Backlash: Proponents of Complementary & Alternative Medicine take issue with David Colquhoun
During his recent visit to Toronto, Dr. David Colquhoun, Pharmacologist at University College London, appeared on CBC Radio‘s Sunday Edition. As usual, he made many damning remarks about the validity of Complementary and Alternative Medicine (CAM). Notably, Colquhoun asserts that an appropriate means of categorizing the different types of medicine is not scientific versus CAM, it is medicines that work versus those that don’t. The C & A medicines, according to Colquhoun, are those that don’t work—or at least, for which there is not sufficient evidence to assert that they do. If such evidence was present, these medicines would not be called CAM, they’d just be normal medicine. Many listeners asserted that Colquhoun’s views were narrow-minded, that Western medicine does not affectively address the mental side of health, and rightly pointed out that studying many alternative medicines scientifically is often strongly discouraged by the high costs of research and the very low financial rewards (alternative medicinal products often cannot be patented), not to mention the desire of pharmaceuticals companies to minimize competition. In response to this listener backlash, CBC Radio had 2 CAM practioners on this past week. You can listen to the PodCast here. I will not comment much on what they said as I am not strongly versed in alternative or standard medicine. However, a few highlights:
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It was claimed that many medical doctors are becoming more open to CAM;
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When asked about findings on research on acupuncture which showed that it didn’t matter where needles were placed—the results were the same either way (which, to me suggests a combination of placebo and endorphan release, which could enhance the placebo effect), the acupuncturist rebutted by saying that in studies in which standard acupuncture, sham acupunture (needles placed randomly), and medication (e.g., anti-inflammatories), the first two groups outperformed the third. The implication being that acupuncture was more effective than medication. What he didn’t mention, though, was if the first two groups differed from each other. My intepretation of the acupuncture (standard and sham) effect, again, was a mixture of placebo and endorphan release.
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The CAMers warned not to group all alternative medicines together. Some are surely scams, but that doesn’t mean all are.
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When asked by the host how to wade through the garbage CAM and find the alleged good CAM, one of the proponents encouraged ensuring that the provider has the qualifications (i.e., relevant training in CAM). Question: What about homeopathy? There are homeopathy-training programs out there, but that doesn’t mean that homeopathy is not BS. Nor does any other CAM training mean that what is being sold is not BS.
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One of the proponents said that a search of Medline will bring up tonnes of research on CAM, and thus, Colquhoun’s claim of an absence of evidence is incorrect. Readers can look into this themselves, if interested. Try PubMed. I did a quick search and found a large number of studies, but many were not on efficacy of CAMs but on other issues (e.g., perception of CAM). I did find a few studies claiming to find positive results, however. Here are a few links:
Feel free to discuss the arguments for and against particular CAMs. Perhaps David Colquhoun will drop by and share his views on the comments of the CAM proponents on the Sunday Edition broadcast.
The Frame Problem 
Hmm, so it looks like some potential evidence for the effectiveness of some form of acupuncture, anyway. Here’s hoping that a large number of studies failing to show such support haven’t been tossed aside unpublished, and that 95% of studies haven’t found no evidence.
Anyways, I think it was noted in that post that if something works, it can simply be called “medicine”, not “complementary” or “alternative medicine”. If there’s real support for acupuncture, then it would be moving toward being described by the former, and taken up by that world I guess. Though it seems the real meaning of “complementary and alternative medicine” might be cultural – as in, did it spring from a traditional or North American subculture versus being developed in a lab. The name of the journal that published all three of those articles wouldn’t make much sense if scientific corroboration was the distinguishing factor – “Evidence-based complementary and alternative medicine”.