I once read about a study where rats were trained to have an allergic reaction to a bell or buzzer or some such. There is an intimate connection between the brain and body through chemical signals. It’s interesting they are starting to track it down.
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I’ve just never understood the hostility. I mean, it wields even when the patient knows it’s a placebo. Surely the chances of addiction, overdosing, and side effects go down with placebos, so what’s the harm?
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Right? I don’t understand why they don’t give out sugar pills like they’re candy!
I’ll be here all night.
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From what I understand, the hostility is due to people taking placebo or pseudoscientific remedies instead of taking something that will actually treat the underlying condition.
When someone takes a placebo for acute pain, then yeah, there’s no harm. If the alternative is an analgesic, then what does it matter how you convince the brain that the pain isn’t there?
But when someone goes off of chemotherapy and starts to feel better taking, say, a homeopathic treatment (because chemotherapy is introducing poison into the body with the intent of killing the cancer faster than it kills the patient), or when someone takes a placebo for depression, and reports feeling better, but still has all of the other adverse symptoms depression gives them…
It’s hard not to be hostile when the placebo effect allows the profitable hoax that is most of naturopathic medicine to endure.
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Another aspect of placebos is that the natural course of things (for minor illness) is that the body heals on its own, so that the natural healing is sometimes associated with taking the pill.
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Okay, but that scenario assumes that either the patient is self-medicating, or else they are being attended by a non-certified quack. In both those cases, the problem is they are not working with a certified MD. That the preparations they’re taking are ineffective is not a root cause of failure.
That’s a really bad reason to reject entire families of therapies.
Counter-example: I’m allergic to so many antibiotics (including a sulfa allergy which only showed up in my early thirties) that I don’t take antibiotics unless I really, desperately, need to. So I’ve had two GPs recommend various herbal teas to ease my symptoms when I have one of my frequent bouts of sinus infections. Nothing radical: mint for clearing my head, hibiscus for cough. They made it very clear these won’t help with the infection itself, but they’ll make me more comfortable while my immune system battles it out, and it’ll help with my recovery if I’m more comfortable.
Such is the hysteria around non-drug approaches that one of the doctors requested I not tell anyone she told me to take the tea. That to me is not a healthy (pun intended) environment to work in healing. I have a family medical history of resisting drugs: several relatives, myself included, have weird non-reactions to anaesthetics, painkillers, and other drugs, where the damn things just don’t work, or don’t work as well as they’re supposed to (I’ve been told that in itself could be a sign of an allergy). If something else works, even not on the molecular level, I’m happy to take it so long as it isn’t doing harm.
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The irony is that if your sinus infections are viral (which they usually are, although yours may be different), antibiotics would only be a placebo anyway.
You’d think that they would face greater censure for unnecessarily prescribing active drugs than for prescribing placebos to take care of mild acute symptoms, but that’s sadly not the case.
As I said, for the purposes of treating short-term symptoms, placebos are awesome.
They’re trying to precipitate a culture change, so that people do go to them instead of the quacks. I don’t know how you’d achieve that without pointing out “Hey, that’s not based on science and not fixing the underlying problem.”
If homeopathic preparations (i.e. vials of water) are accepted enough that they show up on the shelves of legitimate pharmacies, claiming to treat everything from the common cold to cancer, what should licensed MDs do, if not protest that?
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The whole point of the original article is that placebos do seem to have a science-based effect, and that, for some medical issues, they will enable fixing the underlying problem.
I don’t advocate for homeopathy, and I’m not sure why placebos are getting lumped in with homeopathy here. I’m also not sure why placebos = quackery, since the whole point of the article was that they are already part of standard drug trials and may well be an effective therapy on their own in some cases.
As for the cancer stuff… yeah, haven’t heard of placebos killing cancer. But I haven’t heard of painkillers getting rid of cancer either. Doesn’t mean they’re not effective for other ailments.
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They’re being lumped together because homeopathy and other quackery make use of the placebo effect to appear effective.
