A placebo drug usually in the form of either sterile water, saline solution or a sugar pill is administered during research either to a control group along with a research group in which take the real substance or to see the benefits of it after administration. The placebo effect is when a real response is produced from taking a fake treatment. The expectations of a patient contribute massively to the placebo effect as the more a patient expects the treatment to work for them, the more they are likely to produce the placebo response.
For example, in a research study, one group of individuals may be administered a placebo drug for something while the other group receive the actual treatment. The purpose of this is to see whether the real treatment has an effect. If the participants taking the real treatment show huge improvements compared to the placebo group then this could add to the support of a drug being effective. However, if there was no difference in the responses of the placebo drug administration and the actual drug administration, then there could be questions of the drug’s effectiveness.
Mridula Shankar suggested that responses to placebo drugs largely depend on the faith and the mental outlook of the patient towards the treatment. I think that a patient who has high expectations of improvement is more likely to feel better as a response to the placebo drug. Therapy with a patient and the act of taking a therapeutic approach to treatment boosts the confidence of the patient and gives a sense of control over any problem that was once hopeless. Also the production of positive emotions triggers physical change in an individual such as ‘the activation of pain control centres that release endorphins to reduce symptoms of illness’. So altogether, this explanation could contribute to the high success rate of homeopathic treatments that use natural remedies to cure illnesses.
My question is that if placebo drugs have research supporting that they are highly effective when used in therapy and treating illnesses, why is society so uncertain about using them and aims to use real drugs themselves? The power of placebo drugs is responsible for the ethical issues it brings about. Deception plays a huge role in the administering of placebo drugs and its responses. If a patient knew that the drug they were being given was a placebo and not the real thing, this would majorly effect the outcome of the response. Part of the placebo effect is the positive emotions and beliefs of the patient that they are taking something that will make them feel better. The placebo drug essentially takes advantage of the fact that the brain is being tricked into thinking that the drug it has taken will make the illness go away and this in turn, will trigger the natural biochemical processes to bring about the change which is needed in order for the individual to feel better. However, the use of placebo drugs violates the trust between experimenter and participant or doctor and patient but it is this violation and deception which is actually responsible for the placebo effect itself, which is very interesting.
Although deception is wrong in psychological studies and in real life situations when dealing with medicine and treatment, for the placebo effect to work, it is a necessary requirement to deceive your patients in order to see whether the actual drug treatment is effective in treating the illness in question. The placebo effect and response which contributes majorly to drug effectiveness could not happen if deception was not on the cards.
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I agree that the effects of placebos are undeniable. I know someone who cured their child’s travel sickness by telling them that a coffee sweetener was an extremely effective travel sickness pill!
Diederich and Goetz conducted placebo studies in parkinson’s, depression and pain. The parkinson’s patients who received a placebo in place of real treatment showed the same changes in their PET scans as those who received medication. Just the expectation of results caused patients to show significant improvement in their symptoms. Similar results were found in the studies of pain and depression. In the studies of parkinson’s and pain, the more dramatic the treatment (surgery, injection that the patient can see), the more likely the subjects were to benefit from the placebo treatment. This supports the theory that the more the patient believes the placebo treatment is real, the more effective it will be.
One of the added benefits of placebo’s over normal drugs is that they don’t cause side effects. So in that sense they could even be seen as more beneficial than drugs.
A very interesting yet concise blog, providing readers with an insightful overview of some of the benefits derived from homeopathic treatments, also informing readers of the ethical issues surrounding the use of placebos in experiments.
Your blog has provided me with an alternative notion in regards to the use of placebos in research. The stance I immediately arrived at when writing by blog was one of unjust, I believed that administering placebos to participants in any given control group is unethical, when being compared to a known preferred treatment. However, you have highlighted the potential benefits of being given a placebo and the positive outcomes associated.
The ethical issue I have given brief mention to is termed ‘Clinical Equipoise’ and I believe that it is an extremely interesting concern, being highly contended in clinical trials. To reiterate it is “the basic concept is that clinicians have an ethical responsibility to provide the best possible treatment for their patients” (Gravetter & Forzano, 2009); prohibiting the use of placebos as they are classed as ‘non-treatment. This issue has caused great contention in the field of clinical research, with a faction of researchers strongly contending the prohibition of placebos arguing that clinical therapy and clinical research should be treated as separate entities, and researchers should be aware of this, ensuring that their participants are also aware of this (Miller & Brody, 2003). Put lucidly, the primary aim of clinical research is in gaining advances in cumulative knowledge about the population, not providing therapy for individuals.
So it is apparent that when put together our blogs provide a more eclectic view of placebos, with your blog touching upon the benefits and my own touching upon the abolishment of their use.
