This is fascinating – well worth a 30 minute listen!
It seems that the research on the placebo effect is broadening and deepening.
“Over the last several years, doctors noticed a mystifying trend: Fewer and fewer new pain drugs were getting through double-blind placebo control trials, the gold standard for testing a drug’s effectiveness.”
This recent article, which includes some useful links for further reading, points to the degree in which the placebo effect (classified by the writer as a ‘family of overlapping psychological phenomena’) is being studied and considered. The family of placebo effects ranges ‘from the common sense to some head scratchers’, and include:
1) Regression to the mean
2) Confirmation bias
3) Expectations and learning
4) Pharmacological conditioning (‘This is where things get a little weird’)
5) Social learning
6) A human connection
Interestingly, it seems that at least in pain studies, ‘there’s evidence that placebos actually release opioids in the brain’.
In another article in Mother Jones, What the Heck Is a Placebo Anyway?, the authors propose ‘… we now know that they (placebos) often involve real chemicals produced by the body—real drugs from your “internal pharmacy.” Some of these chemicals are used by the brain to make sure that your expectation meets reality. When expectation doesn’t meet reality, the brain steps in and forces it to fit.’
Over at Fox News (of all people), quoting the Wall Street Journal, they’re suggesting ‘Placebo drugs really work, evidence suggests‘.
Placebo ‘drugs’? Come on, folks, that misses the point a bit!
“Certain types of elective surgery only benefit patients because of placebo effect, says Prof Andy Carr.”
We’ve posted on this previously, on the mater of ‘sham srugery’ for knee pain actually having a substantial impact on lessening pain. In this case, a senior orthopaedic surgeon in Britain, says “The correct thing has got to be to do … trials – not to continue doing operations where we don’t know whether or not there’s a strong placebo component or an entire placebo component because that means that tens or hundreds of thousands of patients are having unnecessary operations,” he said.
That’s right – ‘tens or hundreds of thousands’.
Another professor, also from Oxford, points out the opinion, which we have seen has been gathering momentum (and scientific respectablity) over the past couple of years, that ‘deception’ is not a requirement for the engagement of the placebo effect. “In the modern world where we’re trying to limit the amount of time physicians spend with patients we’re going in the opposite direction of what the science is telling us, which is that [expectation] is really important physiologically and therapeutically and we’re throwing that away.”
Read the whole Guardian article here.
And more on the efficacy of so-called ‘open label’ placebos (like ours!)
Linda Buonanno had suffered 15 years of intense cramps, bloating, diarrhoea and pain she describes as “worse than labour”. She was willing to try anything to get relief from her irritable bowel syndrome (IBS) and leapt at the chance to take part in a trial of an experimental new therapy. Her hope turned to disappointment, however, when the researcher handed her a bottle of capsules he described as placebos containing no active ingredients.
Nonetheless, she took the pills twice daily. Four days later, her symptoms all but vanished. “I know it sounds crazy,” says Buonanno, of Methuen, Massachusetts. “I felt fantastic. I knew they were just sugar pills, but I was able to go out dancing and see my friends again.”
Placebos have a reputation problem. It is widely believed they are only effective when those taking them are deceived into thinking they are taking real drugs. As such, prescribing dummy or fake treatments is unethical. Yet in Buonanno’s case there was no deception. And she is not alone. A review of five studies, involving 260 patients, published last month found that “open-label” placebos – those that patients know contain no active medication – can improve symptoms in a range of conditions. This growing body of evidence raises a number of important questions. How do open-label placebos work? Which conditions do they work for? And should doctors prescribe them?
Read the whole article here.
Here’s a fascinating story from a writer at the Smithsonian who experienced that the placebo effect is engaged even if you KNOW you’re taking a sugar pill.
“I was in grad school training as a psychotherapist,” (Kelley) told me once, “and I came across a study arguing that antidepressants work just as well as psychotherapy. I didn’t mind that so much, because I like psychotherapy and see its value. But later I found another study showing that antidepressants actually work no better than placebos, and that definitely bothered me. Did this mean that psychotherapy was nothing but a placebo? It took me quite a while to consider the reverse, that placebo is a form of psychotherapy. It’s a psychological mechanism that can be used to help people self-heal. That’s when I knew I wanted to learn more.”
It seems that here at Universal Placebos we’re selling ‘open label’ placebos, that is, placebos explicitly labeled as placebos. It’s so nice that science is catching up!
In his research, which includes a wonderful ‘one person experiment’ designed to use placebos in tackling writer’s block, the author interviews Kathryn Tayo Hall, a geneticist at Brigham and Women’s Hospital, and ‘sheepishly’ admits to the fact that placebos worked for him.
“Brilliant,” she said, and showed me a box of homeopathic pills she takes to help with pain in her arm from an old injury. “My placebo. The only thing that helps.”
“I don’t have to believe in you,” (the author says directly to his placebo pills), “because you’re going to work anyway.”
This question/comment/assumption comes up a lot when we talk to people about placebos and the placebo effect. ‘It works’ (is the assumption) ‘if people believe it’s something else’ …
Like the ‘real’ thing, perhaps …? We’ve posted on this before, and it seems the research is becoming more robust and rigorous.
Once more, courtesy of Professor Kaptchuk … read Knowingly Taking a Placebo Still Reduces Pain, Studies Find …
From Stephanie Buam, at Medcity News:
“It would be oversimplified to call it the power of positive thinking, but Harvard Medical School Professor Ted Kaptchuk‘s talk at TEDMED 2014 in Washington D.C., highlighted compelling research surrounding the placebo effect. Kaptchuk focused on applications of the placebo effect for conditions as diverse as migraine headaches to Parkinson’s disease. It demonstrates that some of the power of a drug comes from a patient thinking that it will work.”
This research, from 2010, suggests patients benefit from the placebo effect even when told explicitly that they’re taking an ‘inert substance’