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What’s in a word? “Integrative” versus “alternative” medicine, again

I’ve written a lot about the language issue with respect to alternative medicine. As I like to put it (at least in shortened form), first there was quackery. Quacks did not like that name at all, and thus was born alternative medicine. And the quacks did think it good—for a while. There was a problem, however. “Alternative” medicine implied (correctly, of course) that what was being discussed was not real medicine, and the quacks could not abide that. Thus was born “complementary and alternative medicine” (CAM).

And the quacks thought this very good indeed.

Unfortunately, it was not long before the problem with the term CAM became apparent. It had the word “complementary” in it. The implication of that word, of course, is that what they were doing was still somehow not real medicine. It was complementary to real medicine, the icing on the cake, if you will. Real medicine could do without it, and having that implication in the very name that their evolving specialty had taken on was offensive to the quacks.

So they changed it.

Thus was born “integrative medicine.” This was a term that eliminated all implication that quackery such as reiki, acupuncture, naturopathy, and the rest of the pseudoscience and antiscience that made up the bulk of the “alternative” medicine in complementary and alternative medicine was somehow lesser medicine. That it is lesser medicine—or not even medicine at all in most cases—bothered the quacks not at all. It was all about marketing, and “integrative medicine” implied a meeting of equals. More importantly, it could be sold as the “best of both worlds,” which sounds great until you consider that one world consists of medicine that works and the other world consists largely of magic. Few thought of that, however, and the term “integrative medicine” had the added bonus of being so amorphous that it could “integrate” just about anything, even what might or might not have been underutilized areas of real, science-based medicine, such as nutrition, diet, and exercise.

Thus, the term “integrative medicine” not only eliminated the stigma of being “alternative” or “complementary,” but it also facilitated the rebranding of perfectly science-based areas of medicine (like the aforementioned diet and exercise) as somehow being “alternative” or somehow unique to integrative medicine. It was a masterstroke of marketing, because diet, exercise, and lifestyle interventions can actually work (that is, when they’re not distorted beyond recognition by woo, which is part of integrative medicine) and therefore lend some of their legitimacy to the serious woo that has been “integrated” with them in the specialty known as integrative medicine.

But not everyone in the world of “integrative” medicine is happy about this state of affairs. John Weeks, for instance, just wrote a post in that wretched hive of scum and quackery, The Huffington Post, entitled In Defense of ‘Alternative Medicine’. Using the recent BMJ op-ed (no, contrary to how it’s portrayed in the press, it was most definitely not a study and did not add any new knowledge to the scientific to the literature) estimating there to be a quarter of a million deaths due to medical error, Weeks tries to co-opt the word “alternative” in arguing for a bit of a return of the word to describe what he has long promoted. (Note that version of a post about this BMJ article that I’ve written) will be forthcoming It’s also a reversal of sorts, given that he was very much into promoting the term “integrative medicine” not too long ago.

Basically, Weeks co-opts the word “alternative” by conflating the use of the word with respect to medicine and with respect to the bad things he sees in medicine. Basically, it’s a variant of the sort of false dichotomy I rail against not infrequently, the dichotomy that claims that to “fix” what’s wrong with “conventional” medicine one has to embrace quackery. Here’s a taste:

No — we sought and still seek alternatives to dehumanizing, production-centered, technology-oriented, natural process-denying, bulling disregard for the value of other professions and practices that an alternative “holistic” or “whole person” or “natural” or “mind-body” approach to what ailed us.

No one could argue that there are aspects of the way medicine is practiced right now can at times be dehumanizing. However, it is entirely possible to practice “holistic” medicine without embracing the quackery of alternative medicine. Similarly, there’s a reason why science-based practitioners have such “bulling disregard for the value of” of all those “holistic” professions. It’s because most of them are rooted in pseudoscience and practice quackery (e.g., naturopathy). Respect is earned, and what earns respect among physicians is excellent patient care based on the most rigorous science.

Next up are a several demands that mix the reasonable with apologetics for quackery:

We want an alternative to an opioid strategy such as that propounded by the CDC and the Obama administration’s 1.1-billion plan that denies the value of multiple non-pharmacologic, alternative and integrative approaches.

We want an alternative that says Never Only Opioids.

We want an alternative that says never only any long-term course of a drug known to have significant adverse consequences when used chronically if other approaches might limit the need or reduce the harm.

We want an alternative that focuses on health, well-being and healing.

The Obama administration’s plan doesn’t “deny the value of multiple non-pharmacologic, alternative and integrative approaches”; it focuses on strategies that have some science behind them supporting their efficacy and safety. I also note that, through his link, Weeks tries to co-opt the American Public Health Association’s (APHA) call for “provider training programs on mental health, non-pharmacological pain treatment alternatives, substance abuse and overdose prevention.” Unfortunately, the APHA does fall for the pseudoscience behind integrative medicine by suggesting “complementary and integrative care providers.” It irritates me to no end when what should be science-based professional societies fall for the message of alternative medicine providers.

Be that as it may, here’s the language sleight-of-hand going on here. When physicians say “non-pharmacological strategies” to deal with anything, they mean exactly that: strategies that don’t involve pharmaceutical drugs. However, they also mean science-based strategies that don’t involve drugs. That implication is unstated but there. When Weeks uses the term “non-pharmacological strategies,” what he means is alternative medicine, CAM, “integrative medicine,” or whatever you want to call the various forms of quackery that “integrative medicine” integrates.

He soon makes this clear:

We want an alternative to decision processes that exclude entire licensed practitioner groups — chiropractors, acupuncturists, integrative and naturopathic doctors, holistic nurses, massage and yoga therapists — when it is clear that millions of citizens of the United States are benefiting from their services every single day. Right now. This moment. Not awaiting Big Brother’s sanction.

