Knowingly Taking a Placebo Still Reduces Pain, Studies Find
This technique could have applications in pain management and addiction treatment.
Imagine going to the doctor complaining of pain. The physician writes you a prescription. But instead of medication, you knowingly receive a placebo. How would you feel? This is a vitally important question, as the US is going through a chronic pain epidemic right now, with 100 million adults feeling significant pain on a consistent basis. As a consequence, we have the opioid epidemic.
A lot of patients in pain develop a tolerance to opioid pain relievers too quickly, and begin taking more than prescribed to kill bleed-through pain. But the relief only lasts for a time, causing a vicious cycle, forcing the patient to take more, and pushing them ever closer to addiction and overdose. Unfortunately, there are few long-term options, besides alternative medicine, when it comes to chronic pain. Now, imagine receiving effective pain relief without the risk of addiction, overdose, or even side effects?
One way to do that might be to instigate the placebo effect. Usually, we think of a placebo as a “fake” pill, sometimes called a sugar pill. They’re used in clinical trials, made to look just like the medication they are mimicking, but without any active ingredients. Researchers in two important studies found the results of using the placebo effect for medical aims was anything but fake. Today, knowledge of the effect is widespread. It’s so much a part of our consciousness that Harvard University researchers found that knowingly giving patients a placebo reduced their pain.
All medications come with the risk of side effects. What if we could induce the placebo effect for symptom relief?
Though we’ve known about the placebo effect for a long time, medical science still doesn’t know exactly how it works. In this study, researchers at Harvard Medical School wanted to know what impact, if any, the placebo effect would have, if participants knew up-front they were getting one. Dr. Ted J. Kaptchuk led the study on what are being called “open-label placebos.”
Professor Kaptchuk is the director of the Harvard-wide Program in Placebo Studies and the Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical Center in Boston. He’s been studying the placebo effect for over 20 years. In one of his previous studies, he and colleagues recruited irritable bowel syndrome (IBS) patients. Each suffered from abdominal cramps, and either constipation or diarrhea. Half of participants received an “open-label” placebo. The other got no medical intervention. Those who received a sugar pill saw their symptoms improve dramatically.
In a second and more recent study, Prof. Kaptchuk looked at using the placebo effect to treat lower back pain, something every adult in the world will confront at one time or another. Globally, chronic lower back pain is the number one cause for disability. He and colleagues concluded that those patients who took a placebo knowingly, in addition to a traditional pain reliever, experienced more pain relief than those who took medication alone.
"This new research demonstrates that the placebo effect is not necessarily elicited by patients' conscious expectation that they are getting an active medicine, as long thought,” the researcher said. “Taking a pill in the context of a patient-clinician relationship -- even if you know it's a placebo -- is a ritual that changes symptoms and probably activates regions of the brain that modulate symptoms."
The ritual and expectations surrounding medical care may engage the brain in a way that can bring us relief.
97 patients with chronic lower back pain took part. Each was then given a one-on-one, 15-minute session outlining the placebo effect. Then, they were put randomly into one of two groups. The first received the usual treatment, while the second also received an open-label placebo. 85-88% of patients were already on pain medication. None were taking opioids. They were on non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Bayer), aspirin, or acetaminophen (Tylenol).
Those taking these drugs could continue to do so, but weren’t allowed to take part in any dramatic lifestyle changes. After three weeks, those in the placebo group reported a 9% reduction in usual pain, a 16% reduction in maximum pain, and a 29% reduction in disability related to pain. Kaptchuk said the body responds to the rituals we associate with medical care. But how did the patients feel about knowingly taking a placebo? Lead author on this study, Claudia Carvalho, PhD, said that rather than feeling lied to, the patients felt empowered, as they felt like they were taking part in a cutting-edge approach.
Kaptchuk says that placebos can’t replace every medication. It can help with symptom control for things like nausea, pain, or fatigue. But it won’t help with cancer, atherosclerosis (clogged arteries), or high cholesterol, among other maladies. More studies are being conducted by Kaptchuk to help us further understand how the placebo effect might be used in palliative care—to treat symptoms.
