Your thoughts on placebos

[radiantquest]

I just read an article that says that plecebo "medication" is becoming more and more popular. I am not sure if they really work and that is not what is bothering me.

Lets say that you go to the doctors with an illness. Your doctor recommends a prescrition (placebo)and tells you it will fix your, let say, heartburn. You take the prescription to the pharmacy. Now, will the pharmacy charge you less because it is really an inert drug? Wouldnt this throw up some red flags? Or, will the pharmacist charge you what an actual drug for that illness would cost? Wouldnt that then cause problems?

I know if I paid a regular copay for a drug and then found out it was a placebo I would be throwing a fit!

Has anyone had any experience with this? How does it work? Just curious.

 

[brazen_irish_hussy]

It depends on a number of things.
First, the condition is the most important. A placebo instead of a heart drug, very bad. As a pain killer though, it is often just as effective as serious, habit forming pain killers. They are also really good if the disorder is psychosomatic.
As for cost, if you are on a discount plan with your pharmacy and it is one of many generics for a drug, the cost can be really low. 2 of my drugs have been on the market so long that it costs me $10 for one and $6 for the other a month. If the health problems I was having had been psychosomatic as was suspected by the doctor, I would have loved a placebo. It would have cost far less than to keep running tests and made me feel better.

Plus, studies have shown that people report better results for placebo pills if they are quite large or very small. Presumably, this indicates either a lot of the drug or a super concentrated one, and that often has a bigger factor than cost.

 

[waterlilly]

What article was this? I thought it was illegal to prescribe a placebo unless part of a scientific study - where the patient is in agreement that they "may" be receiving placebo medications...no?

 

[kama_s]

Date: 6/12/2010 2:51:01 PM
Author: waterlilly
What article was this? I thought it was illegal to prescribe a placebo unless part of a scientific study - where the patient is in agreement that they ''may'' be receiving placebo medications...no?

Exactly. In Canada we are far more strict even when it comes to clinical trials. We can not ethically do a study on a drug and compare it with a placebo if the disease already has a standard care of treatment established. Which is why we export a lot of our comparative placebo trials to the US.

That said, you''d be surprised to know how high a placebo effect can be. I''ve read studies where placebo resulted in 60% efficacy.

 

[radiantquest]

I found it on stumbleupon so I cant get back to it. It didnt mention actual cases where a doctor prescribed a placebo it just said that they are getting more popular. Not sure exactly what that means. It just got my brain running.

 

[Liane]

I''m strongly in favor of placebo "medication."

For example, whenever someone asks for an antibiotic to deal with a viral infection -- and this is really, really common, as just about anyone working in the medical profession in the U.S. can tell you -- they''re not only asking for a placebo effect (since antibiotics do NOTHING in such situations) but contributing to the problem of antibiotic-resistant bacteria. A real placebo would be just as effective for these people and wouldn''t have that serious negative side effect.

A lot of medications and supplements that people want don''t do anything or do bad things, yet the demand persists. Placebos would be just as good and much less bad. Yes, there''s considerable potential for abuse (since the entire effect relies on the patient''s ignorance); yes, education would be better in many instances. I''m not arguing that it''s a universal good.

But a potentially major one? Sure.

 

[aliciagirl]

As a pharmacist in the US, I can tell you that there are definitely no drugs on the market that are true placebos - as in, they contain no active ingredients but are marketed to treat a disease or condition.

As for whether doctors prescribe drugs for kind of a play on the "placebo effect," I would say absolutely. People go in and they believe they know what is wrong with them and what they need and won''t leave the office without a prescription. A perfect example was the antibiotics for viral infections (like the swine flu! I saw it countless times!) or eye drops for pink eye (which is caused by allergies or viruses, in the majority of cases.) While this doesn''t exactly qualify as a placebo, it is certainly giving a patient something that isn''t going to help them and making them believe that it will.

