4 . People are weak and pampered in modern society so report “pain” because they want attention and the placebo is incidental to the equation.
Right. A placebo is just as effective as Penicillin at treating Penicillin resistant infections. Probably better as the placebo doesn’t kill harmless/helpful bacteria that could compete with the MRSA.
i was just joking.
What’s the emoticon for failing to recognize sarcasm? I need that more often than I should.
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Ah, but you have to take the Doctrine of Opposites into account. Super-diluted sugar pills would lower blood sugar.
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Try my new virtual placebos. All the placebo - none of the sugar.
Just think about them after sending your payment. Virtual payments not accepted.
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[quote=“tgarretteaton, post:7, topic:101769, full:true”]
Ugh… no, this study isn’t saying that placebos work– it is just demonstrating how systematic biases can alter outcomes in a study. [/quote]
That’s one possible explanation for the results.
Another explanation would be that placebo effects are surprisingly resistant to patient awareness, suggesting that the levels of deception required for effective placebo-based therapies may be less than expected. That’d be a genuinely interesting and potentially useful finding.
Most likely, the answer is a bit of both.
They deserve the best care we can give them. Usually, that involves at least a partial reliance on the placebo effect (AKA “the ability of the mind to influence the body’s innate healing abilities”).
Unfortunately, all too often, the placebo effect is still the only effective treatment available. Medicine is hard.
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Maybe some people, but life is pain. Especially once you get over 40 or so.
In psychology the skills of the therapist are much more important than the nature of the therapy. There’s got to be at least a little of that in medicine. Comparing placebo versus no treatment is not a valid comparison. How about Placebo versus a skilled practioner looking at a chart and saying “in my opinion, no treatment is the best treatment in this case”.
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A medical consultation, controlled to minimise variation between treatment groups, is a standard part of a normal pharmaceutical study. The only difference between groups should be the contents of the pill; anything else introduces confounding variables.
Medical research is structured the way it is because that is the best we can achieve with the resources available, and those methods, while imperfect, have proven over time to be an effective means of incrementally improving medical care.
There’s also the point that if you’re testing a new drug, you want to see how it performs in the likely real-world conditions, not how it might perform in a hypothetical ideal situation.
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“but I think others may actually receive some actual effects of the Placebo”
There are no effects of a placebo - that is the whole point. Placebos have zero clinical effect, zero clinical value. They confound clinical studies - THAT is their only effect.
People completely do not get this - they think there must be some way to harness the “power of the placebo”. There AIN"T no power of a placebo - they only seem to have an effect during short clinical studies. They do NOT do anything in real life. They don’t give results in long clinical studies. Placebos are sugar or water. You are arguing that giving patients sugar or water is beneficial to them. This is how quackery is promoted. Please stop this.
We already have enough placebo “medicines” for sale now: homeopathy, acupuncture, reiki, magnets, etc. These are all quackery. They - and virtually all alternative or complementary ‘medicines’ should be banned.
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<— is fifty one, labourer including a decade of dairy farm slavery, three serious knee reconstructions. I don’t use pain killers, do use anti inflammatories.
But the thing is, most of the people I know who now go on about their chronic pain, were previously simply soft-cocks who needed to take a concrete pill and harden up. (I am aware this experience isn’t the sum total of the human condition, but where you hear hooves, unless you are in Africa, you look to see horse, not zebra.)
The younger people I know that are not sportspeople, are usually constitutionally weak, they all want a job where they don’t actually have to get their hands dirty, and if they get a paper cut they talk about it for a week.
But I honestly think most “pain” people in developed countries obsess about, wouldn’t have been even mentioned in the 1800s.
Very much no.
The placebo effect is a genuine medical phenomenon that must be accounted for in all medical research, regardless of how inert or active the pharmacology under investigation is. It is also an important part of clinical effectiveness, again regardless of how active or inert the other portions of the therapy might be.
It is a simple, well-established, readily-observable fact that the innate healing ability of the body is strongly influenced by psychological factors. These factors influence treatment whether you deliberately invoke them or not.
Invoking and enhancing the placebo effect is a central part of all therapeutic traditions. In western medicine, it’s traditionally known as “having a good bedside manner”. In pre-20th century medicine, pretty much all we had was placebo, opiates and surgery. These days we have a lot more options, but placebo is still an essential part of the toolkit.
Yes, sure, the existence of the placebo effect slightly complicates medical research. But it isn’t a bad thing; it’s a good thing. The fact that we can often improve health outcomes through purely psychological means is fucking awesome. It isn’t just an imperfect treatment-of-desperation when we’re at a loss for what to do, it’s also the spice that makes all of our effective treatments better.
As a simplified example: say you’re testing a pain med. Untreated patients give a pain score of 8. Placebo control patients report a score of 6. Active drug group patients report a pain score of 5.
In the real world, assuming adequate n etc., that would be considered a rousing success for the drug under trial. It almost halved the reported pain, and it significantly outperformed placebo! Rush it to market and you’ll make a fortune.
