Is it wrong to give a sham treatment?

  • Mock treatments are given out by GP’s… and their patients get better!
  • The placebo effect and big Pharma, not always good news
  • Discover how the placebo effect works

Just imagine an ideal world where your ailments could be cured without any further risk to you.

Every drug has some risk attached to it, common anti-inflammatories often cause stomach upsets, cold remedies make you drowsy and blood pressure pills risk kidney failure. But, there is a way that you can be prescribed an effective and proven treatment without any side effects at all.

Bizarrely that is to get nothing at all, at least nothing which will affect your health one way or another.

For many years now there has been research showing that UK doctors knowingly give out placebo treatments to their patients.

Now in most circumstances this would be a worry as it implies that these GP’s are taking a liberty – and could be putting lives at risk. However, all the research is actually in support of this approach!

A few weeks ago I discussed the way that placebo treatments are considered to be inferior to a modern pharmaceutical option. But for many conditions the response to a ‘sham’ approach is as good, and sometimes better than for the more expensive alternative.

This isn’t just a UK thing though, far from it.

In Bavaria the practice of giving out sham medication is much more common.

The German doctors actively give out placebos for things like stomach upsets, colds and even depression. What’s more they have found that the results helped at least 60% of all that were offered the placebo.

This is a spectacular success, and I particularly enjoyed a statement made by The German Medical Association who said “we don’t fully understand how placebos work, but we know from this report that they have a stronger impact and are more complex than we realised”.

Can you imagine our own BMA ever saying something like that?

The placebo effect is not good news for everyone

I can’t. For a start they would have to admit that they don’t know everything – and that would make them feel uncomfortable.

Other healthcare practices actively promote the benefits of placebo medicines – arguably this is the basis for homeopathy.

Whilst there are also those who hold the ability of the body to heal itself as core philosophies.

The founder of osteopathy, a man who delighted in the moniker of Andrew Taylor Still instilled the belief that given time and space the body held all it needed to sort out most problems.

It’s true that he was talking about beliefs which were relevant at the time of the American Civil War, and he knew nothing of AIDS, cholera or cancer – however, the principle still has merit. For instance my GP always says that a cold will be cured in a week if he gives medication or will resolve itself in 7 days if he doesn’t!

Sometimes we only have to give the slightest of nudges to our body in order for it to be able to reset itself, and in doing so put us back into a state of good health. It should really be something that we talk about more, after all the impact of these simple interventions has been documented since 1955 – however you can understand that the drug companies don’t want to make too much noise about this one.

In fact the placebo effect is often the cause of their drugs failing whilst in development.

As part of the tests that are conducted before a new drug is sold into the market they have to undergo trails against a placebo. This is often their undoing.

For example, in 2002 the US giant Merck was desperate for a breakthrough drug and was delighted when early trials of MK-869 proved highly effective against depression and carried no side effects. It was only when the drug was tested against a look-a-like pill made of milk sugar that they discovered that the placebo was actually more effective. In the industry jargon the trials crossed the futility barrier… Game over!

The mystery of the placebo effect

So how does the placebo effect work? Well that’s just the thing – no-one is absolutely sure.

Everyone agrees that there is a positive effect for most people, but without properly understanding it there is a reluctance to make more use of it.

Probably the best way to consider its effects is from a three stage model;

  • The treatment causes a change in mental state so that negative states are replaced by positive ones. In most cases this is because the patient expects the drug to have an effect, in part due to our conditioning, but also because we believe that the doctor has experience and expertise and we allow ourselves to be managed by them.
  • By feeling more positive we tend to focus on health more, so that we eat more good things, cut out the bad things and support our bodies in the best way we know e.g. exercise, stop smoking, cut out the booze. Our bodies react by improving our immune status and allowing us to relax more.
  • We recognise any improvement in symptoms and use this to re-enforce our belief that started in stage 1. If our pain level falls we immediately say it was because of the pill, or the excellent doctor rather than just the body sorting itself out anyway.

The end result of all this though, is that we return to good health and function, and that was what we wanted from the beginning.

It would be great for science to properly discover why the effect of placebos is so great, however, in some ways perhaps a little mystery and magic are vital ingredients in the healing process.

If 88% of Bavarian doctors believe so strongly in the power of the body and spirit, for after all that’s what I’m suggesting the Placebo effect is,  why can’t we take heart from this research and make the most of building our own positive mental attitude to health.

Sugar pill anyone?