By By Atty. Romulo P. Atencia
The Placebo Effect
posted 27-Feb-2016  ·  
4,686 views  ·   0 comments  ·  

Since about three years ago when I was diagnosed to be in the final stage of kidney disease, also referred to as end-stage renal disease (ESRD), I became interested in medical literature. One thing I read is the placebo effect. A placebo is an inert substance or belief which produces real biological effects in humans. It’s so widely accepted as fact that a placebo variable is included in most medical tests as a way of proving if, say, a drug works on its own merits or because people “think” it works. Placebo effect, also called the placebo response, is a remarkable phenomenon in which a placebo -- a fake treatment -- can sometimes improve a patient's condition simply because the person has the expectation that it will be helpful. Sometimes patients given a placebo treatment will have a perceived or actual improvement in a medical condition.

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Placebos are an important methodological tool in medical research. Common placebos include inert tablets, vehicle infusions, sham surgery, and other procedures based on false information. However, placebos may also have positive effect on the subjective experience of a patient who knows that the given treatment is without any active drug, as compared with a control group who knowingly did not get a placebo. It has also been shown that use of therapies about which patients are unaware is less effective than using ones that patients are informed about. Placebo effects are the subject of scientific research aiming to understand underlying neurobiological mechanisms of action in pain relief, immunosuppression, Parkinson's disease and depression.

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There are tons of experiments showing the proof of the placebo, but one of the most amusing is a supposed test done by a group of Princeton students who decided to throw a non-alcoholic keg party for their unsuspecting classmates. The experimenters secretly filled a keg with beer which contains only about 0.4% alcohol while regular beer has around 5% alcohol and then watched as their peers acted silly, slurred words, slept on the ground, and generally acted drunk. Although it’s nearly impossible to get intoxicated on 0.4% alcoholic content, these college students had such a strong belief they were drinking standard beer that it affected their behavior.

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While placebos are generally associated with positive outcomes, like curing an illness or getting drunk on almost non-alcoholic beer and having fun (if you consider that positive), the nocebo effect produces negative results, such as a cancer patient vomiting before chemotherapy starts or someone breaking out in a rash because they thought they touched poison ivy, even though it was merely an ordinary plant. Simply put, nocebo is a harmless substance that when taken by a patient is associated with harmful effects due to negative expectations or the psychological condition of the patient. One of the most talked about examples of the nocebo phenomenon was an incident published in “New Scientist” magazine. According to the account, late one night a man went to a cemetery and met up with a witch doctor who told him that he was going to die soon. Believing the witch doctor’s prediction, he soon fell ill and within a matter of weeks was emaciated and close to death. He was taken to the hospital but the medical doctors could find nothing wrong with him. Finally, his wife told the physician about the encounter with the witch doctor, which gave the creative physician an idea. The next day, the doctor told the couple he had tracked down the witch doctor and physically threatened him until the medicine man finally admitted he had put a lizard inside the patient that was eating him from the inside. Of course, the doctor’s story was completely fabricated, yet he made a big show of injecting the patient with a mysterious substance and snuck in a genuine, green lizard that he pretended to extract from the patient. The next day, the patient awoke alert, hungry, and it didn’t take long before he fully recovered.

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Curiously, researchers have discovered the placebo effect is somehow getting stronger, and some drugs that have been on the market for years, such as Prozac, are now proving less effective than placebos. Naturally, this is a major issue for big pharmaceutical companies, which has left many scrambling to conduct neurological studies in an effort to come up with new ways to safeguard their industry from ordinary sugar pills. Incidentally, Big Pharma is currently more profitable than Big Oil, so there’s quite a bit at stake.

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Undoubtedly it’s difficult to keep a positive attitude when you’re facing a life-threatening disease, but, based on a variety of medical studies, doing so may mean the difference between living and dying. For example, in 1989, Dr. David Spiegel of Stanford University conducted a study on 86 women with late stage breast cancer. Half of those women received standard medical care while the other half were given weekly support sessions in addition to the standard medical care. During the sessions the women shared their feelings, talked with other patients, and generally had a positive outlet where they could cope with their illness. At the end of the study, the women in the support group lived twice as long as those not in the group. In 1999, a similar study found that cancer patients who have feelings of helplessness and hopelessness have a lower chance of survival.

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When I was a young lawyer back in the 70’s, I handled a case in Baguio City involving Antonio Agpaoa, a Filipino faith healer. It was alleged that Agpaoa could remove an infected appendix with his bare hands without making an incision. And there were persons who swore that Agpaoa’s patients were cured, luring many Americans to seek his help. Indeed, claims that prayer, divine intervention, or the ministrations of an individual healer can cure illness have been popular throughout history. Miraculous recoveries have been attributed to many techniques commonly classified as faith healing. It can involve prayer, a visit to a religious shrine, or simply a strong belief in a supreme being. This could simply be due to the placebo effect.

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