There! That’s Weeks’ message, his real message. He wants to let the quacks in: chiropractors, acupuncturists, integrative and naturopaths. True, massage therapy doesn’t have to be quackery (although unfortunately massage therapists are prone to injecting a lot of woo into their ministrations, particularly “energy medicine”). Neither does yoga, at least when stripped of its mystical, vitalistic components, such as Kundalini. Stripped of Kundalini, yoga becomes nothing more than a form of exercise.

To confuse things further, Weeks “integrates” some reasonable “alternatives” along with his wanting to integrate alternatives that consist of quackery. His language, of course, is full of hyperbole, but the basic message, stripped of that hyperbole, is not too hard to get on board with.:

We want an alternative to the 5 minute or 15 minute office calls that drive physicians to prescribe drugs and flat-out deny the complexity of what got people in trouble in the first place, and the time needed to learn, and to unravel and resolve the issues.

Elsewhere:

We want an alternative to a payment system that puts the workaday wizards of change agency with people’s health processes at the bottom of the totem pole or, more likely, hatchets them off altogether.

We want an alternative to an industrial approach to payment and delivery that directly drives the morbidity and mortality reflected in those ugly data from the British Medical Journal. First, do no harm.

Who likes five or fifteen minute office visits for complex patients? Not very many primary care doctors that I know. Who likes the “industrial approach” to payment and delivery? Again, not very many doctors I know, if any. Here comes the false dichotomy again, though. The implication is that if you are not in favor of “integrative medicine,” you must be in favor of five minute office visits, reimbursement that doesn’t always cover expenses, and a dehumanized health care system. It’s nonsense, of course. Fixing the system doesn’t require embracing pseudoscience.

Weeks, however, wants you to think that it does, as he cleverly drops little bombs like these in:

We want an alternative to any medical doctors or other health professionals who lack a primary respect for the roles of nutrition, self-care, mindfulness, sleep, movement, environment, community and the actual science of supporting individuals to health.

Again, no good physician lacks a respect for these things. What he does lack respect for are modalities that have no science behind them, like reiki, acupuncture, reflexology, or most of naturopathy—and rightly so. No physician doesn’t want to support patients journey to health or to help patients remain healthy. Again, supporting patients’ health does not require embracing quackery or abandoning science.

Of course, that’s not Weeks is about:

We want an alternative, as Group Health Research Institute senior investigator Dan Cherkin, PhD recently argued to a still dominant focus of resources on reductive biomedical research and practice.

Of course, Weeks (and Cherkin) argue for getting rid of that pesky “reductionistic” science because it doesn’t support the efficacy of the quackery they want to “integrate” with medicine. It’s an old story. When science doesn’t support you, you start complaining about “reductionism” and then decrease the rigor of the science by combining interventions and getting rid of controls. If “reductionistic” science shows that, for instance, acupuncture and sham acupuncture are indistinguishable, it doesn’t mean that acupuncture doesn’t work, even though the same result for a real medical intervention would mean that intervention doesn’t work. Instead, it must mean we’re harnessing the power of placebo or that “complex interactions” are helping patients. In reality, such “explanations,” such as they are, boil down to nothing more than making excuses.

Weeks concludes by characterizing the “complementary” part of CAM as a “suck-up gesture, a way to “play inside the power-centers of the juggernauts, world views, and abiding priorities that daily generate the BMJ outcomes.” Of course, we who argue for science-based medicine and against the integration of quackery into medicine knew that all along. I’ve said as much. Language is the tool used by quack apologists and quacks to integrate their quackery into medicine. Even so, oddly enough Weeks actually likes the term “complementary” more than he does “integrative”:

The reframing to “integrative” was tap-rooted in the work of medical doctors coming from the alternative and natural medicine traditions, like Andrew Weil, MD. They were beginning to engage the daunting political-economic-medical work of reforming academic medicine from the inside. Diplomacy was required. “Alternative medicine” was a bold challenge. “Integrative” was reassuring. Regular medicine is still the center. You are still in the driver’s seat. The word has been a door-opener.

Yet these integrative medical doctor change agents in their self-definition call for a relationship centered system that is inclusive of all health professionals and disciplines, focused on health and healing. Would you say this is an “alternative” to what we have today?

“Integrative” has its value. But does it capture what is needed?

Maybe it’s because I’m a doctor, but I’ve always viewed the reframing of alternative medicine to CAM to “integrative” as the most effective single use of language used by people like Andrew Weil and John Weeks to persuade physicians that they really were “integrating” the “best of both worlds” into medicine and that the pseudoscience would be left out. Of course, the pseudoscience was not left out; rather the association between modalities like diet or exercise and the pseudoscience facilitated the integration of quackery even as quacky as reiki and other “energy healing” with medicine.

Finally, of course, contrary to Weeks’ assertion, integrative medicine will not decrease medical errors. The more rigorous application of science to the process of delivering care, rather than to just the discovery of new treatments, is what will. It won’t be easy as it is, and certainly integrating quackery with medicine won’t make it any easier, despite what Weeks wants you to think.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

98 replies on “What’s in a word? “Integrative” versus “alternative” medicine, again”

To see how silly “integrative medicine” sounds to those of us who love science, replace “medicine” with “physics” or “engineering.” Yes, people are much more complicated than objects, with emotions psychological needs. But the science of how the make and keep them healthy is not subject to different fundamental laws that other fields.

Orac:
“Weeks…cleverly drops little bombs like these in:
We want an alternative to any medical doctors or other health professionals who lack a primary respect for the roles of nutrition, self-care, mindfulness, sleep, movement, environment, community and the actual science of supporting individuals to health.

