Menus Subscribe Search

Dr. Placebo — Half Quack and Half Savant

• November 28, 2011 • 8:25 AM

The placebo effect’s ability to influence human healing and human behavior is well documented, but we must be careful to make sure this fakery does no harm.

[Cue the drum roll] Ladies and gentlemen, introducing tonight, the magical, the amazing, the astounding, the one, the only [cue the cymbal] — DR. PLACEBO!! Performing sleights of hand that will amaze you, entice you, and lure you into miracle cures that will release you from your hard-earned cash. Come see never-before effects. Well, maybe always-seen effects. Step right this way …

OK, perhaps I’m more cynical than skeptical here, but given the successful selling of sham products such as balance bracelets and homeopathy, it’s important that we learn to think critically about one of the most powerful forces in medical research, the placebo effect.

Much has been written on the placebo effect — and an exciting new take is on the way from Miller-McCune — so our focus here is to critically investigate the role of these fake treatments and beliefs in our daily lives and how to use our skeptical skills in dealing with them. It’s important to realize that even when placebos have a positive impact, the effects can be short-term and end up masking more serious symptoms, preventing people from seeking reliable and effective treatments.

Simply stated, a placebo (Latin for “I will please”) is a substance or procedure given to a control group when used in scientific research designs to compare with an equivalent group receiving the real treatment or pill. In medical research, the look-alike treatment is often a sugar pill that does not have any real effect on the illness, allowing comparisons to be made between the actual medicine and the fake one.

It’s fairly common that about a third of people in the control group receiving the placebo report positive changes or lessening of symptoms. Sometimes recipients of the placebo claim negative side-effects (the “nocebo” effect), such as headaches or nausea. Surprisingly, some patients say they have positive outcomes even when told outright that they were receiving a fake treatment!

The power of the mind and its psychological impact has been a common explanation for how the placebo effect works. But continuing research also points to important physiological and neurological brain changes with placebo treatments. Indeed, with real treatment and medicines, some part of the cure can be attributed to patients’ expectations that the substance is working. Recent evidence suggests that placebo medicines are showing more effectiveness that the real pills, again illustrating some powerful physiological responses of patients to social, psychological, and biological expectations.

Headache relief seems to attract lots of placebo products, including one that simply required rolling on a wax-type substance and another by slowly moving a red light across your forehead. The red light should instead remind you to stop with these treatments and save your money, since in most cases, headaches will go away on their own with time and relaxation.

[class name="dont_print_this"]

Skeptic's Cafe

SKEPTIC'S CAFE
Peter Nardi discusses how to use our critical skills to avoid scams, respond to rumors and debunk questionable research.

[/class]

Consider too some non-medical situations where the mind has power over the reality. We know, for example, that people will often claim they are not as full after eating food labeled as healthy or low-fat, compared with foods labeled as an “indulgence” or high in calories. Here the placebo principles can result in people eating more unhealthy foods when they are not satisfied after finishing their better-for-you foods.

In an unusual study from New Zealand, university students who were told they were drinking vodka and tonic, but were really sipping a tonic-only placebo, not only acted drunk but also demonstrated worse eyewitness accounts and were more easily swayed by misleading information. Perhaps they would be willing to buy some fake red light treatment for their fake hangover and fake headaches!

Pricing can also have an impact on placebos, as Dan Ariely illustrated in Predictably Irrational. Researchers sold some students at a university gym a caffeinated soft drink at full price and another group bought it at a two-thirds discount. After finishing the beverage, and because of the caffeine, all students said they felt less tired after their workout. However, the group paying the higher price reported less fatigue than the discounted price group, even though they bought the exact same product. When tested with a problem set of anagrams to solve, those students who paid full price for the caffeine drink performed 28 percent better than the group who paid a discount for the drink. And all students performed even better when told the ads for the drink emphasized scientific studies showing the product improved mental functioning. Even in this experimental situation, the full-price group continued to outperform the students who received the discounted price.

Dr. Placebo, you’re amazing. Not only do you have power over fake medical treatments, you enhance the effect of real medicines, you contribute to our experiences when imbibing alcohol-based and caffeinated drinks, and you help people believe advertisers’ hype.

But do us critical thinkers a favor: because your name is a Latin word, remember the other Latin phrase that guides medical ethics and skeptical inquiry: Primum non nocere, “First, do no harm.” Save your effects and tricks for when it is helping people to feel better and to act more responsibly.

Sign up for the free Miller-McCune.com e-newsletter.

“Like” Miller-McCune on Facebook.

Follow Miller-McCune on Twitter.

Add Miller-McCune.com news to your site.

Subscribe to Miller-McCune

Peter M. Nardi
Peter M. Nardi, Ph.D, is an emeritus professor of sociology at Pitzer College, a member of the Claremont Colleges. He is the author of "Doing Survey Research: A Guide to Quantitative Methods.”

