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Research:
Many ailments have specific treatments. Headaches have aspirin, nausea has Zofran, and anxiety has Xanax. These drugs work effectively to cure their various illnesses, which is not surprising, seeing as they have medical properties that help heal patients. What is surprising is the fact that a sugar pill can often produce the same results as these treatments. Thats right. A drug with no medical properties can sometimes heal a patient just as well as actual medicine. The reason for this is the placebo effect when a drug heals a patient despite it having no medical properties to do so.
Scientists are still unsure of how the placebo effect works, but most suspect it has something to do with what a patient believes will happen when they take a drug. Most of the time, a patient feels that taking medicine will cure their ailment, and simply because of that belief, they start feeling better. Because the placebo effect relies mainly on the opinions of patients, the environment in which a patient gets a drug is almost as important as the drug itself. As Harvard medicine professor Ted Kaptchuk puts it, The placebo effect is a surrogate marker for everything that surrounds a pill. And that includes rituals, symbols, doctor-patient encounters& Its basically the water that medicine swims in. What this means is that traditions or rituals associated with treatment significantly impact how well a pill or placebo works. If you have a kind, caring doctor that tells you everything you need to know about your treatment gives you your medicine in front of you, and just sets you at ease, youll heal better than if you had a cold, remote doctor who you saw only once. With the first doctor, you feel taken care of and believe youll heal. With the second doctor, you feel shunned and doubt youll get much better. In either case, youll be correct. That experience you get when you go to the doctors office, of being taken care of and knowing that you will feel better when you leave has a profound effect on your symptoms.
Comfort levels arent the only things that impact how well a placebo works; research suggests that the color of a pill may impact its effects on a person as well. Pills that are warm colors, such as red, orange, and yellow, tend to give a patient a stimulating effect while those of cool colors, such as blue and green, tend to give a tranquilizing effect. All of this goes to show that the mind has quite a big effect on our bodies and that by helping patients feel comfortable and giving them positive information, doctors can make treatments more effective.
The placebo effect is mainly utilized in clinical testing. Usually, study participants are given placebos and real medicine. Neither the doctors administering the test nor the participants themselves know whether they are getting real medicine or a placebo. Such a test is called a double-blind experiment. This way, scientists can isolate the benefits the specific medicine itself provides from the effects of medicine in general. Although placebos may be used in doctors offices, there are concerns about being honest to patients that prevent the use from being widespread. You simply cannot lie to a patient saying that a sugar pill is a real pill that will heal them. This could lead to a whole host of problems, such as a doctor charging a patient the price of a real drug for a simple sugar pill and so on. Even if this werent a concern, doctors need to be honest with their patients and tell them what theyre being given. There is one exception to this, though. A doctor could tell a patient that a placebo might heal them. This is technically the truth, because of the placebo effect, and as such, this use of placebos could be considered ethical. However, this usage is uncommon.
One more possibility is being tested. Previously, it was believed that if a patient knew that a drug was a sham, the placebo effect wouldnt work. This makes sense: after all, if the placebo effect relies so much on a patients belief that a drug will heal them, telling a patient that a drug is fake should reduce its effects, right? However, a study by Ted Kaptchuk shows this is simply not true. He did an open-label study on irritable bowel syndrome, a disease that has no objective symptoms. The reason he chose IBS, he says, is that placebos cant help against physical problems. Placebos only affect what the brain can modulate. Its not going to shrink a tumor. Its not going to deal with malaria. But it will deal with pain, fatigue, and nausea. Or will deal with feeling malaise. But its not going to deal with killing bacteria. That doesnt happen on the level of the brain. While its true that placebos cannot cure physical ailments, they can help with psychological aspects, such as pain, nausea, headaches, and so on. So they could help a lot with a disease like IBS, where there arent any measurable symptoms.
Usually, in studies like this, neither study participants nor administrators know whether they got a pill or a placebo, which is slightly deceptive. This study wanted to test if the placebo effect would still work without the deception. The drugs were open-label, meaning that the study participants knew they were taking a placebo. Most scientists speculated that the placebos would not affect the patient. This would make sense if you followed the mind-cure idea, which states that if you believe something will happen or wont happen, youll be correct. It has traditionally been associated with placebos and still is the main theory as to why placebos work. If you tell a patient theyre taking a placebo and they know that it’s fake, it shouldnt heal them, right? But Ted Kaptchuk doesnt buy it. People think this is about mind over matter. But all my patients are people who have been to many doctors before. They dont have positive expectations about getting better. Theyve been to 10 doctors already. So from that standpoint, it makes sense to test this point of view.
