All posts by Michael Doneman

A personal account of the value of placebo

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A journey to the land of “I Shall Please”

“I grew up in Marin County, California—a hotbed of holistic health, where “healers” of all stripes (legitimate or not) thrived. My own father was an acupuncturist who treated most of my ailments with tiny silver needles or stinky Chinese herbs. I went to the doctor only for routine physicals and shots required for school. Thus, I grew up believing that my body had the power to heal itself.

Once I left home and moved to the more conservative burbs of Santa Clara County, I came to realize that the average person considered alternative medicine to be a placebo at best—and an outright sham at worst. But perhaps placebos have been getting a bad reputation. New research into the placebo effect suggests that our expectations and beliefs can play a much bigger role in healing than previously thought.”

Read the rest of the article here.

Is it genetic?

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More on the Americans developing a ‘tolerance’ to placebos. Can the answer be genetic?

In May, researchers from Harvard Medical School described a set of variants in 11 genes that they say are linked to the placebo effect and called it the ‘placebome.’ Scientists have known for quite some time that some people are more prone to experiencing the effect than others. And early investigations implicated the body’s natural pain control systems, including the opioid-like chemicals made and released in our own brains.

The Placebo Effect: Can You Be Tricked Into Exercising More?

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It’s true; in workouts and exercise we all get random adrenaline rushes that allow us to give max effort, even when the tank is empty. But what about taking pre-workout supplements, which promise to give you that extra boost? Do they really work, or is it more just the mental idea associated with it? And how much power does your mind actually have? A recent study shows just how much of physical fitness is mental. Read more about placebo ‘encouragement’ in exercise here.

Re-framing the placebo effect and informed consent

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(Medical Xpress)—Imagine that your doctor knows from evidence-based studies that if he tells you about certain, small side-effects to a particular drug, you are significantly more likely to experience that side effect than if he did not tell you about it. Given the three values of autonomy, beneficence, and nonmaleficence, what should he do?

On the flip side, what if your doctor knew that statistically who are gradually weaned off of a chronic pain medication by decreasing their dosage until it is a placebo will still experience relief from their pain as a result of habituation? Should the doctor lie to you about your dosage in an effort to help your chronic pain while mitigating side effects?

Mark Alfano, bioethicist at Delft University of Technology in the Netherlands writes a compelling argument for re-defining our views of placebos and placebo effects and how, by defining them in terms of classical conditioning, expectation fulfilment, and somatic attention and feedback, the ethics of informed consent changes by doing so. His is the target article in this month’s issue of the American Journal of Bioethics.

More information: “Placebo Effect and Informed Consent” American Journal of Bioethics, 15:10, 3-12.

Americans Are Strangely Likely To Fall For Fake Pain Drugs

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Research published in August 2015 (Increasing placebo responses over time in U.S. clinical trials of neuropathic pain) and published in the Journal Pain focused on over two decades’ worth of clinical trials – 80 in all. The results showed that, as many have speculated, our placebo response is indeed getting stronger. And, because one measure of a drug’s effectiveness is its ability to perform better than the placebo, more pain-drug trials are failing than in the past. But, interestingly, the researchers found that this increase was only true for studies conducted in the U.S.

Nature RX: Nature as Placebo

Set in the world of a spoofed prescription drug commercial, Nature Rx offers a hearty dose of laughs and the outdoors – two timeless prescriptions for whatever ails you. Side effects may include confidence, authenticity, remembering you have a body, and being in a good mood for no apparent reason.

More from Seth Godin on placebos and marketing

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We’ve published his work here before, but it’s time for some more truisms on the placebo effect from marketing guru Seth Godin, one of the godfathers of ‘viral marketing’ (in Crucial Elements for the placebo effect). Seth’s really into placebos!

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Placebos, used ethically, are powerful tools. They can cure diseases, make food taste better and dramatically increase the perceived quality of art. They can improve the way teachers teach, students learn and we judge our own safety.

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They do best when they improve something that is difficult to measure objectively.

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Argue all you want about whether or not you want to be buying or selling placebos, but it’s quite likely that the right placebo with the right story can dramatically increase certain outcomes.

If you want to improve performance, the right placebo is often the safest and cheapest way to do so. The opportunity is to find one that’s likely to work, and to market it in a way that’s ethical and effective.

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If you like Seth’s style, he has another blog post on the placebo effect in marketing here (Marketing of the placebo: Everyone gets their own belief) and a whole downloadable essay/course here (Placebos) which contains some keen – and entertaining! – thinking on the placebo effect as it relates to marketing (which to Godin, is critical to more in our lives than we imagine!)

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Facing a long plane trip with a nasty cold, I headed over to the health food store.

“Excuse me, do you have any placebos? I have a really horrible cold… I’ll take the strongest one you’ve got.”

She looked at me with pity. “A placebo?”

“Yes, please.”

“Do you know which company makes that? I don’t think we have any placebos?”

I waited for a second, thinking hard about what was happening.

“Hey Sylvia,” she yelled, “there’s a guy out here who wants some placebo, but he doesn’t know who makes it. Do we carry that?”

Sylvia didn’t know.