Tag Archives: Medicine

Antibiotics Are Still Overprescribed

We’ve mentioned elsewhere on this site that conventional doctors are quite aware that they’re often prescribing ‘placebos’ – that is, antibiotics for conditions which they know will not respond to antibiotics. Why? It seems, that’s what patients expect, and doctors, under the pressure of pushing as many through the doors per hour as they can, just don’t have the time to explain that medication is just not necessary for something like a viral infection. At least, we hope that this is the explanation. We’d hate to think that the medical professiona was at all involved in helping bolster drug sales …

Here’s an NPR news article about the over-prescription phenomenon. Problem is, the practice is not only unnecessary and expensive, it can be dangerous. 

Harvard says placebos are going mainstream

A fascinating article from Harvard Magazine on the work of Ted Kaptchuk, head of the Program in Placebo Studies and the Therapeutic Encounter, a multidisciplinary institute dedicated solely to placebo study.

‘It’s a nod to changing attitudes in Western medicine, and a direct result of the small but growing group of researchers like Kaptchuk who study not if, but how, placebo effects work. Explanations for the phenomenon come from fields across the scientific map—clinical science, psychology, anthropology, biology, social economics, neuroscience. Disregarding the knowledge that placebo treatments can affect certain ailments, Kaptchuk says, “is like ignoring a huge chunk of healthcare.” As caregivers, “we should be using every tool in the box.”’

Kaptchuk is getting some extraordinary results. One landmark study involved patients suffering from Irritable Bowel Syndrom (IBS), and consistent with some other studies cited in our blog, it seems that the placebo effect is still engaged even when patients know they’re being offered placebos.

‘One group received no treatment. The other patients were told they’d be taking fake, inert drugs (delivered in bottles labeled “placebo pills”) and told also that placebos often have healing effects.The study’s results shocked the investigators themselves: even patients who knew they were taking placebos described real improvement, reporting twice as much symptom relief as the no-treatment group. That’s a difference so significant, says Kaptchuk, it’s comparable to the improvement seen in trials for the best real IBS drugs.’

So Harvard and a nest of affiliated research hospitals are getting into placebo research. Check out the website of the Program in Placebo Studies for more.

‘For many years, the placebo effect was considered to be no more than a nuisance variable that needed to be controlled in clinical trials. Only recently have researchers redefined it as the key to understanding the healing that arises from medical ritual, the context of treatment, the patient-provider relationship and the power of imagination, trust and hope.


Although our biomedical health care system often considers these humanistic dimensions of care as secondary to the administration of pharmaceuticals and procedures, the emerging field of placebo studies is producing scientific evidence that these more intangible elements of medicine may fundamentally contribute to the improvement of patient outcomes.’

The value of ‘consensual’ placebo effect in treating Irritable Bowel Syndrome

From PLoS ONE

Placebos administered without deception may be an effective treatment for IBS [Irritable Bowel Syndrome]. Further research is warranted in IBS, and perhaps other conditions, to elucidate whether physicians can benefit patients using placebos consistent with informed consent.*

Source the article here.

* Kaptchuk TJ, Friedlander E, Kelley JM, Sanchez MN, Kokkotou E, et al. (2010) Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome. PLoS ONE 5(12): e15591. doi:10.1371/journal.pone.0015591

Britain’s NHS should subsidise placebos?

Here’s an article from a blog called PRACTICAL ETHICS (Ethics in the News) at the University of Oxford. It’s pretty unfriendly to homeopathy, which we think isn’t quite as cut and dried a domain of practice as the author, Bennett Foddy, assumes. Brian, one of our founders, is happy to advise on both homeopathic and placebo regimes. That’s one point where we differ substantially with Foddy, and at least some of the literature does as well. Buying placebos from Boots, government subsidised or not, makes at least the ‘pleasing the practitioner’ script impossible. ("Pleasing the practitioner" is the idea that a patient’s trust in the authority of an expert induces the placebo effect.)

No fooling: ‘Placebo effect’ real

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A simple sugar pill may help treat a disease — even if patients know they’re getting fake medicine.

The finding, reported online Wednesday in the journal PloS One, may point the way to wider — and more ethical — applications of the well-known “placebo effect.”

“The conventional wisdom is you need to make a patient think they’re taking a drug, you have to use deception and lies,” said lead author Ted Kaptchuk, an associate professor of medicine at Harvard Medical School. And, Kaptchuk added, it seems many doctors do this: In one report, as many as half of rheumatologists and internists surveyed said they had intentionally given patients ineffective medication in the hopes it would have a positive result.

Kaptchuk, however, wondered whether the deception was needed. When he first tried to persuade fellow researchers to explore a sort of “honest” placebo, “they said it was nuts,” he said. After all, didn’t the whole effect hinge on people believing they were getting real treatment?

Patients were easier to enlist. “People said, ‘Wow, that’s weird’ and we said, ‘Yeah, we think it might work.'”

The researchers enrolled 80 people suffering from irritable bowel syndrome, explaining the experiment while framing it positively — they called it a novel “mind-body” therapy.

Half the patients were given a bottle with the word “placebo” printed on it. The pills it held, they were told, were like sugar pills. The patients were told they didn’t even need to believe in the placebo effect, but had to take the pills twice daily.

The other half were given no treatment at all.

At the end of the three-week trial, 59 percent of the patients taking the placebo said their symptoms had been adequately relieved, far outstripping the 35 percent in the non-treatment group.

“We were all taken aback,” Kaptchuk said. “We triple-checked the data before we decided it was real.”

Read the research paper at Plos One: Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome

“Placebo: Cracking the Code”

Featuring members of the the Harvard Placebo Study Group, “Placebo: Cracking the Code” examines the power of belief in alleviating pain, curing disease, and the healing of injuries. This is the first of several videos which can be accessed through Youtube – the first is below.

The placebo effect is a pervasive, albeit misunderstood, phenomenon in medicine. In the UK, over 60% of doctors surveyed said they had prescribed placebos in regular clinical practice. In a recent Times Magazine article, 96% of US physicians surveyed stated that they believe that placebo treatments have real therapeutic effects.

Work on the placebo effect received an intellectual boost when the Harvard Placebo Study Group was founded at the beginning of 2001. This group is part of the Mind-Brain-Behavior Initiative at Harvard University, and its main characteristic is the interdisciplinary approach to the placebo phenomenon. The group is made up of 8 members: Anne Harrington (Historian of Science at Harvard), Howard Fields (Neuroscientist at Univ. of California in San Francisco), Dan Moerman (Anthropologist at Univ. of Michigan), Nick Humphrey (Evolutionary Psychologist at London School of Economics), Dan Wegner (Psychologist at Harvard), Jamie Pennebaker (Psychologist at Univ. of Texas in Austin), Ginger Hoffman (Behavioral Geneticist at Harvard) and Fabrizio Benedetti (Neuroscientist at Univ. of Turin). The main objective of the group is two-fold: to devise new experiments that may shed light on the placebo phenomenon and to write papers in which the placebo effect is approached from different perspectives.

Placebos are getting under the skin of the drug pushers

It sounds counter-intuitive, but it seems that placebos are geting ‘stronger’ … or more to the point, the placebo effect is increasingly recognised as touching the heart of the overall process of healing and the nature of wellness. A fascinating article on this dynamic phenomenon in Wired magazine – looks like the debate is going mainstream!

And lest we forget … there’s money at stake. Big money.