Earlier this month, we groused a bit about scare-mongering, drug-privileging headlines on some worthwhile news stories. It didn’t take long for similar examples to pop up.
For instance, there was the Consumer Reports Health Blog item on choosing a safe acupuncturist, which came under the headline “How Safe Is Your Acupuncturist?” (a type of headline that typically suggests an answer like “not as safe as you think”) and with warnings about the danger of infection.
According to microbiologists from Hong Kong University, those 3 million people [Americans who get acupuncture each year] should be careful when choosing their acupuncturist. There have been more than 50 reports from around the world describing serious bacterial infections after acupuncture, usually originating with contaminated needles or swabs. Skin infections seem to be the most common problem, but there have been cases of deeper infections affecting joints or the tissues around the heart, spine, or brain.
Viral infections can also be transmitted by acupuncture. Worldwide, more than 80 people have contracted hepatitis B through acupuncture, most commonly because of improperly sterilized reusable needles. It’s theoretically possible that HIV could be transmitted by acupuncture, and there have been suspected cases of HIV passed on in this way, but no confirmed cases.
Though it’s bad, of course, that anyone should suffer from medical treatment meant to do good, some perspective is needed. Here, we have about 130 people in the entire world and over an unspecified time span who became infected via acupuncture needles. According to a recent AP story on a new Health and Human Services quality report to Congress , 98,000 Americans alone died last year due to medical error, with infections being a large part of the problem. And the problem is getting worse:
According to the [HHS] report:
- Rates of bloodstream infections following surgery increased by 8 percent.
- Urinary infections from the use of a catheter following surgery increased by 3.6 percent.
- The overall incidence for a series of common infections due to medical care increased by 1.6 percent.
In contrast, the risk of becoming infected from acupuncture needles is extremely low – which the Consumer Reports blogger does acknowledge in an end-of-post summary, adding that
Hygiene is the most important way of preventing these problems. Safe practitioners of acupuncture use disposable needles, wear gloves, and work in clean premises. Bacteria can be transferred from your skin into your bloodstream during acupuncture, so the skin must be disinfected before inserting the needle.
This is important stuff to know. The same can’t be said for the second item that cropped up: an astounding media release about a literature review on herbal treatments for anxiety recently published in the Journal of Family Practice. As the abstract is not available online as of this writing, we don’t know anything about the methodology of this study – selection criteria, in particular. All we get are the lead author’s conclusions, summarized under the headline “Doctor Warns Against St. John’s Wort for Anxiety.”
According to the release, the author found “no evidence” that herbal remedies are effective. However, it’s not clear if “no evidence” means that research has been done and found the herbs wanting or if little research has been done and so there’s not enough evidence on which to judge. Considering that the bulk of research on St. John’s Wort has focused on its use in treating depression – for which it has been found helpful – the latter being the case would not surprise us. But rather than suggest that more (or even better) research be done, the author instead seems to shill for Big Pharma.
St. John’s wort, kava extract and valerian, herbal remedies touted on the Internet, have not been proven to be effective in treating anxiety wrote Kimberly Zoberi, M.D., associate professor of family and community medicine at Saint Louis University School of Medicine. Additionally, she raised concerns about the safety of valerian, particularly lacking any long-term studies of the herb.
“Patients should be extremely cautious about garnering medical advice from the Internet,” says Zoberi. “There is no evidence that those medications are effective. If a patient wishes to avoid drug therapy, her doctor can suggest alternatives such as cognitive behavioral therapy.”
In addition to the findings regarding “natural” treatments, Zoberi compared the differing prescription drug regimens available on the market for patients suffering from anxiety. According to Zoberi, most physicians recommend selective serotonin reuptake inhibitors (SSRIs) as a first-line treatment because they were safe, effective and less expensive. However, some patients suffer sexual or gastrointestinal side effects.
Zoberi found that medications from the anticonvulsant class of drugs are among the quickest and most effective ways to provide relief to patients in distress without the side effects of other first-line treatments. The downside is that these prescriptions are fairly expensive compared to other treatments.
Safe? I guess she’s not read anything like Peter Breggin’s eye-opening book Medication Madness, which goes into painful detail about the sometimes violent “side-effects” of SSRIs.
Effective? I guess she’s not read anything like Irving Kirsch’s masterful Emperor’s New Drugs in which he lays out the evidence showing how most of the efficacy of SSRIs is due to placebo effect, not active ingredients in the drugs themselves.
And these are just two of many widely available books putting to rest the lie that Prozac and its ilk are good and useful drugs. (For a quick summary of some of the key problems with SSRIs, also see Part 2 of Dr. Green’s article which ran recently here on Know Thy Health.)
Clearly, Zoberi has a lot more literature to review.