More From Peter M. Nardi

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

July 23 • 4:00 PM

Who Doesn’t Like Atheists?

The Pew Research Center asked Americans of varying religious affiliations how they felt about each other.


July 23 • 2:00 PM

We Need to Start Tracking Patient Harm and Medical Mistakes Now

Top patient-safety experts call on Congress to step in and, among other steps, give the Centers for Disease Control and Prevention wider responsibility for measuring medical mistakes.


July 23 • 12:19 PM

How a CEO’s Fiery Battle Speeches Can Shape Ethical Behavior

CEO war speech might inspire ethical decisions internally and unethical ones among competing companies.


July 23 • 12:00 PM

Why Do We Love the ‘Kim Kardashian: Hollywood’ Game?

It’s easy enough to turn yourself into a virtual celebrity, complete with fame and mansions—but it will likely cost you.


July 23 • 11:49 AM

Modern Technology Still Doesn’t Protect Americans From Deadly Landslides

No landslide monitoring or warning systems are being used to protect vulnerable communities.


July 23 • 10:00 AM

Outing the Death-Drug Distributors

Calling all hackers: It’s time to go Assange on capital punishment.


July 23 • 8:00 AM

The Surprising Appeal of Products That Require Effort to Use

New research finds they enable consumers to re-establish a feeling that they’re in control of their lives.



July 23 • 6:00 AM

How the Other Half Lifts: What Your Workout Says About Your Social Class

Why can’t triathletes and weightlifters get along?


July 23 • 5:02 AM

Battle of the Public Intellectuals: Edward Glaeser vs. Richard Florida

On gentrification and housing costs.


July 23 • 4:00 AM

Our Fear of Immigrants

Why did a group of fourth graders rally in support of an undocumented classmate while the citizens of Murrieta, California, tried to stop immigrant children from entering their town?


July 22 • 4:00 PM

Can Meditation Really Slow Aging?

Is there real science in the spiritualism of meditation? Jo Marchant meets a Nobel Prize-winner who thinks so.



July 22 • 2:00 PM

The Alabama Judge Who Refuses to Let Desegregation Orders Go Ignored

A federal judge in Alabama says a local school board has failed to meet legal mandate to integrate.


July 22 • 12:00 PM

On the Destinations of Species

It’s almost always easier to cross international borders if you’re something other than human.


July 22 • 10:51 AM

The Link Between Carbs, Gut Microbes, and Colon Cancer

Reduced carb intake among mice protected them from colon cancer.


July 22 • 10:47 AM

Irrational Choice Theory: The LeBron James Migration From Miami to Cleveland

Return migrants to Cleveland have been coming home in large numbers for quite some time. It makes perfect sense.


July 22 • 9:32 AM

This Time, Scalia Was Right

President Obama’s recess appointments were wrong and, worse, dangerous.


July 22 • 8:00 AM

On Vegas Strip, Blackjack Rule Change Is Sleight of Hand

Casino operators are changing blackjack payouts to give the house an even greater advantage. Is this a sign that Vegas is on its way back from the recession, or that the Strip’s biggest players are trying to squeeze some more cash out of visitors before the well runs dry?


July 22 • 6:00 AM

Label Me Confused

How the words on a bag of food create more questions than answers.


July 22 • 5:07 AM

Doubly Victimized: The Shocking Prevalence of Violence Against Homeless Women

An especially vulnerable population is surveyed by researchers.


July 22 • 4:00 AM

New Evidence That Blacks Are Aging Faster Than Whites

A large study finds American blacks are, biologically, three years older than their white chronological counterparts.



July 21 • 4:00 PM

Do You Have to Learn How to Get High?

All drugs are socially constructed.


July 21 • 2:14 PM

The New Weapon Against Disease-Spreading Insects Is Big Data

Computer models that pinpoint the likely locations of mosquitoes and tsetse flies are helping officials target vector control efforts.


Follow us


Subscribe Now

How a CEO’s Fiery Battle Speeches Can Shape Ethical Behavior

CEO war speech might inspire ethical decisions internally and unethical ones among competing companies.

Modern Technology Still Doesn’t Protect Americans From Deadly Landslides

No landslide monitoring or warning systems are being used to protect vulnerable communities.

The Link Between Carbs, Gut Microbes, and Colon Cancer

Reduced carb intake among mice protected them from colon cancer.

The New Weapon Against Disease-Spreading Insects Is Big Data

Computer models that pinpoint the likely locations of mosquitoes and tsetse flies are helping officials target vector control efforts.

People Are Clueless About Placebos

Doctors know that sometimes the best medicine is no medicine at all. But how do patients feel about getting duped into recovery?

The Big One

Today, the United States produces less than two percent of the clothing purchased by Americans. In 1990, it produced nearly 50 percent. July/August 2014

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.