Clinical trials are performed with a randomized sample of several thousand people before statistical significance is achieved and a drug is approved for sale, but all of a specific medication's side-effects will never be known with one hundred percent certainty until after the drug has gone to market and has thus been prescribed to several hundred thousand people... Point-and-case, Vioxx, or Yaz to take two recent examples.

And this is to say nothing of the various "interaction" effects that occur when two or more drugs are prescribed concurrently, with little to no research about how that particular "cocktail" effects which type of person.

>> ^westy:

so much retarded spin on this , This presentation style is very irresponsibly considering the type of people that this is aimed at probably don't understand science very well.
statistically the majority of medicen when proscribed correctly does better than the non usage of it and the drugs go through huge triles that takes years , but this documentry skips over those pionts to focus on random emotional things and hypes the danger.
i dont get the need to spin this as good and evil.
"I actualy got pregnent on the pill " ( well probably because u didn't take it correctly)

For such an opinionated journalist, she didn't make any scientific effort to prove that they don't work. That there's no active ingredient left is very, very compelling evidence against it, and I strongly doubt that homeopathic medicines have any effect at all, but none of this report proves that they don't work.

The sceptics standing outside the hospital provide evidence that homeopathic sleeping pills don't knock you unconscious, but it doesn't say on the bottle that they will knock you unconscious. We're just accustomed to Adavan and Imovane doing that, because that's how they work. The homeopathic stuff may help people sleep in another way. Exercise during the day, for example, helps me sleep well at night, as do light stretching and warm milk and honey before bed. And no amount of those would make me need to go to the hospital. So that whole line of reasoning is unscientific and misleading.

While we're invoking science, and using it to prove or disprove a claim, the only way to conclude that a medicine does or doesn't work is a double-blind placebo test with people who have symptoms that should be treatable by homeopathy, just like any other medicine. Do that, and I'll be satisfied. Don't do it, and they're both just blowing smoke. In fact, as it stands, without any clinical trials, users who claim it works at least have some evidence of success.

There is so much unknown science and medicine, that it's possible that they do work, just in a way that we don't yet have a medical model for. I doubt it, but that's the difference between being sceptical and being cock-sure without evidence, like this journalist.

A great organization:

MAPS (Multidisciplinary Association for Psychedelic Studies)
MMAPS' mission is 1) to treat conditions for which conventional medicines provide limited relief—such as posttraumatic stress disorder (PTSD), pain, drug dependence, anxiety and depression associated with end-of-life issues—by developing psychedelics and marijuana into prescription medicines; 2) to treat many thousands of people by building a network of clinics where treatments can be provided; and 3) to educate the public honestly about the risks and benefits of psychedelics and marijuana.

MDMA for PTSD
MAPS’ top priority project is funding clinical trials of methylenedioxymethamphetamine (MDMA) as a therapeutic tool to assist psychotherapy for the treatment of Posttraumatic Stress Disorder (PTSD) and other illnesses. Preliminary studies have shown that MDMA in conjunction with psychotherapy can help people overcome PTSD. MDMA has empathogenic effects, and it is also known as the popular drug Ecstasy (although "Ecstasy" does not always contain pure MDMA). In laboratory studies, MDMA has been proven sufficiently safe for human consumption when taken a limited number of times in moderate doses.

LSD/Psilocybin for Anxiety Related to Life-threatening Illness
LSD is short for d-lysergic acid diethylamide, and was discovered to be a psychedelic substance by Dr. Albert Hofmann on April 19, 1943. Psilocybin is a psychedelic compound also discovered by Hofmann which are found in psychedelic mushrooms. These mushrooms have been used for thousands of years by a variety of indigenous cultures for a variety of religious and therapeutic purposes. Both of these substances are well known for eliciting personal growth and mystical experiences in people who use them wisely. MAPS is interested in these substances for their potential to help people with a variety of conditions. Currently we are focused on developing these drugs into prescription medicines to treat anxiety associated with life-threatening illnesses.

Though there has been substantial prior research with LSD in cancer patients that demonstrated safety and some degree of efficacy, that research was conducted over 35 years ago. In order to generate data that will be accepted by today’s regulatory agencies, new protocols must meet modern drug development standards. Our research has had to start from scratch and has been designed carefully. Our LSD and psilocybin studies will be used to guide the development of future treatment approaches.

When it comes to psychiatric diseases, there really is no good way to treat them. Almost every single drug we give has side-effects that can be lifethreatening, but, as @Stormsinger said, it's a calculated risk taken by the doctor to treat a disease that we're not really able to treat.

There are different schools of thought when it comes to the treatment of psychiatric patients, and right now the predominant one is medication (it used to be a labotomy). Unfortunately this is not an exact science because consciousness is so intangible and I'd argue almost immeasurable.

