I’ve often wondered, if alternative medicines, including homeopathic remedies, only work at placebo level – they do you good if you believe they will – are they justified just for their placebo effect?
The placebo effect will make one in three people feel better anyway so should we not prescribe them?
Each time I go through this loop I end up saying no.
And professor of complementary medicine, Edzard Ernst, agrees with me despite plenty of research that has increased our understanding of how placebos work.
It turns out the opioids, cannabinoids and dopamine in our own bodies operate placebo responses in Parkinson’s disease showing placebo effects aren’t ‘just in the mind’.
They’re real and lead to measurable changes in our bodies.
Many studies show that the apparent benefit of so-called alternative medicines (which Prof Ernst has wittily given the acronym, SCAM) rely heavily, if not entirely, on this placebo effect.
Now the placebo effect has a scientific explanation, does that makes SCAM legit?
Apparently the rigorous science done on the placebo is being used as proof for SCAMs which, by scientific standards, aren’t effective.
So, the argument goes, there’s no reason to dismiss SCAM simply because it operates solely or mainly via a placebo response.
Fabrizio Benedetti, professor of physiology and neuroscience at the University of Turin is the esteemed researcher of the placebo effect.
Much of the excellent science in this area comes from his laboratory and agrees that his ground-breaking discoveries are lending support to SCAM.
When hard science started investigating placebo effects, it accidentally encouraged dubious practitioners.
According to Professor Ernst, charlatans are becoming more and more aware that their bizarre practices could work through a placebo effect.
As he says: “Indeed, whereas hard science has so far denied any scientific basis for non-conventional therapies, now the very same hard science certifies that the placebo effect has scientific grounds.
“Therefore, quacks are no longer interested in showing that their pseudo-interventions work; rather, they justify their use on the basis of the possibility that these bizarre interventions may induce strong placebo effects…”
The problem is that while placebos may alleviate some symptoms, their effects are neither strong nor long-lasting.
Crucially, placebos never cure any disease and “all claims by SCAM practitioners that their therapy offers a cure are based not on fact but on wishful thinking,” adds Prof Ernst.
Plus, we don’t need placebos to produce placebo effects. Conventional therapies generate such effects when given with compassion.
But a patient benefits also from the specific effect of the treatment.
So while the placebo effect may be real, placebos aren’t enough. The patient loses out.