Is homeopathy “just placebo”?
I’m a homeopath, so what are the chances I’d say ‘yes’ to that?
‘Placebo’ translates as ‘I please’. Is a person administering ‘inert’ treatment – a mother ‘kissing it better’, a doctor or any other practitioner – trying to ‘placate’ the patient? Is a standard painkiller free from the ‘placebo effect’?
Homeopathic remedies are serially diluted, while undergoing a vigorous agitation process called ‘potentization’. Homeopaths argue that this produces a medicine that is not less but more powerful than the origin substance. Ultra-high-dilution research has its own journal and studies continue.
‘Implausible’ is not the same as ‘impossible’
Popular opinion now holds that homeopathic remedies can’t possibly work. But for 250 years patients have patently been getting better due to homeopathic treatment. So detractors typically argue: it’s got to be down to ‘placebo’ (and they suggest placebo is a con).
Now let’s take a brief look at mainstream medicine. How effective is it, and why?
Take migraines, 190,000 attacks a day in the UK: prescription painkillers have a panoply of side effects but give only ad-hoc relief. Or eczema, experienced by 15-20% of all UK children. Standard treatment is ‘emollients’ (effectively moisturisers) or steroids, with a plethora of side- and after-effects and, again, no cure.
Doctors and GPs are good people who wish to help. And almost 75% of patients have confidence and trust in their GP (BMJ, 2013).
Trust and expectation are considered key aspects of the placebo response
Additionally, 30-50% of the effectiveness of any given treatment is down to placebo – e.g. painkillers: relief is faster and greater than chemically plausible. Other effects also matter, e.g. is the GP surgery clean and patient-centred?
Add to this trust in the science behind modern medicine etc: partly due to the real physiological changes from the medical ingredients, partly due to these cumulative placebo layers, mainstream medicine has it all stacked in its favour. So why are there so many patients who don’t seem to respond to 'placebo power' plus ‘real medicine’?
And why, in the face of much public ridicule, do so many people still consult a homeopath for their migraine, or their child’s eczema, and a host of chronic conditions?
Patients find homeopathy highly effective
Outcome studies typically report ‘great’ improvement in over 50%, and ‘improvement’ around 70% (e.g. https://www.hri-research.org/wp-content/uploads/2018/01/NHS-homeopathy-in-the-spotlight-Jan2018.pdf).
The typical homeopathy patient comes with a long history of disappointing medical treatments. Sometimes they come armed with serious doubts but nothing to lose. Sometimes they come with unrealistic expectations of miracle cures. Is it ‘just the long consultation’ perhaps? But homeopathy consultations here and worldwide can be as short as a GP appointment. Migraine attacks permanently mitigated, eczema removed or minimised without steroids – homeopaths see such results regularly. Can it be ‘just the placebo effect’ of taking a homeopathic remedy?
My answer: homeopathy works because the prescribing principle – careful selection of similars, verified by healthy provers – simply works. The mechanism of action may not be fully understood yet, and the discussion will continue. But there is no doubt that homeopathic remedies, correctly prescribed by a homeopath, are highly effective in treating a wide range of ailments. So yes, a proportion of this effectiveness will be due to the ‘placebo effect’ – just as it is in mainstream medicine.
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