Cough and Cold Products

Coming into the cough and cold season, the Science-Based Medicine blog has posted an article concerning OTC substances for such. This blogger recommends that all parents read the article in its entirely. Below are the conclusions:

Despite a long history of reasonably safe use, there’s no evidence that traditional cough and cold products have any effectiveness in children. Mild side effects are not uncommon, and fatal side effects are exceptionally rare, but possible. Given that colds are generally mild and resolve on their own, and that no product has ever been demonstrated to have a meaningful effect on the duration of a cold, over-the-counter products, “natural” or not, are unnecessary for children. Rest, adequate fluid intake, and acetaminophen or ibuprofen for the feverish child, may be all that is required.

Homeopathic and other “natural” remedies have emerged as the only marketed alternative — not because they are effective, but because of regulatory double standards and loopholes allow the sale of these products without demonstrated efficacy (or even any medicinal ingredients at all). With the medicinal products pulled off the shelf, they’re the only game in town now. And while homeopathy is admittedly safer than restricted products, given there’s no medicinal ingredients, and they’re not effective, all you can expect are placebo effects. Are parents aware the substitute remedies are just sugar and water?

Pharmacists have some challenges to manage. They may be concerned that the “traditional” products they’ve recommended for years are gone, and embrace the new remedies, without pausing to look for the evidence. Others may rely on marketing, anectodal reports of efficacy, or just read the parent’s desire to have a product – any product, as justification for selling them. And in some cases, they may just recommend these products because it’s profitable to do so. As a pharmacist, I admit that it’s more time consuming and less profitable to reassure an anxious parent that the cough and cold product they’re seeking isn’t necessary. But it’s far more ethically acceptable to me than to sell a homeopathic nostrum or unproven “natural” remedy that has no demonstrated evidence of efficacy, just so parents have the illusion they’re doing something to ease their children’s symptoms.

Alt Med - Homeopathy (2 of 20)

(from Quackwatch.org)

Introduction
In the late 1700’s, Samuel Hahnemann , German physician, began formulating homeopathy’s basic principles. He postulated the “Law of Similars” --- symptoms of disease can be cured by extremely small amounts of substances that produce similar symptoms in healthy people when administered in large amounts. At first he used small doses of accepted medications. But later he used enormous dilutions and theorized that the smaller the dose, the more powerful the effect—a notion commonly referred to as the "law of infinitesimals."

What are in Homeopathic products?
Homeopathic products are made from minerals, botanical substances, and several other sources. These substances are diluted up to 1 in 100²⁰⁰ (vastly greater than the estimated number of molecules in the universe). They are then vigorously shaken or pulverized, with each step of dilution leaving behind a "spirit-like" essence—"no longer perceptible to the senses"—which cures by reviving the body's "vital force."

Further history
Because homeopathic remedies were actually less dangerous than those of nineteenth-century medical orthodoxy, many medical practitioners began using them. At the turn of the twentieth century, homeopathy had about 14,000 practitioners and 22 schools in the United States. But as medical science and medical education advanced, homeopathy declined sharply in America, where its schools either closed or converted to modern methods. The last pure homeopathic school in this country closed during the 1920s.

The 1938 Federal Food, Drug, and Cosmetic Act, which was shepherded through Congress by a homeopathic physician who was a senator, recognizes as drugs all substances included in the Homeopathic Pharmacopeia of the United States.

Present day

Homeopathic "remedies" enjoy a unique status in the health marketplace: They are the only category of quack products legally marketable as drugs. The FDA has not held homeopathic products to the same standards as other drugs. Today they are marketed in health-food stores, in pharmacies, in practitioner offices, by multilevel distributors, through the mail, and on the Internet.

Summary

The homeopathic concept violates known science and any positive effects are purely placebo.