The importance of placebo

Baron d'Ormesan

So lying to patients is a good thing?

tuppy

Barbarous witchcraft is what it is, and it has no place in a Christian civilisation, where the comforts are stronger and more true than the formulas of shaman in white coats.

Paul B

The biggest and best placebo. Kissing your child/or any child, on the arm, head, knee or whichever part of the body they have bumped and reassuring the said child, that you love them. The pain disappears and tears seem to dry up almost immediately. It also instills a warm glow within the kisser.

SUSAN HILL

I think lying to patients is a good thing sometimes, absolutely. I will post another blog before long explaining why and when and when not it should be done.

mike o'hare

Recent controlled research shows the placebo effect is very strong AND is nearly as potent when the patient is told beforehand that they are being given a placebo. Strange but true

hadrian

Surely it cannot just be assumed that all such medicine has no actual healing powers! Many herbal remedies do accomplish more than placebo!

Richard Manns

"Now they tell you â˜scratch comingâ™"

Actually, they say "it'll only be a scratch", thus rather like Dr McGill.

"They have to tell or even exaggerate the truth for fear you will sue them."

What utter rubbish. Have you a single recorded case of a case like that, let alone a successful one?

"Any good old fashioned doctor or nurse will tell you they used placebo all the time, either when there was nothing else or to help along the treatment."

Indeed, when we had nothing better. Now we have better. The placebo effect does not disappear when the drug actually works.

"The power of mothers to administer placebo should never be underestimated either."

We don't; but tests show that anti-histamines work even faster, and repeatably so. If they didn't, they wouldn't have passed double-blind, placebo-controlled tests.

"Anyone who has gone to so much trouble to back up their system with all of this must surely be able to cure things."

One easy counter-example: the Theory of Four Homours which led to blood-letting, which is thought to have killed millions over the centuries.

"An unpleasant doctor who does not relate well to people"

Homoeopaths rely on a pleasant manner to sell you placebos, so unpleasant ones go out of business.

"You should be able to demand the former as of right on the NHS."

Why? They have limited funds. Why pay for a placebo pill when all efficaceous medicines have the placebo effect as well as a measurable physiological one?

By all means, buy your magic potions, and your happy pills. That is your right, if you wish, to partially self-delude. But it is not your right to demand that we must all pay for your self-delusion and divert cash from more effective treatments.

SUSAN HILL

Richard Manns. Either I have written badly or you are confused. I certainly do NOT think we should get placebo pills or homeopathy on the NHS. I think we should get the placebo effect of the good doctor's personal touch. I thoughtthat was what I had said.
As I have mastocytosis I rely on anti-histamines to keep me functioning every day of my life, on a rotating course of them. I should have said that if my daughter is here she takes those unless they are ones she can't have in which case it's the apis mel administered by me.
I was being ironic. I meant 'it must surely seem that if they go to all that trouble there must be something in it and they manage to make it sound and look all so scientific.'
I think I need a lesson in how to write.

MickGJ

hadrian: homeopathy and herbal medicines are completely different things: herbal remedies contain active ingredients and many have therapeutic effects (and side effects). Homeopathic treatments have nothing in them and can therefore offer not benefit over placebo. .

London Calling

Sue “Placebo costs nothing – well, in the case of homeopathy, a few pence for a sugar pill sometimes”... however Susan the core issue here is the lack of evidence that supports the continuation of homeopathic treatment on the NHS, unfortunately feeling better (possibly the placebo effect) comes at a high price.

‘The total cost to the NHS of homeopathic treatment between 2005 and 2008 was £11.89m.
Over the three years, there were 68,647 treatment "episodes" – each episode is treatment for one patient but some patients may have been treated more than once. The average cost per episode was £173, which breaks down to £151 for each outpatient treated and £3,066 for each inpatient.
But Dr Peter Fisher of the Royal London Homeopathic hospital defended the use of the treatment, claiming the benefits seen by some patients were not just imaginary. "There is strong evidence that patients benefit in the long term," he said. "There is also an issue of democracy ... I wouldn't do it for two minutes if I thought it was a placebo."

http://www.guardian.co.uk/society/2009/jun/10/complementary-medicine-nhs-more4

More importantly though, the placebo effect is a powerful tool of the mind and could be the very cure for the creative innovation Britain now needs to succeed. In other words feeling better about ourselves results in a more productive state of mind instead of an unproductive mind that ultimately leads to depression and a sense of hopelessness. However I’m not talking about in your face hyped up disillusioned get positive forced team building or the ‘Get Positive’ conferences that came over from the states in recent years followed by endless books on how to reclaim your inner power. Someone should have mentioned that the Brits don’t do Bull crap and dislike anything phoney.

Currently all eyes are focused on our political leadership for a placebo lead, sadly what we are witnessing is the inability for Government to get on with the job due to political infighting for the seat of power (I know its politics, but its none productive in the current climate). What needs to be realised though is the negative impact this has on the publics placebo which is far more damaging to the public than within Government and in turn far more damaging for the Government when Trust, Faith and Placebo and is all but lost.

If we’re in this together, that sweet pill shouldn’t cost us anything…:)

Jennifer

Homoeopathy most certainly does work. I have used it for almost 30 years, after medical trials and tribulations (at great cost and terrible side-effects). I have used homoeopathy for sciatica, breast cancer, our children have not needed anti-biotics and have been fantastically healthy.
And on the placebo subject: how would a small child, or animal recognise a placebo?
No need to convince any one, but my goodness - am I happy I am homoeopathic.

