Placebos: Can a Sugar Pill Cure?

Placebos: Can a Sugar Pill Cure?

Placebo: the word is Latin for "I will please." Originally it started the Vespers for the dead, often sung by hired mourners, and eventually "to sing placebos" came to mean to flatter or placate (1). Later, the term was used for any kind of quack medicine. Today, it is a medicine that has no value in itself, but improves a patient's condition because the patient believes it to be potent. Belief in a swallowed sugar pill or saline injection has been shown to produce real reactions. 80% of patients given sugar water and told it is an emetic respond by vomiting (1). People often show an allergic response to something they believe they are allergic to, even if it is only plastic flowers. Does

this strong reaction hold true for more serious medical conditions, then?

There are three explanations as to why placebos may work. The first, called the opoid model, says that the positive response is a result of endorphins released in response to swallowing a pill, etc. The second is the conditioning model, which holds that the important factor is not the medicine, but contact with a medical professional. Because patients are used to getting better after they go into a doctor's office and talk to someone in a white coat, they are psychologically conditioned to get better after contact with the medical environment. The last is the expectancy model, in which patients improve because they expect the placebo to have a certain effect.

There are even more arguments, though, as to how the placebo effect has been exaggerated or fabricated. Some studies include additional treatment along with the medication, sosimply being in a study may produce results (1). Some studies on placebos often show similar rates of success for a drug and a placebo, but do not include a control in which no treatment is used. In such studies, it is impossible to tell what improvement was actually due to the placebo and what would have happened anyway (3). Patients may also tend to report improvement because they think this is what is expected.

This is especially true with poorly designed response forms with more options for improvement than worsening. Many illnesses, like colds, improve by themselves given time. Others, like depression and chronic pain, fluctuate. Thus improvement in these types of illness might well have happened without any medicine or placebo.