Homeopathy is just one of a plethora of therapies termed “complementary” by the medical establishment. It’s a classic example of pseudoscience – a very broad category encompassing beliefs which claim to be scientific but do not meet the criteria to justify it. Even though some pseudosciences are fairly benign, homeopathy is one that can have serious consequences. The practice, and others like it, are so common it’s easy to take their existence for granted. But in the context of modern society, highly dependent on science and technology, how do these unscientific ideas still persist?  In the case of homeopathy the main driving factor is, perhaps unsurprisingly, money.

The evidence for its medical efficacy is clearly not in its favour: study after study show it has no more impact than a placebo. In fact, all meta-analyses carried out show that, when badly-designed trials are excluded and publication bias is accounted for, there is no statistically significant benefit to homeopathy over the placebo. Chemically and physiologically, there is no mechanism by which a homeopathic remedy could act, given the absence of active ingredients after the extreme dilutions which define the practice. That’s not to say it has no impact: the placebo effect can be powerful. But homeopathy isn’t the only way to obtain the benefits of a placebo. Simple sugar pills will do the same job – and are significantly cheaper. The difference is that homeopaths create an impression of effective treatment and use this to justify the costs to the patient. In reality, though, it simply isn’t worth it.

So why do people choose to use homeopathy? Research suggests that disappointing experiences with mainstream medicine correlates with turning to homeopathy and other complementary therapies. However, this is not an outright rejection of science: studies indicate that people who use homeopathy still want a therapy backed by evidence. To tap into this need, homeopathic practitioners actively peddle misinformation, cherry-picking poorly-controlled trials to support their remedies as well as denigrating mainstream medicine to bring in customers and drive up profit. That’s not to say a capitalist approach is exclusive to pseudoscience: mainstream medicine is often run on a for-profit model. The difference in homeopathy is the treatments’ inefficacy, coupled with practitioners’ irresponsibly misleading marketing.

This is a problem. One of the well-known issues with homeopathy – that some patients delay seeking treatment from mainstream medicine in favour of continuing homeopathic treatment – is a direct effect of this practice. The inefficacy of the treatment would be much less of an issue if weren’t for homeopaths convincing people otherwise, at the expense of patients’ seeking treatment supported by evidence. Plus in this light, the monetary cost to the patient (or even the taxpayer – two hospitals in the UK still provide homeopathy on the NHS, for some reason) is not justified.

More seriously, a few (admittedly rare) homeopathic remedies have been known to have directly caused harm to patients. A homeopathic teething gel sold in the US was reported by the Food and Drug Administration (FDA) in 2010 for containing varying levels of belladonna, a highly toxic plant more commonly known as ‘deadly nightshade’. After investigations into the product, including 10 reported infant deaths and over 400 reports of seizures, fever or vomiting, the FDA issued a warning against the gel in September 2016. The cause of this incident was thought to be an improperly controlled manufacturing operation, leading to biologically active levels of the poison making their way into the gel.

This exemplifies other issues with homeopathy: it is less carefully controlled than mainstream medicine, which can be dangerous given the remedies often use poisons and toxic substances in their preparation. What’s worse is that throughout the FDA investigation the company selling the teething gel continued to make the same superior-efficacy claims, before hypocritically accusing the FDA of causing confusion by issuing the warning, highlighting the extremes the marketing can stretch to. 

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There are wider consequences too. Medicine isn’t perfect, but when pseudoscientists actively damage its credibility as part of their business model, real scientific evidence and practice is devalued. The relationship between science and the public is fragile but important for so many reasons. At the level of research, further funding and acceptance depends on the public’s opinion of science. Undermining public health campaigns simply for profit puts patients at risk from potentially fatal diseases. One study revealed that half of homoeopaths were damaging the vaccination effort by advising patients against the MMR vaccine.

These consequences of the homeopathy business model are too serious to ignore. However, efforts to tackle these issues by focusing on the effectiveness of homeopathic remedies may be misguided: the problems caused by homeopathy do not solely stem from the treatments’ inefficacy. Instead, they are a direct consequence of the profit-driven undermining of real science and effective medical treatments. If these issues could be properly addressed with tighter regulations and responsible business practice, homeopathy would not be so dangerous – and could even have a clinical role by virtue of the power of its placebo effect. However, until this can be harnessed ethically, without the misleading marketing, homeopathy will remain nothing more than a deceitful and harmful pseudoscience.