Sunday, June 24, 2012

Natural remedies vs medicine

It's a tired trope that seems to be trotted out again and again. Pharmaceutical companies are evil, are only there to make money, promote drug dependencies and drug-fixes for lifestyle problems. We should use natural medicine instead. For the purposes of this post, I'm going to focus on herbal/plant-based medicine, but many of my arguments apply to any alternative treatments.

I'm not going to argue that drug companies are squeaky clean and altruistically motivated. They're not. If you want to learn about some of the medically and scientifically questionable things they're up to, listen to this fantastic TED talk by Ben Goldacre. However, admitting that one player has problems does not mean that the opponent is any better. For example, I don't like many of the Labour Party polices. However, that does not mean I think the answer to all our problems lies with the LNP.

The thing is that despite its quite obvious limitations, medicine still has a huge advantage over alternative medicine. To quote the brilliant Tim Minchin:
By definition”, I begin
“Alternative Medicine”, I continue
“Has either not been proved to work,
Or been proved not to work.
You know what they call “alternative medicine”
That's been proved to work?
Actually, if the above lines are not familiar to you, go and watch Storm now, and then you can come back to reading this post.

Mainstream medicine actually utilises a lot of "natural and "traditional" remedies. To list a few:
  • Aspirin was discovered by studying the pain relieving properties of willow bark
  • Quinine is an anti-malarial drug originally derived from the bark of the cinchona tree and used by groups of native Peruvians. It is no longer heavily used as it has unpleasant side-effects, but is still used to treat severe cases.
  • Morphine is the most effective pain relief known to modern medicine, originally derived from the opium poppy. Most strong painkillers are opioids .
In fact, here's a list of well over 100 plant derived drugs. This far from incomplete list shows that medicine has learned much from "natural" remedies. It's just that in order for natural remedies to be accepted into mainstream medicine, a few things are required:
  1. Rigorous scientific testing to establish an actual effect, and to check for side-effects
  2. A study of the chemical structure of the plant/source to establish which chemical(s) have the active effect
  3. Isolation of that compound, preferably finding a way to artificially synthesise it, to ensure that controlled dosages can be administered.
I expect that mainstream medicine still has a lot to learn from the traditional remedies of various cultures, and indeed it is still an important area of study (for an example, see the research conducted by SATREPS). It's just that until rigorous scientific testing has been carried out, it is not possible to know which natural remedies are helpful, which do nothing, and which are actively harmful. Even with natural remedies that have no effect, the results can be deadly if they delay or replace treatment with real medicine. So until these natural remedies are proven to work, and thus accepted into mainstream medicine, I'm not going to use them, and when I do, they will no longer be alternative, they'll just be medicine.

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