Kaptchuk said, “Our hope is that in conditions where the open-label placebo might be valuable, instead of putting people on drugs immediately — for depression, chronic pain, fatigue — that people would be put on placebo.” He added, “If it works, great. If not, then go on to drugs.”
To learn about the genetic component of the placebo effect, click here:
Researchers have just discovered the remains of a hybrid human.
90,000 years ago, a young girl lived in a cave in the Altai mountains in southern Siberia. Her life was short; she died in her early teens, but she stands at a unique point in human evolution. She is the first known hybrid of two different kinds of ancient humans: the Neanderthals and the Denisovans.
These thought leaders, founders, and entrepreneurs are propelling the kind of future we want to be a part of.
- The tech industry may be dominated by men in terms of numbers, but there are lots of brilliant women in leadership positions that are changing the landscape.
- The women on this list are founders of companies dedicated to teaching girls to code, innovators in the fields of AI, VR, and machine learning, leading tech writers and podcasters, and CEOs of companies like YouTube and Project Include.
- This list is by no means all-encompassing. There are many more influential women in tech that you should seek out and follow.
Most said they want to act on their desire someday. But do open relationships actually work?
- The study involved 822 Americans who were in monogamous relationships at the time.
- Participants answered questions about their personalities, sexual fantasies, and intentions to act on those fantasies.
- Research suggests practicing consent, comfort, and communication makes open relationships more likely to succeed.
Consensual non-monogamy fantasies<p>For the new study, published in <a href="https://link.springer.com/article/10.1007/s10508-020-01788-7" target="_blank">Archives of Sexual Behavior</a>, researchers asked 822 people in monogamous relationships to:</p><ul><li>Describe their favorite sexual fantasy, defined as "mental images you have while you are awake that you find to be sexually arousing or erotic."</li><li>Select which themes apply to that fantasy, such as having sex with multiple people at the same time, experimenting with taboos, or engaging in a sexually open relationship.</li><li>Answer whether they intended to carry out these fantasies, and discuss them with their partner.</li><li>Complete assessments on relationship satisfaction, erotophilia and personality, as measured by the Big Five Personality inventory.</li></ul><p>The results showed that 32.6 percent of participants said being part of a sexually open relationship was "part of their favorite sexual fantasy of all time." More surprising is that, of that one-third, 80 percent said they want to act on this fantasy in the future.</p>
Pretzelpaws via Wikipedia Commons<p style="margin-left: 20px;">"The present research confirms the important distinction between sexual fantasy and sexual desire in that not everyone wanted to act on their favorite sexual fantasy of all time," study author Justin J. Lehmiller told <a href="https://www.psypost.org/2020/09/one-third-of-people-in-monogamous-relationships-fantasize-about-being-in-some-type-of-open-relationship-study-suggests-58102" target="_blank">PsyPost</a>. "This suggests that fantasies may serve different functions for different people."</p><p>Even though most participants said they want to act out their fantasy in the future, far fewer reported acting out sexual fantasies in the past. Other findings included:</p><ul><li>Men were more likely to fantasize about CNMRs.</li><li>So were people who scored high in <a href="https://en.wikipedia.org/wiki/Erotophilia#:~:text=Erotophilia%20is%20a%20personality%20trait,ranging%20from%20erotophobia%20to%20erotophilia." target="_blank">erotophilia</a> and sociosexual orientation.</li><li>The psychological predictors of fantasizing about CNMRs differed from predictors about infidelity fantasies.</li></ul>
Do open relationships work?<p>A <a href="https://www.tandfonline.com/doi/full/10.1080/00224499.2019.1669133" target="_blank">2019 study</a> from psychologists at the University of Rochester suggests it <em>is </em>possible<em>, </em>but especially when both partners practice a trio of behaviors: consent, communication, and comfort — or, the Triple-C Model.<br></p>But the study also suggests not all forms of open relationships are equally viable. For example, people in one-sided CNMRs — where one partner stays monogamous, the other seeks outside sexual relationships — were nearly three times more dissatisfied in their relationships than the monogamous group <em>and </em>the consensual non-monogamous group.
The results of this study showed depressive symptoms being highest in adolescence, declining in early adulthood and then climbing back up again into one's early 30s.