US Medical Research Expendatures: Alzheimers Versus Alternative Medicine
February 17th, 2012
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The other day I was thumbing through an old USA Today newspaper. I don’t usually read USA Today and if I did, I wouldn’t usually read an old one, but I was in a waiting room. There was one thing that really caught my eye and put into perspective how poor the government can be at prioritizing spending.
In 2011, the government will spend about $502.5 million on research for Alzheimer’s and related dementias. About $450 million of that will come from the National Institutes of Health. By comparison, NIH is expected to spend $521 million on complementary alternative medicine and $823 million on obesity.
Lets first get some context here. Alzheimers is a debilitating condition that affects more than 26 million people, mostly those over 65, although it can occur much earlier. It’s a progressive degeneration of brain tissue. Once it begins, it will only get worse. Early symptoms include difficulty with memory, but this is only the tip of the iceberg. As time goes on, it slowly eats away at all mental function, leaving the sufferer, at first confused then increasingly incapable of doing anything. In highly progressed cases, the individual is really just not “there.” They can’t talk, can’t feed themselves, can’t recognize family and don’t know their own name. It’s really more of a slow death than anything else, although sufferers can live for years before dying, usually from an infection or some other secondary cause.
The implications of the disease are quite bad for society. The US alone spends over one hundred billion dollars a year caring for Alzheimers patients, many of whom need constant intensive care. There are ethical issues too, because it is difficult to draw the line at where a person is no longer capable of making their own decisions. When first diagnosed, many sufferers have enough mental capacity to understand the horrible implications of what is happening to them. It tears families apart and puts enormous burdens on care givers. Long term care in nursing homes is extremely expensive and those who have no relatives or other means to pay for such care may end up in public institutions, which are becoming increasingly burdened by Alzheimers patients. The problem will only grow as the population ages.
There are no known treatments for Alzheimers. There are medications that do reduce the symptoms slightly, but none that will truly slow the progression. There’s no known way to prevent it from happening and the cause remains elusive, although it is known to be at least partially genetic. There may be other factors. Some studies have found that the occurrence of Alzheimers may relate to everything from alcohol to exercise levels, but the relationship is small and does not account for most cases.
The thing about Alzheimers that is striking is that, based on everything we know, it *should* be possible to prevent it from happening. Plaques form in the brain, but it’s not clear if this is the cause or the result of the destruction of brain tissue. Brain cells die, toxins accumulate and the disease progresses. Something is happening in the brain, some biochemical reaction is either occurring when it should not or is not occurring when it should. It does not occur in everyone. There should be a way to introduce a drug or chemical that will either suppress the destructive process or restart the renewing process that has stopped. Having a better understanding of the genes that are involved can help a lot. If that can be determined, then it might be possible to suppress those genetic effects. First, the exact mechanism must be determined and understood, and there’s no reason to think that can’t be done.
Alternative medicine is nothing more than treatments and preparations that have already been tested or evaluated by science and rejected. Most alternative therapies have no basis in science, have no plausible mechanism of action and have absolutely zero evidence of effectiveness. As a general rule, they have all been extensively tested already.
If the government is to fund scientific studies, shouldn’t it spend more on the ones that actually have the potential to make an important difference than the ones that are just rehashing things that are already known to not work and are not even scientifically plausible? That seems rather obvious to me. Tell me I’m not alone on this.
This entry was posted on Friday, February 17th, 2012 at 12:01 am and is filed under Bad Science, Politics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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February 17th, 2012 at 12:32 am
You’re not.
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February 17th, 2012 at 8:01 am
At the root of the problem is that governments are seeing alternative medicine practitioners as a solution to taking some of the load off an overloaded standard medicine system. Faced with crowed ER’s, lack of doctors wanting to go into general practice (now called family medicine in some places) governments have come to believe CAM can deal with some of the lighter cases, in other words, those cases where medical intervention really isn’t necessary.
Of course this is a terrible policy, but to some extent the public has brought it on themselves, clogging ER’s when they have a common cold, or some other condition that will pass in time by itself.
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February 17th, 2012 at 9:23 am
As long as Tom Harkin serves in the senate his baby, the National Center for Complimentary Medicine, will continue to piss hundreds of millions of taxpayer dollars onto the curb. His brainwaves also dreamed up the National Driving Simulator, another colossal waste, but I digress. His re-election doesn’t come up until 2014. Even then, he serves Iowa on several ag subcommittees and knows how to keep the farm lobby and liberals happy.
