Dana Ullman is an idiot. Or maybe insane. I'm not sure which, but his latest article at the Huffington Post reveals such a severe defect in rational thought that it must be one or the other (charitably speaking). He calls it "Lies, Damn Lies (sic), and Medical Research," and the point of it is quite clear: Ullman calls himself an "expert in homeopathic medicine" (which is akin to being a unicorn veterinarian) and since he has never been able to show that his particular health religion has any validity, he lashes out futilely at reality.
His entire argument boils down to a profound ignorance of medical science and a series of rhetorical/logical fallacies. His first straw man is a typical argument of alternative medicine gurus: that modern medicine only treats symptoms and not their causes. His first claim in this regard is that clinical studies define efficacy wrong because we consider symptom relief to be "efficacy". This is simply wrong. End points of studies depend on what is being studied. If, for example, we wish to know if a pain medication works, then pain relief is a reasonable end point. If we want to know if a particular drug prevents heart attacks, then heart attack is a reasonable end point. Ullman is either intentionally raising a straw man, or simply too ignorant to understand the barest basics of medical science:
The bottom line to scientific research is that a scientist can set up a study that shows the guise of efficacy. In other words, a drug may be effective for a very limited period of time and then cause various serious symptoms. For example, a very popular anti-anxiety drug called Xanax was shown to reduce panic attacks during a two-month experiment, but when individuals reduce or stop the medication, panic attacks can increase 300-400 percent (Consumer Reports, 1993). Would many patients take this drug if they knew this fact, and based on what standard can anyone honestly say that this drug is "effective"?
The "bottom line" is that anyone can create a crappy study, but that the method we use approach prevention and treatment of disease depends on data. In the case of alprazolam (Xanax), this drug is not generally used for the long-term treatment of anxiety. For example, the package insert for Xanax XR states that:
XANAX XR Tablets are indicated for the treatment of panic disorder, with or without agoraphobia...The longer-term efficacy of XANAX XR has not been systematically evaluated. Thus, the physician who elects to use this drug for periods longer than 8 weeks should periodically reassess the usefulness of the drug for the individual patient.
See, the data don't give us much guidance beyond short term usage. There is, of course, no guarantee that a doctor will use this data, but that's what education is for. Drugs such as alprazolam can be life-savers. Alleviating symptoms of an illness is one of the most important things we do and in the case of panic and anxiety disorders, symptoms are often all we have to work with. We don't know enough about these protean disorders to separate out "cause" from "symptom".
His next burning heap of stupid regards his understanding (sic) of how medicine works. He claims that drugs are inherently dangerous, and that doctors just don't get this.
These problems are evidence of the limitations of a model of medicine that over-emphasizes a biochemical, biomechanical pharmacological approach to healing that ultimately seeks to "attack" disease, "combat" illness, and wage "war on cancer" or on the human body itself (Ullman, 2009) This paradigm can be invaluable in emergency medicine and help us survive certain infectious diseases, but for the large majority of people facing day-to-day chronic illnesses, it provides short-term results, serious side-effects, and stratospherically high costs.
Which "day-to-day chronic illnesses" does he think are inherently not amenable to a "biochemical, biomechanical pharmalogical approach?" Is there some other way to approach human biology besides, you know, human biology? Where is all this expensive inefficacy? For example, our current medical regimens for coronary heart disease, including life-style modification, prevent hundreds of thousands of heart attacks and deaths every year, with safe medications that cost a few dollars per month. Reality is indifferent to Ullman's lack of interest and knowledge.
Ullman goes on to defend homeopathy as a legitimate alternative to real medicine. Right after railing against clinical trials, he defends homeopathy's failure in clinical trials:
The deniers of homeopathy love to say that homeopaths "cherry-pick" the positive studies and ignore the negative ones. They then incredulously assert that we should ignore ALL of the positive trials. Such statements and viewpoints are profoundly misguided and simply daft. Will these same people say that Thomas Edison "cherry-picked" his positive study and ignored all of his "negative" studies in his efforts to invent electric lights? The (il)logic of the deniers is that they would recommend ignoring Edison's discovery because the vast majority of his studies were not positive.
This isn't even a clever use of the Galileo Gambit. The fact is, when you turn on an intact and properly functioning light bulb, it illuminates. Every. Single. Time. The magic potions of homeopathy do not even come close to this sort of success. Ullman's tenacious support of magic does not make him a brave maverick---it makes him a pitiable unicorn cowboy, riding his fantasy into a unsung oblivion.