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Placebos: the little lies that can heal August 19, 2001 It's the greatest wonder drug of all time. It lifts your depression, bolsters your sex life, relieves your chest pain, even makes your hair grow. It's the placebo, the dummy pill. Experts estimate that 30 percent of any treatment's benefit comes from the expectation it will make you better. Placebos are 60 percent as effective as the pain-relievers now in your medicine cabinet. Two thousand years after Hypocrates endorsed sham treatments, they're still as popular as ever. Except now, for the first time, there's a debate about whether the "placebo effect'' is for real. In May, Danish researchers concluded it's not. They looked at 8,500 placebo-taking volunteers in various studies. They reported in the New England Journal of Medicine that placebos had no effect on their illnesses. The University of Chicago's Dr. John Bailar wrote the accompanying editorial: He says the effect of placebos has been "grossly overstated.'' But last week, Canadian researchers showed the opposite. They gave patients with Parkinson's disease injections of saltwater. But they told those patients they were getting a drug that would raise their levels of a brain chemical called dopamine. The result? The dummy injections raised dopamine levels 19 percent, just as much as injections of a real drug. I'm not surprised. When I worked in the emergency room, we routinely gave saltwater injections to Demerol abusers. We told them it was Demerol, then we somberly told them to lie on stretchers so they wouldn't collapse when the narcotic hit. Minutes after their injections, they'd be pleasantly asleep. We even stocked placebo pills, impressive horse-size tablets with polka dots. We jokingly named the pills "placebin.'' Such pills are still used all the time but not so obviously. They're used when your harried doctor gives you an antibiotic for what he knows is a simple cold. Or he gives you allergy pills for what he knows is no allergy at all (a recent study found two-thirds of patients who get allergy pills lack allergies). You get the pills partly to get you out of the office, but also because many doctors still believe you benefit more from a useless drug than from no drug at all. And many studies back that up: They show placebos don't just make people "feel better,'' they produce physical changes that are hard to believe. In baldness studies, researchers count the hairs of rapidly balding men. In one study, 42 percent of men taking a placebo either grew hair or had no further hair loss. Other studies show placebos open up the lungs of asthmatics and make warts disappear. Placebos have power, but that includes the power to harm. First, to harm the doctor-patient relationship. "It's basically a kind of deception,'' says Bailar. Placebos may have been called "lies that heal.'' But they're still lies. And lies create mistrust. And placebos harm doctors. Physicians don't like deceiving people any more than anyone else. And patients don't like being duped. When study volunteers find out they're taking placebos, many feel insulted. Worse, their illness soon comes back, more aggressive than ever. Even the sham treatments themselves can be harmful, as when surgeons tested fetal brain implants by cutting into some patients brains and giving them no treatment at all. Researchers said the sham surgery was necessary because the cutting, pain and scars of surgery have a healing power all their own. The placebo effect is a two-edged sword. It's voodoo, deceit, and a reminder of just how little we understand. But it does exist, and it can heal. Dr. Michael Breen is the medical editor at WBBM-Channel 2. SOURCE: The Chicago Sun Times http://www.suntimes.com/output/health/cst-nws-breen19.html * * * [log in to unmask] ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn