lots of practical reasons why “alternative therapies” might not be in the mainstream that have absolutely nothing to do with whether they are safe and effective or not.

First up...if you forget the mumbo jumbo that often dresses up alternative approaches, to totally dismiss all alternative therapies out of hand is quite simply unscientific. Science doesn't discriminate against the apparent wackiness of an idea - it's just a method to work out whether there is any basis to a particular claim or not using a standard approach that involves experimentation. A lot of alternative medicine has probably never been tested properly so we simply can’t actually say whether it “works” or not. This can be done rigorously using exactly the same approach as with mainstream drugs/procedures, with the gold standard being a double-blind randomized placebo-controlled clinical trial.

So why haven’t they been tested? For better or worse, it is money and money alone that drives almost all applied medical research - and who pays? On average, for any new drug it costs in the order of a billion dollars (give or take) to get it through the safety and efficacy testing process and drug companies are not charities, they need to get a return on their investment. Does big pharma want to spend this kind of money to investigate whether putting candles in your ear cures cancer? This is the obvious nut job end of the spectrum but it gets tricker than that. The reasons why drug companies won’t touch some treatments are not necessarily obvious...for example, if the end market isn’t large enough (ie there aren’t enough people who have the disease), or that those people don’t have any money (eg third world only diseases) then development costs can’t be covered. Ethically and morally objectionable, but that’s just the way it is with the current system.

Then there’s patenting. The basic take on this is....patenting gives a drug company a 20 year monopoly to charge pretty much whatever the hell they want to for the drug/product/ procedure. This is what motivates them. You can’t patent a healthy diet, regular exercise or a proper work/life balance so drug companies are not interested in these (hopefully this is where taxpayer-funded government schemes come in... not always). But just as often it’s technical reasons why pharma isn’t interested – if anyone has ever promoted or published or presented some kind of new therapy, it’s assumed to be common knowledge and no longer patentable – this is called “prior art” in patent jargon. There’s also an incredibly complex paper trail that is needed to justify all claims about therapeutics for patenting and to be approved for clinical trials -this is not the sort of thing your average alternative type is likely to be good at dealing with.

So, if some non mainstream person (AKA, “a wacked out new age nut job” to most folks) does, astonishingly, happen to develop a treatment or therapy that does actually work, it will almost certainly never become mainstream. This is because, chances are, they’ve put it up on their website or treated a patient without making them sign a non-disclosure form (i.e. causing it to be prior art). If they haven’t done this, they almost certainly haven’t documented the specifications of every single batch of every single substance they have used, or noted down the serial number of every pipette for every test and when it was last calibrated and by whom, or recorded their testing in double counter-signed laboratory note books that have been stored in locked fire proof cabinets every night as per the required OECD Good Laboratory Practice procedures (blah blah blah blah). This means that no one can patent it so they can’t recoup the costs of taking it through preclinical safety testing and then clinical trials. If it hasn’t gone through these processes then it can never get regulatory approval and can never be mainstream.

So...what percentage of alternative therapies might actually not harm people and even do some good? 0.01%?0. 1%? who knows? Only something like 1-2%(??) of conventional therapeutic candidates make it from scratch through the whole process and end up being used anyway. It's more worrying that any particular alternative treatment might do something bad than actually work. Then again, more often than it should be that’s the case with “regular” treatments too...