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The popularity of CAM modalities has seen them become part of the curriculum in health profession schools. One of the most commonly used CAM modalities is homeopathic treatment. Homeopathy is a treatment modality whose basis is the principle that an illness can be cured by administering a drug which is highly diluted; this drug in higher concentrations should be able to produce symptoms which are the same as the ailment (Shelton, 2004).
The mantra for homeopathy thus is ‘like cures like’. Homeopathic remedies are generally so dilute that they actually do not have any molecules of the original medication. Homeopathy is based on vitalist philosophy which explains disease as originating from disturbances in life force or vital force. These disturbances present as unique symptoms. Homeopathy holds that the vital force can react to and adapt to external and internal causes: the law of susceptibility (Shelton, 2004). This law has the implication that a negative state of mind has the potential to attract disease entities referred to as miasms (Shelton, 2004). These invade the body and produce disease symptoms. Hahneman, the man associated with the origins of homeopathy however rejects the notion that disease occurs as a separate entity. He asserts that disease is part of the ‘living whole ‘ (Hahneman, 1833).
Origins of Homeopathy
This alternative form of medicine was proposed by Samule Hahnemann, a German physician. Homeopaths also use certain aspects of the psychological and physical state of the patient when recommending remedies (Shelton, 2004). Hahnemann’s ‘law of similars’ is based on his observations of working with a cinchona bark used for treating malaria. He claims that the experience of ingesting the cinchona bark produced effects similar to those of malaria symptoms and from this he inference that cure proceeds from similarity (Shelton, 2004). Further experiments with other curative substances led Hahneman to conceive the law of simialrs. However this law remains an unproven assertion and not really a law of nature (Shelton, 2004).
Remedy in homeopathy refers to substances which are prepared following a certain procedure and which are used to treat patient (Shelton, 2004). This is different from the conventional use of the word in modern medicine. In describing remedies, two types of references are used: repertoires and Materica medica (Shelton, 2004). Repertoires refer to the index of disease symptoms which are associated with certain symptoms; the Materica medica is the collection of pictures of drugs that are associated with a particular pattern of symptoms.
Therapeutic usefulness
In achieving better personal health, homeopathy has been one of the most effective CAM modalities as it has helped in the management of my asthma. The homeopathic treatment is used together with conventional medicine and has resulted in lower treatment costs as well as a greater feeling of general wellbeing. This is because homeopathy as described by Hahneman involves the incorporation of adequate exercise and good nutrition as a way of achieving optimum health. Additonally, the proposition on disease being in some cases attributable to a negative state of mind has also helped in fashioning my lifestyle such that I focus on stress reduction, good nutrition and physical exercise to maintain general body health.
Evidence in support of the usefulness and effectiveness of homeopathy has been illustrated by other investigators. For instance, in a meta-analysis of six trials, homeopathic treatments were found to have encouraging evidence in the reduction of side effects following cancer therapy (Milazo, Rusell and Ernst, 2006). Other areas in which homeopathy has been used as a treatment modality includes: induction of labor, osteoarthritis, migraines and asthma (McCarney, Linde and Lasserson, 2004; McCarney et al, 2003; Smith and Smith, 2003).
Benefits for specific populations with particular health concerns
Homeopathy has been reported to have therapeutic applications in the child-bearing cycle ranging from the treatment and prevention of miscarriage, cystitis, anaemia, vaginitis, digestion complaints, pain in the pelvic region, postpartum bleeding, postpartum complications, varicosities, failure to dilate, initiation of labor and retained placenta (Kliger and Lee, 2004). A review by the Cocharane Pregnancy and Childbirth Group Trials Register, and the Cochrane Controlled Trials Register found that there was insufficient evidence to recommend caulophyllum, a popular homeopathic remedy for the induction of labor. The review compared the use of homeopathy in randomized controlled trials for the induction or maturation of labor with placebo treatment or other methods (Kliger and Lee, 2004).
The conclusions arrived at regarding efficacious use of homeopathy in problems related to pregnancy are not easy to reach due to the difficulties in methodology which arise when comparing conventional medical interventions with homeopathic interventions. Some of these challenges include the lack of research designs that would consider the differences in theory and practice between conventional medicine and homeopathy. Thus even though the Cochrane Review may not have found sufficient evidence to support the use of homeopathy for pregnancy related problems, there still remains some room for further investigation. Patients receiving treatment for cancer form a large group of the patient population that has benefited from homeopathic medicine. Most of these patients use homeopathy to manage the side effects brought about by their cancer treatment. Some of the side effects addressed using homeopathic medicine includes stomatitis and dermatitis.
