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The placebo effect: worthwhile or a waste of time?

Lara Andreski, Online Science Editor, discusses the placebo effect

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The placebo effect is where a drug of no therapeutic value, often sugar pills or saline injections, causes a physical effect. Although commonly talked about (people acting drunk before realising they’ve been sipping on non-alcoholic beer, or feeling immediately better when taking paracetamol, before any analgesic effects could have kicked in), the process by which it works is widely debated.

 

The recent BBC2 Horizon programme, ‘Can my brain cure my body?’, trialled 100 people with chronic back pain on a “new” painkiller. However, unknowingly to the participants, everyone was placed on a placebo drug, made up of nothing but ground rice.

 

The largest study of its kind carried out in the UK, the results were astounding. Half of the partakers found “significant relief” from taking the fake pills and reported medically significant improvement in their back pain. The pills prescribed looked authentic with a blue-and-white striped design, based on research into which pill appearance had the greatest effect on pain. They also came in carefully labelled bottles with cautions of side effects and warnings to keep away from children, a convincing replication of powerful painkillers.

 

Other studies have found similar results, such as a 2001 study on Parkinson’s Disease, which discovered that there was a considerable release of dopamine in the brain of patients in response to a placebo. These results indicate that placebos play a role in the activation of dopamine pathways within the brain and also raise the question of whether psycho-social effects and the “ritual” of taking a pill could have more substantial benefits than that of traditional medicine.

 

Placebos won’t cure cancer, but they may have a significant effect on the treatment of symptoms controlled by the brain, for instance the perception of pain. As this is an issue for many serious afflictions, such as arthritis, studying the placebo effect could lead to extensive medical breakthroughs.

Does prescribing placebos breach the faith of individuals in their doctors?

However, these studies also highlight the ethical issues involved in the prescription of inactive drugs. Does prescribing placebos breach the faith of individuals in their doctors? Is it unjust to give sugar pills when there are tested, effective drugs available.

 

This concern over a breach of trust and the issue of uninformed consent when giving placebos could become a nonissue due to several recent studies, which have suggested that the placebo effect is present even when the individual is aware that they are taking an inactive compound. A 2010 study on IBS found that the participants felt markedly better on the placebos, even when told beforehand, and reminded after, that they were taking an inactive drug.

the participants felt markedly better on the placebos, even when told beforehand, and reminded after, that they were taking an inactive drug

These results appear to support the theory that a theatre of healing and a ritual of taking a pill can stimulate one’s expectations to heal and hence cause a physical response. If this theory continues to hold up to rigorous testing, many of the ethical issues surrounding placebo tests could be eliminated, by using informed and aware participants.

 

Overall, the placebo effect raises interesting questions as to the control we have over our own bodies, and whether social environments and expectations really can have a significant effect on well-being.

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