The popularity of homeopathy worldwide

(This was originally posted by Dana Ullman, an American homeopath. The bit about the UK is particularly interesting)

Numerous surveys over the past 150 plus years have confirmed that people who seek homeopathic treatment tend to be considerably more educated than those who don’t (1). What is not as well known is the fact that homeopathic medicine is the leading “alternative” treatment used by physicians in Europe…and growing numbers of the citizenry.

And despite homeopathy’s impressive popularity in Europe, it is actually even more popular in India where over 100 million people depend solely on this form of medical care (2). Further, according to an A.C. Neilsen survey in India, 62 percent of current homeopathy users have never tried conventional medicines and 82 percent of homeopathy users would not switch to conventional treatments (3).

Skeptics of homeopathy insist that homeopathic medicines do not work, but have difficulty explaining how so many people use and rely upon this system of medicine to treat themselves for so many acute and chronic diseases; and a very large number of these people do not have to use anything else. A previous article that I wrote at this site presented a strong case for the scientific and historical evidence for homeopathy. Further, other articles here have provided additional scientific evidence for the use of homeopathic medicines in respiratory allergies and in pediatrics. Although a small and vocal group of skeptics of homeopathy continue to deny its viability, homeopathy’s growing popularity throughout the world amongst physicians, other health professionals, and educated populations continue to prove that skeptics are really simply medical fundamentalists.

The entire field of “alternative and complementary medicine” was so hot in the 1980s that, according to a respected market survey, the field of alternative and complementary medicine in Europe was second only to the computer industry for growth during this decade (4). This explosion of interest in natural medicine has continued in the 21st century.

In 1998, homeopathy was the most frequently used CAM therapy in five out of 14 surveyed countries in Europe and among the three most frequently used CAM therapies in 11 out of 14 surveyed countries (5). Three out of the four Europeans know about homeopathy and of these people 29 percent use it for their own health care. In other words, approximately 100 million Europeans use homeopathic medicines (6).

The sales of homeopathic and anthroposophical medicines grew by 60 percent between 1995 and 2005, from 590 million Euros in 1995 to 775 million Euros in 2001 and to $930 million Euros in 2005 (7). Because of homeopathy’s impressive and growing popularity in Europe, this alternative treatment poses a significant threat to conventional medicine, which may explain why there are ongoing efforts to attack it (and homeopaths) using devious and questionably ethical means.

France
Homeopathy is particularly popular in France, where it is the leading alternative therapy. In 1982, 16 percent of the population used homeopathic medicine, rising to 29 percent in 1987, and to 36 percent in 1992 (8). In 2004, 62 percent of French mothers used homeopathic medicines in the previous 12 months (9). A survey of French pharmacists was conducted in 2004 and found that an astounding 94.5 percent reported advising pregnant women to use homeopathic medicines (10).

Homeopathy is popular not only among the French public but also among the French medical community. As many as 70 percent of physicians are receptive to homeopathy and consider it effective, at least 25,000 physicians prescribe homeopathic medicines for their patients. Homeopathy is taught in at least seven medical schools: Besancon, Bordeaux, Lille, Limoges, Marseille, Paris-Nord, and Poitiers, and there are numerous postgraduate training programs. Courses in homeopathy are taught in 21 of France’s 24 schools of pharmacy, and also taught in two dental schools, two veterinary medical schools, and three schools of midwivery.

United Kingdom
England’s Royal Family has been homeopathy’s strongest advocates, thereby confirming that this system of natural medicine is not some “new age” therapy. There are five homeopathic hospitals working within the National Health Service, some of them with a two-year waiting list for non-emergency visits to a homeopath.

According to a House of Lords report (2000), 17 percent of the British population use homeopathic medicines (11). The respect accorded homeopathy and homeopathic practice by British physicians is evidenced by a 1986 survey in the British Medical Journal that showed that 42 percent of physicians referred patients to homeopathic doctors (12). Other evidence of support from health professionals was a 1990 survey of British pharmacists that found 55 percent considered homeopathic medicines “useful,” while only 14 percent considered them “useless” (13). The normally conservative British Pharmaceutical Association held a debate in 1992 to decide whether pharmacists should promote homeopathic medicines (14). They concluded by a large majority that they should.

