Placebo Myths and Reality
Jul 09, 2018
Placebo is one of the subspecies of "opium for the people", a dummy that provides a subjective improvement in the patient's well-being based only on belief in the effectiveness of the substance.The effect is due to the natural suggestibility of each person, which is exacerbated by external factors - for example, aggressive, obtrusive advertising, the opinion of a qualified doctor or a high price.
For the first time, the placebo effect was investigated and described not so long ago - in 1955 the American anesthesiologist Beecher conducted several studies that confirmed that in 35 cases out of a thousand patients felt a significant improvement in health after using dummies.And for the first time a similar effect was noted by the anesthetist during the war - the wounded, in the absence of morphine, received instead of him a normal physiological solution.At the same time, the patients were told that each injection was morphine, which provided them with a sense of the disappearance of pain.
To date, the placebo industry is very powerful and only for one reason - there is no therapeutic effect of the dummy, but notPose a health hazard.But the real medicines have a lot of side effects( and pharmacologists point out in each annotation), and people with undisguised pleasure give money for pacifiers - it will help / not help - a question, but it will not do any harm either.
Desserts can include glucose, saline, vitamins, vegetable oils( corn or olive), lactose, calcium and even valerian.This category includes any color solutions, turned off devices( they only have light bulbs) and hypnosis - there are rumors even about successful surgical interventions "under hypnosis".
In order not to get confused in medicines and clearly understand where the medicine is actually offered and where it is a dummy in the hope of a placebo effect, it is worthwhile to know some features of the effect in question.
This is the opposite of the placebo effect, which is most often observed in overly hypochondriac individuals and hypochondriacs: the dummy provokes mild discomfort or panic attack, which is classified as a pseudo-side effect.But it is worthwhile to know that the effect of nocebo can develop in overly hypochondriac individuals and when taking real medications - a person is very afraid of side effects and, naturally, he "appears" all at once.
Note: in some cases, you need to replace a normal medication with a pacifier, to see if there are any real side effects, or still nocebo.
How the placebo effect works
The persistence, expectations / hopes of a sick person and giving him only positive information, the belief in the possibility of a complete cure can have an incredible effect on improving health.If such a suggestible person is surrounded by care and attention of medical personnel, then any pacifier will be perceived as a "magic" medicine.
In the formation of the placebo effect, endorphins are involved, which is due to the ability of the body to excrete( reflexively) the blood corticosteroids, catecholamines and endogenous opiates.This explains the effectiveness of various acupuncture, and dissatisfaction with the result of such procedures in some patients.In addition, scientists conducted an experiment in mice - they were given a syrup first with an immunosuppressor, which had a suppressive effect on the immune system, and then - a normal syrup, without any medicinal components.The result was a completely identical result - suppression of the immune system occurred in the first and second cases.
Many merchants( girudoterapevty, homeopaths, osteopaths and others) quite aggressively use the placebo effect - they literally turn from patients wishing to get a quick healing.Moreover, many people perfectly understand that the proposed treatment is a dummy, but still fall under the influence of the placebo effect, in medicine this phenomenon is called metaplacebo.
How the placebo effect is used in official medicine
This effect has only three rational applications in normal medicine:
- It can be used to compare the present drug or the method of treatment when performing efficacy studies.
- Soothers are actively used to "treat" absolutely unconvincing patients who require the doctor to "designate anything."In Denmark, for example, 50% of the total number of practicing doctors use dummies to "treat" their patients at least 10 times a year!
- Often, the use of a dummy is a diagnostic method that allows you to divide fictitious symptoms from actually present in a particular patient - in 25% of cases, the placebo effect is used just for this.
Is it ethical to use dummy medications?Do not forget that there are 20% of people who do not respond to the placebo effect - is it fair to instill in them the hope of recovery?This question remains controversial, meanwhile, although official medicine claims that this can not be done, it sometimes resorts to a placebo, and it's not worth talking about alternative medicine - it's all based on the placebo effect.
The described effect is, first of all, a significant improvement in subjective well-being.Moreover, this is only an illusion of recovery, no changes in the clinical picture is observed!For example, a patient may have a headache on the background of high blood pressure, but hypertension remains, or agonizing joint pain may disappear, but the thickness of the articular cartilage remains unchanged.
Placebo: research and facts
If a person signs a voluntary agreement to participate in a research program about the placebo effect, then he can expect the following:
- If the body has warts, then the patient begins to smear some color solution, Convincing that as soon as the paint is washed, warts will disappear.Do not believe it, but in some cases it works! !!
- Asthmatics objectively expand their bronchi, if they take medications with a bronchodilating effect - so, at least, they are told, but in fact they give out a pacifier.
- After removal of the wisdom tooth, the pain sensation disappears when using the laser, and when exposed to the oral cavity by the switched off device.
- Colitis is treated with pacifiers in many patients - in 52% of cases, the placebo effect works.
- Any pain is reduced by giving a dummy - people just say that they are prescribed powerful painkillers.
- Migraine refers to psychosomatic diseases, so it is not surprising that the attack stops immediately after taking a pacifier.It is interesting that the placebo effect is more pronounced if patients were injected, and not given a pacifier in tablets.
In addition, some patients during the study did imaginary operations - cut and immediately sewed, and the person confirmed the improvement of his health.Naturally, such a complex experiment has never been conducted with people who are diagnosed with serious pathologies that do not tolerate experiments.
However, to feel the effect of a placebo, it is not necessary to look for experimental groups - dummies are widely used in life.For example, there are a number of drugs without proven effectiveness.Another option - homeopathy with the notorious sugar balls, or osteopathy - "specialists" try to influence the functionality of the internal organs through the massage of the skin.And sanatorium treatment?Yes, it will have a beneficial effect even on an absolutely healthy person, and if you think objectively, different SPA procedures, physiotherapy and some "magic" climate will have a real positive effect only for patients with tuberculosis and a couple of other very serious pathologies.
Placebo is a great thing, which in some cases is literally required to be used by doctors.But you need to understand that this is also a huge, powerful industry to take money away from the population.And notice, to the lawful weaning, voluntary!
Tsygankova Yana Aleksandrovna, medical reviewer, therapist of the highest qualification category