“Again, no good physician lacks a respect for these things.”

Um, I keep seeing a lot disrespect here for things like vitamin C, that readers here really have no clue on the actual physiological effects, applications and technology. Admittedly it’s not served on a platter in massive data blocks for an IND.

Food for thought on this patient: With timely IV vitamin C infusions and some of the other flu season supplements, he would have never had to go to the hospital in the viral stage. Not a chance.

Orac:
“Weeks…cleverly drops little bombs like these in:
We want an alternative to any medical doctors or other health professionals who lack a primary respect for the roles of nutrition, self-care, mindfulness, sleep, movement, environment, community and the actual science of supporting individuals to health.

“Again, no good physician lacks a respect for these things.”

Um, I keep seeing a lot disrespect here for things like vitamin C, that readers here really have no clue on the actual physiological effects, applications and technology. Admittedly it’s not served on a platter in massive data blocks for an IND.

Food for thought on this patient: With timely IV vitamin C infusions and some of the other flu season supplements, in the uncomplicated viral stage he would have never even had to go to the hospital. Not a chance.

@prn: as you’ve been told many times in many places: there are no GOOD studies that support your all claims for IV vitamin C. As has been noted, a few studies show it *may* work as an adjuvent for one type of cancer chemotherapy (sorry, I’m at work and don’t have the reference at hand). But your claim that it will cure everything, anywhere, anytime, is ridiculous and obnoxious.

We don’t ignore nutrition, as you put it. We respect – and account – for the body’s nutritional needs. We care about diet, exercise, smoking cessation, weight control, and other ways to improve a person’s health and well-being. We just don’t throw them into a “one-size-fits-all” treatment of BUY MY STUFF AND LIVE FOREVER.

@ PRN Honestly it’s like you only read one word out of ten in this article. Orac admits that nutrition is important for health. What Orac is arguing against is the conflation of scientifically proven treatments, with ‘alternative’ treatments that have been shown to be little better than placebos.

Secondly, oh my god! A rubbish current affairs show from New Zealand said man was cured by Vitamin C. Therefore it’s proven. Quick someone call Stockholm!!!

And before you start yelling, ‘wake up sheeple’, you should read this http://www.quackwatch.com/01QuackeryRelatedTopics/pauling.html

“integrative medicine will not decrease medical errors”
I am not convinced. Defining errors means that you are able to define the truth. These guys never commit errors.

@Orac,

You receive a promotion recently:

alternative promotion;
complementary promotion;
integrative promotion; or
science-based promotion?

It’s possible that each type of promotion, in variable degrees, applies to your particular situation.

Congratulations!

I’ve always viewed the reframing of alternative medicine to CAM to “integrative” as the most effective single use of language used by people like Andrew Weil and John Weeks to persuade physicians that they really were “integrating” the “best of both worlds” into medicine and that the pseudoscience would be left out. Of course, the pseudoscience was not left out

Sometimes it’s worse than that. There have been examples on this blog of “integrated medicine” that combines the worst of both worlds: one-size-fits-all treatment claims that have no supporting science whatsoever–in some cases the claims are so transparently ridiculous that even a layperson should recognize them as wrong.

The Vitamin C stuff prn mentions above is an example. Some people (including Linus Pauling) have claimed that megadoses of vitamin C will cure just about anything. It doesn’t. At least it doesn’t eat up your life the way some of the vegetable juice protocols do.

“Stripped of Kundalini, yoga becomes nothing more than a form of exercise.” That’s correct. In fact, “hatha” or physical yoga is not required to experience the kundalini. Without any knowledge of what it is or even what to expect when it ‘awakens’, many have experienced the force of the kundalini during the practice of meditation. But what if any therapeutic role it might have is not clear.

@PRN: “With timely IV vitamin C infusions and some of the other flu season supplements, in the uncomplicated viral stage he would have never even had to go to the hospital. Not a chance.” But you don’t and can’t know that for certain. I would be curious to see what other treatments the patient may have received before the i.v. and oral ascorbic acid.

If integrative medicine will reduce errors, then clearly it has recently undergone a profound change and now has objective mechanisms for detecting and correcting error. I look forward to seeing how homeopathy will fare when these new tools are used to evaluate the competing claims of classical versus combination homeopathics, for example – a long-standing schism can finally be healed as the new science of integrative medicine proves once and for all whether combination homeopathy is valid or whether only the classical similimum should be applied.

“Deny the complexity of what got people in trouble in the first place” can easily get into victim-blaming. I know at least” two people who are using opioids for chronic pain. In one case, the complexity of her situation is orthopedic weirdness that has been an issue for at least 40 years; the causes of the pain are not being ignored, but identifying them doesn’t magically make them go away, or even point to a cure. In the other, “the first place” was repetitive stress, and the surgery somehow made things worse instead of better. She has tried everything plausible, and a few that didn’t seem plausible but that her doctor wanted to try. What works, somewhat, is opioids, acetominophen, and NSAIDs; there are limits to how much of any of those a person can take safely. “Not just opioids” sounds good, but I don’t think any doctor is telling their patients “avoid those horrible NSAIDs and Tylenol and just use morphine,” though of course there are specific people who can’t use NSAIDS, and others who can’t use acetominophen.

*”at least” both because it’s something that people don’t always want to talk about, and because I don’t assume all my friends would even consider it relevant.

As a long-time pain patient, I am insulted when I read things suggesting acupuncture as a better treatment for my pain. When I read the new recommendations for pain treatment I was angry. Suggesting placebos?

