Studies on the placebo effect have been done over and over again to understand its efficacy. Ted Kaptchuk
, head of Harvard's placebo program has been investigating placebos for over 35 years in various contexts and expanding the scope of the field which included his own acupuncture practice.
Placebos are medical interventions without active drug ingredients, and to Kaptchuk, its effects are brought about by much more than sugar pills and saline injections. It's about the whole "drama" or "theater" of medicine. "The placebo effect is the effect of everything surrounding the fake pill, or the real pill," he says. "It's the compassion, trust, and care. It's the ritual and symbols. It's the doctor-patient interaction."
Kaptchuk got a big response for a study with irritable bowel syndrome patients, where he showed that placebo could be effective even when patients knew the treatment was fake (the drug bottle had a big "placebo" label on it). The study only included 80 volunteers, but the results seemed to indicate something profound: When patients want to get better, and believe that doctors are there to help them, good results happen.
"The discovery of neurobiology has made physicians in the medical community more comfortable that something is going on that they have to pay attention to," Kaptchuk says. "Before it was just the imagination. Now, the imagination has a real neurobiology."
Kaptchuk doesn't believe in deception, or that sugar pills can cure cancer. He does however believe placebo research can help with conditions where self-appraisal is important. "You can change a person's sense of the symptoms. The only thing we know for sure is that the ritual of medicine changes subjective outcomes and that there's a biological substrate to that," he says. "The placebo is going to be for things like headache and back pain, muscular skeletal pain, and digestive and urinary problems."
"Placebo is about how we improve care independent of medication. It really puts the onus on the physician, because it says, 'if you're not doing this, it's actually bad care.' In the pharmaco-centric world that medicine is, it's about finding the right drug. Placebo research begins to shift that whole concept."