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September 11, 2014

Placebos: it's all in our heads

The Canadian Charger

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Although placebos have long been considered to have no effect on human health, Dr. David Suzuki, host of the CBC show The Nature of Things, said scientists are discovering they can actually heal our bodies, allowing us to breathe easier, walk better and, even soothe our pain.

On a recent episode of the show, Dr. Suzuki said science is proving that it's real.

“We can tap into the magic of the brain to create something out of nothing. “The power of the mind to heal the body is something researchers are starting to take seriously.”

Dr. Amir Raz, Canada Research Chair in Cognitive Neuroscience in n the Department of Psychology at McGill University, said placebos are something quite powerful.

“Placebos actually instigate action; they change physiology for real, not for show.”

He explained that placebos have the ability to influence, for example, your heart rate and your blood pressure.

“It shows us a placebo response is as real as a drug response,” Dr. Raz said.

In fact, Harvard's prestigious medical school has devoted an entire program to placebo studies

Professor Ted Capchuck , Director of Harvard-wide, Program in Placebo Studies, oversees a team of researchers dedicated to uncovering the truth about what placebos can and can't do.

“They can't shrink a tumor; they can't lower you cholesterol; they can't heal broken bones,” Dr. Capchuck said. “But they can alleviate the symptoms of depression, reduce pain, nausea, and anxiety and cure functional problems with bowels and the urinary track.”

A women who had long suffered from irritable bowel syndrome and bloating, said the placebos Dr. Capchuck gave her, cured her.

“You feel sick; you can't eat. It's horrible. After taking pills for three days from Harvard, I had no intestinal pain, no intestinal cramps.”

Dr. Capchuck said forty patients with irritable bowel syndrome were subjects in a study. Half weren't given any pills and the other half were given placebos and told they were only sugar pills.

“Twice as many patients who received placebos reported symptom relief as those who didn't get any pills at all.”

He said there's no pharmaceutical agent, but the ritual symbols of medicine activate neurotransmitters: that relevant area of the brain that actually changes the experience of illness, and alleviates symptoms.

Dr. Suzuki said that in WWII injured soldiers begged for morphine, but when the nurses ran out of morphine they inject salt water. It reduced pain and prevented onset of shock.

There are at least five pathways that carry pain related information to the body. Our minds decide what that pain means to us. Once our brains access that meaning, they spring into action, becoming our very own drug factory, producing and dispensing neurochemicals called opioids that actually act as natural painkillers.

Dopamine is an important neurochemical the brain produces. It's important for motor control and thus used for Parkinson's patients.  Production of dopamine is stimulated by the expectation of reward, and the taking of placebos creates this expectation. Dr. John Stoffel Director of Parkinson's Research Department U of B.C., said after taking placebos people got up and were able to walk, which they hadn't been able to do before taking the placebo.

Scientists say our assumptions about who will respond to placebos are just plain wrong. The truth is even the most intelligent people and most critical thinkers can be extremely susceptible to placebos Dr. Raz said the size of the pill, the color of the pill, and how many times you take the pill, all influence the effect of the pill.

“A bigger pill is better than a small one. Blue is more soothing than red.  Even price makes a difference. A more expensive one gives a better effect. And it doesn't have to be pills. Creams are also effective. Needles pack a more powerful placebo punch.”

Dr. Capchuck said the pharmaceutical industry is feeling very threatened by the results of studies in placebos because for some kinds of conditions the placebo effect is so big that it's making it hard for them to distinguish between the placebo and the drug, which they need to do for regulatory agencies.

“Since the 1950's drug companies have used placebo trials as the gold standard to measure the efficacy of medicine. If their pills work better than placebos then the active drug can be submitted for approval.”

A 2008 poll found more than half of US doctors treated with what they considered to be placebos: things like vitamins and unnecessary antibiotics. Dr. Raz said above 75% of Canadian doctors have engaged in a placebo treatment at least once.

Prescribing placebos and not disclosing it is allowed in Germany. In fact, since 2011 German doctors have been encouraged to treat certain conditions like chronic depression and pain with placebos. That's a stark contrast to North America: Canada has no official policy on use of placebos, while the American Medical Association (AMA) guidelines state that a doctor is never allowed to give a placebo deceptively.

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