My doctor has suggested what we might have to consider if the regulatory environment gets too ugly. It amounts to tapering off and going back to where I was before I started. We only ever medicated me well enough to reduce some obvious physical reactions to the pain level, not to end it. I would be so worn out ignoring it and working through it to make a meal, I couldn’t eat the meal after it was made. I would rest while my family ate, then clean up when I felt a little better.

“Here. Too many people are overdosing on narcotics, so we are taking them away and giving you acupuncture and homeopathy instead. We know we don’t have a definitive treatment for your illness; but if you believe enough that you are well, these treatments will work.”

Completely insulting.

@Gulbert #14: And the uncritical reference to avten month course of antibiotics for “Lyme disease” didn’t set off your bullshit alarm?

It needs a new battery.

From the Huffington Post article:
“Despite the crackdown, there isn’t a scientific consensus on kratom’s full range of potential benefits and dangers. People in Southeast Asia have been using kratom for centuries, if not longer, and thousands of Americans now tout it as a promising therapy for opiate withdrawal and an alternative to certain prescription drugs…”
To paraphrase Hammett. I “tried to count how many fallacies could be found in those…words, and had reached four, with promise of more…”
This is not science reporting. This is just shoddy yellow journalism. There are the weasel words, logical fallacies, anecdotes, and conflation of a known problem with a speculative remedy.
If the good folk at H.P. believe in it so much, they can afford to fund a real study, but they won’t. I predict that there will be little to no followup, and the Huffington Puffers will move on to the next flavor of the month in short order..

I don’t see how integrating woo into actual medicine will reduce medical errors when all of naturopathy is a huge error.
Let’s face it: Every one of those forms of quackery is just a puddle of runny pigshit, not worth the imaginary energy fields they tout, and in my less civil moments, instead of engaging them with facts and reason, I just want to tell them that and walk away.

Ahh, but you probably have never heard of kratome before now, Old Rockin’ Dave #15.

It is a plant. It is innocuous. It is now being gone after hard.

If you have it there today, we’re going to arrest you. If you call us, we’ll come get it but after today you will be put in jail,” said Etowah County Sheriff Todd Entrekin.

http://www.wtvm.com/story/31953208/crackdown-on-kratom-differs-county-by-county

The new designation of Class D felony, which took effect Jan. 30, includes a punishment of up to five years in prison.

http://www.al.com/news/huntsville/index.ssf/2016/05/north_alabama_da_warns_public.html

Many people were using it for pain and as a substitue for opioids; It is a plant.

I get that ‘drug warriors’ are dejected over rolling back of cannabis prohibition but come the fuck on already.

@Gilbert you say it’s a plant as if that makes it inherently safe and effective – obviously this is a core doctrine of the cult of naturopathy, but it is dangerous bullshit.

Hemlock and belladonna are plants, and ricin comes from the castor plant. Bein natural does not mean being safe and certainly does not mean being useful. Of course if this plant does have a worthwhile active ingredient then pharmacognosy will isolate it and separate it from impurities.

Reality-based approaches to safety rely on things like LD50, not bogus labels like “natural”.

I mean, that fascist prick Paul Ryan came out with a news conference this morning attacking the ‘problem’ of opioid medications:

The U.S. Congress took up that fight this week with a series of bills addressing a startling reality: the United States represents only five percent of the global population but Americans consume eighty percent of the world’s supply of pain medication. Opiate use in the United States has quadrupled since 1999, helped along by low cost and ease of access to opiate pain-killers and a lack of understanding about their dangers.

http://www.voanews.com/content/us-congress-opiate-pain-medication-abuse/3326371.html

And we have this concurrent crackdown on a plant (kratom) that helps people escape the big pharma deadly soma.

Doctors are going to go down over this… What will be their get out of jail free card? Not prescribing cannabis?

Food for thought on this patient: With timely IV vitamin C infusions and some of the other flu season supplements, in the uncomplicated viral stage he would have never even had to go to the hospital. Not a chance.

That 60 Minutes episode is notorious in NZ as a compilation of flim-flam and fabrication, from a program that seemed determined to become the TV version of the Daily Mail. It would be a source of journamalistic shame if there were such a thing. It was rubbish the last time it was mentioned at RI, and it’s still rubbish now.
ht_tp://respectfulinsolence.com/2014/09/05/high-dose-vitamin-c-can-cure-ebola-virus-disease-not-so-fast/#comment-368963

If the program was to be believed, the patient was suffering from leukemia which went away (because Vitamin C), but that diagnosis doesn’t seem to have existed outside of the reporters’ capacity for creative misunderstanding.

essentially the episode was a half-hour advertisement for a group of Vit-C-peddling / chelation consultants, the “Centre for Advanced Medicine”. I’m not sure if the practice exists any more… the doctors involved seem to have moved on to other forms of grifting.

““Alternative” medicine implied (correctly, of course) that what was being discussed was NOT REAL MEDICINE, and the quacks could not abide that. Thus was born “complementary and alternative medicine” (CAM).”

Orac, how would YOU define “*real* medicine”?

Following up on my last post…

At least what you call “quacks” usually put the words “alternative” or “complementary” before their “medicine”.

I give them points for that.

But no such luck in some other fields.
For instance, some “Christians” who are pro-gay “marriage”/pro-abortion/pro-divorce don’t even put “alternative” or “complementary” (or “whatever”) in front of their “Christianity”.
Yet they indeed practice a “whatever Christianity”.

In general though, I commiserate with Orac’s angst over the misuse of words, the twisting of words into meaninglessness, or perverting them into their opposite.

Some current examples:

‘The rich are not paying their “FAIR” share of taxes!’
Which is often wailed by the same people who on another subject proudly proclaim:
‘We are Pro-“CHOICE”!’

