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The Reverse Placebo Effect

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By Author: Steven Johnson
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The human mind is one of the last unexplored territories. We may have traveled to the moon and our deep water submersibles can send us pictures from the floor of our oceans, but we actually know very little about the way the mind works. This is not to say that our understanding of the way the brain works has not been improving. We can watch it from outside with different types of scanner and imaging machines, and we can analyze the minute changes in chemistry as messages move from one part to another. But ask our top scientists what we are thinking, and they look strange and mutter darkly that telepathy is not scientific.

Against this background, there's new research published in Science Translational Medicine. It seems there's a new application of the WYSIWYG rule. This was a big idea in word processing packages a few years back. What you see on a screen is what you get when it's printed out. Well, here it is applied to taking prescription drugs. We have long understood the reality of the placebo effect. In all drug trials, the chemically inert pills and potions we give to the unlucky participants actually prove effective ...
... in about one-third of cases. The rule is that, if people believe strongly enough in a particular treatment, it will be effective. So, to be approved as effective by the FDA, the real drug under test must be shown significantly more effective than the placebo. Interestingly, many new drugs fail this simple test.

Well here's real evidence of the reverse placebo effect. Bending the rules of ethics slightly, our super scientists recruited twenty-two healthy people to a trial of a "new" painkiller". In fact, the drug has a good track record, being used during surgery to help ensure patients do not wake up halfway through the procedure. So here's the test. Our brave volunteers were hooked up to an IV primed with a real drug and inserted into an MRI scanner. A pain source was then applied to one of their legs. It was intended to produce a pain level of 7 on a scale of 10. The researchers then lied to the participants on whether the actual drug was or was not being delivered through the IV. Not surprisingly, the reported levels of pain fell when the drug was secretly administered. When the participants were told the drug had stopped, reported pain levels rose.

What makes these results more convincing that the the MRI scans showed brain activity changes in those parts of the brain known to regulate levels of anxiety. Scientists may not know exactly what people are thinking, but they can see changes in brain patterns to match against the words used. So, when looking for the best results from the use of a painkiller like Ultram, you must sincerely believe it is the world's best painkiller and that, once it is in your bloodstream, you will feel less pain. If you doubt Ultram, you will feel more pain. No matter what you may think of the ethics of this research, it really is better for doctors to lie to patients when it comes to getting the best results out of drugs.

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