I wrote a book review

So I wrote my first book review on Dr. Paul Offit’s “Do You Believe in Magic: The Sense and Nonsense of Alternative Medicine.” It appeared in the August UNC TIBBS (Teaching Initiatives in Biomedical and Biological Sciences) Times newsletter (http://tibbs.unc.edu/wp-content/uploads/2013/07/TIBBSTimesAug2013.pdf). To be honest, writing the piece was incredibly stressful, like I might really have an ulcer now. Writers who review books for a living, consider me impressed and sympathetic. What a challenge to decide what parts to highlight when there is an abundance of amazing and heart-wrenching stories while also capturing the essence of the book. But it really was worth it and thanks so much Erin for putting it in the newsletter, I appreciate the opportunity to write about this important book.

Science vs. Sensationalism: A High-Stakes Battle

In 1970, ten-year old Joey Hofbauer died of Hodgkin’s disease, a treatable cancer of lymph tissue. Doctors’ estimated that Joey had a 95% chance of survival through radiation and chemotherapy, but his parents tragically opted to treat him with a natural remedy called laetrile, coffee enemas, massive doses of vitamin A and raw liver juice. Social services attempted to intervene through the courts, but faced with financially powerful laetrile advocates, a movie star and a burgeoning social movement, their efforts to save Joey’s life were denied.

Joey’s story was one of Dr. Paul Offit’s earliest encounters with alternative medicine and opens his latest book, “Do You Believe in Magic: The Sense and Nonsense of Alternative Medicine.” The case contains all of the staples of a fraudulent alternative medicine movement: a desperate and vulnerable family, a charismatic alternative medicine doctor, a celebrity advocate and a highly profitable industry. This cast of characters assemble in each of his accounts, always ending with a tragic and preventable death. This narrative structure is repetitive, but highlights alternative medicine’s perpetual reliance on the same tactics and treatments for a range of unrelated diseases.

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Image: http://bit.ly/19A88xK – And yes, everytime I picked up the book I did wonder if someone had thrown up on the corner

In the book’s most captivating chapter, Offit reveals how the dietary supplement industry’s successfully positioned itself as separate from the pharmaceutical industry to justify its deregulation at the cost of public safety. The industry spent billions of dollars to pass the Dietary Supplement Health and Education Act in 1994, which blocks the FDA from regulating the safety of vitamins, supplements or amino acids. Referred to by the New York Times as the “Snake Oil Protection Act,” this deception was made possible by a powerful publicity campaign. Industry lobbyists recruited politicians and movie stars to spread the message that the government was attempting to limit the American people’s right to choose their vitamins. The public not only accepted the deregulation of the vitamin industry, they demanded it. It was the FDA’s worst defeat, one that millions of American’s are paying for.

Only 170 of the 51,000 herbal supplements in the market have undergone any safety testing. Yet a recent poll shows that 58% of the American public believe that over the counter supplements are approved by the FDA. An investigation of 450 supplement manufacturers found that half had significant problems, from lacking ingredient lists to contamination with rat droppings and urine. Money, power and greed drive this $34 billion dollar a year industry even though about 50,000 adverse reactions to supplements are reported each year.

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Photo: Dr. Paul Offit, Wikipedia Commons

Yet alternative medicine has not survived on dishonesty and charisma alone. Offit illustrates the power of the placebo effect and warns against underestimating it. One therapy he targets is the ancient practice of acupuncture. Studies show that there is no difference in patient relief when needles are placed in correct or incorrect position or whether standard or retractable needles are used. The placebo effect has specifically been proven in pain alleviation. In response to pain, spicy foods, or exercise the human body can produce endorphins, which have the same effect as morphine. In an experiment in 1978, patients were given morphine, a placebo, or naloxone, a drug that blocks endorphins, after dental surgery. Individuals from the morphine and placebo groups reported feeling less pain while those that received naxolone did not.

Offit allows that using the placebo effect can be ethical if the patient is at low risk, low cost or low burden. However, he specifies four ways in which alternative medicine becomes harmful quackery. This happens when practitioners recommend against conventional therapies, promote potentially harmful therapies and charge inordinate amounts of money that bankrupt people. Lastly, it is most dangerous when it promotes magical thinking and discourages scientific literacy, which is the only defense against those who would exploit disease for their own gain. At its best, alternative medicine provides placebo induced comfort, but at its worse it bankrupts families and kills people.