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This episode is sponsored by Dropbox
Hello. I’m Doctor Joseph Hanson, PhD.
The following video about placebos has been scientifically proven to cure viewers of boredom,
fatigue, dad bod, Star Wars over-hype, chronic back pain, and a host of other common ailments.
Now open wide, it's time for science.
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On the North African battlefields of WWII, wounded soldiers were plentiful, but morphine
was often scarce.
Army doctor Henry Beecher needed to operate on an injured soldier, but had no drugs to
give him for the pain. A desperate nurse grabbed a vial of salt water,
filled a syringe, and miraculously the soldier’s pain went away.
When Henry Beecher returned to Harvard University after the war, he found that a range of ailments,
from gunshot wounds to the common cold, could be treated with “fake” medicine.
It’s known as the placebo effect, from the latin for “I shall please.”
So what’s in ‘em? Let’s turn to our chemistry expert friends from Reactions.
The perfect placebo has a look, color, and taste of the drug it's being compared to.
Ideally, it contains all the inactive ingredient of the real pill but doesn't include the active
drug ingredients. That just leaves the other stuff that make
up the bulk of the pills. These might include sugar, that's why placebos
are often called "sugar pills", cellulose from plants, corn starch or yeast, along with
other common ingredients that bind the pill together and others that help it break down
in your stomach. Placebos used in big drug trials often contain,
well actually we don't exactly know what these placebos contain.
In a study called "What in Placebos: Who Knows?" researchers went through over 150 trials involving
placebos from 4 medical journals. Only 8% of the trials disclosed the placebo's ingredients,
although no two placebos are created equal. Some of them get better results. For more
on that, here's Joe.
A placebo capsule works better than a placebo tablet, placebo injections work better than
placebo capsules, and placebo machines work better than placebo injections.
Even having a nice long talk with a doctor before taking a placebo can increase its effect.
Taking two placebos is better than taking one, expensive placebos stamped with brands
work better than cheap generics, even putting them in fancy packaging or giving them fancy
names can add to all of this.
Clearly, the effectiveness of a placebo is tied to our perception of how sophisticated
the treatment is.
Even pill color can make a difference. Placebo sleeping pills work best if they’re blue,
red placebos are better as stimulants or pain relievers, and yellow placebos make better
antidepressants.
It’s pretty wild. One thing with absolutely no therapeutic value can work better than
another thing with… absolutely no therapeutic value.
Some placebo effects are easy to explain. I mean, sometimes people just get better.
But we can’t just write them off as fake psychological tricks, placebos can lead to
very real chemical changes in our bodies. They can cause the brain to release its own
natural pain killing chemicals, and they can even improve symptoms in Parkinson’s patients
by releasing dopamine.
It seems like where placebos do work, our higher order brain functions are in play,
like when they relieve pain, reduce stress, or even change our moods. But they have limits,
they can’t shrink tumors, or cure infections, or regrow limbs.
These days, before drug companies can sell a new medicine, they have to test it against
a placebo. The idea is pretty simple. Give one group
of patients a sugar pill or something, and one group the real drug, then see what happens.
Subtract the placebo group’s improvement from the other group, and we should see if
the drug has a real effect. Simple, right?
But strange things are happening these days. Even with all our advancements in science,
more and more drugs are failing to pass the placebo test. It’s as if the placebo effect
is getting stronger.
In countries like the United States, drugs can be advertised directly to consumers…
"Do you feel healthy, happy and comfortable? Are you not suffering from headaches, indigestion
or irritability? A lack of symptoms may be a symptom of antohypochondriasis, commonly
known as invisible illness disorder, or IID. But now there's Contradictol! Contradictol
brings hidden ailments to the surface so they can be treated with other medications. Ask
your doctor if Contradictol is right for you."
All that marketing has increased our expectations of what drugs can do, and as a result, some
old drugs like Prozac perform worse in placebo tests today than when they first came out.
This growing placebo effect is making it harder to figure out which real drugs really work.
And just in case you think this couldn’t get any weirder… it gets weirder.
In one study, patients were even told they were receiving placebos, and they still felt
real results. Likely because the doctors had told them that placebos often have healing
effects. Clearly, the critical ingredient in a placebo
is expectation. If they ever work, they work because we expect them to. So much so, that
a fake drug can also make a patient feel worse, if that’s what they’re expecting.
By this point some of you are probably asking, if placebos are so effective, why not use
them as real medicine? Well, prescribing one thing but telling a
patient they’re taking a different thing is deception, and according to Hippocrates,
little white lies like those are not okay.
But many doctors think parts of the placebo effect can still be used without turning every
practice into a carnival side show. I mean, if talking to your patients more can
make really them feel better, then why not talk to your patients more?
There’s a lot we don’t understand about how and why we sometimes get better. But in
addition to all the amazing medicines we’ve got, it’s nice to know the brain has some
quality medical care built in. Next time you get sick, maybe you can find
a little relief in knowing that the doctor is always… in.
Stay curious.
Some of us take pills every day in the form of vitamins and supplements. If you've ever
wondered what's in 'em, or if they actually work, follow me over to Reactions and find
out more.