Interesting CNN article and video on the real -and growing – effects of fake pills. It concludes:
‘As most of us would guess, the placebo perceived by patients to be more expensive worked better than its seemingly lower-cost equivalent … Perceptions of cost are capable of altering the placebo response,.
Quite a buzz lately about the placebo effect and back pain, extending from a randomized control trial in Portugal.
“Our findings demonstrate the placebo effect can be elicited without deception. Patients were interested in what would happen and enjoyed this novel approach to their pain. They felt empowered.” – Lead author Claudia Carvalho, Ph.D., ISPA
“It’s the benefit of being immersed in treatment: interacting with a physician or nurse, taking pills, all the rituals and symbols of our healthcare system,” (says placebo researcher Ted Kaptchuk, Professor of Medicine at Harvard Medical School). “The body responds to that.”
While this study focused on chronic pain, Kaptchuk says it is possible that patients with other conditions that involve self-observation – such as fatigue, depression, or digestive problems – may benefit from open-label placebo treatment.
“You’re never going to shrink a tumor or unclog an artery with placebo intervention,” notes Kaptchuk. “It’s not a cure-all, but it makes people feel better, for sure. Our lab is saying you can’t throw the placebo into the trash can. It has clinical meaning, it’s statically significant, and it relieves patients. It’s essential to what medicine means.”
There’s so much attention right now given to Olympic atheletes’ use of ‘placebo’ rituals and objects, from favourite items of underwear to ancient Chinese ‘cupping’ techniques and herbal supplements.
“Judo gold medalist Kayla Harrison wears the lucky socks that were a gift from her grandmother. Hockey player Alex Danson spins her stick 15 times before each game. Tennis player Rafael Nadal takes alternating sips from two water bottles at every break between games.”
Quartz looks in some depth into the phenomenon.
It’s unpacked further here.
“In sports, it’s a little different in that in the vast majority of cases relying on the placebo effect probably won’t hurt, and in many cases might actually help because of the power of belief. Aside from some potential BO, is it really a problem that an athlete regularly wears the same t-shirt under his uniform to help with on-field success? In fact, savvy coaches regularly use various placebo approaches when trying to help their team with belief — and often these tactics work.”
In Why Placebos Really Work: The Latest Science the Wall Street Journal points to the increasing frequency of ‘serious’ science envisioning health interventions that consciously include placebos and invoke the placebo effect. It seems the mind-body divide is something of an illusion!
Nevertheless, even though at least 50% of doctors actively prescribe placebos – often active drugs in such low doses that there is no apparent therapeutic benefit, or vitamins, antibiotics or over-the-counter analgesics like aspirin – they are still disinclined to prescribe a sugar pill. I guess they feel like it’s cheating, somehow.
Well-timed placebos may be useful in managing type 2 diabetes.
It seems that time, like everything else, has a subjective level – that is, one’s perception of time can actually manifest in the body. How does that work? Check this out …
… and have helped people with migraines, IBS and Parkinson’s.
Placebos have been shown to work for migraines, toothache and IBS
Parkinson’s patients continued to get relief after switching to placebos
After drugs, body becomes pre-conditioned to expect treatment and reacts
50% of American doctors found to prescribe placebos instead of drugs
New studies in the Boston suggest that placebos may causes changes in the body as well as the mind. Even with patients knowing they are being given a non-medicinal drug substitute they have still reported reduced pain and other symptoms in everyday, debilitating conditions such as irritable bowel syndrome or migraines.
So you want to run faster — but you’re not ready for steroids?
No problem: just swallow a pill made of sugar and water that you think is a steroid — and you’ll run faster, because you believe you can.
A recent Scottish study found runners told they were getting performance-enhancing pills felt stronger and ran faster than normally — even though the pills were fake.
It’s just the latest example of the Placebo Effect, one of the most powerful effects known to humans, along with the Greenhouse Effect, the Brexit Effect and the Trump Defect.
Placebos are fake drugs you think are real — and a third of the time, they’re more effective than most drugs in the pharmacy at reducing everything from headaches, pain, nausea, coughs and colds to anxiety caused by fear that the pills your doctor gave you are actually placebos.
Read the full article here.
As practitioners become a little more ‘open’ about their use of placebos, it’s time now to discuss the ethics of such use. From Glackin’s abstract:
It is widely supposed that the prescription of placebo treatments to patients for therapeutic purposes is ethically problematic on the grounds that the patient cannot give informed consent to the treatment, and is therefore deceived by the physician. This claim, I argue, rests on two confusions: one concerning the meaning of ‘informed consent’ and its relation to the information available to the patient, and another concerning the relation of body and mind. Taken together, these errors lead naturally to the conclusion that the prescription of placebos to unwitting patients is unethical. Once they are dispelled, I argue, we can see that providing ‘full’ information against a background of metaphysical confusion may make a patient less informed and that the ‘therapeutic’ goal of relieving the patient of such confusions is properly the duty of the philosopher rather than the physician. Therapeutic placebos therefore do not violate the patient’s informed consent or the ethical duties of the doctor.
The whole paper can be found here. It seems the article has stirred up something of a hornet’s nest among ‘psychopharmacologists’ – see the recommendations listed at the foot of the website.
A nocebo is the opposite of placebo …
“The nocebo effect is the placebo effect’s less attractive younger sibling. While the placebo effect has the ability to help people feel better in the absence of any active ingredients, the nocebo effect has the ability to make a person feel poorly in the absence of any active stimuli … a very real medical phenomenon.”
Further nocebo thoughts, related to people’s perception of harm from WiFi radiation, here.
Here’s a review of Jo Marchant’s fascinating Cure.