 

[lyra]

Date: 6/12/2010 5:53:42 PM
Author: aliciagirl
As a pharmacist in the US, I can tell you that there are definitely no drugs on the market that are true placebos - as in, they contain no active ingredients but are marketed to treat a disease or condition.

As for whether doctors prescribe drugs for kind of a play on the ''placebo effect,'' I would say absolutely. People go in and they believe they know what is wrong with them and what they need and won''t leave the office without a prescription. A perfect example was the antibiotics for viral infections (like the swine flu! I saw it countless times!) or eye drops for pink eye (which is caused by allergies or viruses, in the majority of cases.) While this doesn''t exactly qualify as a placebo, it is certainly giving a patient something that isn''t going to help them and making them believe that it will.

Wow. That`s crazy sounding. I`m in Canada too. Here they just tell you flat out you can`t have an antibiotic for a virus, and we accept that. Generic medication is okay IMO, but placebo sounds silly.

 

[perry]

Dr''s prescribing something as a placebo is common.

I wish there were real placebo''s available though.

I won''t describe the situation I just learned about (I promised confidentiality - but it affects someone close to me). But, a good placebo may have prevented another destroyed life and the immediate family, and the extended family does not yet know. It will take years, if possible at all, to recover to a normal situation.


Just think of it this way: You can''t overdose or become addicted to placebos.

Perry

 

[kama_s]

Date: 6/12/2010 5:53:42 PM
Author: aliciagirl
As a pharmacist in the US, I can tell you that there are definitely no drugs on the market that are true placebos - as in, they contain no active ingredients but are marketed to treat a disease or condition.

As for whether doctors prescribe drugs for kind of a play on the ''placebo effect,'' I would say absolutely. People go in and they believe they know what is wrong with them and what they need and won''t leave the office without a prescription. A perfect example was the antibiotics for viral infections (like the swine flu! I saw it countless times!) or eye drops for pink eye (which is caused by allergies or viruses, in the majority of cases.) While this doesn''t exactly qualify as a placebo, it is certainly giving a patient something that isn''t going to help them and making them believe that it will.

That just pisses me to no end. Way to go, doctors. Because we just love having resistant bacteria floating around. Marvelous. Just marvelous.

 

[kama_s]

Date: 6/12/2010 7:04:08 PM
Author: perry
Dr''s prescribing something as a placebo is common.

I wish there were real placebo''s available though.

I won''t describe the situation I just learned about (I promised confidentiality - but it affects someone close to me). But, a good placebo may have prevented another destroyed life and the immediate family, and the extended family does not yet know. It will take years, if possible at all, to recover to a normal situation.


Just think of it this way: You can''t overdose or become addicted to placebos.

Perry

Perry, what do you mean by a ''good placebo''?

 

[Liane]

Date: 6/12/2010 7:27:55 PM
Author: kama_s

That just pisses me to no end. Way to go, doctors. Because we just love having resistant bacteria floating around. Marvelous. Just marvelous.

I don't blame the doctors. They're not faultless here, but a lot of them do refuse to give antibiotics to patients with viral illnesses (just as a lot of them refuse to give drugs to addicts who come in complaining about nonspecific pain that can mysteriously be cured only by certain specific medications they know suspiciously well). A sufficiently determined patient, though, will beg and moan and scream and yell until he or she gets what s/he wants, even if that requires going to 20 separate doctors' offices that day.

It's on the patients, not the doctors. And it is not exclusively a problem with antibiotic prescriptions. Antibacterial hand wash? Tissues? Wipes? All contributing to the same problem with nonexistent benefits. The other day in a drugstore I saw toothbrushes and disposable razors with "antibacterial" HANDLES.

It's insane. And it all feeds into the same cycle of believing that "antibacterial" or "antibiotic" is some magic incantation that will prevent you from getting sick or cures what ails you, no matter what that may be, while simultaneously hitting the fast-forward button on developing actual germs' resistance.