So as I do agree with the first part of what Stormsinger said, I'm compelled to disagree with the second part because this is the only way that we can really tell if these drugs/methods work or not. That's the unfortunate part of medicine, where theory can only take you so far and you need clinical trials to test hypothesis. Maybe one day in the future this will not be necessary, but so far it's the best we've got.

>> ^Ryjkyj:

"These results suggest that the incidence of these cancers may be decreased by reducing the prevalence of smoking, gastroesophageal reflux, and being overweight and by increasing the consumption of fruits and vegetables."
"...no study has comprehensively examined their contributions to the cancer burden in the general population."
And I'm sure the fact that it's what his father died of is just pure coincidence?
Lucky for me though. Even though I smoke, I also eat pizza:
http://www.ncbi.nlm.nih.gov/pubmed/12949808
...so the two should cancel each other out right?


No. Reflux is a major risk factor for adenocarcinoma, a different disease than what Hitchens has. Smoking and drinking account for the vast majority of squamous cell carcinoma.

Genetics is important in certain kinds of cancer, like breast or colon, but it plays a much smaller role in this particular disease than smoking or drinking. Considering that Hitchens does not have any of the other risk factors, such as notable esophageal disoders, smoking and drinking are almost certainly what caused his cancer.

And yes it is impossible to ethically conduct clinical trials to definitively prove the causation between smoking and drinking and cancer. However, the science and world wide epidemiological data supporting this causation is overwhelming. Hitchens, a man of reason, has taken responsibility for his disease, but you still seem to be in denial. In any case, there's no need to bring the straw man into this discussion, as we are talking about a completely different level of evidence.

>> ^m00t:

SSRIs have some very adverse side effects in a non-trivial percentage of the population which typically include increased aggression and suicidal behavior. Frankly, SSRIs should be banned. They're often more harmful than good and there are alternate medicines that work as well or better with fewer side effects. For medications such as Zoloft the clinical trials were heavily manipulated where patients that committed suicide were removed from the results after the fact, even though the suicide rate for the control group was significantly lower.
Gun owners on SSRIs should have their guns taken from them until they are safely off the medications (after withdrawal symptoms have subsided) and then returned, no questions asked and no records.


Imposter!

SSRIs have some very adverse side effects in a non-trivial percentage of the population which typically include increased aggression and suicidal behavior. Frankly, SSRIs should be banned. They're often more harmful than good and there are alternate medicines that work as well or better with fewer side effects. For medications such as Zoloft the clinical trials were heavily manipulated where patients that committed suicide were removed from the results after the fact, even though the suicide rate for the control group was significantly lower.

Gun owners on SSRIs should have their guns taken from them until they are safely off the medications (after withdrawal symptoms have subsided) and then returned, no questions asked and no records.

Chiropractic is NOT joint manipulation, it is not sports massage, it is not physiotherapy. It is the spiritual belief that bodily ailments are caused by "subluxations" - misalignments in the spine - that interrupt the flow of life-force energy to various areas of the body. Now, some people who call themselves chiropractors do also practice sports massage and physiotherapy alongside (or even instead of) this energy-medicine quackery, and they may well provide excellent treatment of injuries and disorders within those fields.

But I say again, that's not chiropractic, which is an unscientific, evidenceless alternative medicine technique, the purported benefits of which simply disappear under clinical trials and systematic reviews. While spinal manipulation may benefit back pain, it also poses risks, especially in children. I would not let my baby's developing spinal cord be shunted about by what is essentially a witch-doctor in a white coat.

There really isn't a placebo "effect" as much as there is a placebo process. Otherwise, my sugarpill supplements called "Placebos" would have taken off.

The idea was, any clinical trial has about a 30% responsiveness to placebo. If the placebo process occurred 3 out of 10 times when studying a headache medication, anytime you have a headache, just take 12 placebos!

Simple.

Statistician on clinical trials? You've just admitted to being a professional liar. Also, you've just admitted to the source of all your bias.

I use my powers for good - not evil... ...unlike political statisticians or CLIMATE scientists.

>> ^Winstonfield_Pennypacker:
And leave us not forget that the reason it costs these companies so much money to make even a single drug is - that's right! - GOVERNMENT. The FDA regulations & requirements for drug companies are ridiculous. Yes you want drugs to be safe and tested. But the process today is so labrynthine and difficult that it is almost impossible to get a drug out of testing without around 20 YEARS (!!!) of testing. As a guy who works as a statistician for clinical tests, I can tell you that even small tests are not cheap. Every drug that goes through the FDA chipper/shredder must have literally dozens of large scale longitudinal tests performed. And if the results don't satisfy even ONE of those bazillions of FDA rules then back to the lab you go to start all over again.
You want to know why drugs are so expensive in America? It isn't because "Big Pharm" is trying to rape you. It is because they are trying desperately to recover from the raping they got from government. You want to drop drug prices by 50 to 75% in a day? Abolish the FDA.