Ghastly.

See Noevo
“Orac, how would YOU define “*real* medicine”?”

Click on the category “Medicine” and when you have read those 3,540 entries, for comprehension, come back and see us..

Today on twitter: “Not $CAM but to CANT – Complimentary & Alternative Non-Treatment. It’s not #medicine.” Vince Ianelli MD.

I like this new acronym. I will use it until it becomes the default.

To Ross Miles #25:

I didn’t ask you.

I asked Orac.

I’ll ask again:

Orac, how would YOU define what you call “real medicine”?

I didn’t ask you.

I asked Orac.

Which only further emphasizes the fact that you’re trolling in an increasingly desperate bid for attention. This is superfluous, given that you’ve already demonstrated that you’re a neither more nor less than a proudly ignorant, frustrated piece of shіt who doesn’t even have the balls to seek pastoral review of your abominable on-line behavior.

Just fυck off.

Which only further emphasizes the fact that you’re trolling in an increasingly desperate bid for attention. This is superfluous, given that you’ve already demonstrated that you’re a neither more nor less than a proudly ignorant, frustrated piece of shіt who doesn’t even have the balls to seek pastoral review of your abominable on-line behavior.

Just fυck off.

all of this.

Gilbert, if you read a little more carefully, I was not discussing the merits of one plant or another. I was picking apart a typical example of what used to be known as “yellow journalism”, which today is known as “journalism”. Anyone who makes up their mind about kratom from it is seriously deficient in the reading for meaning department, a skill that should have been mastered by middle school.
“It is a plant. It is innocuous.” Many people were using it for pain and as a substitue for opioids; It is a plant.” Yes, I think it’s clear that it’s a plant. Your two statements suggest that because it’s a plant, that it is harmless. If so, it’s just plain stupid. Neither you nor your article

[Sorry, accidental key press up there.]
Neither you nor your article offer any real evidence that it’s safe or effective. If you want to beat the drums for kratom, come back with some evidence.
There really is nothing more to say, since it’s all irrelevant to the topic at hand.

Orac, do you consider psychiatry “real medicine”?

You know, the M.D.s who push profitable pills to the pleading depressives on about the same basis as blindly throwing darts? (Sure as hell, speaking of pointy things, even acupuncture seems more directed and precise.)

As I recall, they gave up on the Wizard (Freud) long ago and have gone on to a succession of “alternative” theories and studies which were/are controversial, contested, unconfirmed, un-replicated.

Those psych M.D.s have so many issues they’ll need a shrink.
Oh… wait a minute.

Do you know if “60 Minutes” got much flack from Big Pharma and the Shrinks for this piece?

Do you have any opinion on the “real medicine” of psychiatry?
Or do you focus only on certain other flavors of alternative medicine?

Hurrah! A game of fallacy bingo! I see straw man, non sequitur, begging the question, false dichotomy, poisoning the well and appeal to conspiracy.

Orac, do you consider psychiatry “real medicine” why don’t you respond to my prayers?

FTFY.

@See Noevo you are new to this game aren’t you? Anyone can answer a question here, and fifteen seconds of Googling will give the definition of science based (I.e. real) medicine.

MI Dawn@4 @prn: as you’ve been told many times in many places: there are no GOOD studies that support your all claims for IV vitamin C.
But there is better evidence for historical IV C claims than yours in total denial. You complain about “weak” for what we might call overkill (ahem!), when you have **nothing** for similar dosage ranges. You might realize what scientific quackery you all practice when you extrapolate 2-3 orders of magnitude with ***no data*** to say “quackery”. You really have no idea what’s what on acute viruses, like 150,000-200,000 milligrams of C per day (tid) for several days. Killing acute viruses with IV C has been a lot easier than stopping cancer, almost like a recipe book. We even had a 1 to 1 BSC control in one event. The biggest problem is 24 hr treatment out side a hospital, or infusion(s) and nurses across 16-18 hrs.

As has been noted, a few studies show it *may* work as an adjuvent for one type of cancer chemotherapy (sorry, I’m at work and don’t have the reference at hand). But your claim that it will cure everything, anywhere, anytime, is ridiculous and obnoxious.
I don’t claim “…cure everything, anywhere, anytime”. Merely surprising breadth and benefit (to you all) with a lot of potential cures. http://www.medfoxpub.com/medfoxnews/Primal_Panacea_Chapter_1_Excerpt.pdf

We don’t ignore nutrition, as you put it. We respect – and account – for the body’s nutritional needs.
This is patently false. Life Extension Foundation’s measurement of vitamin D blood levels during the last few years show that many people, even those supplementing, were inadequate. Blood levels, or even urine levels, of vitamin C don’t even get measured in most situations that it has been badly depleted by cancer, surgery, trauma and infections. Mainstream ignores these oversights, else the C and D deficiency fusses would have been over decades ago.

We just don’t throw them into a “one-size-fits-all” treatment of BUY MY STUFF AND LIVE FOREVER.
I’d say for mCRC what I’ve seen for 5+ years, “one-size-fits-all” std of care: “BUY MY STUFF AND die envying a dog” might be closer. The fighters who mix (integrate) intelligently got better treatment and results, Imho. Papers do show there are examples with better cancer kill with integrative chemo, with far fewer side effects.

@prn: one minor problem – the Life Extension Foundation are in the business of selling product. That’s why their nonprofit status was revoked.

Lighthorse
@PRN: “With timely IV vitamin C infusions and some of the other flu season supplements, in the uncomplicated viral stage he would have never even had to go to the hospital. Not a chance.”
Lighthorse”
But you don’t and can’t know that for certain. I would be curious to see what other treatments the patient may have received before the i.v. and oral ascorbic acid.

