Drugs, Placebos and Perceptions

http://www.sacbee.com/107/story/1060018.html

Dr. Wilkes writes "ethics professor Howard Brody believes there is a more global explanation for Hoffman's truism. He explains that most medicines exert a powerful placebo response. So, for example, let's say you take a group of people with real and substantial pain – patients who have just had abdominal surgery or broken a large bone – and you give half of them a placebo (sugar pill) and the other half a new drug. Neither group knows what they are receiving. About a quarter of those who receive the sugar pill report significant pain relief.

Does this mean they are faking their pain? Of course not. It means that the mere act of taking a pill is enough to alter their brain chemistry so that it perceives less pain. This "placebo effect" has been known for centuries. Ironically, the effect of placebo seems, in part, due to the patient's beliefs about the pill, but part of the outcome emanates from the doctor.

When a patient trusts and respects the doctor, this effect is transmitted to the power of a pill (be it a real chemical or a sugar pill) so that the effect of the medicine is far greater the more a patient trusts the doctor. Once the public loses trust in a pill or treatment, the pill loses its effect. So when a doctor gets pumped up about a new medicine, say as a result of attending a drug company-funded class or a meeting with a drug company's representative, and conveys this excitement to the patient, there is a higher likelihood of a positive effect from a pill even if the pill is ineffective."

* * *

It's been noted that there is no placebo effect in CFS patients.  Much of the problem is that we no longer trust doctors; we've been lied to and mistreated so often that we don't automatically believe what they're telling us.

I do tend to be skeptical about new medications, and rightly so, because so many didn't help at all.  When I was in the clinical trial for the experimental sleeping pill, I could tell the first night of a new packet of pills whether these were the real thing or whether they were placebo.  The real thing put me to sleep, placebo didn't do a thing.  And this was a doctor I did come to trust!