Healing without drugs – the placebo effect | Print edition

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A few days ago I was watching on YouTube a faith healing service by a well known preacher. Many hundreds attend this service to seek a remedy for their various illnesses. People with difficulty in walking, some suffering from years of pain, people with hearing and vision problems are instantly healed or relieved of their ailments after being touched or blessed by the preacher. Is it a miracle or are there more mundane explanations for this fascinating phenomenon?

The word “placebo” from Latin, meaning “I will please,” derives from the Office of the Dead, the cycle of prayers recited for the rest of the souls of the dead in the Roman Catholic Church. The vespers service of this series of prayers is called Placebo from the phrase “placebo Domino in regione vivorum” – I will please the Lord in the land of the living.

During the COVID outbreak, many concoctions have been touted as effective. Several people have come forward to urge health officials to recommend their formulas for mass production. Angry members of the public wrote letters to the media claiming that the Ministry of Health was not using these preparations because the pharmaceutical companies were influencing them. People who used these preparations also wrote to tell how they were healed by these wonderful preparations. Most weren’t lying but firmly believed that they were getting better from these potions. No doubt the feeling of well-being was mainly due to the placebo effect but had little effect on the epidemic, which was only brought under control after an effective vaccination program.

In the 1700s, doctors used placebos when writing a prescription for an inert substance to please a patient. Many patients actually benefited from what later became known as the placebo effect. Until the 19th century, when effective drugs and procedures became available to doctors, the placebo effect was the most a doctor could offer patients. Although we now have scientifically validated drugs, the placebo effect remains an important factor in the recovery of patients.

Henry Beecher of Harvard Medical School did pioneering work in the study of placebos after World War II, where he served as a US Army frontline physician. During the conflict, he saw that due to the shortage of morphine, a nurse injected saline solution into a soldier before an operation. The soldier thought he was being given morphine and felt no pain. After the war, Beecher reviewed several studies that used placebos as a control and found that the treatment effect of placebos in patients was 35%. This had a major implication for the testing of new drugs. If a doctor wanted to know if a new drug worked for a particular condition, it wasn’t enough to just give it to patients with that condition and see if the drug worked. If Beecher was right, more than a third of patients would get better even if the drug had no direct effect on the disease process.

To assess the effectiveness of the drug, the response of a group of patients taking the placebo should be compared to another similar group of patients taking the drug, and the placebo effect subtracted from the overall response. For example, if the placebo patient group had a 30% response and the drug patients had a 60% response, the actual drug response would be 30%. This discovery paved the way for an effective new method of drug evaluation: the double-blind, placebo-controlled clinical trial. Since 1962, the United States Food and Drug Administration has required pharmaceutical companies to prove that their drugs are effective through a double-blind, placebo-controlled clinical trial.

Although the placebo response was originally thought to be around 35%, we now know that it can differ from disorder to disorder. Among psychiatric disorders, the placebo effect is high for depressive disorder but low for obsessive-compulsive disorder. The exact reason for this difference is still uncertain.

What are the likely reasons for the placebo effect? Your mind is a powerful tool for healing under the right circumstances. But it’s more than just a positive thought. A placebo probably won’t lower your blood sugar or lower cancer, although it may reduce side effects of cancer treatment like nausea and fatigue. Placebos work better for reducing pain and stress-related conditions like sleep problems. For years, the placebo effect was thought to be proof that certain drugs didn’t work. But now researchers understand that this is instead evidence that another non-pharmacological mechanism contributes to the disease’s adverse effects.

Do placebos work if patients know they have been given a placebo? A study by Harvard-based researcher Professor Ted Kaptchuk answered that question. It tested how people responded to migraine pain medication. One group took migraine medication, another group took a placebo labeled “placebo,” and a third group took nothing. Yet the placebo was 50% as effective as the real drug in relieving pain. The researchers hypothesized that patients associated taking the pill with a positive healing effect, even though they knew they were not taking the active drug. Besides taking an inert pill, there are other ways to get the placebo effect. According to Kaptchuk, other healthy living activities, such as eating a good diet, exercising, meditating and spending quality social time, can produce the same beneficial effects as the placebo effect.

If you are a healthcare worker, note that warmth, empathy, good listening skills in a supportive environment can enhance the effect of any medication or procedure you use on the patient. You will then also perform the placebo prayer – “placebo Domino in regione vivorum” – I will please the Lord in the land of the living.

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