Statistician on clinical trials? You've just admitted to being a professional liar. Also, you've just admitted to the source of all your bias.

All your bias are belong to us!

On the topic of swine flu vaccines, Maher doesn't know what the fuck he's talking about. And that's even with some major issues to criticize, especially with pretty significant gaps being jumped in the FDA's clinical trials (relying instead on foreign trials, which are of variable reliability) right now because of the rush to get vaccines to market in preparation for if/before shit can hit the fan.

Maybe he's reasonable in questioning the many biases (social, governmental, corporate, etc.) that can influence the adoption of particular vaccines, but it's easy to handwave and fingerpoint without examining any clinical data, the kind of stuff Maher clearly hasn't even farted in the direction of much less mulled over himself.

Also Frist is delusional if he thinks the US has the best healthcare in the world. Then again, this is the same asshole who gave a completely incorrect, uninformed opinion on Schiavo's PVS based on an hour or two of video footage of her.

guymontage: an interesting point; pharmaceutical companies need to know the mechanisms, risks, and effects of medicine before they release them ( via FDA, clinical trials and lab tests )

While I agree, on the whole, with everything you said.. the fact that the FDA approves these medicines is not really saying much.
http://www.nytimes.com/2008/11/18/health/policy/18fda.html?_r=1
http://www.cnn.com/2009/POLITICS/01/09/fda.scientists/index.html
http://www.ucsusa.org/scientific_integrity/abuses_of_science/summary-of-the-fda-scientist.html

the FDA is pretty damn corrupt.

Bill is funny, but his views on alt. med are wrong. When he states that treatments we've been using for 50 years haven't worked at all, he is dead wrong. Cancer is much too complicated to practically wipe out with a single solution, like polio or small-pox.even still, for white people the survival rates for cancer has gone from 39 percent in the 60's to 62 percent in 1998; this despite the cancer rates having increase (National Cancer Institute, Cancer Rates and Risks, 1998). I’m not sure where they are at now in 2009 but you can bet its better.

PS, they have been increasing for other races too, but for what ever reason, whites have increased the most.


I dont know if rotty is trying to point out another fallacy or if he is actually perpetuating it; surprise results in clinical trials does not mean "big pharmas (doesn’t) know WHY things work in many cases.". The end result might not be the same as the initial intent before and after the trials, but that’s how a lot of discoveries are made, and they might not have initially known the mechanism behind the end result, but they know the mechanisms by the time it is released on the market, that’s what the FDA requires by law of them. Teflon, microwaves, penicillin and Viagra where all accidental discoveries, but we obviously now know how they work and did know how they worked before they were released.

an interesting point; pharmaceutical companies need to know the mechanisms, risks, and effects of medicine before they release them ( via FDA, clinical trials and lab tests ) but alternative medicine companies ARE NOT REQUIRED TO TEST, PROVE OR UNDERSTAND THE MECHANISMS OR RESULTS THEY CLAIM OF THEIR PRODUCTS! simply because the legal classification of "alt. med".

gwiz, i don’t know if you heard this, but you may be pleased to know (since we are definitely on the same page on this), that acupuncture has been proven no more effective that a placebo; double blind studies have shown it doesn’t matter if you puncture the skin in the "appropriate places"(according to acupuncture techniques), if you puncture the skin in random places, or if you don’t puncture the skin at all (using "stage knife" needles that only look like they are puncturing); there is no difference! This means that the only benefits you get from acupuncture are merely placebo and not medically valid.

http://www.time.com/time/health/article/0,8599,1897636,00.html

http://www.ncbi.nlm.nih.gov/pubmed/19250001?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDoc
Sum

http://www.sciencebasedmedicine.org/?p=1518#more-1518

Yeah, i have a serious hair up my ass when it comes to this too. Especially when you hear public figures like bill saying that current medicine is not working and that bullshit, unproven quackery; the reason is that some people will take that advice and drop effective treatments for the alternative ones, usually get ripped off and often end up dying.

check this site out to see what i mean

http://whatstheharm.net/

an incredibly important story. these drugs are overprescribed off-label not just in children, but also in the elderly. these were developed and approved for treating bipolar disorder and schizophrenia in otherwise healthy adults. the clinical trials did not include enough children or older adults to be considered to have sufficient power.

it should be said this class of drugs can be quite effective for treating the conditions for which they were originally approved.


also, that voice-over announcer needs a kick in the throat.