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Great blog
I personally believe that placebos should be introduced into mainstream medicine. You may ask why? It’s just a pill filled with glucose, which shouldn’t have any beneficial physiological or psychological affect. However, the research done which include the use of placebos show that placebo’s have a positive influential effect. Kleinman A, Guess HA, Wilentz JS (2002) described the placebo effect as a “positive physiological or psychological changes associated with the use of inert medications, sham procedures, or therapeutic symbols within a healthcare encounter”. This fully describes the diversity of procedures that can be produced by the placebo effect. If placebos were brought into mainstream medicine, there would be a variety of options available to patients. In addition to this the National Institutes of Health (2001) appear to support this idea “understanding how to enhance the therapeutic benefits of placebo effect in clinical practice has the potential to significantly improve healthcare”. Of course you raised the point that if the patients know they are being given a placebo it will have no effect. However, this is not always the case as some studies have shown that placebos can have the same effect as the drugs even if the participants known they are consuming a placebo.
One of the major factors holding back the introduction of placebos into mainstream medicine is that placebos are seen as less reliable, valid and are not encouraged by individuals within the medical profession. While some individuals believe that placebos should have no place in medical science or psychology there are individuals who believe quite the opposite. Critelli, Joseph W. Neumann, Karl F. The placebo: Conceptual analysis of a construct in transition (1984) argue that if all scientific therapies use precise methods which are continually tested and refined, why can’t this be applied to placebos. Therefore, if this can be applied to placebos they are more likely to be accepted by the medical and psychological disciplines as potential aids.
Finally the most interesting but most obvious point I would like to raise is that the placebo effect has been used for centuries by the medical profession. Herbert Benson, MD, Mark D. Epstein’s (1975) paper shows that the placebo effect was relied on as one way of “curing” people all the way up until the 19th century. This evidence leads me to believe that placebos have a place in medicine and psychology. But how do you feel? Is the use of deception to high a price to pay? Well if so read Miller FG, Wendler D, Swartzman LC (2005) Deception in Research on the Placebo Effect and you might just reanalyze your perspective.
Another brilliant blog and a topic that i hadn’t ever really thought about before.
The use of placebo’s is something i find fascinating because often the mere belief in the drug and the good that it can do and play such a huge role in regards to the improvement in wellbeing of the patient. I personally see no problem in deceiving participants when administering placebo’s due to the fact the potential risk to participants is next to none, there is very little that sugar and water is going to do to you. Although i see placebo’s as being of great use, they will never achieve wide range use due to the lack of backing it receives from the medical profession, and rightly so. The Placebo effect can be, at times, quite astonishing. For example, telling someone that what they’re taking is Prozak and two days later the person feels happier is not far out of the realms of possibilities. But for such an effect to occur in the treatment of cancer? Not a chance. Without the backing of medical professionals, its use will stick to the psychological field.
Placebos have been around since the 17th century and were used regularly as medicine up until the 20th century.
In 1955 Henry K. Beecher published ‘The Powerful Placebo’. It was around that time that the placebo effect was deemed ‘scientific’.
It has even been reported that patients have been addicted to a placebo. According to Ben Z. Krentzman, one patient felt they were unable to stop taking the ‘medicine’ without psychiatric help and showed the classic symptoms of a drug addict. (http://www.acsh.org/healthissues/newsID.678/healthissue_detail.asp)
I believe the key question to be asking when discussion placebos is- to what extent can we justify the deception?
“The power which a man’s imagination has over his body to heal it or make it sick is a force which none of us is born without. The first man had it, the last one will possess it.” Mark Twain 1903
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this a very interesting blog.i was most anxious on how patient mental health or release of endorphins could react to responses of placebo drugs.this could broader the taught thats most drugs serve the same purpose if they treat for similar illness.but it is noted that the difference between placebo and effective drugs is the effective drug undergoes clinical trails,this trails are important to check for dose effectiveness and toxicity of drugs.homeopathic drugs are more herbal and they could be conindicated in certain illness.
really good blog here, you clearly understand the process and effectiveness of placebo usage and explain it in a really clear way. i completely agree with your statement that deception in the majority of cases is a necessity for the success of the experiment, however to look at the subject from a different angle i would suggest you also look at experiments in which participants are not deceived and infact told they may be taking a placebo drug. speaking form personal experience this year i took part in a experiment in which the above happened, i was told that i had a 50/50 chance of receiving a placebo drug. as a result of me knowing this information i found my self not trying to hard throughout the experiment in case i did have the placebo drug and provided the experimenter with in valid results. from this information you could back up the statement claiming deception is a necessity by showing the fact that if the participant is told the results could lack alot of internal validity.
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