Efficacy and safety issues in homeopathy
Most people who use homeopathic medicine use it to complement conventional medicine; this is especially the case with cancer patients. This is because cancer treatments have been known to cause morbidity. Patients receiving treatment thus use homeopathic medicines to help alleviate the side effects of cancer medications. In a review of studies to find out the efficacy of homeopathic treatments for alleviation of cancer treatment side effects, two studies showed benefit: one showed that the topical calendula was superior to trolamine in prevention of dermatitis induced by radiotherapy while another study showed that Traumeel S was superior to mouthwash in preventing chemotherapy induced stomatitis (Kassab et al, 2009).
Other studies gave positive results albeit there was an unclear risk for bias while other four studies in the review gave negative results. From the review, there were no serious adverse effects that could be attributed to the use of homeopathic medicine (Kassab et al, 2009). In recommending homeopathy as a treatment modality, the NAACM recommends that the client who is using alternative treatment methods should provide a list of these medications to their healthcare giver so that the healthcare giver can advise accordingly as to whether there could be any potential adverse reactions from the combination of conventional medicines with homeopathic medicines.
Homeopathy and research
Homeopathy has received much criticism since its inception. Generally, the methodological research base in homeopathy is low with weaknesses in reporting, design, sample sizes and selection bias. The efficacy of homeopathy remains largely unsupported by weight from research findings of modern science. Homeopathy uses extreme dilutions which leave no original material in the final remedy. There has been a modern mechanism proposed by homeopaths but most scientists consider this implausible because short-range order in water remains for a period of about a picosecond (Texeira, 2007). Most of the pharmacological effect in the absence of the active drug ingredient is generally inconsistent with the conventional dose-response relationship seen in modern-day drugs. This leaves only a placebo effect to explain the efficacy of homeopathy (Texeira, 2007). The water memory explanation runs contrary to the laws of physics and chemistry.
The National Center for Complementary and Alternative Medicine (NCCAM) points out that homeopathy is controversial due to some of its key concepts being inconsistent with the laws of science. However, the NAACM also points to the anecdotal and observational evidence of the efficacy of homeopathy and argues that it should not be rejected because of the inability of science to explain how it works (NCCAM, 2010).
Cultural/Religious Implications
Homeopathy has been part of Asian and Indian cultures for some time and is thus acceptable to these cultures. The Catholic Church has however distanced itself from the practice of homeopathy. Some homeopath practitioners incorporate religious beliefs into their practice but homeopathy does not require that someone follow a particular religion in order to practice it. It is a secular practice.
Possibility decrease/increase healthcare costs
A cost benefit analysis of homeopathic versus conventional therapy in respiratory disease found homeopathic medicine to be significantly lower than conventional pharmacological therapy (Rossi et al, 2009). The study was an observational study which was carried out on patients to identify the cost of conventional medicinal products in a year preceding appointment at the Homeopathic clinic. These were compared to first and second year following homeopathic treatment. The costs for patients who were affected by chronic asthma, acute recurrent respiratory infections and allergic complaints were found to be reduced in comparison to the costs for conventional drugs (Rossi et al, 2009). The cheaper cost of homeopathic medicine may perhaps present an avenue for further investigation into the efficacy of homeopathic medicine so that it can confidently be presented as an option for accessible healthcare to the patient. The fact that it is fairly inexpensive is a factor in its favor for its use as a complementary alternative since it does not increase the cost of health care by much.
Potential for homeopathy in the delivery of healthcare
The criticism leveled at homeopathy has significantly lowered its chances for inclusion into the delivery of healthcare. It has met with much resistance as practitioners point out ethical and safety issues in the practice of homeopathy. One of the most commonly cited concerns over homeopathic medicine is the case of patients failing to receive proper treatment for easily diagnosable diseases and diseases that can be managed with conventional medicine. Several patients are reported to have died as a result of this. There have also been reports of homeopaths advising patients against immunization, against the use of anti-malarial drugs and generally against the use of conventional medicine.
While the concerns maybe legitimate in the cases presented by critics, the benefits of homeopathy are also very real, making it a treatment modality worth investigating further. In a review by Steven Pray, the author recommends the inclusion of a course in unproven therapies and medications in which the ethical dilemmas in recommendation of such products can be discussed. The course should also include teachings on the point of divergence between complementary alternative modalities and conventional medicine (Pray, 2006). Edzar Ernst, a professor of Complementary Medicine who also used to practice homeopathy expresses concern over ethics violation by the failure of practitioners to provide consumers with the relevant and necessary information regarding the nature of homeopathic products (Baum and Ernst, 2009). He emphasizes on the need for honesty even as people are let to make their own choices regarding the use of homeopathic medicines.
The response to homeopathy has been mixed with some conventional health practitioners maintaining an open mind about its use while others have blatantly rejected and dismissed it as a potential treatment modality to some of the illnesses affecting the American population.
