If you walk into a drugstore looking for a remedy for that pesky mid-summer cough, you'll come across a mish mash of non-prescription drugs and natural health products, both of which might suggest to you they'll produce the same result: restoring you to good health.
In Canada, the use and regulation of natural health products has been a really contentious issue since last year, when a little boy died of meningitis after his parents treated him with natural remedies.
Health Canada is running public consultations right now relating to its plan to update regulations around natural health products, and doctors say it's about time. But in the meantime, there's concern that consumers are getting duped in pharmacies, supermarkets, and convenience stores, and that as a result, natural health product manufacturers are cashing in.
"The majority of Canadians cannot tell the difference between a drug and a natural health product. They think that both of the products have the same backing in terms of scientific evidence, when they don't," said Dr. Matthew Stanbrook, an associate professor at the University of Toronto's medical school, who makes his case in a new editorial in the Canadian Medical Association Journal. "The consumer is being deceived," he continued. "We need to make sure that people know what they're getting."
Under "lax" government regulations, natural health products have "flourished," he writes in CMAJ, calling the current system a "rubber stamp."
Under Health Canada's proposed regulations, Stanbrook writes, non-prescription drugs and natural health products will be held "to the same standard" based on their risk profile. But risk can be hard to quantify, he argues. What's more, although products wouldn't be able to make any health claims that aren't supported by scientific proof, they could still claim other benefits, which he calls "a loophole ripe for exploitation."
Stanbrook proposes that natural health products should be sold on different store shelves than non-prescription drugs. "This would make it clear [to consumers] that there is a difference between products which are based on scientific evidence—that they have health benefits—and products that do not have that evidence," he said.
I reached out to Shawn O'Reilly of the Canadian Association of Naturopathic Doctors. He said in an email that separating the products would not give consumers any extra information.
"From our perspective the real priority is ensuring consumers have the information they need to make an informed decision, not the shelf they are on," he wrote in an email. "Measures like including a natural product number to indicate whether the product is a [natural health product], or, a drug identification number if it is a drug help the consumer make those decisions."
A Health Canada spokesperson told Motherboard in an email that the agency is "committed to maintaining an open and transparent dialogue with Canadians by continuing to consult and seek feedback to inform, evolve and refine the proposal" for changes to the regulation of self-care products, which include natural health products. "Feedback from Canadians tells us that the regulation of these products and the proposed changes are important to them," they said.
Stanbrook isn't arguing that natural health products should be wiped off store shelves. If consumers make the choice to treat their colds with echinacea, for example, that's fine. "They should be allowed to do that," he said, "but we should not allow people who think they're getting an effective evidence-based therapy to be deceived into getting something that's not that."
"I think that a product that wants to put itself forward as being sold to benefit a particular health condition should be made to provide evidence that it actually does that," Stanbrook said.
He believes the public needs to be better educated on this. "In general, health is neglected in our education," Stanbrook said. "We should do more of it in elementary school and all the way up. We think people will just figure it out all on their own and they don't."
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