I increasingly feel sort of isolated in my concerns about this sort of thing and how they are framed, and what it says about the power of the FDA and problems it might lead to in other areas.
I think homeopathy is nonsense really, has no scientific evidence in its support, and makes no physical or biological sense.
At the same time, I believe if someone wants to place such products on their shelves, they should be able to. In my opinion it doesn't matter if there is any placebo effect, or any effect of any kind, as long as the contents are correctly labeled and are uncontaminated.
The lead-up in this piece is misleading. Yes, there have been problems with a number of eye drop products. But — and this is critical — those products were not homeopathic, and still had problems. That is, the homeopathic nature of the products was irrelevant to their safety.
So now we're in a situation where, instead of aggressively pursuing eyedrop contamination in general, the FDA is focusing on the putative purpose of the eyedrops, which has nothing to do with the underlying problem.
Meanwhile, we're facing ongoing problems with contaminated generic medications, that have been going on for years or even the scale of decades even (it's turned into an interesting exercise, Google "Indian generic medication" at any random time of any year and see what the latest scandal is; e.g., https://www.bloomberg.com/opinion/articles/2023-04-04/big-ph...). These scandals, in contrast to homeopathy, seem to get slaps on the wrist from the FDA without any dramatic calls for complete market removal, because they somehow fit in the schema for science-based medicine. Homeopathic products with no evidence of active harm must be removed from the market because they have no efficacy, but tainted medications that are killing people or landing them in the hospital year after year are ok.
Homeopathy and the FDA is an odd topic for me, because although I think homeopathy is completely unscientific nonsense, by the same token I also suspect it shouldn't be actively harmful unless there's a different problem, which should really be the focus. I guess I have problems with an agency regulating with reference to intended purpose rather than purity and safety, because for me there's a direct line from that to a failed drug wars, lack of access to needed medications due to overregulation, treatment protocols lacking in scientific or ethical rigor that become de facto standards, and inequities in medical care.
I was expecting an article about how the FDA found homeopathic eye drops in particular as a class of eye drops to be systemically contaminated, and how they were going to pull them off the market until manufacturers complied with safety inspections. But that's not what I found at all.
Put it a different way: what is the actual safety concern about these eyedrops? Is it about the homeopathy, or contamination? Is it possible for homeopathy per se to be unsafe? Which, then, should be the real focus of the FDA?
This is the only measured take I’ve read in these comments.
If a sugar pill makes a lot of people feel better they should by every means have access to it. Within scientifically proven and “understood” mechanisms of action there are a litany of misunderstandings and MoA’s that are total guesses that folks seem so eager to dismiss in hindsight relative to homeopathy in particular. Every exception to the rule gets pulled out of the book when it comes to misrepresenting safety and efficacy for the newest juice big pharma’s pushing, like there was some sort of update to the collective consciousness rather than cheap lies and misrepresentations.
It’s silly how polarized and fixated people and western administrations are on this large quadrant of “relatively harmless, many people think it does some good”. Like it’s some low hanging fruit always there to punch down to.
Regardless, the vast majority of folks I know using homeopathy don’t actively ignore other options or deny other forms of treatment at all– if anything they respect it more and approach powerful drugs with a prudence I believe is important to preserve.
I find your opinion here fascinating and value your perspective! It's neat to debate which kind of 'scam' is worse. Every value proposition for health supplements/medicine has 3 parts:
1. Features (what it is: ingredient, quality, purity, potency etc)
2. Advantages (how does its mechanism of action work and how is it unique/better than alternatives)
3. Benefits (why does the consumer care because it relieves pains or acquires gains)
I agree with you that 'scams' that target the Features (like the fake/counterfeit generics example) are terrible and we should aggressively go after this type of scam. However, had those Features been real, the Advantages and Benefits of those generics probably had good evidence/support. Just because you got fake pills, doesn't mean that the real ones don't work well.
But Homeopathic medicines ALWAYS have Advantages and Benefits problems. Even if the Features are okay, and you get exactly what you expected, the mechanism of action will never work and you will never get the benefits more than a placebo. If any marketing convinces you otherwise (like the label or having shelf space at CVS in the 'eye care' aisle), then you are a victim of another type of 'scam'. Homeopathic products, as far as an rigorous research is concerned, always have Advantages/Benefits problems.
On one hand, regulating Features is maybe easier for a government to do and that is an argument for limiting the scope to Features issues. However, the health and monetary costs of products with fake Advantages/Benefits is undoubtedly many years of life and billions of dollars, so there will be pressure to regulate. (maybe you disagree with the costs/externalities here)
It's definitely an interesting discussion. Hopefully smart people are working on getting real data about the pros and cons!
I think homeopathy is nonsense really, has no scientific evidence in its support, and makes no physical or biological sense.
At the same time, I believe if someone wants to place such products on their shelves, they should be able to. In my opinion it doesn't matter if there is any placebo effect, or any effect of any kind, as long as the contents are correctly labeled and are uncontaminated.
The lead-up in this piece is misleading. Yes, there have been problems with a number of eye drop products. But — and this is critical — those products were not homeopathic, and still had problems. That is, the homeopathic nature of the products was irrelevant to their safety.
So now we're in a situation where, instead of aggressively pursuing eyedrop contamination in general, the FDA is focusing on the putative purpose of the eyedrops, which has nothing to do with the underlying problem.
Meanwhile, we're facing ongoing problems with contaminated generic medications, that have been going on for years or even the scale of decades even (it's turned into an interesting exercise, Google "Indian generic medication" at any random time of any year and see what the latest scandal is; e.g., https://www.bloomberg.com/opinion/articles/2023-04-04/big-ph...). These scandals, in contrast to homeopathy, seem to get slaps on the wrist from the FDA without any dramatic calls for complete market removal, because they somehow fit in the schema for science-based medicine. Homeopathic products with no evidence of active harm must be removed from the market because they have no efficacy, but tainted medications that are killing people or landing them in the hospital year after year are ok.
Homeopathy and the FDA is an odd topic for me, because although I think homeopathy is completely unscientific nonsense, by the same token I also suspect it shouldn't be actively harmful unless there's a different problem, which should really be the focus. I guess I have problems with an agency regulating with reference to intended purpose rather than purity and safety, because for me there's a direct line from that to a failed drug wars, lack of access to needed medications due to overregulation, treatment protocols lacking in scientific or ethical rigor that become de facto standards, and inequities in medical care.
I was expecting an article about how the FDA found homeopathic eye drops in particular as a class of eye drops to be systemically contaminated, and how they were going to pull them off the market until manufacturers complied with safety inspections. But that's not what I found at all.
Put it a different way: what is the actual safety concern about these eyedrops? Is it about the homeopathy, or contamination? Is it possible for homeopathy per se to be unsafe? Which, then, should be the real focus of the FDA?