#26 TAM9: Placebo Medicine

This was a panel discussion moderated by Dr. Steven Novella discussing the Placebo effect and what it means. Mark Crislip began by defining it in basic terms as, "bullshit". Nice.

The discussion is based around the idea that alternative medicine has pretty much agreed that the placebo effect is real and that they are now trying to get the placebo effect from their treatments because it is still beneficial to the patients.

Mark Crislip: If CAM is equal to a placebo and placebo is equal to nothing then CAM is equal to nothing. It was brought up that there is a placebo effect in Parkinson's. Not everyone agrees. Steve Novella is commenting on how the brain can be a tool for pain management. You can convince the brain of different things that are akin to a placebo which might lend some validity to it. There is, however, no direct way to measure pain in response to placebo.

On the big screens are a couple slides from this weeks New England Journal of Medicine relating the effectiveness of Albuterol in treating asthma. They compared the results between Albuterol, a placebo, sham acupuncture, and a non-intervention control. The results showed that Albuterol greatly improved lung function while the other three had no effect. However, in the patient's reported results the placebo and the acupuncture appeared to have a nearly equal effect as the drug. The panelists are discussing how this is being reported in the media. They are saying that the placebo has a positive effect when the physical results show that the effect is really all in the patient's head. So, the acupuncture and the placebo made the patients feel better mentally but they still had reduced lung function. Wow.

The panel is disagreeing as to wether the placebo effect belongs on medicine. Crislip is not buying it. He is constantly saying that he doesn't want to use the placebo effect because he feels that it is essentially lying to the patient. The others seem to disagree. Unfortunately, I think the placebo effect would, and does, work in a lot of the people in this country. Personally, I would rather have the truth and the real medicine. If I can't be cured, tell me. I'll start working on those things I need to do before I die. Steve is saying that there is a gray area where you use certain treatments that may or may not work but you do it to placate the patient.

Don't placate me or lie to me! I want the truth! Doctor: You can't handle the truth!

Live blogging from TAM9, Las Vegas, NV.