It’s still a mystery how the placebo effect works. Some say it’s a matter of expectations. Some think it’s <a href="https://www.sciencedirect.com/science/article/pii/B9780123750006000902">classical conditioning</a> at work. We’re conditioned to feel better after taking medicine, so we do. The placebo effect on pain could be activating natural opioids in the brain as a response to the relationship between the physician and patient.

Why The Placebo Effect Works

To determine if a new drug is more effective than no therapy at all, researchers must account for the placebo effect. Simply receiving medicine is likely to influence some patients. This suggests when testing a drug, a response does not necessarily mean the medicine is superior to doing nothing.

Nothing Is Better Than Something

Today’s “gold standard” of drug testing is the double-blind, randomized controlled trial (RCT). In an RCT, some of the patients receive the actual drug; others receive a placebo. Neither the researchers nor the patients know who gets the drug and who gets the placebo, hence the “double-blind.” Experts won’t approve a drug if it is not more effective than a placebo.

The Double-Blind Test

Researchers have observed placebos producing changes in blood pressure and heart rate, as well as relieving pain, depression, anxiety and irritable bowel syndrome. Sham injections seem to work better than sham pills, large pills work better than small ones, and two pills are better than one.  In one study, a surgeon gave patients a sham knee surgery, where the surgeon made an incision, but did nothing to the knee before sewing it back up. The patients were just as likely to find relief as those who underwent the procedure.

Sham Injections, Sham Pills And Sham Surgeries

But one thing is not a mystery. For all the good a placebo might do, lying to patients is not ethical. In clinical trials, the participants know that they may be in the group that gets a placebo. However, experts could take advantage of the placebo effect without fraud — pious or otherwise. One of the most intriguing things about placebos is that they can work even when patients know they’re getting a placebo.

The Ethics Of Placebo

A placebo is a medical treatment that doesn’t contain any kind of medicine. In fact, it contains no active ingredients at all. But in many cases, placebos can have a therapeutic and sometimes dramatic effect.Doctors would give placebos to patients that had little else to offer or seemed to have nothing wrong with them. They might give a patient a tincture of sugar water, or a pill filled with nothing but sugar, hoping that the patient’s belief in the medicine or trust in the physician would help relieve the symptoms.

The Placebo

If your doctor gave you a pill that contained nothing but starch and water, yet your headache got better, you’ve experienced the placebo effect.

Nothing Is Better Than Something

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Placebos in research