Why Talk About Research? Risk-Benefit Analysis

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I probably should have written to preface my research series, but it just came up for me today due to a conversation I was involved in.  In this post, I am simply fleshing out a hurried reply to that conversation.

I keep up with the research so I can help my clients make good choices.  Ultimately, I may suggest traditional methodology and plant agents, but when I do I make sure I can support my recommendations with anecdotal, historical and modern information.  That includes knowing if a plant preparations has side effects, drug interactions or is a risk in any way.

There have been several conversations on Facebook recently about whether or not certain herbs contain certain substances and what the risks are to that. The number of people who get caught up  arguing that a plant is “safe” in these  conversation always surprises me.

Of course plant preparations may be toxic. Hell, water can be toxic, if you drink too much of it. Many really potent herbal medicines are dangerous to our health, if taken in excess. So are many pharmaceuticals-probably most of them to be honest.  Healers have always understood the notion that many times they are using a poison to provoke a healing response.  We’ve known that for centuries, if not millennia.

“All substances are poisonous, there is none that is not a poison; the right dose differentiates a poison from a remedy.”  — Philippus Aureolus Paracelsus

Toxic phytochemicals are not some fairytale made up by the drug companies to discredit herbal medicine.  They don’t really do that.  More frequently  the drug companies have isolated and synthesized these poisons and turned them into medicines like morphine.

To my way of thinking though as a community we are are getting stuck in this somewhat futile stalemate and not moving on to discuss what to do with this information.

So let’s move on….

When you propose a research study in college, you have to go through a process known as IRB. One of the things that they ask you to do is a risk -benefit analysis.  This is a valuable tool for most people really, as it is just a form of critical thinking informed by three questions:

What are the risks of a potential intervention?

Risk refers  to the combination of the probability and magnitude of some future harm. So basically what we are asking is:  “What could happen?  How likely is this to happen? and How bad will it be if it does happen?  (Some of this involves critical assessment of the research, also)

What are the benefits of a potential intervention?

It is kind of  a given that we are looking at interventions which result in improvement of health.  That isn’t the question we need to ask ourselves here.  What we really want to ask are more specific questions like:

How likely is it that this intervention will achieve the desired results?
How  dramatically will the intervention improve quality of life?

Are the risks reasonable in relation to anticipated benefits?

Ideally we want our risks to be minimal.  If something has greater than minimal risk I then move on to ask questions about how to reduce the risk:

How was it prepared and administered in traditional practice?  – Using more concentrated forms  of plant medicine (like tinctures and essential oils) requires that we adjust our thinking about the safety of these preparations.

Is a preparation less risky if made with a certain part of the plant, or a certain species?

Can using a low dose minimize the risks?

Is there an there an alternative intervention that has less risk?

MD’s and nurses are taught to go through a similar process when prescribing pharmaceutical medicines or some other therapy. I am not saying they do it, but they are generally taught that this is the responsible way to frame your recommendation.

Granted herbal practitioners don’t have quite so much pressure on us.  We are simply educating clients as to ways phytochemicals could improve their quality of life and support their health- not prescribing life altering chemical agents.

But it is still our responsibility to provide clients with the best education possible. This brings us to the importance of knowing the research.  How are we going to be reasonably sure that the benefits outweigh the risks if we blindly turn an eye to the risks?

IMG_8486No one can promise anyone a completely safe intervention.  If a practitioner is telling you that plants are “nature’s medicine” and harmless, stop seeing that person immediately and find someone who knows what they are talking about.

A good healer has done their research and understands  risk-benefit analysis.  That is one of our most important jobs.  We mediate between the plant world and the human world through many different ways of knowing. There is no wisdom in stubbornly clinging to one way of knowing.

Sometimes I deem an intervention to be too risky for a certain client and don’t mention it. You pretty much have to apprentice with me before I will talk about some of my traditional  poisons.

I generally present clients with a few options explaining the risks and benefits of each option, because the final decision rests with the client. I educate my clients with all of the information at my disposal about a plant preparation–anecdotal, historical and modern research—so they can make their own informed decisions.