Homeopathy is a placebo, but what about the others? – 01/12/2023 – Bruno Gualano

An illustrious professor gives a master class on the surgical technique that bears his name. Over the course of 40 minutes, he describes numerous cases of patients who underwent successful surgery. At the end, when the effusive applause fell silent, a wavering arm rose from the back of the crowded amphitheater. The young postgraduate student introduces himself shyly and adds: “What happened to the patients in the control group?”

In a mocking tone, the speaker replies: “Do you really think I should have stopped operating on half the patients?” Without knowing it was a rhetorical question, the student ventures again: “That’s exactly what I thought.” And the surgeon, now stripped of academic liturgies, finally becomes indignant: “But that’s nonsense, boy! Your idea would have condemned half the patients to death!” The tension that fills the environment is only broken by the newcomer’s final whisper: “Which half?”

In clinical studies, controls are participants who do not undergo the intervention being tested. Ideally, they should receive an inert intervention — similar in every way to the experimental one — that takes care of the so-called placebo effect.

Simply put, a positive response that cannot be attributed to active treatment is called a placebo effect. And this phenomenon is genuine to the extent that it can be measured in its manifestations not only psychologically, but also biologically. That’s right: placebos —although “inert” by definition— are capable of modifying genes, hormones, inflammatory markers and even brain activity.

Popularly, the term placebo has been used in a derogatory way to refer exclusively to ineffective treatments. “Homeopathy is a placebo!” we often hear. Well, scientifically, it is correct to say that homeopathy works thanks to the placebo effect, for the simple fact that, in well-controlled studies, the benefits of this intervention are equivalent to those of placebo. On the other hand, you don’t find many people protesting that allopathic medicines are placebos. Which would also not be incorrect, as we will see.

A series of experiments compared the action of several active drugs when administered by doctors or a pre-programmed infusion machine. Therefore, in the first condition, the treatment was received with the patient’s knowledge. In the second, their expectations were suppressed by the automatic supply of the drug. Using this creative approach, possible superior responses to medical prescription could be attributed to the placebo effect.

In the case of morphine (a potent analgesic), post-operative patients who had the drug administered by doctors reported greater pain relief than those who received it through the machine. Similar results have been seen with other known classes of medications, such as antihypertensives. But the most disconcerting finding refers to the anxiolytic diazepam. While medical prescription of the drug reduced patients’ anxiety states as expected, machine administration was unable to produce any clinical benefit.

The placebo effect, as noted, is far from being a homeopathic anomaly. And, at this point, I imagine that the dear reader won’t even be shocked if I tell him that the therapeutic responses of most antidepressants do not exceed those of their respective placebos by 20%.

Since treatment expectations greatly affect responses, placebo control has become a bastion of good science. Studies without this methodological rigor are considered to be of low quality. But his absence is not always due to the scientist’s carelessness. How to create a placebo that accurately simulates psychoanalysis sessions? Or that it exactly imitates a physical exercise program? Since there is no perfect control for interventions like these, we can only admit that their effects, at least in part, are due to the placebo.

To a greater or lesser extent, therefore, they ride the wave of the placebo effect, homeopathy, reiki, family constellation, ozone therapy, geotherapy, laying on of hands, spiritual surgery, anabolic and multivitamin supplements, antidepressants, anxiolytics, platelet-rich plasma, magnetotherapy, auriculotherapy, serotherapy, anthroposophic medicine, functional foods, functional training, coaching. As our student in the story learned early on, you don’t make friends by talking about placebos.

LINK PRESENT: Did you like this text? Subscribers can access five free accesses from any link per day. Just click the blue F below.