Monday, September 5, 2011

Placebo & Research

Placebo & Research

It has been my experience that two of the most common questions asked of alternative health practitioners are:
1. What is the research?
2. Is it placebo?
These are excellent and appropriate questions. But, with that said, these questions are ingrained in us, like knee-jerk responses, to ask of all alternative therapies, serving as tools/weapons used by the prevailing medical paradigm to undermine alternative treatments and distract from the dangers of allopathic medicine.
Let me explain.
First, and most obviously, I am reasonably sure that most patients are not asking these same questions of their doctors about all prescribed drugs and recommended courses of care; from statins to anti-depressants, from chemotherapy to radiation, from cardiac catheterization to bypass, from mammograms to prostate screens, and on-and-on. It is assumed that the research exists and supports the treatment, and that treatment is, not only, not placebo, but better than placebo.
In the same way the knee-jerk response has been ingrained to ask alternative practitioners, it has been ingrained into us to trust medicine, and specifically not ask doctors.
Throughout their history, the AMA and its extension, the FDA, have suppressed and persecuted alternative treatments that challenge medical dominance. One of their most powerful tools has been controlling and denying funds to research alternative therapies. Their consistent justification has been: ‘just by looking at it gives it a level of credibility we don’t want to promote.’ The self-serving result has been their mantra ‘there is no research to support... (fill in the alternative therapy).’ How convenient?
At the same time, the quality and reliability of medical research and its peer review have been totally corrupted by their highly profitable incestuous relationship with BigPharma. It is corporate science, plain and simple. And, it has emphasized research on dangerous pharmaceuticals and invasive medical procedures to the willful exclusion of the empirical and scientific evidence of natural remedies that work.
In what I believe is one of the most damning statements ever made, in September 2001, the editors of the 12 most prestigious medical journals published a unified message titled Sponsorship, Authorship and Accountability:
“We are concerned that the current intellectual environment in which clinical research is conceived, study subjects are recruited and the data analyzed and reported (or, not reported) may threaten (scientific) objectivity….In light of that truth, the use of clinical trials primarily for marketing makes a mockery of clinical investigation and is a misuse of a powerful tool.”
And yet, they continue to print and disseminate what they know to be fraudulent research that results in widespread use of unsupported and lethal treatments. At the same time they propagate skepticism, doubt and fear about alternative therapies.

As for the dreaded placebo…
The fundamental principle and underlying effect of placebo is as a catalyst that activates the mind/body’s innate capacity for self-regulation and self-healing. Placebo pills alone have been 30 to 90% effective. And, the placebo effect for successful outcomes has been estimated to occur in 30 to 70% of all therapeutic treatments. That is, that the patient got better because of the placebo effect, and not the specific treatment. In addition, “A paper published in the October 19 issue of Annals of Internal Medicine – entitled “What’s In Placebos: Who Knows?” calls into question the foundation upon which much of medicine rests (comparative testing to placebo), by showing that there is no standard behind the standard – no standard for the placebo.”
It is sad and emblematic of the major problem of the medical model that it denigrates the placebo effect and uses it in a pejorative manner to undermine and cast doubt on other effective forms of therapy, up to and including alternative treatments for cancer. And while patients routinely ask alternative practitioners whether or not their treatment is placebo, the patients are distracted from asking their medical doctor critical questions regarding their medical treatment:
1. What are my absolute risks verses benefits of treatment?
2. What is the NNT? the number of patients needed to treat to see the outcome you are saying?
Bearing in mind that hospitals are killing 12,000 patients per week (624,000/year), as a result of the care they received and not because of what brought them to the hospital in the first place, one can see the supreme importance of these questions!
In my opinion there is no better treatment than placebo to activate the mind/body’s life-force capacity to heal itself. The question then becomes not if the therapy is placebo, but (with, or without, supporting research) how often does it succeed in improving the health of the patient?

1 comment:

Val Welts said...

Right you are, Doc May! Many of us who work with people in a psychotherapeutic capacity know the power of beliefs and expectations (positive or negative, unfortunately...) We also understand that it is nearly impossible to do "hard" research on treatments such as LENS or Cognitive Behavior Therapy or whatever because there are ALWAYS confounding variables that simply can't be controlled for. Of course the same applies to treatment with antidepressants and other psychotropic drugs. Some of us DO place great importance on "anecdotal evidence." And why shouldn't we? What our clients tell us about how they feel is all we need to know that the treatment is working (or not). -Val Welts