The field of complementary medicine has gained much support in the 1990s. In 1993 the British Medical Association published a book entitled, Complementary Medicine: New Approaches to Good Practice (15). Britain’s health minister (in 1994), Dr. Brian Mawhinney, stated, “Complementary medicine has generally proved popular with patients, and a recent survey found that 81 percent of patients are satisfied with the treatment they received” (16). Another health minister stated that 80 percent of general practitioners want training in complementary therapies; 75 percent now refer patients to complementary therapists.

Despite the use and acceptance of homeopathy throughout the U.K., there is a very active group of skeptics, with significant Big Pharma funding, who work vigorously to attack this system of natural medicine. Even though there is a wide variety of serious and significant pressing issues in British medicine and science today, an active group of skeptics of homeopathy successfully resurrected in October, 2009, a House of Commons committee, called the Science and Technology Committee, with the intent to issue a report on homeopathy. A leading skeptics organization, Sense about Science, that has been pushing for the re-creation of this Committee is led by a former public relations professional who worked for a PR company that represents many Big Pharma companies. Of additional interest is the fact that other Directors of the Sense about Science organization are a mixture of former or present libertarians, Marxists, and Trotskyists who also, strangely enough, seem to advocate for the GMO industry (ironically, libertarians normally advocate for a “live and let live” philosophy, but in this instance, it seems that they prefer to take choice in medical treatment away from British consumers).

Sense about Science is a registered UK charity despite being a political pressure group. As such they have to divulge their sources of income which they do on their website. Not surprisingly, much of this comes from named pharmaceutical manufacturers.

One of the investigators for the House of Commons Science Committee is a Liberal Democrat MP, Evan Harris. He has collaborated with Sense About Science on various projects, and he was also one of the skeptic demonstrators against the national pharmacy chain, Boots, which sells homeopathic medicines. This advocacy role does not make him an unprejudiced observer as is required for this type of investigation.

A report from this kangaroo court was issued recommending that the National Health Service stop funding for homeopathy and homeopathic doctors, despite the support for homeopathy and for consumer choice from Mike O’Brien, the country’s present Health Minister. This report is only of an advisory nature, and because the Health Minister has already expressed his support for consumers’ right to choose their own health care, it is uncertain what, if anything, will result of this report. What was most surprising about this report was that it verified that when people repeat a lie frequently enough, such as “there is no research on homeopathy,” many people actually believe it, despite its transparent falsity.

Any rational person should and must be very suspicious of this “report.” The MPs (Members of Parliament) who were a part of the Science and Technology Committee which voted for this anti-homeopathy report comprised of five members, with three members barely eking out their victory. Of the three votes, two members did not attend any of the investigational meetings, one of whom was such a new member of the committee that he wasn’t even a member of the committee during the hearings, and the remaining “yes” vote was from Evan Harris, a medical doctor and devout antagonist to homeopathy. This report was not exactly a vote of and for the people.

In Scotland, 12 percent of general practitioners use homeopathic medicines and 49 percent of all general practitioner practices prescribe them (at least one medical doctor in a group practice)(17).

The use of homeopathic medicines is not simply popular in the treatment of humans but also animals. Although there is little data presently available on this subject, one survey discovered that 20 percent of Irish milk producers have tried homeopathic medicines to treat mastitis or high cell count cows, and 43 percent believe that they work. In the herds surveyed, 50 percent added homeopathic medicines to the cow’s drinking water, 27 percent administered medicines via injection, six percent orally doses the cows, and six percent of herds placed the medicines in the cow’s vagina (18).

Ireland
A survey in Ireland was conducted at 13 pediatric settings over a 4-month period (19). They found that 57 percent of parents reported using CAM for their child. Use was significantly higher in the two to four years age group. The most common medicinal CAMs used were vitamins (88 percent), fish oils (27 percent) and Echinacea (26 percent). The most common non-medicinal CAMs used were homeopathy (16 percent) and craniosacral therapy (14 percent). Only 13 percent of parents had informed their pediatrician of their child’s CAM use.

