Placebos, Effects, What They are, How They Work

Placebo Control Value to Medical Studies and Results Interpretation

Oct 19, 2009

The history of medicine is awash with drug trials and procedures that failed in well-controlled experiments. Controls are basic and essential for validation of science.

A history of science and medicine clearly shows that experiments without controls are invalid and, essentially, meaningless. If valid controls are missing, no scientific reliability exists for drug X, or treatment Y — even though each might positively effect health, or disease management. For some, controls will never matter — they have faith in the treatment based on personal, or hearsay, evidence. The world of herbs and alternative medicine is filled with numerous unsubstantiated claims from A to Z. Many people stake their money on non-validated alternatives — sometimes, they trust their very lives to these alternatives. This scientific inquiry discusses placebos and the placebo effect.

Placebo Control Value to Medical Studies and Results Interpretation

Experiments may be simple, or complicated, but all valid and good experiments require good design and controls. Well-designed experiments are balanced and double-blinded — ie., neither the invesitgators, nor the treated subjects know which is the placebo (false drug, or treament) and which is the actual medicine, or experimental treatment. This double-blinded experimental approach is invaluable since it removes bias of investigators and participants.

Placebos, What They are and How They Work

A placebo sugar pill is a control – it is not the true, test medicine. There are also placebo procedures, e.g. an acupuncture that is really not an acupuncture, but a sham. Thus, the placebo is a substance, or procedure, used as a control to validate experimental studies.

Placebo controls serve to compare differences in the experimental medicine, or procedure, and the placebo. Placebos controls should not have beneficial, positive effects. Placebos help show that a drug or procedure is truly efficacious. In medicine, placebos are essential. Experiments without proper controls are meaningless.

As an example, someone assumes that Echinacea alleviates cold signs and symptoms, and shortens the duration of disease. Common cold subjects, taking or not taking Echinacea, would be compared. The controls would receive sugar pill placebos. If the two groups at the end of the study show no differences — Echinacea is deemed ineffective, as has been shown. Despite these experimental results, some insist that Echinacea works — they ignore the validated research.

Placebos, however may sometimes actually work and improve a patient's health — the "placebo effect". What does the placebo effect really mean?

Placebo Effects, Manifestations of Real and Positive Health Benefits or Effects

Placebos sometimes have actual positive health effects. Placebo subjects have reported relief of headaches, arthritis, rheumatism, blood pressure and other conditions. Why? The "placebo effect" is apparently a real biochemical and physiological effect. Simple deep breathing and relaxation techniques lower blood pressure. Why? Brain endorphins are produced that promote these effects. Anti-anxiety and anti-depression placebo pills have calmed, comforted and mood changed some placebo partakers as well as or better than some of the best known, approved medicines used for those conditions. What does the brain produce to justify the reality of the placebo effect?

Brain Endorphins Affect Biochemistry Metabolism Physiology as Part of the Placebo Effect

Measurements of placebo subjects demonstrate objective, scientific, real placebo effects are mediated by natural endorphins. Test subjects with saline-induced pain were verbally told that pain medicine (a placebo only) was being delivered. This communication caused increased activation of mu-opioid receptors, as measured by PET and MRI, located in pain-related areas, that activated endorphins in this natural painkilling system. (Zubieta et al., Placebo Effects Mediated by Endogenous Opioid Activity of u-Opioid Receptors, in The Journal of Neuroscience, August 24, 2005, 25(34):7754-7762).

Some of the strongest health medicines apparently reside in each brain that can produce its own healing medicines. Successful medicines must always significantly outperform the "placebo effect" to prove their true medical value.

Bausell, R.B. 2007. Snake Oil Science. Oxord University Press, Inc., New York, New York, 324 pp

The copyright of the article Placebos, Effects, What They are, How They Work in Scientific Research Methods is owned by Donald Reinhardt. Permission to republish Placebos, Effects, What They are, How They Work in print or online must be granted by the author in writing.