Here’s why the placebo effect is stronger (and stranger) than previously imagined

What would you say to a future largely without drugs? It’s not all that farfetched – doctors are finding that placebos are proving increasingly effective for pain relief, depression and the treatment of psychotic conditions.

There is even talk of doctors prescribing placebos instead of medicine.

The general belief among physicians that placebos are completely inert and powerless, and that any positive result on a condition as a result of taking a placebo is merely the patient’s imagination, is changing. Doctors used to think that if a placebo is as effective in clinical trials as drugs, that the drugs were a failure. More recently, though, medical experts have come to the conclusion that another factor is at play.

According to Professor Ted Kaptchuk placebos involve a complex neurobiological reaction that includes increases in neurotransmitters, like endorphins and dopamine and greater activity in certain brain regions linked to moods, emotional reactions, and self-awareness.

He sees the placebo effect as a surrogate marker for everything that surrounds a pill, like the rituals of taking medicine and a warm, empathic doctor.

People taking a placebo feel better, or experience less pain because the whole engagement, not only the medication, everything surrounding it, have an effect on the brain.

For instance, why do placebos work for irritable bowel syndrome when little else does?

This is just one example of the complex workings of the placebo effect that Brian Resnick reports on for Vox. If you suffer from this painful condition, you’ll know that it’s notoriously hard to find effective treatment for it.

There is something that seems to work though: empathy and care.

In the early 2000s, Kaptchuk and colleagues found in their experiments that simple human traits like warmth and empathy and extra attentiveness by caregivers boosted the effect of treatment on patients.

In an unrelated study, Luana Colloca, a physician and researcher at University of Maryland found that patients get more pain relief from morphine when they know that a caring professional is giving it to them, writes Resnick.

Should doctors start prescribing placebos?

Resnick reports that researchers he spoke to are optimistic about the prospect, but the placebo effect is complex and not fully understood yet.

As a first step we could remind doctors that they can relieve pain simply by being warm and caring to their patients.

Want to know the best part?

The placebo effect could possibly be harnessed so people living with chronic pain can get greater pain relief with smaller dosages of opioid treatments. This could alleviate the current misuse and addiction to opioids. A lot of research is still needed, but we might soon have the option of taking less drugs for the same or better results than what we get from current prescriptions.

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