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MARCH 15, 2013
THE RAW POWER OF
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f there is any one subject in the entire fascinating world of medical science that stands alone in the realm of the extraordinary and the sublime, it might very well be the placebo effect. This article will explore a tiny fraction of the magic and the mystery — and how this amazing phenomenon can be put to use in everyday medicine.
Take two
The most powerful drug known to mankind Know what it is? Ironically, it’s the inert “medicine” that offers no therapeutic effect whatsoever. That, if by chance you were unaware, is the definition of a placebo. Despite that description, placebo lives up to its name, Latin for “I shall please.” Not that placebos always please. More about that in one second. Placebo has earned a lofty perch in the pantheon of medicines, and it got it the oldfashioned way: it earned it. Pharmaceutical companies spend billions of dollars every year developing new medications, and what do they measure their effectiveness against? To a significant degree, against placebos. Such studies typically pit new drugs against placebos. Half the group is taking the next wonder drug and half are taking an inert placebo, perhaps a concoction of cornstarch or sugar. It must be disconcerting to be a pharmaceutical researcher who has spent years developing a new drug only to have placebos produce better results, but that’s exactly what sometimes happens. For every placebo, there can be its corollary: nocebo, the onset of negative symptoms, also caused out of thin air by inert pills, injections or creams. Nocebo means “I shall harm.”
and call me in the morning.
It gets complicated The preceding paragraphs were merely an introduction to the subject for the uninitiated. Let’s get into some of the placebo research into this fascinating topic. The January-February issue of Harvard Magazine caught our attention and got this idea off our idea list where it has been for a couple of years. In the magazine, researcher Ted Kaptchuk recounts his randomized clinical trial for patients with severe arm pain. Half the patients were given pain pills, the other half acupuncture treatment. In short order, about a third of the 270 people in the study were suffering from acute side effects: some of the patients were experiencing abnormal swelling and redness at the acupuncture sites; some of the pain pill patients reported that the drug made them so sluggish they could barely get out of bed in the morning. For the two-thirds majority, however, the results were better. They pain pills gave them genuine relief, and those who received acupuncture treatments reported even better results. Given the context of this article, you might expect what’s coming: both groups got placebo treatment. The pills that offered relief and caused terrible side effects were made of cornstarch. The acupuncture was also fake. It was performed with retractable needles which never pierced the skin. Researchers didn’t conduct this study simply to humiliate 270 people. Then why do it? Please turn the page.
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