Research Shows Placebos May Have A Place In Everyday Treatments
February 20, 2013
By Dr. Mercola
A placebo is an inactive treatment or substance, such as a sugar pill or sham procedure, that looks and feels just like a regular medical treatment.
Patients receiving a placebo generally believe it is the same as the typical standard of care, and many experience what’s known as the “placebo effect” – an improvement in symptoms – even though they received no actual “active” treatment.
Whether or not these inactive “treatments” have a place in real medicine has been debated, because placebos typically have far fewer side effects (if they have any at all) than prescription drugs, injections or actual surgeries – and they often work just as well as the standard of care.
And as research from numerous experts, including those from Harvard Medical School, has revealed, the placebo effect is not only real... it appears to be stronger than was once believed.
Most Dramatic and Classic Example of Medical Placebo Effect
There are certain modern-day examples that show just how powerful placebos can be... and why exploring them as an alternative to side-effect-ridden medications makes sense.
One such example is the classic New England Journal of Medicine knee surgery study.1 This was, without question, one of the most amazing studies I have ever seen published, as it definitely proves the power of your mind in healing.
This double-blind, placebo-controlled, multi-center trial performed at some of the top U.S. hospitals found that most knee surgery for osteoarthritis results in a $3-billion hoax. It is not actually the surgery itself that is responsible for the improvement, but rather is the placebo effect. More precisely, it's the ability of your brain to produce healing when you believe it should be happening (such as after you receive knee surgery). The researchers concluded:
“In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure.”
Another example has to do with antidepressants. Research suggests there is little evidence that antidepressants have any benefit to people with mild to moderate depression, and they work no better than a placebo.2
One meta-analysis published in PLoS Medicine3 concluded that the difference between antidepressants and placebo pills is very small – yet these drugs remain one of the most prescribed drugs in the United States!
In a case like this, where there is little difference in effectiveness, but the sugar pills produce far fewer detrimental side effects, it makes the placebo far preferable to the antidepressants.
Placebos and the “Ritual of Medicine” May Prompt Brain Changes That Reduce Pain
Speaking with NPR, Ted Kaptchuk, a professor of medicine at Harvard Medical School and the director of placebo studies at Beth Israel Deaconness Medical Center, explained that receiving a placebo may work because it’s part of the “ritual of medicine.”4
When you visit a physician, explain your health problem and receive a treatment (whether it’s an active one or not), you have a certain expectation that you’re going to get better – and this is often what happens. Kaptchuk continued:
“We have expectations; we have previous experience; we have non-conscious awareness. And we're in a medical environment, and we're used to that environment producing beneficial results. The ritual of medicine activates particular areas in the brain that actually will reduce pain, or at least reduce the sensations that we have in relation to pain.”
Further, in one study Kaptchuk and colleagues conducted on patients with asthma, the same amount of relief was reported for both the active medication and the placebos, leading them to conclude:5
“Placebo effects can be clinically meaningful and can rival the effects of active medication in patients with asthma.”
Do Placebos Have a Real Place in Medicine?
The problem with actually “prescribing” a placebo is that it would be unethical to let a patient believe they’re receiving a “real” medication if they’re not. So the question is: do placebos have a place in medicine, or would telling patients they’re receiving one simply cancel out its benefits? Researchers are currently looking into this, as Kaptchuk explained:6
“We've done two experiments like that. They're small; they're pilot studies. We're hopeful that maybe this will pan out in the future; that we can actually, instead of putting people on drugs right away, maybe put them on the ritual of medicine, and see if that's enough. So I see there's a place for it, but it's still in infancy whether this is really an option or not.”
In one such study designed to determine if the beneficial effects still exist when a patient knows they're receiving a placebo, nearly 60 percent of the patients given a placebo pill (and, again, told they were receiving a placebo) reported adequate relief from irritable bowel syndrome (IBS) symptoms, compared to only 35 percent of those who received no treatment.7
Even more astonishing, those taking the placebo reported improvements that were virtually the same as those reported from people taking the strongest IBS medications.
The jury is still out on whether the practice of taking a sugar pill or simply going through the ritual of treatment is what's causing the beneficial responses... but either way studies have shown that if you think you're receiving a treatment, and you expect that treatment to work, it often does -- and even if you know you're receiving a placebo, the beneficial effects still hold strong. That is the power of your mind! Interestingly, a survey of Chicago-area physicians revealed that 96 percent believed that placebos could, indeed, have a real therapeutic effect – and 48 percent had actually prescribed placebos or “placebo-like treatment” in regular clinical practice.8
How Does the Placebo Effect Work?
As Scientific American reported:9
“In recent decades reports have confirmed the efficacy of various sham treatments in nearly all areas of medicine. Placebos have helped alleviate pain, depression, anxiety, Parkinson’s disease, inflammatory disorders and even cancer.
Placebo effects can arise not only from a conscious belief in a drug but also from subconscious associations between recovery and the experience of being treated—from the pinch of a shot to a doctor’s white coat. Such subliminal conditioning can control bodily processes of which we are unaware, such as immune responses and the release of hormones. … Researchers have decoded some of the biology of placebo responses, demonstrating that they stem from active processes in the brain.”
In one study, it was shown that simply thinking a placebo will help relieve pain will prompt your brain to release more natural painkillers, known as endorphins.10 It’s also been found that some people may be more susceptible to the placebo effect than others because of varying levels of dopamine activity in the area of the brain known as the nucleus accumbens, a region involved with the ability to experience pleasure and reward.11
So while the exact mechanisms behind the placebo effect are still being explored, there’s no denying that the effect is real. And, most likely, the placebo effect takes on many different forms, impacting brain mechanisms involved in expectation, anxiety and rewards. In short, a placebo really does change your brain, in a number of different ways. Writing in the journal Neuropsychopharmacology,12 researchers noted:
“First, as the placebo effect is basically a psychosocial context effect, these data indicate that different social stimuli, such as words and rituals of the therapeutic act, may change the chemistry and circuitry of the patient's brain. Second, the mechanisms that are activated by placebos are the same as those activated by drugs, which suggests a cognitive/affective interference with drug action. Third, if prefrontal functioning is impaired, placebo responses are reduced or totally lacking, as occurs in dementia of the Alzheimer's type.”
How to Harness the Placebo Effect in Your Own Life
There may be cases in your own life where you can use your mind to help heal your body or reduce your reliance on conventional medical care, including medications. And when I say that, I mean that if you strongly believe you will benefit from something, you radically increase the chances that you will. But there is one caveat: you must resolve any emotional blocks that are standing in your way first.
For example, this could be disbelief that the pain or illness will go away, resentment that you have the pain, or even an unconscious desire to keep the pain or disease because of the extra attention you gain from it. If you look at it in terms of energy -- pain is energy and your mind is also energy -- you can see how one directly influences the other.
The Emotional Freedom Technique (EFT) is an extremely powerful tool that you can use to get to the root of your emotional conflicts, and release them, to help open your mind to the power of the placebo effect. It’s often possible to feel better just because your mind subconsciously believes it's time, or your subconscious alters body processes in response to the placebo treatment without you even being aware of it.
As often as possible, always try to use the placebo option first. This is a new way of thinking about healing for most people, but can be extremely powerful, especially when combined with a healthy outlook and disease-preventive lifestyle.