Richard Manns

@ Susan Hill

I apologise for missing the irony; I missed that possibility. Your comments on the 'flu jab, etc, seem to have coloured my view of your following comments.

I would also contend that placebo pills can cost a great deal as it is difficult to encourage many patients to complete their courses of drugs in the first place, let alone a nagging suspicion that the drug isn't "real" being allowed to plague patients. Placebo can also work both ways: tell a recovering heart surgery patient that they are being prayed for, and they're more likely to die, irrespective of actual prayer.

Beer Moth

Placebo is important of course. But no need, the viagra route.

Chaps of that certain age can take measures to help with nature's waning. Mrs Moth and I can recommend the discriminating use of soft porn DVDs and one or two items from the Anne Summers catalogue.

SUSAN HILL

Richard Manns. Perhaps you would care to reply to 'Jennifer' who not only claims that homeopathy works but that it has worked for Breast Cancer. This is very dangerous stuff.

EC

The spanish tenor has indeed a wonderful and spiritually uplifting voice but ...

Beer Moth, Does that mean the Lesley Garrett DVDs didn't work?

Simon Too

At £4M p.a., ther emust be plenty of greater economies to make in the NHS.

Doctor's have this unhealthy obsession with curing disease. Usually nature will take care of that : what we patients want most of the time is relief from the symptoms.

What do we want? A better placebo! When do we want it ...

hadrian

Anyone care to support the contention that homeopathy and herbal medicine are entirely different things. I ( perhaps entirely mistakenly!) had always assumed at least a substantial degree of overlap between the two. For sure, I have great confidence in herbal remedies.

SUSAN HILL

They are indeed entirely different things. Herbal medicine is something we have probably all used - aloe vera juice straight from the plant soothes and heals minor burns, calendula heals small cuts and abrasions, dock leaves help soothe nettle stings...and of course many orthodox medicines are derived from plants - Tamoxifen for breast cancer comes from Yew, digitalis for heart disease from foxgloves, etc etc. Point is you need to know what you are taking/using and if it is pure, has been tested etc and if it is suitable for your particular condition. Chinese herbalists set up shop in malls etc and may be fine but you are taking a risk they are not doctors.
Homeopathic remedies contain NOTHING. They have an elaborate pseudo-scientific 'rationale' behind them but the fact is they contain no discernible active ingredients. Nat. Mur is just one- that is the name for salt but the tablets do not contain any.
If people want to take these things let them, I am not for banning anything that is not dangerous, but they should not be available free on the NHS. And people should be fully aware that if they refuse orthodox treatment in favour of homeopathy they could be risking their health - and their lives.

Chris

I pasted this article into Word, and found that it is 947 words long. I read the first word of it, and was 947 times more convinced than I would have been by reading the whole thing.

hadrian

Susan,

Many thanks for the clarification which draws clear distinguishing lines between the two approaches. I think I am not alone in simply assuming that whilst some homeopathy has solid 'herbal' grounding, other parts lack this. Anyway, I'm glad herbalism - genuinely tested- has been vindicated!

Jennifer

No not at all. What IS dangerous is chemotherapy and radiation, and total reliance on drugs. What was dangerous for me was being told that I would have to take certain drugs for the rest of my life. What rubbish.
What IS dangerous is an orthopaedic surgeon booking me in for emergency surgery before I'd got dressed. I declined the surgery. He told me I'd NEVER have the use of my small toes again. After HOMOEOPATHY and OSTEOPATHY, the toes are perfectly fine. And I can bend over and do yoga because I did not have my vertebrae fused,
Why would you think that homoeopathy cannot cure? Why only accept that drugs can?
My experience was real, and what IS dangerous is the control the drug industry has over the doctors and people with health problems.
Homoeopathy is inexpensive and honest.
Anyway, I don't need to convince anyone.

James Delingpole

Another lovely, thoughtful - and right - piece, Susan.

Beer Moth

Chris

Are you puddled all the time?

Merlyn

I gave a homeopathic remedy to my 6 week old baby for colic. He did not know he was getting a remedy. It worked. How is it placebo when the recipient does not realiZe he is getting a remedy?
It also worked for my cat.
I took it myself for mastitis. At the time I did not believe in homeopathy but was so far away from real medical help that I agreed reluctantly to take it. Worked like a charm, overnight, no side effects to me or baby.

I reckon the pharmaceutical giants just could not cope with loss of earnings should this one get out.
Whats good enough for HRH, is good enough for me.

Merlyn

Have to agree with Jennifer here,we are in a slavish society made powerless by authority bodies who know everything, whilst we know nothing. My doctor refuses to tell me my blood group!?
Since practicing yoga, meditation and carefully chosen diet, my thyroid problem has all but gone away.
It is time we learnt how to listen to our own bodies more and became more proactive in our own healing... instead of being another dependent person in this dependency driven world.
"They" out there don't have ALL the answers.

Jennifer

Indeed, Merlyn.

Have just read a heartbreaking account of a woman who had a breast removed "by mistake". Now, HOW is a mistake made, with all that is available through machinery, screenings, and countless consultations. 'Oops, your breast was not actually cancerous. Mistake. Sorry" Too damn late.
And the women who are losing ALL of their hair because of
Tamoxifen.
Cancer's gone, but the drug effects continue.

Think about it.