![]() ![]() In the double-blind study, patients were given either the surgery, a simple saline lavage (washout) of the joint, or a sham surgery where an incision was made but no surgery performed. Until then, the standard treatment for the condition was a surgery known as arthroscopic debridement. “Things like surgery or treatments that involve equipment and machinery – things that convey that this is a serious treatment.”Ī famous example is a groundbreaking study conducted in 2002 on patients with osteoarthritis in their knees. In general, more serious “treatments” have a bigger placebo response, he says. “Drug companies have increased their use of X and Z in drug names dramatically over recent years … the letter Z has connotations of efficacy, while the letters T and S have been shown to be associated with ideas of smaller, lighter, faster and more tolerable treatments,” Petrie wrote. In a 2019 review on placebos, Petrie and colleagues cited research findings that certain letters of a brand name can produce a link between a sound and a meaning. When patients suspect they’re receiving an “active” treatment – if it tastes strong, for example, or fizzes in the mouth, or even creates mild side effects – it can condition them to think a placebo treatment is working better.Īnd in fascinating evidence that plays into how drugs are marketed, it’s been found that the name of a pill can even have an impact. And “two pills are usually better than one”. The design, colour and shape of a placebo pill can affect how much of a response there is, Petrie says. So does the design of the placebo itself. Social cues – observing the experiences of other people, social buzz and word of mouth – also come into play. So, too, does conditioning: what we’ve experienced in the past with drugs and treatments. It makes intuitive sense that expectation – what we think is going to happen when we receive a treatment – might have a major influence. Many things influence how and why the placebo response works. And a treatment that’s completely worthless also has a response wrapped around it, but its total response is just due to the placebo response.” Cue reinforcement So, you can have a treatment that’s very effective it still has a placebo response boosting its overall effectiveness. “What people don’t realise, I think, is the placebo response actually wraps around all treatments. Research has found that only a healthy brain can develop a placebo response. Positive effects on pain in particular are seen in the same ways in the opioid system with placebo treatments and drugs alike. Petrie – one of a handful of researchers around the world who have looked at the placebo response in depth – says it’s now understood that placebos operate on the same circuitry in the brain as drugs do. That the placebo response is simply all in the mind – an imagined effect, in other words – is an idea many of us may hold. His studies have ranged across conditions including chronic back pain, irritable bowel syndrome, menopausal hot flushes, depression and cancer-related fatigue. Kaptchuk is an advocate for the potential of the placebo as an evidence-based, clinically relevant tool for relieving chronic pain. The placebo has the potential to improve existing treatments and medications, and to teach us more about the mind-body connection when it comes to health and healing.Ĭrusaders such as Harvard professor of medicine Ted Kaptchuk are excited about the potential for the placebo response to enhance existing drug treatments and potentially treat pain conditions. Experts now believe it’s more than just something to factor in and allow for in medical research. But the placebo effect is the subject of serious research. And, of course, there’s always megavitamin nutritional solutions for this and that.” “They’re often some sort of machine that does powerful things or they’re showing models to people of all the great benefits they’ll get. Petrie’s students tend to come up with creative ideas for their placebos along similar lines, he says. Do better than the placebo with your treatment, the thinking goes, and you’re on to a winner. There’s always some degree of placebo response in drug studies. Placebo arms are a standard feature of drug studies they’re there to help determine the effectiveness or otherwise of the treatment being tested. The University of Auckland professor sets the task after teaching his students about the placebo effect, the intriguing response that’s baked into every drug or treatment study: when patients feel better even though they’ve been given a treatment that’s not active, such as a sugar pill or saline solution. Keith Petrie sets his health psychology students a challenge each year: create your own sham treatment, snake oil or pseudo-scientific therapy – something you could theoretically charge big bucks for. ![]()
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