Germany
The German people are so supportive of natural medicine that the German government mandated that all medical school curricula include information about natural medicines. Approximately 10 percent of German doctors specialize in homeopathy, with approximately 10 percent more prescribing homeopathic remedies on occasion. In 1993, there were 1,993 medical doctors who had formally qualified in homeopathy, while in 2006, this number jumped over 100 percent to 6,073 (20). In Germany there are 9,000 natural health practitioners called heilpraktikers in 1993 and over 20,000 in 2007. Approximately 20-30 of heilpraktikers specialize in homeopathy.

A cross-sectional survey was conducted in a large random sample of 516 German outpatient care physicians with qualifications in 13 medical fields representative of a basic population of 118,085 statutory health insurance physicians in November and December 2005 as part of a national healthcare survey (21). In this survey, 51 percent were in favor of CAM use (26 percent were very much in favor, 25 percent were in favor). This survey found that 38 percent of the medical doctors prescribed homeopathic medicines.

A survey of departments of obstetrics in hospitals in the state of North Rhine-Westphalia, Germany, found that acupuncture and homeopathic medicine were the two most commonly used CAM practices (22). A total of 187 department of obstetrics were identified, and 138 (73.4 percent) responded to a questionnaire. Almost 96 percent of the obstetrical departments offered homeopathic medicines for obstetrical care.

The 2003-2006 German Health Interview and Examination Survey for Children and Adolescents (KiGGS) found a higher than expected use of homeopathic medicine amongst German children (23). The survey found that pediatric homeopathy is quite popular in Germany, particularly among children from families with a higher socioeconomic status. Nearly half of the homeopathic preparations were obtained by prescriptions from medical doctors or Heilpraktiker (non-medical practitioners) and used most often to treat certain self-limiting conditions. About 60 percent of homeopathy users concomitantly received conventional medicines. Homeopathy use was closely related to socioeconomic factors, with a significantly higher prevalence rate found in the zero to six year age group, among children residing in the former West Germany or the south of Germany, among children with a poor health status, with no immigration background , who received breast-feeding greater than 6 months, were from upper social-class families, and whose children’s mothers were college educated.

In 2002, the British Medical Journal (BMJ) reported that 75 percent of Germans have used complementary or natural medicine (24). They also reported that 5,700 doctors received specialized training in natural medicine, with this number doubling to 10,800 by 2000. Homeopathic medicine is practiced by 4,500 medical doctors in Germany, almost twice as many as did so in 1994. The German government conducted this survey, and it also discovered that there was a 33 percent reduction in sick days if people used natural therapies, especially homeopathy or acupuncture. It was also reported that women used natural therapies more than men did, but when men used them, they benefited more than women did.

In 2009 a survey of Germans who used homeopathy or acupuncture was published (25). This survey found that seven percent of the population used homeopathy and 10 percent used acupuncture. Individuals who had a high education level used homeopathy (68 percent), as compared with 53 percent who used acupuncture.

A survey of patients in Germany with chronic lymphocytic leukemia found that 44 percent had used alternative treatments. No correlation was seen with educational level, gender, or previous or current chemotherapy. The most common alternative or complementary treatment modality was vitamin supplementation (26 percent), followed by mineral (18 percent), homeopathic (14 percent), and mistletoe therapy (9.2 percent) (26).

A 2008 survey of German children with cancer was conducted and which found that 35 percent of the responders had used CAM (27). The most frequently used methods were homeopathy, dietary supplements and anthroposophic medicine including mistletoe therapy. Factors which increased the probability of using CAM were the previous use of CAM, higher social status and poor prognosis of the child’s disease. An impressively high percentage of parents of patients (89 percent) reported that they would recommend CAM to other parents.