/offtopic rant for today.

 

[Lynn B]

I absolutely agree that there are A LOT of unnecessary prescriptions written, but I work in a hospital, and I have NEVER once seen any Rx written for a placebo!!!

I can *maybe* see come country doctor somewhere sending a patient home from his office with some pills in an envelope that may or may not be what he says they are. But thinking that a real Rx is deceptively written for a true ("sugar pill") placebo, then taken to a pharmacy, filled, dispensed, and possibly even billed to insurance... well... I know that ANYTHING is possible... but honestly, I'm seriously doubting THAT scenario!

 

[redfaerythinker]

Date: 6/12/2010 3:23:09 PM
Author: Liane
I''m strongly in favor of placebo ''medication.''


For example, whenever someone asks for an antibiotic to deal with a viral infection -- and this is really, really common, as just about anyone working in the medical profession in the U.S. can tell you -- they''re not only asking for a placebo effect (since antibiotics do NOTHING in such situations) but contributing to the problem of antibiotic-resistant bacteria. A real placebo would be just as effective for these people and wouldn''t have that serious negative side effect.


A lot of medications and supplements that people want don''t do anything or do bad things, yet the demand persists. Placebos would be just as good and much less bad. Yes, there''s considerable potential for abuse (since the entire effect relies on the patient''s ignorance); yes, education would be better in many instances. I''m not arguing that it''s a universal good.


But a potentially major one? Sure.

This... exactly

 

[LtlFirecracker]

Date: 6/12/2010 7:27:55 PM
Author: kama_s

Date: 6/12/2010 5:53:42 PM

Author: aliciagirl

As a pharmacist in the US, I can tell you that there are definitely no drugs on the market that are true placebos - as in, they contain no active ingredients but are marketed to treat a disease or condition.


As for whether doctors prescribe drugs for kind of a play on the 'placebo effect,' I would say absolutely. People go in and they believe they know what is wrong with them and what they need and won't leave the office without a prescription. A perfect example was the antibiotics for viral infections (like the swine flu! I saw it countless times!) or eye drops for pink eye (which is caused by allergies or viruses, in the majority of cases.) While this doesn't exactly qualify as a placebo, it is certainly giving a patient something that isn't going to help them and making them believe that it will.

That just pisses me to no end. Way to go, doctors. Because we just love having resistant bacteria floating around. Marvelous. Just marvelous.

Well, I won't write an antibiotic for a viral infection, and neither will anyone in my practice. But, I am really close to Mexico, and everybody who goes and sees the doctors there gets antibiotics for every stuffy nose. One mother brought in her child, who had a viral illness. She got an antibiotic for her son from Mexico. She came to me because it was "cheap" so it must have been an "older drug." She wanted to know if there was anything newer or better

.

He was a teenager, so I gave him a decongestant, and tried to explain to her that the antibiotic was not going to help, but she wasn't having any of it.

I know if some parents can't get an antibiotics from me, they will see a doctor in Mexico and get one. And I can tell you, this area has some of the worst resistance in the country. I have a patient with an ear infection that is laughing at every antibiotic I give it. I am probably going to have to send her to get her ear drums drained. I have never seen anything like this.

As for doctor's prescribing placebos, by law, we have to tell our patients exactly what we are giving to them and the drug they get needs to be properly labeled. This is, of course, out of a research setting. I don't know a single doctor who has prescribed a sugar pill (except maybe the last 7 pills in a package of birth control).

I do believe the placebo effect is real, and it would be great if we could find a way to use it to help people get better. If it wasn't real, they would not make drug companies prove their drug is better than placebo.

 

[HopeDream]

I''ve noticed that in my area more and more homeopathic products are available in local pharmacies - and knowing the concentrations used, I would guess that that''s about as close to a placebo effect as possible.

I don''t think you can be perscribed a placebo, but you can be told to care for yourself in a way that may not be directly effective in treating your symptoms - the old "take two aspirin and call me in the morning". I think people feel better when they feel like they are taking an active role in their own wellness.