The results did not support the hypothesis. 30% of participants healed from time alone. Testing this is significant because if a patient usually heals from a disease in a few days without a pill, pills may not be needed. Compare that to the 60% of participants who healed after taking an open-label placebo. Thats about as effective as most of the drugs in the market that treat IBS! Unfortunately, real drugs werent tested alongside placebos, but Kaptchuk plans on doing this in his repeated trials.
This study suggests that the placebo effect doesnt have anything to do with the mind-cure theory. But in that case, what does cause it? As of now, scientists just dont know. More research is required to get a grasp of the psychological/physiological effects of a placebo. This discovery was still significant, though, because it increases the use of placebos in the real world. Previously, giving patients placebos was difficult because it would require the doctor to lie about the placebo and force them to imply that it was a real drug. But now, if open-label placebos work this well in all cases, doctors can give them to patients without that deception. This would be a huge gain in medicine because of how helpful placebos can be. They are usually less effective than actual drugs because real drugs can change the body physically as well as psychologically. But with some diseases like IBS, the current treatments arent very effective and may hurt the patient because of their side effects. Placebos are made of relatively harmless materials, so they have no side effects. In such a situation, a placebo would work well. With this discovery, placebos will finally have practical usage in medicine rather than being waved off as just a placebo . No wonder the National Institutes of Health gave $2.5 million to support this project! Thats a small price to pay to learn about something that will shake the field of medicine on its foundations.
Analysis:
Prior to completing this research paper, I knew a bit about how the placebo works. I understood that it had to do with false treatments that healed patients despite having no medical properties, but little else. I didnt know about the web of different psychological and medical processes involved, such as double-blind testing and the mind over matter theory. If you asked me what factors affect how well a placebo works, I would have been completely blank. I wouldnt have been able to comprehend why so much controversy surrounds the placebo and its use. Over the last few months, all of these things have become solid facts to me and I know them like the back of my hand. However, I still understand that placebos are rather confusing to people and that their significance is not understood by most. I attempted to find what aspects about placebos were the most confusing to students so as to address them properly in my convocation presentation. I did this by distributing a ten-question survey about placebos to one-hundred eleven students and teachers in the district. My findings are listed here.
- This question was easy to solve due to the process of elimination. Option D can be removed since theriacs are only found in myths, not scientific environments like medicine. Option B is unlikely because smell, taste, and texture are all subjective properties and would not be considered in a scientific field. Options A and C are the remaining, and option C is more reasonable, because placebo translates to I shall please in Latin. With good reasoning, you can arrive at the correct answer. Since the majority of people got this question correct, I wouldnt change this question if redoing it.
- The hint for this question makes the answer clear. If something was discovered recently, it’s unlikely that people know what causes it, making A the preferable choice. Option B is unreasonable because something pleasant to one person can be horrid to another, and happiness can only go so far when healing a patient. Option C has the same fallacy built into it. Also, having sugar daily as part of a pill will be rather unhealthy and most likely be deleterious to health. Of the remaining options, A is the best. Since 72 people chose this answer, I would keep this question the way it is if revising this survey.
- The hint for this question removes all doubt that the correct answer is B. Also, nocebo translates to I shall harm in Latin, making it a clear winner over stimulants, depressants, and hallucinogens. Furthermore, all 3 incorrect options are taught in health, so every student should be able to eliminate them as viable options. From the 91 students who got this question correct, you can see that my constant barrage of hints did work. I would keep this question the way it is for any revisions of this survey.
- What you chose for this question depended on your answer to question 1. If you chose A, B, or D on the latter, you would have selected A, B, C, and D for the former since none of the options are addictive drugs; pleasant tasting, smelling, or feeling; or remotely sweet. If you chose option C for the former, you would select A and D for this question, since only they are real treatments. The options for this question were all chosen equally, suggesting that people didnt read the not in the question or that they thought they were taking too long by going back to question 1. One way to fix the first problem would be to change the question, asking for examples of placebos instead. As for the second issue, the questions could be rearranged so that 1 and 4 were next to each other, making it more convenient for participants to look at the questions together.
- This question is one of the few difficult ones in this survey. Only option A can be eliminated because sugar concentration is on objective quantity, not subjective. The answer you choose after that point depends on what you chose for question 1. If you chose answer B, choice D would be the most reasonable for this question. If you chose C, choices B and C make the most sense. To fix this, I would change option D to something objective such as melting point.
- This question relies largely on reasoning skills. As stated in question 5, the placebo effect is subjective and depends on the thoughts of patients. This means that color can change how effective a placebo is if a person believes something about a certain color. The only option that addresses this reasoning is choice B. Although only a few people answered this question correctly, I wouldnt change it because there are already so few options and there is a clear path of reasoning to arrive at the answer.
