It seems that the regulation of supplements, homeopathy, and “natural” products in Canada is as bad as the US. The Canadian Broadcasting Corporation (CBC, the equivalent of NPR and PBS in the US) recently conducted a demonstration of just how worthless and deceptive the regulations are.

They created a fake treatment called “Nighton” which they claimed treated fever, pain, and inflammation in children and infants. They then applied to the government for a Natural Product License. On the application they checked all the appropriate boxes amd submitted as evidence copied pages from a 1902 homeopathic reference book. That was it. Five months later their fictitious product was approved as “safe and effective.”

What this means is that when the Canadian government approves a natural product as safe and effective, it is completely meaningless. It is essentially a license to lie to the public about a health product.

It is reasonable to assume that many if not most of the public, if they see a product on the pharmacy shelf with the label, “licensed as safe and effective for fever, pain, and inflammation,” with an official government issued product number, that some sort of testing and quality assurance was involved.

The situation is identical in the US. Companies can market homeopathy products or supplements without providing any evidence that the product is safe, and can even make health claims (as long as they don’t mention a specific disease by name) again without the need to provide any evidence. In essence, in the US or Canada a company can put anything in a pill or bottle (as long as it doesn’t contain an actual drug), then without any testing market their random assortment of vitamins, herbs, or just water (in the case of homeopathy) with specific health claims. Pharmacies are happy to sell these fake products side-by-side with real medicines.

This is nothing short of a scandal. It amazes me that consumer advocates are nowhere to be seen on this issue. Where is Ralph Nader when you need him? Companies are allowed to sell products (health products, no less) with made-up claims, all government approved and sealed. This is a legislative gift to a specific industry at the expense of the consumer, a government-sanctioned scam.

The CBC asked Health Canada to comment on their sting operation, and they responded:

“Canadians want a range of treatment choices available to them for conditions they can manage themselves,” wrote Health Canada spokesperson Eric Morrissette.

People want choices, sure, but they don’t want to be scammed by their own government working with snake oil salesmen. If this is all about choice then give consumers total transparency. Don’t pretend these products are regulated when they aren’t. Prominently display on the package – “Not regulated by the government. There is no assurance of safety or effectiveness with this product. The manufacturer did not provide any evidence of safety or efficacy. Hey, we don’t even know what’s in this crap.” Pharmacies should not sell them, or if they do they should sell them is their own section, clearly labeled as “Potions and Snake Oil. Use at your own risk.”

What Health Canada is missing is that real choice requires true information and transparency. The problem with the system is the inherent deception. Regulations as they currently stand in the US and Canada are inherently deceptive. They are pro-industry and anti-consumer. Consumers should be pissed and demanding change, but it seems like the public has been so thoroughly sold on the supplement industry propaganda they don’t even realize how they are being scammed.

There are some easy fixes to this regulatory scandal (conceptually easy, politically very difficult). First, ban homeopathy. Homeopathy is 100% a complete pseudoscientific scam. It is the poster child for snake oil. Just ban it already.

Next, put in place some actual regulation for any other product that makes health claims. There is debate among my colleagues and I about where, exactly, the threshold of evidence should be placed for non-pharmaceutical products. I don’t think we necessarily need to have the same threshold of evidence as for drugs. That’s never going to happen anyway, I would argue. But, health claims need to be specific, and should be backed by a reasonable degree of scientific evidence. This can include a systematic review of studies in the peer-reviewed literature, even if they were not performed specifically by the company for the purpose of approval.

Companies should provide evidence and monitoring of their products for purity and accuracy of the ingredients on the label. Safety data should also be required, including drug-drug interactions. I also think bioavailability evidence should be provided – how much of the product actually get absorbed into the system?

These are the regulations that the public already assumes are in place. People assume that when the government sanctions a product and a pharmacy sells the product with health claims that those claims have been vetted. Just give the public what they think they already have, and end the deception.

These regulations should dramatically reverse the explosion of supplements and natural products over the last two decades, and that’a a good thing. I suspect that almost every such product is utterly worthless for health. The net effect of the natural health product industry is to suck billions of dollars out of the public without benefiting their health one bit. In fact the net effect on health is probably negative, as consumers spend their finite healthcare resources on worthless products and may replace or delay effective treatment.

I applaud the CBC for doing this expose. I hope they see the opportunity to keep the momentum going, and not treat this as a one-off news item. The public needs to understand what is going on so that we can build the political will to make real change.