The use of homeopathy and CAM in Germany by people with other chronic disease is also high, as was observed in a survey of German’s with multiple sclerosis (28). A 53-item survey was mailed to the members of the German Multiple Sclerosis Society, chapter of Baden-Wuerttemberg. Surveys of 1,573 patients were analyzed. In comparison with conventional medicine, more patients displayed a positive attitude toward complementary and alternative medicine (44 percent vs 38 percent, P less than 0.05), with 70 percent reporting lifetime use of at least one method. Among a wide variety of complementary and alternative medicine, diet modification (41 percent), Omega-three fatty acids (37 percent), vitamins E (28 percent), B (36 percent), and C (28 percent), homeopathy (26 percent), and selenium (24 percent) were cited most frequently. Most respondents (69 percent) were satisfied with the effects of complementary and alternative medicine. Use of complementary and alternative medicine was associated with religiosity, functional independence, female sex, white-collar job, and higher education (P less than 0.05). Compared with conventional therapies, complementary and alternative medicine rarely showed unwanted side effects (9 percent vs 59 percent, P less than 0.00001).

Sales of homeopathic medicines in Germany were approximately $428 million in 1991, growing at a rate of about 10 percent per year. Evidence of the significant support from the German medical community is the fact that 85 percent of these sales are prescriptions from physicians. Surveys indicate that 98 percent of pharmacies sell homeopathic medicines.

Switzerland
A government-sponsored survey was conducted in Switzerland that evaluated patient satisfaction and side effects in primary care and that compared homeopathic treatment and conventional medical treatment (29). A total of 3,126 adult patients responded to a questionnaire, 1,363 of whom received conventional medical treatment and 1,702 who received homeopathic treatment. This survey found that a higher percentage of homeopathic patients had chronic and severe conditions than the conventional medical patients, that homeopathic patients were more often “completely satisfied” with their treatment (53 percent vs. 43 percent), that homeopathic patients experienced significantly fewer side effects (7.3 percent vs. 16.1 percent), that the proportion of patients reporting complete resolution of symptoms was non-significantly higher in the conventional medical patients (28 percent vs. 21 percent). What is particularly important about this survey is the observation that homeopathic patients had a higher percentage of seriously ill patients but they expressed a much higher amount of satisfaction with their treatment than the patients who received conventional medical treatment. This survey also confirmed a common observation about people who seek homeopathic treatment and that is they were much more educated than those who didn’t (32.4 percent vs. 24.7 percent received “higher education”).

The Swiss Federal Office for Public Health issued a report to the government of Switzerland which concluded that “the effectiveness of homeopathy can be supported by clinical evidence, and professional and adequate application be regarded as safe” (30).

Other European countries in which homeopathy has a relatively strong presence include Switzerland, where different surveys have suggested that somewhere between 11 percent and 27 percent of general practitioners and internists prescribe homeopathic medicines; Italy where nine percent of the medical doctors prescribe homeopathic remedies sometimes; and the Netherlands where 45 percent of physicians consider homeopathic medicines effective and 47 percent of medical doctors use one or more complementary therapies, with homeopathy (40 percent of these select doctors) being the most popular (31).

The prevalence of CAM use in a sample of Swiss patients undergoing kidney transplant was 11.8 percent. The most frequently used alternative therapy used among these was homeopathy (42.9 percent) (32).

Italy
In 2004 a total of 7.5 million Italians use homeopathic medicines, 2.5 million more than a survey showed in 2000 (33). Approximately 14 percent of Italian women and 10 percent of men prefer homeopathic medicine to conventional medicine. A total of 9.6 percent of children between three and five years of age are treated with homeopathic medicines. Almost 90 percent of Italians who have used such medicines say these treatments helped by them, with 30 percent saying that they used homeopathic medicines for pain syndromes and 24 percent for severe or chronic diseases.

A 2005 survey on the use of complementary and alternative medicines (CAM) among cancer patients in Europe reported that 73 percent of the Italian cancer patients had used CAM, a number well above the European average of 36 percent (34). The most popular treatment modalities used by cancer patients in Italy were high use of homeopathy, herbal medicine, and spiritual therapies. A 2008 survey in Tuscany, Italy found that the incidence of CAM use after cancer diagnosis was 17 percent, with the most widely used forms being herbal medicine (52 percent), homeopathy (30 percent) and acupuncture (13 percent) (35). Use was higher in the urban area and among women, breast cancer patients, and persons with a higher education.