- The phrasing of this question is rather deceiving. It mentions the word subjective, which has been repeated multiple times throughout this survey in conjunction with placebos. However, after thinking through this question, the answer becomes clear. If doctors could prescribe placebos to patients, they may sell them at the same price as drugs with medical properties. It also would be difficult to stay honest with patients. From this, the answer is B. I wouldnt change this question if revising the survey because it already has two choices and one can be reasonably eliminated.
- The word clinical trials is essential to answering this question. If you dont know what it means, youre forced to guess between options. If you do know its meaning, though, the answer can be reasonably determined. Clinical trials test the effectiveness of a drug, but how much of a drugs efficacy comes from medical properties can only be determined when it is compared to a placebo. Only if a drug has a significantly higher success rate compared to a placebo is it sold in the market. Hence, the answer is true. While there is a clear path to determining the answer, it may be unfair to expect students to derive this conclusion or to presume they know what clinical trials are. If I were redoing this question, I would add the definition for a clinical trial as a hint. I cant add anything else because the question already is cut down to two options.
- The answer to this question is fairly obvious. If a placebo is a drug that has no medical properties, it cant help against physical problems. All it can do is make patients feel better about their illnesses and give them relief from subjective symptoms such as headaches, nausea, and so on. I wouldnt change this question at all if revising it because, in addition to there already being only two options, the answer can be derived fairly easily. No wonder 91 people got it correct!
- Placebos, as mentioned earlier in the survey, are rather subjective. Factors that change person to person affect them. Certain environments allow the placebo effect to work while others dont. Hence, any given placebo will only work some of the time, making the correct answer to this question choice C. I would not edit this question in any way if revising it because the answer can be derived from information already in the survey and the fact that there are only three options to pick from. It’s a fairly easy question to answer already, so there are no additional hints needed.
The goal of this survey was to determine areas of weakness in the general publics knowledge of placebos. It has succeeded in completing this goal. After analysis, I can see that certain points, such as what a placebo is and examples of placebos, are well known while others, like factors that contribute to the effectiveness of a placebo and the controversy that surrounds placebos in the medical field, are slightly esoteric to most people. Because of this additional research, I know what topics should be covered in greater depth in my convocation presentation and which ones should be covered more quickly. This knowledge will help keep my presentation relevant and useful for students.
As to the accuracy of the results and the dedication of the participants, I feel that most people tried their absolute best on this survey. Very few unreasonable answers were chosen and quite a few of the respondents of the survey were teachers or filled it out under the directions of teachers, making them a great deal less likely to randomly guess. All in all, I feel as though this survey went very well and will help quite a bit with my presentation in January.
Bibliography:
- Harvard Health Publishing. The Power of the Placebo Effect. Harvard Health, www.health.harvard.edu/mental-health/the-power-of-the-placebo-effect.
- Jacobs, Tom. Placebo Effect Produces Higher Test Scores. Pacific Standard, 24 Mar. 2013, psmag.com/economics/placebo-effect-produces-higher-test-scores-54276.
- Mados, et al. The Mastermind Effect Psychologists Boost Students’ General Knowledge Using Priming Placebo. Research Digest, 30 July 2016, digest.bps.org.uk/2013/03/07/the-mastermind-effect-psychologists-boost-students-general-knowledge-using-priming-placebo.
- Newman, Tim. Placebos: The Power of the Placebo Effect. Medical News Today, MediLexicon International, 7 Sept. 2017, www.medicalnewstoday.com/articles/306437.php.
- Placebo Effect to Better Grades. Brainscape Blog, 22 Feb. 2017, www.brainscape.com/blog/2013/05/placebo-effect-better-grades/.
- Placebo Effect. National Center for Complementary and Integrative Health, U.S. Department of Health and Human Services, 24 Sept. 2017, nccih.nih.gov/health/placebo.
- The Placebo Effect: What Is It? WebMD, WebMD, www.webmd.com/pain-management/what-is-the-placebo-effect#1.
- The Self Fulfilling Prophecy ‘ Dr. Madeline Daniels. Dr. Madeline Daniels, www.drmadelinedaniels.com/2007/02/07/the-self-fulfilling-prophecy/.
- Shmerling, Robert H. The Placebo Effect: Amazing and Real. Harvard Health Blog, 2 Nov. 2015, www.health.harvard.edu/blog/the-placebo-effect-amazing-and-real-201511028544.
- TED-Ed. The Power of the Placebo Effect – Emma Bryce. YouTube, YouTube, 4 Apr. 2016, www.youtube.com/watch?v=z03FQGlGgo0.
- Resnick, Brian. A Radical New Hypothesis in Medicine: Give Patients Drugs They Know Don’t Work. Vox, Vox, 2 June 2017, www.vox.com/science-and-health/2017/6/1/15711814/open-label-placebo-kaptchuk.
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