I do wonder how much of most natural health products'' effectivness is actually due to a placebo efect.

 

[elle_chris]

Question for medical professionals here.

I remember getting an antibiotic prescription from my doctor for a URI but being told not to take it unless I didn''t start feeling better in a few days. When I asked why, he told me because secondary bacterial infections are common after the viral one.

He wasn''t pushing the antibiotic on me, just making sure that if it developed into something else, i''d have the proper meds. Is this common practice?

 

[elrohwen]

I agree with the others that I don''t think it can be prescribed unless part of a trial. Your doctor can''t regularly give you a prescription for one without telling you.

I think they''re fantastic though. I take tums whenever I have an upset tummy - I''m fairly sure they don''t do anything, because I don''t actually have heartburn, just indigestion, but I always feel better afterwards. I don''t care if it''s in my head - I like feeling better by taking a safe med, that is hardly a medicine.

I think placebos can also work wonders for pain management.

 

[Regular Guy]

Date: 6/12/2010 5:53:42 PM
Author: aliciagirl
As a pharmacist in the US, I can tell you that there are definitely no drugs on the market that are true placebos - as in, they contain no active ingredients but are marketed to treat a disease or condition.

As for whether doctors prescribe drugs for kind of a play on the ''placebo effect,'' I would say absolutely. People go in and they believe they know what is wrong with them and what they need and won''t leave the office without a prescription. A perfect example was the antibiotics for viral infections (like the swine flu! I saw it countless times!) or eye drops for pink eye (which is caused by allergies or viruses, in the majority of cases.) While this doesn''t exactly qualify as a placebo, it is certainly giving a patient something that isn''t going to help them and making them believe that it will.

So, I guess I see this.

Perry, not so much, or clariification needed.

This is a world where it really is best that we don''t assign our best interest to our doctor.

But, even if we did...the whole process has to make some kind of sense, from theory to practice.

The whole point of a placebo working, is your not knowing it''s a placebo.

I mean...to cut down on costs, the doctor could open up a bag of M&Ms, offer two, and practically say...he''s/she''s recommending two of these, now hold out your hand...

 

[studyer83]

Given how ineffective many drugs are, and given how strong the placebo effect is, I wouldn''t mind at all, I think.

That said, it would be hard to truly replicate the placebo effect today, with all of the information available on the internet, etc -- it would simply be too easy to find out the drug is truly a placebo! Who knows, maybe if I were to google and find out I was just given aspirin I would be mad, but I really think placebo treatment might sometimes be a good thing.

RE Canada & drug testing. Amen. So many drugs on the market give barely any different result over the next best drug or even the placebo. Leads to a plethora of ineffective, expensive drugs.

 

[LtlFirecracker]

Date: 6/13/2010 12:38:23 AM
Author: HopeDream
I've noticed that in my area more and more homeopathic products are available in local pharmacies - and knowing the concentrations used, I would guess that that's about as close to a placebo effect as possible.


I don't think you can be perscribed a placebo, but you can be told to care for yourself in a way that may not be directly effective in treating your symptoms - the old 'take two aspirin and call me in the morning'. I think people feel better when they feel like they are taking an active role in their own wellness.


I do wonder how much of most natural health products' effectivness is actually due to a placebo efect.

At least for children, I see so many parents look they they are going to cry when I tell them they don't need an antibiotic for the child's infection. That has made me wonder if it is the idea that they have something they can actively do to make their child better, so they feel they have more control over the situation that they are looking for. Being that for infants and children, cough and cold medicines are not advised, I don't have much to offer for a viral infection other than tylenol or ibuprofen for the fever.

I try to make a point to discuss non-medicinal remediates so that the parent still has something to do for their child. I am just trying to replace the unnecessary medicines with something else to give that parent the feeling they are helping their child get better.