A survey of Italian children with cancer who were being treated at a conventional pediatric oncology unit found that 12.4 percent of the children used at least one type of CAM, with homeopathy being the most popular (36). Eighty-three percent of the parents of these children reported benefits, ranging from improved immune defenses, regression of diplopia, or improved blood values. This study confirmed the observation of many other surveys which found that users of CAM tended to be more educated than those who did not use CAM (37)(38)(39).

Five hundred and fifty-two patients who had inflammatory bowel disease and who were under treatment at an Italian tertiary medical referral center completed the questionnaire (40); 156 (28 percent) reported using alternative and complementary therapies, of which mainly involved homeopathy (43.6 percent), followed by controlled diets or dietary supplements (35.5 percent), herbs (28.2 percent), exercise (25.6 percent) and prayer (14.7 percent). An improvement in well-being (45.5 percent) and inflammatory bowel disease symptoms (40.3 percent) were the most commonly reported benefits. A higher education (P equal to 0.027), a more frequently relapsing disease (P equal to 0.001) and dissatisfaction with the doctor’s communication (P equal to 0.001) correlated with alternative and complementary therapy use. Non-compliance with conventional drugs, disease severity and curiosity regarding novel therapies were predictors of alternative and complementary therapy use.

Spain
In Spain, homeopathy has gotten so popular that INE, the country’s statistic institute, added expenditures on homeopathic medicines to their calculations for monthly inflation rates (41). Sales of homeopathic medicines in Spain are growing at 10-15 percent annually, with approximately 15 percent of the population saying that they have used a homeopathic medicine and 25 percent said that they would be happy to try one (42).

Eastern Europe
When the Iron Curtain was up, Hungary, Czechoslovakia, and East Germany banned homeopathy, but this medical iron curtain fell with communism. Homeopathy holds a unique place in Russia, where it has been widely accepted, but is not sanctioned by the state medical bureaucracy. Thus, homeopathic care is not free and has been a part of the new Russian economy where fees are paid for health services. Demand for homeopathic care is so great that Russians prefer to pay for homeopathic care than to receive free conventional medical care.

Some skeptics have asserted that homeopathy and natural medicines are becoming increasingly popular in Russia because “real medicine” is either unavailable or too expensive (43). However, this assumption has been disproven, because the trend toward homeopathic and natural medicine is particularly popular among those Russians who are more educated and are in higher economic classes. Journalists and skeptics tend to assume that homeopathic medicines simply do not work, and thus they create fanciful theories about why the use of homeopathy is increasing.

A survey of Russian physicians in three academic hospitals in St. Petersburg was published in 2008 (44). This survey found that 100 percent of the respondents had practice CAM and/or referred patients to at least two CAM therapies. On average, each physician had practiced or referred patients to 12.7 different CAM treatments. Homeopathic medicine was the 8th most popular, with 58 percent using or referring for homeopathic treatment, 31 percent using on themselves, 29 percent using it on their own patients, and 38 percent referring for homeopathic care.

In Hungary, homeopathic literature was banned for 40 years until 1990. Homeopathy has now been accepted and integrated into regular medical education and is taught in two medical schools. The Hungarian Homeopathic Medical Association started with 11 members in 1990, grew to 75 after 18 months, and grew further to 302 members in 1994.

After the fall of communism in Czecholslovakia, a homeopathic organization in the Czech Republic was established in November, 1990, and it was immediately accepted and integrated within the larger conventional medical society. Within a year, the Ministry of Health officially recognized homeopathy as a medical specialty.

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Dana Ullman, MPH, is America’s leading spokesperson for homeopathy and is the founder of www.homeopathic.com. He is the author of 10 books, including his bestseller, Everybody’s Guide to Homeopathic Medicines. His most recent book is, The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy. Dana lives, practices, and writes from Berkeley, California.