But note that, even with this hypothetical proven effective painkiller, placebo is accounting for more than half of the therapeutic effect.
That’s how it tends to actually work in real-world medical trials. The placebo effect is a fundamental part of medicine, including modern, scientific, evidence-based medicine.
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I feel like everyone’s missing a crucial point here, i.e., that the placebo patients were told that placebos work.
The study says:
[…] the placebo pills were truthfully described as inert or inactive pills, like sugar pills, without any medication in it. Additionally, patients were told that “placebo pills, something like sugar pills, have been shown in rigorous clinical testing to produce significant mind-body self-healing processes.”
[emphasis added]
This is not a so much a confirmation of a “placebo effect” as a confirmation of a “belief in placebo effectiveness” effect, or perhaps more precisely, a “faith in physicians’ statements” effect.
The doctors running the study said, “Here’s a ‘placebo pill,’ which is like a sugar pill, but rigorous clinical studies say that these pills sometime help.”
So, sometimes, they helped.
This a “faith in rigorous clinical studies” effect, not a placebo effect.
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Homeopathy is not from the East; it is a bad idea from Germany, a failed offshoot of the predecessors of modern “Western medicine”. Also,
I really don’t think ideas that are supposed to benefit all of humanity should be labeled “Western”.
Anyway, you’re too late. Real madness has once again outstripped all parody.
In the German speaking areas of Europe (Germany is, after all, Ground Zero of the homeopathy madness), homeopathic globuli explicitly labeled as placebos have been on sale for a long time.
I haven’t found anything in English, but this page (Google-translated version here) explains how useful those little sugar balls are. You can use them to make your own homeopathic medicines, or you can give them to your child as a placebo (and train them to believe in homeopathy when they grow up).
But isn’t that the definition of a placebo effect? The patients expect a positive effect, and a positive effect happens.
The study shows that the belief doesn’t have to involve belief in an active substance in the pill.
Next, I want to know what happens when the doctor says “Clinical studies have shown that your symptoms can be effectively treated using just placebos [explain if necessary]. So now that you know that your body can heal that by itself, we don’t need to actually give you any sugar pills to trick you into self-healing.”
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“Faith in rigorous clinical studies” is a part of the placebo effect. You can make an informed, rational decision to utilise evidence-based medicine, and benefit from the somewhat irrational ways in which the mind affects the body. They aren’t mutually exclusive.
Sugar pills given to you by a doctor in a white coat are more effective painkillers than sugar pills you get from some random dude. Put 'em in a fancy packet and they’re even better. Add a brand name that you’ve heard of and they’re better still. Two are more powerful than one, despite containing the same amount of active compound (zero).
The healing process, via the placebo effect, is affected by the entirety of the cultural context around the clinical interaction. It’s the water that medicine swims in.
You do have a point, though. The study as you describe it could just as easily be explained by the subjects’ failure to fully comprehend the information they were given. It appears to assume some preexisting understanding of medical terminology.
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My wife developed a debilitating pain condition at 36. She has stupidly high pain tolerance. In a separate incident, when she arrived at the ER with a 103 degree fever, the admitting doctor looked at the scan results and said “wow, you’re really calm. Normally, the people I see come in here in this condition are rolling on the ground, screaming for morphine.”
When her chronic pain condition developed, she didn’t go on about the pain; she just started sleeping 12-16 hours a day and had no energy to do anything. Amazingly enough, this lack of energy abated when she went on a regular regimen of painkillers, after the anti-inflammatories failed to do much of anything.
I daresay that your experience of pain is highly subjective and shouldn’t be extrapolated to others.
But if you suggested in my presence that my wife just needed to “harden up,” I would repeatedly punch you in the mouth. Until you asked for painkillers.
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To be clear, I don’t think it is the placebo is causing the effect directly. But one can have an effect triggered or at least coincide with the placebo that makes one feel better. So the effect is real, even if, like I said, there is no chemical reason for it from the placebo. There seems to be another reason we don’t fully understand causing this. I am referring to things like pain, not things like stopping the spread of cancer.
As someone with chronic pain, I can reduce my perceived pain through distraction. What ever external stimuli I am using isn’t doing anything internally to make my pain less, but at the same time I feel less pain.
No I didn’t.
Eh, I see your point, but it comes off as “old person yelling at clouds”. “In my day, we would cut a finger off plowing the field and not even come in to wash it off until the end of the day.”
I get that some people seem dramatic for the sake of attention, but if “hardening the fuck up” was an option for me, I’d gladly just do that. (Grew up in Rural/Small town Kansas, so, not usually one to whine about paper cuts.)
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There must be a study on this, but would be interesting to have the doctors describe two different medications to test subjects. One pill has a bunch of adverse side effects with a few positives, another has mostly positive effects with a few normal downsides. Give two groups the same placebo pill and record their reactions.
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