Today people are using medicines for certain illness like pain, nausea fever etc. Over use of drugs can cause many health problems as well as some medicines create dependency, which is harmful for people. It will be very helpful if we can heal ourselves without the help of any medicine. Placebo is such a thing that is not itself a medicine but can cure disease. Placebo is a Latin word that means “I shall please”.
Placebo is anything that seems to be real medical treatment but it isn’t. It can be a pill, or any type of fake treatment. Placebos do not contain any active substances needed to cure a disease or affect patient’s health. It may contain sugar, starch, distilled water or saline solution. Actually it is a pill or capsule or injection made of excipients without the active ingredient. Typically, the person getting a placebo doesn’t know for sure that the treatment isn’t real. Placebo is used for disease such as boredom, fatigue, headache, blurred vision, acid reflux, dihydrogen mono oxide intolerance, tooth decay, post-micturition convulsion, chronic back pain, toenail goblin, binge watching, hypochondriasis etc.
While treating the wounded American soldiers during World War II, Henry Beecher ran out of pain-killing morphine. So, he decided to continue telling the soldiers that he was giving them morphine, although he was actually infusing them with a saline solution. Amazingly, about 40 percent of the soldiers reported that the saline treatment eased their pain. Today, scientists better understand that why those soldiers felt better. Beecher gave the soldiers a placebo, a substance that may look like a real medication, but isn’t. That’s how placebo was discovered. Now many researches are going on this placebo.
Research has shown that a placebo treatment can have a positive therapeutic effect in a patient, even though the pill or treatment is not active. This is known as the “placebo effect” or “placebo response”. This happens in up to 1 of 3 people. Usually the term “placebo effect” speaks to the helpful effects a placebo has in relieving symptoms. This effect may last for a short time. It’s thought to have something to do with the body’s natural chemical ability to briefly relieve pain and certain other symptoms.
Expectation plays a potent role in the placebo effect. Placebos work because patients expect them to work in the body. The more a person believes they are going to benefit from a treatment, the more likely it is that they will experience a benefit. Studies in both laboratory and clinical settings consistently show that when people ingest a pharmacologically inert substance or placebo but believe that it is an active substance, they experience both the subjective sensations and physiologic effects expected from that active substance. Exactly how placebos work to relieve pain and other symptoms remains a mystery but neuroscientists have uncovered several important clues. They have discovered that placebos help the brain release natural chemicals and change brain activity in ways that mimic the effects of real drugs and treatments. Scientists have found that placebos can cause the brain to release its own pain relief chemicals such as opioids. In addition, the brain areas that process pain show reduced activity following placebo treatment. One study has shown that men were more likely to report relief from heat-induced arm pain when they thought a fake anesthetic numbing cream was the real thing. Imaging data has revealed that the placebo effect had suppressed incoming pain signals from the arm to the brain. Other studies showed placebos can affect symptoms of certain brain diseases. Parkinson’s disease, a neurological condition has marked by low levels of the brain chemical dopamine, is often treated with a dopamine drug called levodopa. Research has shown that placebos can increase the dopamine levels in the brains of Parkinson’s patients, and help them move more easily just like levodopa itself.
Along with the expectation, placebo effect depends on some factors. Research has shown that placebo capsule works better than tablet, placebo injection works better than capsule and placebo machines works better than injection. Two tablets or capsules works better than one and costly, big, branded, shiny packet of pills produce greater effect. Other research showed blue pill is more effective as sleeping pill and red is for stimulant pain relief and yellow pills as antidepressant.
Placebo effect also works geographically. For example, in Germany using placebo to treat ulcers were better than anywhere else in Europe. Using placebo to treat hypertension does not work in Europe.
Today placebos are used while testing the effectiveness of the therapeutic effect of other drugs. This test is conducted by two groups of peoples. One group take placebo and other group take the medicine to be tested. But the volunteers do not know whether they are taking real or fake medicine. If the recovery is more in the group taking real medication, then the medicine has therapeutic value. But nowadays things are changing. Surprisingly placebos are showing more therapeutic level than the real one. Even sometimes patients are told that they are taking placebo, but they still recover. This is may be because they know that this fake pill has healed patients.
Therefore a question arises that, if we can heal ourselves then why we need any fake drugs like sugar pill, saline water or a talk with doctor? Actually we need this because we are not interested to cure ourselves immediately whatever the circumstance is. Taking any pill or injection works as safety signal to cure illness. That’s why fake medicines are needed.
In terms of ethics, in a research about 66% of the doctors felt that pure placebos are acceptable under certain circumstances, although the majority felt that they were unacceptable when they involved deception or threatened doctor-patient trust. The other 33% of doctors felt pure placebos are always unacceptable. Of the impure variety, there was much more acceptance, with 84% of doctors believing that they are okay in some circumstances.
Maliha Afroj Zinnia is a undergrad student of East West University, Department of Pharmacy. She can be reached at firstname.lastname@example.org
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