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February 17th, 2012 at 1:02 pm
DV82XL said:
Okay, fine, that works, I guess, if you completely ignore the collateral damage, like the fact that those who go to alternative medicine practitioners for colds are likely to go back for more serious conditions, avoiding treatment which makes it worse, and that it could provide an opertunity for all kinds of frauds to spread lies about vaccines or chemotherapy etc.
Don’t we have more effective solutions?
Too many people in the ER with a head cold? How about establish some non-emergency care clinics nearby and when someone comes to the ER, send them to one of those. Actually a hospital near me did something like that. If you go to the ER there’s a sign that says something similar to “Seriously injured or in need of urgent care? You’re in the right place. Feeling sick, looking for diagnosis or need pain relief? Please visit our adjacent quick care clinic. Personal crisis or overwhelmed? Please visit our nearby counseling center.”
I think that *technically* the quick care clinic is part of the ER, but it has a separate waiting room and receptionist.
What about other solutions?
If there are not enough doctors doing family practice, how about some nurse practitioners for the most basic cases like stuffy noses or people who are just concerned because their kid has a very low grade fever? Or even have some kind of medics or something to do the initial remittance and stuff.
What about having a phone number people can call for basic advice as to where they should go for treatment or if their condition needs urgent care. That might avoid some who just say something like “I’m a healthy young person, but today I woke up with a fever of 101. Do I need to get to the emergency room or can I just take it easy and take some aspirin?” (only problem here is it would need a disclaimer. Less than .1% of the time that mild fever might really be deadly, but most doctors would still probably say emergency care is not necessary in the above situation. So you’d want to cover it from lawsuit if it were)
I can think of others I’ve seen in my own life. When I was a kid they used the school nurse to do basic health screenings for scoliosis and to do a regular annual vision and hearing test. It was easy on her because they did it by last name spread out through the year. That would reduce some load if made universal.
Sure, these are problems in medicine, but if you think about it and try to come up with some solutions that actually **improve care** you’ll realize that they do exist and there are ways of making it better.
Turning to alternative doctors is nothing but copout to an easy answer that is not really an answer at all.
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February 17th, 2012 at 1:50 pm
I think what they’re hoping is that the quacks will refer their patients to real doctors for things that actually need treatment while keeping the hypochondriacs from wasting the time of the real GPs.
Oh and if you’ve got a shortage of physicians why not just create more places in medical schools?
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February 17th, 2012 at 2:11 pm
I can only speak to the situation in Quebec, (where I live) but all of those have been tried here. The CLSC system does have walk-in clinics, yet people still crowd the ER’s. There is a phone number people can call for basic health advice, and in the North nurse practitioners are quite common. Yet still 25% of Quebec’s people are without a regular physician. As for school nurses, there aren’t enough RN’s for the hospitals these days.
In many Provinces the government has ratcheted up the standards for naturopaths and instated licensing boards making that field about on par with nurse practitioners, and they are expected to pass patients on up the chain if any rear medicine is needed. I am not suggesting that this move to alternative medicine is a good thing, however the situation is getting out of hand and this is at least provids some control.
The fact remains that the current systems for delivering health care are in serious need of a major reorganization which needs to include what amounts to a technologist class of practitioner between the levels of nurse and physician. While CAM providers may not be the ideal choice, some of these fields may provide a starting point for this if standards can be raised.
I don’t like it any more than any sceptic, but I recognise that those in standard medicine are putting up a lot of resistance to change, and policy makers are trying to play with the cards they have in their hand.
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February 18th, 2012 at 1:06 pm
“There are no known treatments for Alzheimers. There are medications that do reduce the symptoms slightly, but none that will truly slow the progression.”
Not quite true. There is a new treatment currently going through trials that show imense promise. Unfortunatley it is an old drug used against reumatism, just used differently. After a few days a patient who hadn’t recognised his wife for over 5 years, recognised her for who she was and in what context.
The actual succes rate is unknown to me at the moment however…
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February 19th, 2012 at 5:26 pm
Alternative “medicine” is big business – I recently read that it is worth about $34 billion per annum in the USA – so of course it gets lots of political support!
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February 23rd, 2012 at 11:28 am
Matte said:
Sounds promising, but lets be very careful about getting too enthusiastic about experimental treatments. What you have presented is an anecdote. It would be great if that turns out to be what this drug does, but there are many cases of experimental treatments not panning out despite such dramatic stories being associated with them early on.
I stand by my statement that there are no known treatments, because I consider this to be a speculative treatment.
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