Alternative To What?

stone of madnessBy Marvin Ross

Two interesting events this past week. Scientists at Northwestern University in Chicago announced a major breakthrough in the cause of ALS which may lead to an effective treatment. It has taken a team of researchers studying one family who are genetically prone to this disease to uncover what they believe is a cause using, of course, the scientific method.

In Orlando in contrast, we had the 28th annual Alternatives Conference put on by the National Mental Health Consumers’ Self-Help Clearinghouse and funded by the US Government. Their theme was Creating the Future: Change, Challenge, Opportunity and that “Learning from each other is a clear example of self-help, mutual support, and the principles of recovery in action!”

Looking through their program, I don’t see anything that in any way suggests that they are going to come up with solutions to the cause or effective treatment of mental illnesses. And effective treatment (recovery) does require an understanding of why and how these conditions afflict us. We are nowhere near that. What I do see is a lot of talk about peers helping peers and concepts like Emotional CPR.

I’ve always had a problem with the term alternative. It is as irritating as political correctness but on two occasions I did attend alternative conferences – the Total Health Expo Billed as “North America’s premier natural health show”. The event has been held every year since 1977 by the Toronto-based Consumer Health Organization of Canada. Both times I attended, it was with physicians and I described that visit for a magazine.  

The one person there who talked about mental illness (depression) was Carolyn Dean who claimed that 784,000 people are killed annually by doctors in the U.S., but thought that the true number might be five times greater. Dean is a popular speaker who recommends magnesium for many ailments and currently lives in Hawaii. She is a medical graduate of Dalhousie University in Halifax and then had her medical license revoked in Ontario in 1995 for “incompetence and professional misconduct.

She claimed in her talk that when she appears on TV in the U.S., she is not allowed to talk about depression and St. John’s Wort. She told the assembled faithful that the networks tell her the subject is too heavy for the audience. But she says that is not the real reason. She believes that pharmaceutical advertisers probably have a clause in their contracts with networks preventing them from mentioning anything other than prescription drug treatments.

Now I don’t know how far out the Alternatives delegates in Florida are as I was not there but I have to wonder at their use of the term alternative. I agree with Montreal scientist Jonathan Jarry who said in his Cracked Science Video on homeopathy that there is no shame in looking after our health if we feel underwhelmed by the medical system. It’s natural to look for alternatives (as the folks in Orlando are doing) but these substitutes are often not based on scientific evidence.

I’ll go even farther and support the  definition put forth in an editorial in the New England Journal of Medicine by two of its editors. In 1998, Marcia Angell and Jerome Kassirer said:

It is time for the scientific community to stop giving alternative medicine a free ride… There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted.”

So, if the Orlando alternative folks want to support each other as is indicated in their tag line that’s great. But they need to realize that all pills, substances, medicines are placebos. All have the potential to make us feel better, at least for a while. But some of these placebos also have scientifically proven pharmacological effect, proven help beyond that of a placebo. Those are true medicines. The others are not. But as long as the others make us feel better, give us hope, do not bankrupt us, do not cause harm, and do not prevent us from seeking real medicine, they are fine. The last two phrases being the most important: if they do not harm, and they do not prevent us from seeking real, scientifically proven, medicine.

And the drawing at the beginning of this blog is of an old treatment for mental illness – drilling a hole in the skull or trepanation. It was mainstream for a large part of history and, according to Wikipedia, “In 2000, two men from Cedar City, Utah were prosecuted for practicing medicine without a license after they performed a trepanation on an English woman to treat her chronic fatigue syndrome and depression.”

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3 thoughts on “Alternative To What?

  1. Thank you Marvin, once again, for stressing the focus on and supporting scientifically based treatment. The quote by Marcia Angell and Jerome Kassirer is profoundly important for people to understand. Peer support and self-help are important for people but it is NOT treatment but an adjunct to treatment. People can learn from each other and find support and understanding but they are not functioning as clinicians. There is a myth that the pharmaceutical companies lobby clinicians and command treatment modalities. That is an untruth. Clinicians are dedicated to discovering and providing the best, efficacious and evidenced-based treatments for their patients.

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  2. What is the worst part about alternatives? The money spent on these feel good solutions, and the conferences to introduce them, when those most seriously affected are left to rot in gutters.

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