When is a Drug not a Drug?

I’ve written before about the placebo effect, the phenomenon where a patient is given a harmless sugar pill, yet experiences improvement.  That’s why this article from CBS News about the use of placebos in England caught my eye.  A recent survey revealed that 77% of British doctors admitted to treating a patient with a placebo at least once a week.  The treatment could be an unnecessary test, a real pill not deemed effective for the patient’s specific complaint, or just a sugar pill.  In England, as in the US, this is considered unethical, but doctors contend that it works.

Reading the article led me to a few more links and finally to this 60 Minutes Extra video on one of their earlier stories about the placebo effect and anti-depressants.  The original interview was with a placebo expert from Harvard who believes that most anti-depressant drugs are not much more effective than placebos.  This short video is worth watching.  He explains how capsules are more effective than pills, injections more effective than capsules and surgery most effective of all.  And the color of the pill makes a difference as to how it is perceived.  Remember that this entire conversation relates to remedies with no active ingredients, non-drugs.  Another article mentioned one study where patients who merely had their knees cut open and then sewn shut with no further intervention did better after the fake surgery than those who had the real surgery!  This is the healing power of the mind unleashed!

Consider that the antidepressants and other drugs referred to in these articles have earned FDA approval, a several-year long, intense, progressive testing process.  The drugs are tested against placebos and checked for side effects to ensure that they are both safe and effective.

If these highly tested drugs could be of questionable value, what about those untested pills and treatments backed by no more than endorsements and advertising material that we run across every day?  How much of their positive results come from nothing more than hype and the placebo effect?  Are we spending time and money on the equivalent of sugar pills?  Shouldn’t we be asking that question of every cure or treatment or feel-good experience that we go after:  all the supplements, non-traditional remedies, homeopathy, or even visits to chiropractors?  Are we getting our money’s worth or are we playing into the hands of people who either believe their own hype, or don’t think it’s unethical to sell us a placebo as long as it makes us feel better, makes them a buck and keeps us coming back for more?

This subject brings up some interesting and possibly troubling questions.