Again, when placebos are good enough, I think they should be prescribed (assuming that, under the principles of informed consent, patients are kept informed that it’s the placebo effect and the positive effect of a caring bedside manner responsible for the effects, rather than any particular active ingredient). But I can see how practitioners could see that wholesale endorsement of therapies based upon the placebo effect could, if not carefully thought through, might lead to people looking to those same therapies for answers to things that need something more potent than a placebo. How sending someone for, say, acupuncture, as a treatment for stubborn migraines, while possibly effective in alleviating the debilitating pain/nausea/sensitivity of those migraines, might lead that person to go back when the acupuncturist suggests the same treatment for, say, Alzheimer’s.
I think wholehearted support of the medical community for placebo-based medicine for those things that placebos can treat won’t happen until placebo-based medicine is eliminated from those fields that placebos can’t treat. And, since there’s always been snake-oil salesmen, the latter seems a long way off.
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Given that quacks also use regular drugs for treatment (such as antifungals to treat cancer) that’s never going to happen. Yet antifungals still get used in regular medicine. And so do placebos, in drug trials and in other medical testing.
In other words, it’s coming back around to prejudice, not science.
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I don’t understand - prejudice against the placebo effect or against quackery?
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It’s like what they talked about on the article. Doctors have been trained to think along the lines of, “this molecule latches onto that bacterium” or “this molecule reacts with the body’s T cells in order to…”. Saying, “this placebo, when administered with these instructions, causes the patient’s brain to release these chemicals which boost the healing process” is just too far removed for them, so it gets dismissed as quackery.
The whole point of the article is that placebos are not quackery as such, because even when the patient knows they’re taking a placebo, it still works.
Therefore there is potential to add placebos to the list of treatments for things like chronic pain. But it’s a very tough sell, because the whole quackery spectre gets raised, unfairly.
It comes up with patients too, especially the parents of young children, where the advice “let nature take its course” does not go down well. I’ve heard the reverse in some cases – of doctors resorting to sugar pill prescriptions because the parents insist on drugs when none are required.
Therefore prejudice.
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Sometime in the late 90s, Conan must have taken elocution lessons.
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They may start that way, and sometimes might even end that way, but they also may progress through bronchitis to pneumonia with a side order of ear infection. Similarly, the immune system may fight off tooth infections and strep throat, but if it doesn’t, the results can be disastrous. People still die from those things. Why take chances when cheap antibiotics are readily available? Even if you would’ve survived without them, you may have lost extra weeks to fighting something that would’ve been gone if you’d treated it. ‘Just a virus’ may bring its bigger badder bacterial buddies along and weaken you enough for them to take hold.
There’s a lot of fear of antibiotic-resistant bacteria pressuring people not to go to the doctor and doctors not to prescribe antibiotics. But there needs to be some pressure the other way, against the … anti-antibioticers(?), just as we need pressure against anti-vaxxers.
I kind of veered off the topic about placebos, which can be surprisingly effective. But to tie it back together, I think they’re best kept for cases where there aren’t some other living entities (bacteria, cancer cells, etc.) actively involved. Placebo for your muscle pain after doing too much yardwork, or your urge to smoke, ok. Placebo to fight infection or cancer, not such a good idea. Sure sometimes you might heal up and be fine, but is the potential cost of failure worth the gamble?
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You need Sherman’s Bacterial Vaccines, for Cold, Influenza, and Pneumonia.
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Thank you for this. That basically describes most of my medical history from the age of two until today. It’s partly why I have so many drug allergies – because I’ve taken so many of certain types.
These days, I can often get rid of the worst of an infection if I take antihistamines at the right time. And before somebody says they don’t cure anything – no, but they do dry out the nasal passages, which makes it less hospitable for bacteria or fungus. Doesn’t always work but it’s another trick in the arsenal.
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I suffered from sinus infections my entire life…was never able to breathe through my nose, smell anything, etc.
Finally, a specialist determined that I had gotten to the point of needing sinus surgery to correct the passageways. The surgery worked!
But in the long process of trying everything else first, I asked his head nurse if she had any recommendations on at-home treatment. She said: as soon as you can tell you are coming down with an infection or cold, that night take a dosage (2 fizzy tablets) of Alka-Seltzer Extra Strength Nighttime Cold & Flu and go straight to bed.
It’s not that you don’t get sick, it’s just that you’ll get 10% sick for a day or two instead of 250% sick for weeks, if you know what I mean.
A stitch in time saves nine!
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Interesting to some:
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