The Placebo Effect – A Question…

A recent episode of Skeptoid on the Placebo Effect made me think of a simple, yet interesting question. But before I get to my question, I’d like to get into a little background on The Placebo Effect, courtesy Brian Dunning…

Got some chronic pain? An itchy rash? Hypertension? Depression? We’ve got the solution for you. It’s guaranteed to have no side effects, but it’s an extraordinary treatment for your symptoms. It’s the placebo, a completely inert and ineffective intervention, that does nothing to your body at all, except to convince you that it does. Whether it’s a pill containing no medication, an expensive looking electronic device that does nothing, an inhaler that provides the same air you’re already breathing, or just a manipulative treatment that doesn’t manipulate anything, the medical placebo is not only a crucial component of clinical trials, but it can also be an effective medical treatment in itself. After all, placebo is latin for “I please you.”

There is a very important caveat. As powerful as the placebo effect can be, it does not have therapeutic value in actually treating a physical disease. It also does not usually produce any kind of measurable improvement. Its value is almost exclusively for the reduction of symptoms that can be self-reported by the patient. Basically, it can help the way a patient feels, but it can’t treat their illness. Exceptions are cases like stress, insomnia, or nausea, where there is an actual condition, but no disease agent is involved.
 

 

All of this is fairly well understood by anybody with a general understanding of placebos. Nothing earth-shattering or unexpected has come to light in this podcast. But then almost in passing, he mentions something which makes me think of another question…

Many over-the-counter remedies, and even some prescription drugs, have been found to have effects only comparable to a control placebo. And yet, we perceive that they work, and so we keep going back for more. For example, a review of randomized controlled trials of over-the-counter cough syrups found that no such products work better than a placebo. And so, for all practical purposes, non-prescription cough syrups are placebos. That doesn’t mean they don’t work; it means they only work as well as a harmless substance that you think will help your cough. And often, that effect is sufficient.

I tend to not to rush off to pharmacy quickly (in fact my wife often chides me for taking too long to get meds when I don’t feel well), but I do tend to find that over the counter cough syrup has helped me on occasion feel better. With the information Brian gives, “for all practical purposes, non-prescription cough syrups are placebos”, it makes me wonder how much of the relief I have felt from cough syrup and other meds is a placebo and how much is an actual physical effect on the body. For me another example of this is my addiction to caffeine, which has lead me to keep a bottle of Excedrin on my nightstand next to my bed in case I wake up with a head-ache. I “know” that the 65mg dose of caffeine included in every pill helps me quickly recover until I can grab a Red Bull, Coke, or other “pick-me-up” drink.

Which leads to my question…

If some remedy that you currently use, and feel works, is found to be nothing more than a placebo, would you want to be told?

Now I’m not talking about something you believe cures a major disease or illness here. Nothing that is a life and death type of issue. I’m talking about something minor, like your favorite hangover cure, headache remedy, cough syrup, etc…

Would you want to know it’s all BS, and thus likely lose any placebo effect you once had, if an alternative was not given to replace this placebo you currently use?

One final note, unrelated to my question (but related to The Placebo Effect), that I thought was a great ending to the Skeptoid episode on the subject, and a good ending to my post:

Understanding the power of the placebo effect is crucial to understanding the value of a claimed alternative therapy. If it’s well designed and well delivered, an implausible therapy with no clinical value can indeed produce a subjective improvement in the patient’s symptoms. To debunk a worthless alternative therapy, it’s not necessary to prove that it has no effect at all. Rather, understand that under the right conditions it can, in fact, have a sometimes significant effect; an effect which can almost certainly be fully explainable as a placebo.

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About Rodibidably

Jeff Randall is a frequent volunteer for free-thought organizations, including the Center For Inquiry – DC. Having been blogging since January 2008, he decided that a community of bloggers would be an interesting new experience (or at the very least a fun way to annoy his friends into reading his posts more frequently). Since finding out about about the existence of, and then joining, the atheist/skeptic community in 2007 he has been committed to community activism, critical thinking in all aspects of life, science, reason, and a fostering a secular society.
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4 Responses to The Placebo Effect – A Question…

  1. nahgems says:

    …it does not have therapeutic value in actually treating a physical disease. It also does not usually produce any kind of measurable improvement…

    As someone who has worked in medical research for an extended period of time, I take issue with this statement. Many studies have shown placebos often have a fairly significant impact on physical disease. While this can sometimes be explained (i.e. placebo may help patients sleep better, or be less stressed – which effects their blood pressure). Sometimes the link is less clear. Regardless, placebos often help “real” physical illness.

  2. You wrote:
    …If some remedy that you currently use, and feel works, is found to be nothing more than a placebo, would you want to be told?

    Would you want to know it’s all BS, and thus likely lose any placebo effect you once had, if an alternative was not given to replace this placebo you currently use? …

    I must say, why is the placebo effect be the enemy? I think of it as a “self-healing effect,” and that simple reframing changes the terms of the debate dramatically – suddenly, instead of it being the culprit of many a “ruined” drug trial, the placebo effect is an empowering and amazing gift that we human beings have to move ourselves towards homeostasis and a balanced wellness.

    Every remedy works in concert with the body/mind/spirit… don’t we often say that a person died because he “lost the will to live”? Without his will, the doctor’s best efforts were impotent. This is true because we are not simply chemical “machines,” “imbalanced” by “disease.” Our spirit/mind plays a complex role in determining the level of balance or imbalance in our beings.

    • Jeff Randall says:

      I am not saying the Placebo effect is “the enemy”. But when people take a placebo in place of actual treatment, in many cases the results can be fatal.

      Yes there are cases when a placebo can help, but when you bring up “spirit” I am not quite sure what you mean. Are you referring to a soul? Or something a bit more new-age like, and equally undefinable? Unless it can be defined and quantified, it’s hard to give it any credence.

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