Certainty is here degrees and kinds of certainty.
Non-complicated flu with full dose IV vitamin C (and oral D3 etc) was considered about like hunting a squirrel with a 30-06.

#21 herr doktor bimler
My flu comment is based more on Klenner, Cathcart’s and others writing than the NZ story other than Allan Smith existed, nearly died.and then recovered while using C.

#5 GiJoel
Secondly, oh my god! A rubbish current affairs show from New Zealand said man was cured by Vitamin C. Therefore it’s proven. Quick someone call Stockholm!!!
Actually if you have IV vitamin C available, much better is a commonplace. Allan Smith was lucky to escape with his life. For me, the film showed the extreme hazards and brutality of skepticism from delay and denial for something we would consider an annoying but almost trivial application of IV vitamin C.

Oh, prn. You just made me laugh so hard. Thanks!

Life Extension Foundation? As if THEY are a totally unbiased group? That’s like telling me that all of the labs that do ALCAT testing are SOOOOOO very unbiased and altruistic. I’d keep laughing, but I feel too sorry for the poor suckers who spend hundreds and thousands of dollars out of pocket for this crap.

(By the way…part of my job consists of reviewing labs and procedures for effectiveness and cost. So I’m very familiar with many of the testing labs that change their names like they change their addresses).

@Guy Chapman:
No, See Noevo isn’t new to this game at all, he’s been doing it for years. He just so obviously feels he already knows everything that he has no need to learn.

My flu comment is based more on Klenner, Cathcart’s and others writing than the NZ story other than Allan Smith existed, nearly died.and then recovered while using C.

Can we agree that the NZ “30 Minutes” segment has no evidential value, apart from demonstrating that TV journamalists can be lazy incurious sensationalist barmpots with no interest in facts or sources that might fail to fit their chosen narrative? (I think everyone already knows that).

The term integrative is also very close to the word integrated, one of the terms being used to describe the effort to combine mental and physical health care into primary care.

https://www.psychiatry.org/psychiatrists/practice/professional-interests/integrated-care

I find that very subtle of them and expect the two to be conflated in people’s minds when reading the popular press.

SN, know of any alt med practioners who routinely cure, or even manage, psychosis, mania and catatonia?

MI Dawn@41,42
The problem seems to be your bias, perhaps too close see the forest.

LEF gets contracts with Qwest or LabCorp for testing. Vitamin D testing is not in the same category as ALCAT testing. Modern times have a pandemic of vitamin D deficiencies, even by the most stupid standard like 20 ng/mL much less 30-32 ng/mL.

Your might find this Siemens lab paper instructive. Basically they are saying an RDA of 2400 iu of vitamin D2 might be close to ok for a 20 ng/mL (based on bonehead bone studies alone) but not 30-32 ng/mL of endocrinology and pediatric societies. This paper used only 20 individuals for 139 points. The “healthy” population edge prone to vitamin D deficiencies is not well examined at all, much less those with incipient cancers like CRC.

Who knows?
Maybe someday psychiatry will be transformed and actually be considered scientific, maybe even real medicine.

“WELCOME to the future of psychiatric diagnosis. It will be based on science, and will look nothing like today’s Diagnostic and Statistical Manual of Mental Disorders. The DSM, the profession’s “bible”, has dominated medicine’s approach to mental illness for 60 years…”

https://www.newscientist.com/article/mg21829164.000-how-a-scientific-dsm-will-transform-psychiatry/

Shrinkdom may need a boot in the…

“The US National Institute for Mental Health (NIMH) said the DSM-5 had so many problems we effectively need to tear it up and start again. The way forward, it said, is a new research programme to discover the brain problems that underlie mental illnesses…
Criticism of psychiatry has been growing for years – existing treatments are often inadequate, and myriad advances in neuroscience and genetics have not translated into anything better. Vocal opponents are not confined to the US. Last week, the new UK Council for Evidence-based Psychiatry launched a campaign claiming that drugs such as antidepressants and antipsychotics often do more harm than good.”
https://www.newscientist.com/article/dn25509-psychiatrys-scientific-reboot-gets-under-way/

Does anyone have a clue (or really care) why SN is babbling about psychiatry?

MI Dawn,

It’s all that Guy Chapman @ 34 wrote but I took the bait by asking SN a question – just because it bothers me when a relatively young field of medicine without many resources outside of Big Pharma is used as a whipping boy whenever there is a discussion on what is science based and what isn’t in the medical field.

In another context it is a valid discussion to have but I don’t know why the ‘sins’ of psychiatry would make up for the phony treatments in CAM/CANT. It also prompted me to think about what an alt med practioner would do for symptoms psychiatry routinely treats such as psychosis and mania or rarely sees but is severe such as catatonia, and if there is enough money in it for quacks to even bother.

SN – I’ll read more about alt med in psychiatry. You peaked my interest in the subject; I’ll give you that.

Ar first glance, I see the Mayo clinic is referring to it as using nonconventional vs conventional approaches. One more way to refer to this garbage, I guess.

@HDB
How did they manage to have a Nobel prize winner and some credible scientists?

Well, it’s undoubtedly the OMICS gang — scroll down to the bottom of their garish blinking-lights site to “View Proceedings of Previous Conferences”
http://integrativebiology.conferenceseries.com

How did they manage to have a Nobel prize winner? I’m guessing that they offered her money and lied to her about the predatory purpose of the meetings.

How did they manage to have a Nobel prize winner

Ada Yonath does not seem to be especially discriminating about the sources of her Plenary Speaker gigs. As well as allowing OMICS to buy her reputation for turd-polishing purposes, I see that she’s a regular speaker for the yearly “Drug Discovery and Therapy World Congress”:
http://www.ddtwc.com/abstracts.php
along with a string of other Nobel laureates.

