Homeopathy in Pharmacies: The Great Debate

While at this year’s 78th FIP World Congress of Pharmacy and Pharmaceutical Sciences in Glasgow, Scotland, I sat in on a session on homeopathic products.

As a practicing community pharmacist for the past 12 years in multiple countries, I have come across these products on store shelves from time to time but never truly considered the rationale for their use. When I have been unable to recommend an appropriate OTC treatment, I have advised on homeopathic products with the caveat that “it may help, but it certainly will not hurt.”

Following this meeting I am less likely to provide that same advice.

The first speaker at the session was Geoff Tucker an emeritus professor of clinical psychology from the University of Sheffield in the United Kingdom, and he provided his case against the sale of homeopathic products in pharmacies. The basis for his argument was based on systematically identifying if the products could work physiologically, if they actually do work according to research, whether they can cause harm, and finally if the dispensing of these products is ethical.

The crux of his argument was that homeopathic products contain such infinitesimal amounts of the claimed ingredient that no body response could reasonably be expected to occur. As most studies researching the products demonstrated no greater effectiveness or efficacy than placebo, it is difficult to make a claim that homeopathic products actually do initiate an effect.

Although the products themselves do not specifically cause harm to the patient, the use of these products in place of a legitimate medical diagnosis may delay a real need for patient care. This can be especially serious in developing countries where HIV, malaria, and tuberculosis are rampant.

Regarding ethical concerns, Tucker said that “while the placebo effect is real, it is usually only effective for relatively minor ailments. It is variable.”

Christine Glover, owner of and pharmacist at Glovers Integrated Healthcare in the United Kingdom, thinks that there are positives to be gleaned from homeopathy.

She began her presentation by saying that “pharmacists have a scientific training, and a good scientist has an open mind; dependence on evidence-based medicine has become draconian and closed-minded.”

Stating efficacy and use studies from a number of countries, Glover said that despite us not fully understanding the mechanism of how homeopathic products work, there are in fact large communities internationally that have seen good results.

One area that both speakers agreed upon was the holistic principles of treating the whole person, rather than just a disease state.

There is no issue with taking the time to talk with a patient and trying to understand his or her situation as a complete human being. But the use of homeopathic products is not recommended, based on Tucker’s argument.

The heart of this problem is whether there is sufficient evidence to justify the use of homeopathic products. With an understanding of scientific principle, the concept of homeopathy has some clear issues. Ethically, for patient choice to be real, they must understand the implications of treatment. For homeopathy this would require explanation that it is a placebo, which then diminishes the effectiveness.

Joel Claycomb, PharmD, is a community pharmacist working in the Pittsburgh area. He has also spent time practicing pharmacy in Haiti and New Zealand.