Julie Deardorff
Published January 22, 2006
If you're concerned about sham medicine, look up the countless Internet watchdog groups that promise to protect us from rampant health-care fraud.
There's Quackwatch, a skeptical view of virtually everything except pharmaceutical drugs and surgery, and its sister site, Homeowatch, which criticizes homeopathic cures.
Acupuncture Watch tells us why inserting tiny needles into the body is a waste of time and money.
Chelation Watch warns us about the dangers of removing heavy metals from the system.
And Chirobase sounds an alarm about chiropractic care.
Yet most "quackwatchers" were strangely mum after the heretical announcement this month by the nation's chest physicians that over-the-counter cough medicines do little, if anything, to relieve coughs.
According to new guidelines issued by the American College of Chest Physicians, the over-the-counter cough syrups generally contain drugs in too low a dose to be effective or contain combinations of drugs never known to treat coughs.
So Americans waste billions of dollars on these ineffective medications every year. Why isn't this a national scandal?
The answer is lurking in Robert Carroll's skeptical response to the news. Carroll, the author of "The Skeptic's Dictionary" (Wiley, $19.95), wrote on his Web site:
"Millions of people know [that using OTC cough medicines] works because they've used them and given them to their children. They've seen their good effects with their own eyes. They must be effective if millions of people swear by them. I've used them many times, and I know they work."
Then he decided that his own personal experience was more telling than the guidelines issued by the Northbrook-based international medical society, which has more than 16,000 active members from all chest disciplines, including pulmonology, critical-care medicine, sleep medicine, cardiology and cardiothoracic surgery. Ninety percent of association's members provide clinical care.
"Who's right?' Carroll asked. "The millions of us with common sense and experience or some group of pointy-headed medical doctors who want us to get pneumonia so we'll have to check into the hospital and pay large medical bills to help pay for their SUVs and vacation homes?"
I hate to imagine the vicious torrent of e-mail I'd receive if I used this logic to defend holistic medicine, the use of herbs, osteopaths, naturopaths or other "alternative" treatments.
But this is exactly the case with folk remedies; they haven't necessarily been proved by double-blind placebo-controlled clinical trials. Our own experience--even if it's just the placebo effect--gives us information to work with.
But efficacy is one issue, and safety is another. Homeowatch admits that homeopathic "remedies" usually are harmless but warns that "their associated misbeliefs are not. When people are healthy, it may not matter what they believe. But when serious illness strikes, false beliefs can lead to disaster."
Cough medicines, unlike homeopathic remedies, are not necessarily harmless. Not only are they ineffective at treating coughs due to colds, but they also can lead patients to delay seeking treatment for more serious coughs, including whooping cough, according to the college of chest physicians.
This sounds a lot like Homeowatch's concern that false belief in a product can lead to negative consequences.
Even more worrisome, state health-care professionals have seen a rise in the number of drug-abuse cases involving dextromethorphan (DXM), an ingredient found in more than 100 cough and cold products. At higher-than-recommended doses, teenagers have discovered that it can produce hallucinogenic effects and distorted perceptions of sight and sound. When abused, it causes nausea, vomiting, diarrhea, abdominal pain and rapid heart rate, and high doses can slow breathing and cause death.
Cough medicine also is sometimes abused in combination with other medications, alcohol or illegal drugs, which can increase dangerous side effects.
What people tend to forget is that just because the Food and Drug Administration approves something, that doesn't mean that it works or that it's safe.
----------
E-mail Julie Deardorff at jdeardorff@ tribune.com. Send health and fitness news to
[email protected].
Top of Document