DD&TW is the conference-scam branch of the Bentham predatory publishers, and an indication of its legitimacy is the odd fact that the same conference — same dates, same venue, same speakers — is also advertised as the Global Biotechnology Congress, to double the number of suckers.
http://www.globalbiotechcongress.com/index.php

SN – I’ll read more about alt med in psychiatry.

Has S.N. actually recommended “alt med”? He appears to simply be on some random anti-psychiatry trip (although one might wonder about the motivation for its sudden appearance).

Denice and I, at very least, could go on about the history of this movement, but S.N. is just whining like a bitch in heat without advancing an alternative.

I thnk S. N. is jealous because there’s a 500+ comment thread he’s not a part of and hopes if he flings about enough topics, one will catch on.

To Emma Crew #61:

“I thnk S. N. is jealous because there’s a 500+ comment thread he’s not a part of…”

Which thread would that be?

“… and hopes if he flings about enough topics, one will catch on.”

You seem to be implying that my posts here are off-topic.
I don’t know why you’d think that.
The topic of Orac’s article is quackery/alternative medicine/integrative medicine vis-à-vis “real medicine”.

I’ve asked Orac to define in his own words what “real medicine” is.

Secondly, I’ve asked him if he considers psychiatry to be real medicine, and if he sees the plethora of problems with it that I and many others, even within the field, see.

Both questions are on-topic.

Both remain unanswered by Orac.

P.S.
Don’t forget to tell me about that 500+ post thread.
I may have something to add.
Maybe it will even be as captivating as this 2100+ one:
https://www.respectfulinsolence.com/2015/07/27/when-the-antiabortion-movement-meets-the-antivaccine-movement/

“I thnk S. N. is jealous because there’s a 500+ comment thread he’s not a part of…”

Which thread would that be?

This neatly encapsulates S.N.’s narcissistic, trolling mentality, as if there were any more need: the only comment threads are S.N.’s threads.

You seem to be implying that my posts here are off-topic.

You seem to be ignoring the fact that your random babbling about psychiatry has been noted as such well before Emma Crew’s comment. But, being a coward – as amply demonstrated at Ethan’s and by your completely moronic “Do Not Call/No Fly” routine – that’s your shtick.

MI Dawn, off his meds again?

I don’t even have that as an excuse. Sigh.

Though when the health insurance stops abruptly (soon) we’ll see.

I can probably get on what a friend calls the “poor people insurance” pretty quickly, I hope.

JP, I hope you are doing well, my comment was not directed at anyone who is trying to make their life better. Hang in there.

Boy, talk about going off-topic. What’s with JP #64?

But since YOU brought up the issue of getting health care insurance, JP, and maybe getting on “poor people insurance”, you better try to get it while you can.
Because a judge just ruled against another unconstitutional aspect of Obamacare:
http://www.usatoday.com/story/news/politics/2016/05/12/federal-court-obamacare-president-obama-republicans/84281474/

P.S.
So, you’re currently ON meds?

I, for one, would nominate S.N.’s #64 as ban-worthy, which is why I’m going to put this into the mod queue by not obfuscating the suggestion that he fuck off and die in a fire.

There are respected members of the commentariat, and then there are geysers of shit such as S.N.

JP, I hope you are doing well,

Been better. Everyone keeps reassuring me things will work out one way or another.

So, you’re currently ON meds?

Yep, three or four. What about it?

From the article quote: The ruling does not represent as big a threat to the health care law as two previous conservative challenges swatted down by the Supreme Court in 2012 and 2015. The first would have gutted the law; the second would have eliminated tax credits in many states.

Also, this was a ruling from a district court judge and has little if any affect outside of the district.

SN go back to your dark corner and do what you do best: JAQ off.

JP, don’t let a shrew like SN get to you. Hopefully, we’ll have a decent day tomorrow. If we do; I think I’ll head up to the Olympic NP and enjoy the place.

@ HDB
Is Global Biotechnology Congress related to Integrative Biology?
They seem to have a caught a bunch of Nobel laureates.

JP: “I can probably get on what a friend calls the “poor people insurance” pretty quickly, I hope.”

Le sigh. It is what folks who work for companies that are too cheap to provide benefits. Some deliberately cut the employees hours to less than 38 hours per week so they do not have to provide health benefits. Plus there are lots of people who work for small companies that get Apple Health, though they have an actual monthly fee.

There should be no stigma if you get Apple Health. Just be glad this is a state that provides it, unlike Idaho. Don’t let anyone belittle you about. Plus, you are a graduate student, that is a basic definition of a “poor person.” (been there, done that, and dropped out of grad school twice!).

Is Global Biotechnology Congress related to Integrative Biology?
They seem to have a caught a bunch of Nobel laureates.

No, they are competing grifters.
I begin to suspect that Nobel laureates are just as venal and willing to prostitute themselves as everyone else.

JP, the manufacturers may have a Patient Assistance Program that will cover your meds gratis (until Apple Health kicks in). Most have a fairly straightforward, sometimes online application.

Best,

@JP: I know it’s a trite statement, but please hang in there. I’ve been where you are – though not as deep – and I know how hard it is to climb out. And know that we here care a great deal about you. You are funny, intelligent, and very worthwhile knowing (even if it is just through the internet). And ignore SN, since, to him, we women have no other use than wombs.

And before you ask, SN, I’ve been very lucky to have been able to get off those meds. Many need them for life, and those who do have all my support. I’d rather my friends be on medications and alive than off medications and dead.

