Experts discover new potential benefits of the placebo effect
Keith Petrie sets his health psychology students a challenge each year: create your own sham treatment, snake oil or pseudo-scientific therapy – something you could theoretically charge big bucks for.
The University of Auckland professor sets the task after teaching his students about the placebo effect, the intriguing response that’s baked into every drug or treatment study: when patients feel better even though they’ve been given a treatment that’s not active, such as a sugar pill or saline solution. Placebo arms are a standard feature of drug studies; they’re there to help determine the effectiveness or otherwise of the treatment being tested. There’s always some degree of placebo response in drug studies. Do better than the placebo with your treatment, the thinking goes, and you’re on to a winner.
Petrie’s students tend to come up with creative ideas for their placebos along similar lines, he says. “They’re often some sort of machine that does powerful things; or they’re showing models to people of all the great benefits they’ll get. And, of course, there’s always megavitamin nutritional solutions for this and that.”
It’s a lighthearted exercise. But the placebo effect is the subject of serious research. Experts now believe it’s more than just something to factor in and allow for in medical research. The placebo has the potential to improve existing treatments and medications, and to teach us more about the mind-body connection when it comes to health and healing.
Crusaders such as Harvard professor of medicine Ted Kaptchuk are excited about the potential for the placebo response to enhance existing drug treatments and potentially treat pain conditions. Kaptchuk is an advocate for the potential of the placebo as an evidence-based, clinically relevant tool for relieving chronic pain. His studies have ranged across conditions including chronic back pain, irritable bowel syndrome, menopausal hot flushes, depression and cancer-related fatigue.
All in the brain
That the placebo response is simply all in the mind – an imagined effect, in other words – is an idea many of us may hold. But that’s not what’s really going on.
Petrie – one of a handful of researchers around the world who have looked at the placebo response in depth – says it’s now understood that placebos operate on the same circuitry in the brain as drugs do. Positive effects on pain in particular are seen in the same ways in the opioid system with placebo treatments and drugs alike.
Research has found that only a healthy brain can develop a placebo response.
“It seems like we have to have a pretty healthy, well-connected brain in order to get the maximum placebo response,” says Petrie. “I don’t think anyone these days argues that it’s an imaginary response. If the brain is impaired, it doesn’t seem to work as well.”
Another misconception about the placebo response is that it only applies to inert treatments (those with no active ingredient).