If you walk into a Quebec pharmacy and reach the 鈥渃old and flu鈥� section, you may see a sign you鈥檝e never seen before. The green-blue notice will tell you, 鈥渄ear customer鈥�, that there is 鈥済enerally鈥� no scientific evidence to support the effectiveness of homeopathic products. In one store (perhaps in an act of quiet vindication), the pharmacy staff slapped the notice over a pull-out display meant to help you figure out which homeopathic product may be right for you. The notice essentially answers, 鈥淣one.鈥�
How did we get here?
First, a crash course in how we know homeopathy does not work. For anything. Take, a plant that produces vomiting. Dilute in water, then dilute that dilution, and dilute some more鈥� until there鈥檚 no ipecac left. Put that drop of water on a sugar pill. Give to somebody who鈥檚 been vomiting鈥� to stop them from vomiting. This absurdity may make you nauseous, but these are the foundational principles of homeopathy, created by a German physician in 1796 because medicine at the time relied too much on leeches and bloodletting.
Despite homeopathy being the pinnacle of preposterousness, a number of scientific studies have been done to see if it works. Some were of dubious quality and are held by homeopaths as irrefutable proof. The best evidence was reviewed by many governments around the world and their conclusions were congruent: homeopathy is for and should not be recommended. So why do pharmacies sell these products?
Presumably for the same reasons that pharmacies also sell sugary beverages, chips and, up until 2000 in Quebec, cigarettes. Pharmacies extend well beyond the prescription counter. They are businesses, one-stop shops for all your bathroom needs and quick fixes in the kitchen. When it comes to homeopathy, there is a tension between a pharmacist鈥檚 scientific knowledge and the corporate interests of a store whose defence is usually, 鈥渋f a consumer wants it, we can sell it鈥� especially if it鈥檚 approved by Health Canada.鈥� And there鈥檚 the rub. Health Canada gives validation to these nonsensical products in a way that looks to the average consumer like a proper drug approval process but which is not. No efficacy needs to be scientifically demonstrated. Anecdotes and 鈥渉istorical evidence鈥� suffice. As long as they don鈥檛 endanger the population directly, they get approved. The system is so easy to game, CBC鈥檚 investigative journalism programme Marketplace got its authorization for a targeting children after sending in photocopies from an old book as proof that it would work.
And the word 鈥渟ystem鈥� is important here. To move us into a more evidence-based consumer landscape, we need to understand who take part in this system. Pharmacists say they鈥檙e at the mercy of the chains. The chains defend themselves by highlighting the fact that Health Canada approves these products. And Health Canada claims it鈥檚 up to pharmacists to sell these products or not. But recently, another cog in this machinery refused to give in to inertia.
The is the French initialism for the Quebec Association of Pharmacy Chains. When a little investigation I conducted revealed that two-third of Montreal pharmacies were selling a particularly popular homeopathic product against the flu, French newspaper La Presse followed with an investigation of its own, questioning the various cogs in this system and highlighting the absurdity in pharmacists being told they can sell this type of product but can never endorse it. And the ABCPQ said to La Presse they would create signs for pharmacies to display next to homeopathic products. A few months later, lo and behold, the signs are here (though optional). 6,000 were printed out, intended for the 鈥渘ear totality of Quebec pharmacies鈥�, we . Moreover, the ABCPQ wrote to Health Canada to demand they revise how they authorize these products in the first place. Health Canada did not answer, but we know they are in the midst of a multi-year deliberation聽to revise this聽process. An announcement is scheduled for spring 2020.
As a scientist and a communicator who cares deeply about people making informed decisions about their health, I can say that homeopathic products have no place in pharmacies. Their mere presence represents a tacit endorsement by an evidence-based profession. Getting to the point where they are banished from drugstores is a long way off (if even possible), so I am pleased that we are now seeing a concrete step in the right direction. Consumers who know little about homeopathy and wander down the cold-and-flu aisle will now be faced with a fairly bold notice. It may be enough to nudge them away from wasting their money. And it might just make them wonder why, if pharmacists know these products don鈥檛 work, they are still selling them.
鈥淐onsult your pharmacist for details,鈥� the sign will tell them.
Take-home message:
-聽Pharmacies in Quebec recently received signage to put up next to homeopathic products
- The signs tell the consumer that the effectiveness of homeopathic products is generally not supported by scientific evidence
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