SoylentNews is people
SoylentNews
A fascinating new article in knowable magazine https://www.knowablemagazine.org/article/mind/2017/rebranding-placebos
Indicates that a group of savvy scientists are looking at the potential for placebo as a front line therapy for a host of illnesses and conditions.
The article is rather long, but to summarize, placebo and its related effects are powerful. So powerful in fact that most medical therapies are only slightly more effective, while running the risk of serious side effects. Therefore the scientists pose the questions. Why not use placebo as a front line therapy, a first line of defense in most cases?
But for this to work, placebo would need a rebrand.
The problem with the placebo effect is that it stops working once a person knows that they are receiving the placebo.
So here is a thought. What if instead of using the word "placebo", we make it ok for doctors to write initial prescriptions for monosaccharide https://en.wikipedia.org/wiki/Monosaccharide and Dihydrogen Monoxide DHMO therapy https://www.lockhaven.edu/~dsimanek/dhmo.htm and / or other fancy chemical names for the ingredients actually in these placebos. Then a simple updating of wikipedia pages showing their efficacy in treatment of various ailments along with their relative safety. In otherwords, since we are a society that places our faith in chemicals, why not just give the chemicals in the placebos their due and forget the word "placebo" all together?
(Score: 0) by Anonymous Coward on Thursday February 28 2019, @12:05AM (4 children)
Original AC from the article here and following up with some thoughts and additional questions.
The general consensus here seems to be that rebranding placebo would be patently unethical.
I have to disagree with this. I guess the way I put it, does bring about a conspiracy type of worry. However that was not the intent.
You see here's the truth. In medicine, most doctors don't actually have a clue what is in the medicine they prescribe. This is why pharmacists are supposed to serve as a check point and be knowledgeable about potential drug interactions, at least the dangerous ones. Ergo, to my mind simply changing the conversation from one of "which chemical is most effective vs placebo" to simply "which chemical is most effective" wouldn't be unethical. The chemicals in placebos are what constitutes them. The studies (with very few exceptions), show that they are safe and effective treatments for most things. Ergo, a prescription for saline will bring relief if the studies show it brings relief. Thus the chemical, not the common derogatory term, should be the thing talked about. Obviously the instructions would be given to the compounder or pharmacist, not as a joke but as a real "hey give them sugar and water and explain that these chemicals are effective for symptomatic relief".
Now there is a caveat and it is this...
There are some drugs / chemicals which no placebo can replicate the effects of or even provide symptomatic relief for. An example given in the comments is a tumor medicine for which placebo provided symptomatic pain relief, but not a reduction in tumor size. Obviously you would use placebo in this case instead of a powerful opiod painkiller, but you would still prescribe the tumor med, to deal with the cause. These would be treated as co-therapies in this instance, one for cause and one for symptoms.
In the same vein, Insulin's effects on blood sugar cannot be replicated with placebo. Ergo prescribing a bottle of saline instead of insulin would be denying a patient life saving medicine and that would be unethical. But prescribing a glass of water to deal with the thirst issues inherent in high blood sugar, is still giving the patient placebo. Ergo, take a shot of insulin and drink more water. In this case though, the placebo (water), does in fact dilute the sugar a bit and makes the blood less syrupy (according to my diabetic wife), and thus increased water intake = decreased need for insulin.
Mostly when I was considering this article and my position on it, I was talking about using placebo for symptomatic relief when a cause is well understood and treated via well known medicines or when a cause cannot be found as is the case with certain symptomatic constellations such as fibromyalgia or IBS.
So allow me to rephrase the question...
Should we work to change the conversation about placebo for symptomatic relief, by opening a discussion about the chemicals in the placebo and claiming their effectiveness at treating symptoms, vs what we do now which is say "well this drug is slightly better than placebo".
Another thought of course is that perhaps the chemicals in placebos are not as inert / inactive as we assumed. There is some interesting shit in some of these, even sugar pills are sugar + binder. Sugar has systemic and mood effects all on its own, the binders too could be putting some load, somewhere that we aren't accounting for. Therefore perhaps we are doing a disservice by labeling placebo as placebo instead of account for it at the chemical systems level.
Just my thoughts, but thanks for your thoughts everyone! I do appreciate having a place where we can have intelligent debate and the mean IQ is over 100.
(Score: 0) by Anonymous Coward on Thursday February 28 2019, @12:44AM (3 children)
How is this a placebo when the underlying cause is the body's need for water?
Also, in most of these studies no one has any idea what the "placebo" even was. Eg, I doubt sugar pills actually make for a good placebo. A quick jolt of sugar can do all sorts of stuff to your body.
(Score: 0) by Anonymous Coward on Thursday February 28 2019, @01:01AM (2 children)
Blood sugar induced thirst is not satiated with water. This is one of the signs of high blood sugar, an unquenchable thirst and also one of the earliest warning signs of diabetes. Ergo water is a placebo for this. Yet, drinking water will reduce the chance of running a high blood sugar if performed in conjunction with insulin; (this would be in addition to the body's normal intake of water). Thus despite being "technically a placebo", there is a co-therapy here between what a placebo and an active drug and this works for a chemical systems reason, one that isn't ordinarily accounted for.
(Score: 0) by Anonymous Coward on Thursday February 28 2019, @01:25AM
Whether the thirst is quenchable or not is irrelevant. If you don't drink the water you crave you will become dehydrated even moreso as you urinate. Your body needs the "extra" water consumption, it isn't a placebo effect.
(Score: 0) by Anonymous Coward on Thursday February 28 2019, @01:39AM
https://www.webmd.com/a-to-z-guides/why-am-i-always-thirsty#1 [webmd.com]