@ HDB “I begin to suspect that Nobel laureates are just as venal and willing to prostitute themselves as everyone else.”
And maybe they realize that the business model of this type of congress is the same as the usual one.

Are you on the three or four meds for depression?
If so, firstly, good luck with that alt medicine.
Secondly, does your depression in *any way* relate to this?

You’ve reached a new level of evil sn, belittling someone simply to link to another of your misrepresentations. You truly have no decency.

Plus, you are a graduate student,

Well, was, really. I’m planning to notify the department and my advisor when my mom and I go back to move me out in early June.

Sigh. Oh well, sh!t happens.

^I actually still have pretty good insurance at the moment; I’m not sure how quickly the coverage will end once I’m not enrolled. Pretty quickly, I imagine.

My friends assure me that it should be pretty easy to get on Apple Health, and yes, I’m lucky to be in a state that provides it.

And know that we here care a great deal about you. You are funny, intelligent, and very worthwhile knowing (even if it is just through the internet).

Thanks. I need to keep reminding myself that this only feels like the end of my life, that I’m still young, there are lots of possibilities ahead of me, etc. (Though some of those possibilities are not fun to contemplate. I guess I already avoided some of the worst things that could have happened during the manic episode, like ending up on the streets or in jail or whatever.)

But since YOU brought up the issue of getting health care insurance, JP, and maybe getting on “poor people insurance”, you better try to get it while you can.
Because a judge just ruled against another unconstitutional aspect of Obamacare

Which I’m sure S.N. approves of, but as usual, he’s too fυcking stupid to understand that it has nothing to do with the topic at hand, which has already been addressed by the Supreme Court. (Hint: What is Apple Health?)

“Which I’m sure S.N. approves of, ”

Since sn has stated that if poor people are unable to obtain insurance they should become “not poor”, or else simply die, I’m sure he does approve of it.

Since sn has stated that if poor people are unable to obtain insurance they should become “not poor”, or else simply die, I’m sure he does approve of it.

Extra irony points for his inability to obtain a wife.

I didn’t think SN was advocating alt med for psych issues. It just made me curious about what was out there. So far I see similar to what Orac states. Therapies such as Vit D and exercise are touted as alt med with no mention that the studies proving any efficacy would make them evidenced based.

“Since sn has stated that if poor people are unable to obtain insurance they should become “not poor”, or else simply die, I’m sure he does approve of it.”

That would make him Not. A. Christian.

JP, not sure about Apple Health but I think it applies to any Medicaid managed care program that they cover any bills 3 months prior to the application date.

To Not a Troll #85:

“I didn’t think SN was advocating alt med for psych issues.”

Then you probably thought rightly.
SN was advocating or proposing that *psychiatry itself* is an “alt medicine”, i.e. not “real” medicine.

““Since sn has stated that if poor people are unable to obtain insurance they should become “not poor”, or else simply die, I’m sure he does approve of it.”
That would make him Not. A. Christian.”

Yes, it probably would.
But that’s not what SN states or believes.

SN was advocating or proposing that *psychiatry itself* is an “alt medicine”, i.e. not “real” medicine

Many do. I’m not qualified to make that determination but the pragmatist in me will defend skilled and compassionate psychiatrists because they go where angels fear to tread.

But that’s not what SN states or believes
I’m glad you clarified. Even though I’m not qualified in this area either, there’s too much in the Christian Bible about the poor to think that bootstrapping or dying off is something it promotes.

JP, do what I did, go to your nearest DSHS office and tell the navigator at the input desk that you need help. Trust me, they will tell where to go to wait, wait, and wait some more.

Bring a book or a device to watch video. It will take some time. But it is time well spent, because they will take care of you. Most of these state employees are quite lovely people.

This is exactly what I did a bit over a year ago, and I am still navigating the system to help my autistic son. My “go to” phrase is “help me, I have no idea what I am doing.” Apparently that works.

Even though your circumstances are different, that might be useful. Good luck, just try to go with the flow.

And bring a book or video for the wait.

“I didn’t think SN was advocating alt med for psych issues.”

Then you probably thought rightly.
SN was advocating or proposing that *psychiatry itself* is an “alt medicine”, i.e. not “real” medicine.

*plonk*

Jeezums, I’ve been mistyping my E-mail address all day long. One-word comment in moderation.

@JP: Unless you really want rank Catholicism thrown at you, don’t bother.

Short version: Kris was raised Catholic, asked too many logical questions, was shut down for questioning the orthodoxy. Rebelled because of that and became a scientist, was in the military (division not specified), agnostic/atheist until her suicide attempt after her marriage failed, when God reached out to her and saved her life. She now does lots of talks about God saving people. (and yes, she’s Catholic again). She’s a great catch – one of those “redeemed” atheists.

Personally, I dislike testamonials, so I refused to listen to the show. If you like them, go for it.

“Personally, I dislike testamonials…”

“I’ve been where you are – though not as deep – and I know how hard it is to climb out.”

Thanks for your testimony, sister MI Dawn.
……..
To JP:
At that same website you can find the audio from two other ex-atheists and an ex-agnostic.

Thanks for your testimony, sister MI Dawn.

wow, you really slapped down that raging hypocrisy… or, i mean, maybe MI Dawn sees a difference between a few words of encouragement and 60 minutes of propaganda, but idno, I’m going with you and saying hypocrisy.

[…] Such amenities and services requested by donors become available for all patients and can improve their treatment experiences. But in the past decade, many cancer centers found competitive advantage in offering a full range of unproven and disproven alternative treatments. Sometimes donors specifically requested that such services be established. The availability of complementary alternative medicine (CAM) became a selling point. But then, a name change was required. As the pseudonymous cancer surgeon blogger Orac noted: […]

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