The title of this blog post is identical to the title of an outstanding book by Jo Marchant. The phrase, “it’s just a placebo effect,” has been one of my pet peeves for a long time as I find the placebo effect to be one of the most important facts of medicine. Any medical trial needs to be run against a placebo treatment as the placebo treatment will result in a measurable effect, and the desire is to measure the effect of the treatment above and beyond the placebo effect. However, what I find ironic is that this genuine effect is not routinely administered. Absent some treatment, why not give the patient a placebo as there will be a benefit for at least some of the patients? The reason that the physician would provide is that the placebo effect is not a real treatment so it would be dishonest to deceive the patient even though the patient might benefit from the deception. Research has shown that patients still benefit from placebos even when they know that they are indeed placebos. I find it ironic that physicians routinely treat viruses with antibiotics even though they know that the antibiotic is ineffective against viruses. This practice has weakened the effectiveness of antibiotics, Why not administer a placebo shot instead? Any effect the antibiotic might have would be a placebo effect, so why not simply administer an injection of a placebo?
The truth is that too many physicians are infected with the bias that medicine is physical and that placebos are mental. They refuse to appreciate the effect that the mind has over the body. Marchant’s book goes a long way to documenting these effects. The failure to correct this bias will result in unnecessary deaths, pain, and suffering.
At the outset, Marchant makes two important points about the limitations of the placebo effect. The first is that any effects caused by beliefs in a treatment are limited to the natural tools that the body has available Note, however, that the body might not use some of the natural tools absent a placebo effect.
The second point is that effects mediated by expectations tend to be limited to symptoms—things that we are consciously aware of,such as pain, itching, rashes or diarrhea, as well as cognitive function, sleep and the effects of drugs such as caffeine and alcohol. Placebo effects also seem to be particularly strong for psychiatric disorders such as depression, anxiety, and addiction.
However, these limitations are not as constricting as they might seem as placebo effects can affect the immune system, which is the disease fighting system of the body. This is a new field of research, one that has been encouraged by the father of the Salk vaccine, Jonas Salk, called psychoneuroimmunology. The potential of this new field of research is unknown.
So, who knows what placebos hold for the future, but today in many cases painkillers and antidepressants may not work much better than a placebo. Moreover there are risks of addiction and side effects with these drugs. The top ten grossing drugs in the United States help only between 1 in 25 and 1 in 4 of the people who take them,. Statins might benefit as few as 1 in 50.
A study published in the British Medical Journal concluded that drugs are responsible for more than half a million deaths in the Western world each year with minimal benefit.
I would also call your attention to the healthy memory blog post, “Most Published Research Findings are False.” So most physicians are working in the dark with research, most of which is wrong.
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