Friday 13 August 2010

Your Toothbrush, Sir?

Last night to Llandovery for a delightful meal with friends including a good discussion on alternative or complementary medicine. I can't be shaken from a position that all treatments, traditional or modern, herbal or chemical (if that distinction means anything), should be assessed against the same evidential standards for both efficacy and risk. It is the government's and its agencies' job to ensure that there is fair play in such assessment, taking care to see through the vested interests of the pharmaceutical industry and the retailers of herbal remedies alike; they should also not be swayed by the privileged media-exposure of high-profile amateurs like Prince Charles - there is no more reason to give weight to his view of homoeopathy (for example) than that of the valet who puts the toothpaste on HRH's brush.

Of course it's a free country and people should be able to take what they want to treat themselves so long as (i) the supplier does not make claims which are not substantiated by the evidence and (ii) the substance or treatment supplied does not pose risks at a threshold where it should be on prescription or banned altogether.

Consumer choice and opinion are often advanced as arguments to qualify the test of effectiveness but there are surely limits to this. I recollect a recent TV programme which demonstrated that big brand pain-killers were "more effective" because people believed in them more than the identical supermarket brand products. That may be so but you won't convince me that the NHS should pay £3 for a fancy-packaged version of something which is 16p in Asda (and indeed they don't). Rather we need to educate people not to be gulled by advertisements showing headaches dissolving diagrammatically before the grateful consumer joins their friends at the disco.

Hafal rightly promotes choice in both medical and non-medical treatments for mental illness (interestingly most of the popular alternative treatments are medical) but with a firm eye on the evidence. See our treatment guide here, including information on alternative or complementary options, and our recently-updated specialist guide on anti-psychotics here. We also facilitate where possible alternative or complementary treatments which our clients want. I recollect sampling aromatherapy in one of our services and can bear witness to the therapeutic value to my mental well-being (and this is supported by evidence) of getting a gentle massage from an engaging practitioner with a pleasing fragrance in the air. However, there is no compelling evidence of the effectiveness of aromatherapy per se.