(elegant orchestra music)
- Hi there and welcome to Brain Stuff.
I'm Josh Clark, and
this is the Brain Stuff
where I teach you about
placebos and their effect.
You've surely heard of placebos before.
They're those phony drugs that real drugs
are tested against.
Placebos mean "I will
please" in Latin, and
originally it was applied to fake mourners
who were hired to attend
funerals during medieval times.
Well eventually this
term for fake mourners
was applied to fake drugs.
Eventually placebos
became a permanent fixture
of double-blind studies.
Those are the kind of studies where
the participants are
divided into two groups.
One group gets the real drug,
one group gets the placebo.
If the real drug outperforms the placebo,
then the real drug is successful, hooray.
The thing is though, a
lot of researchers noticed
that some people who received the placebo
still showed a favorable response to it.
In fact, further research
has revealed that
as many as one third of all people respond
favorably to placebos.
So let's recap this for a second.
Actual sick people receive fake drugs
and really get better.
That's not supposed to happen.
So studies were launched to find out
exactly what was going on.
One study in 2004 in Michigan is
particularly brutal but enlightening.
It used actual painful
injections that were harmless,
but again painful, delivered
into people's jaws.
Then the participants were
given a saline injection
that they were told was
a powerful pain killer.
The thing is, saline doesn't have
any pain killing
properties, which means that
the saline injection was a placebo.
What's astounding, however,
is that every single
participant in the study
reported a lowering
of their pain levels after they were given
the saline injection.
Even more astoundingly, when
viewed through a PET scan,
the researchers found
that the patients' brains
were releasing endorphins,
the body's real pain killer.
The patients experienced relief of pain
not just in their heads, but in actuality.
Prepare for the largest mind blow of all,
the nocebo effect.
Not only can fake drugs
elicit a positive response
from people, under the nocebo effect
people can suffer from
actual, harmful, negative
side effects from a placebo.
So what's going on here?
Well typically researchers' explanations
fall in one of two camps.
First, the subject expectancy effect.
That's where you, the patient,
expect a certain outcome
to come from say the fake drug,
and you unconsciously conform
your response accordingly.
Then of course there's good
old classical conditioning.
But instead of Pavlov's dog salivating
at the sound of the bell,
patients respond favorably
to what they perceive is a real drug,
even though it's fake.
We have to say, however,
that the jury is definitely
still out on exactly what's
behind the placebo effect.
Now ethically there's kind of
a wrestling match going on.
On the one hand, the
idea that people can heal
just through the power of their bodies
rather than having to take powerful drugs
that often have negative side effects is,
as Martha Stewart would say, a good thing.
But on the other hand,
being truthful, honest,
and transparent with your patients
is a central tenant of modern medicine.
So what is a physician to do?
Well, some clever doctors
have come up with a loophole.
They can give a placebo
as a cure to a patient
but they have to say they're
not sure how it works.
All that's missing is
the wink and the nudge.
So where do you fall on
the ethics of placebo?
Let us know in the comments below
and make suggestions for
future Brain Stuff episodes.
And, heck, go ahead and subscribe
while you're down there.
If you're feeling frisky, go
ahead to BrainStuffShow.com.
