Understanding Placebo Effect

The rate of placebo effect in clinical trials is around 30%. That rate has been consistent and is an expected outcome. Placebo rates that are higher or lower can call the entire study into question. How is that 30% of patients receiving an inert substance actually improve? When researchers study a medical treatment, they use placebos for two reasons.

1. Placebos reduce the risk of observation bias.

Both researchers and patients have an emotional investment in the success of a new treatment study. Both genuinely want a positive outcome. That natural desire can create observation bias. This is a situation in which an individual pays greater attention to the desired outcomes, ignoring or minimizing the undesired results. Patients may report “feeling better” with no measurable proof.  Because pain perception is subjective, patients may genuinely feel less pain simply from mere suggestion or expectation. Using a placebo group that is blinded to both patient and doctor helps to reduce the impact of observation bias on the study’s results.

2. Placebos help determine the true physiological action of the treatment being studied.

By comparing the results of a placebo group versus an active treatment group, researchers can determine what positive effects are actually attributable to the therapeutic actions of the drug itself. Side effects can be determined this way as well. Without that placebo group, researchers could mistakenly report that a drug is more (or less) effective than it truly is.

Is the mind really that powerful?

Yes, and no. The mind is the brain; there is no separation. Therefore, what we think and the emotions we experience produce a physiological response. Neurons fire. Neurotransmitters are inhibited or released. Our bodies and minds react. Some behaviors, thoughts, and emotions produce pain-inhibition by releasing naturally-occurring endorphins.

Sometimes, the mere suggestion that a drug might help is sufficient to see positive results. Generally, though, this effect does not last long-term. Sooner or later the body figures out that the positive results were a result of an internal neurological process and not the result of a new drug treatment.

Can you tell when it’s placebo effect?

You might not know for sure. Frankly, if you feel better, you might not care why. Sometime, patterns appear that give you clues. Over the course of many years I was able to recognize a unique pattern. Every time I tried a new treatment, my symptoms would improve for 2-3 weeks. It never changed. I tried to remain hopeful, but not too excited. That didn’t change a thing. My body responds positively to any new treatment for a limited time. It’s only by sticking with the treatment for several months that my doctors and I can discover the true effectiveness of any treatment. Because I know this, I wait to assess the results of any new treatment until after a few months. It is only with time and patience that my doctors and I can learn its effectiveness.

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