clinical trial, it’s fair to conclude that the drug isn’t good enough to receive approval. However, when it comes to the pain field, distinguishing between placebo and drug effects can be tricky because both activate the same mechanisms, such as the release of endorphins. This means that strong placebo responses could mask drug effects in painkiller trials. Nonetheless, that doesn’t answer the question: why approve and administer a drug, which costs money and has potential side effects, when a sugar pill would have the same effect? At that point, we might as well just prescribe the placebo (or make better drugs)!
Conclusions and future directions
The placebo effect has traditionally been regarded as something negative, as a seemingly unexplained mystery at the heart of modern medicine. However, as we are beginning to understand the biological mechanisms underlying the placebo effect, it is becoming increasingly evident that placebos present a unique opportunity to harness the power of the mind in controlling pain.
The placebo effect highlights the importance of the environment in which treatment is received, and indicates that patients can benefit from language used to boost expectations. But what if there was a role for placebos themselves in medical care – what if they could be prescribed as a treatment?
Of course, this unleashes a Pandora’s box of ethical issues. The assumption is that placebos, by their very definition, must be concealed as a drug in order to work; they require deception. But maybe this doesn’t have to be the case. Doctors could prescribe placebos honestly, a so-called “open-label” placebo. Sounds like an oxymoron, right? Well, it turns out that one discussed application is to administer blister packs of painkillers that contain both the active drug and the placebo, but the patient doesn’t know which pills are which. Such pill packs might achieve the same degree of pain relief, but with less medication – thereby limiting side effects, cost, and problems with drug dependency. The next few years are sure to bring a multitude of studies, and ethical debates, of “honest” placebos.
Let’s briefly return to cupping, a treatment that may not cause a real physical benefit, but makes people feel better. If the placebo effect teaches us anything, it’s that the complex neuropsychological response that results in “feeling better” is not to be discounted. And, with six medals added to his tally, I think it’s safe to say that Michael Phelps was feeling great in Rio.
Benika Pinch is a third year Ph.D. student in the Chemistry and Chemical Biology program at Harvard University.
For More Information:
To read more about the biology behind the placebo effect, check out:
For more information about cupping in relation to the placebo effect:
In Germany, doctors prescribe placebos! Check it out: