"Placebo": how to properly use that term!

[fastandbulbous]

Can somebody please decide where they want this to go? I'm happy with it living here until that time though...

 

[tobala]

ED?

Considering that's what most of those pills really are...

 

[ebola?]

My take on it:

Placebos serve a purpose in experimental methods to make controls more directly comparable to the experimental group. But the logic of the situation dictates that even active drugs exert "placebo effects".

Imagine a study involves a drug administered to an experimental group, and we don't yet know if it is active or not. We need to compare the drugged group to a placebo group. If the drug is inactive, it would exert a placebo effect, as would the control group, which is administered a placebo that exerts the placebo effect. This would be a null result. However, if it is active, it would presumably exert the combined effect of its actual action and the placebo effect, creating a contrast in results between the drug group and placebo group. Thus, active drugs exert a placebo effect.

Thus, in trip reports it is correct to expect expectation-effects (a placebo effect) to manifest with active drugs.

ebola

 

[specialspack]

I'm not sure this belongs in ADD. Most of the people here already understand what placebo means. This information needs to be posted up where the noobs etc. can see it and be educated.

I bed to differ!

Respectively, Jamshyd... this is where the thread goes wrong:

I am referring to the term "Placebo" as used in pharmacological and other scientific studies and anecdotes.

To put out a simple definition, the term "Placebo" refers to an imagined perception of a drug's effect when given a false stimulus (such as an empty or flour-filled capsule). The term is also frequently used to refer to the false-stimulus that produced the imagined effects, too.

No, there is not one term "placebo" which is sometimes used to refer the false stimulus and sometimes to the effect of said stimulus. Also, using "imagined perception of a drugs effect" I'd take pretty strong issue with, but let's talk terms and get back to that in a bit.

Quite simple really, there are two different terms

"placebo" and "placebo effect"

It seems a lot confusion in this thread, and probably within this culture in general is caused by the use of "placebo" when people mean "placebo effect", and using other confusing similar phrases e.g. "placebo effects".

Wikipedia nails it:

A placebo is a substance or procedure which a patient accepts as a medicine or therapy but which has no specific therapeutic activity for the condition. Any effect is thought to be based on the power of suggestion.

A placebo effect or placebo response is a therapeutic and healing effect of an inert medicine or ineffective therapy,[1] or more generally is the psychosocial aspect of every medical treatment.[2] Sometimes known as a non-specific effect or subject-expectancy effect, a placebo effect (or its counterpart, the nocebo effect), occurs when a patient's symptoms are altered in some way (i.e., alleviated or exacerbated) by a treatment, due to the individual expecting or believing that it will work. The placebo effect occurs when a patient is treated in conjunction with the suggestion from an authority figure or from acquired information that the treatment will aid in healing and the patient’s condition improves. This effect has been known since the early 20th century.

http://en.wikipedia.org/wiki/Placebo
(this is a pretty comprehensive, and highly recommended reading)

So you can take a placebo (a sugar coated pill), some placebos will be used in a drug trial. You can also experience a placebo effect. These are not the same thing.*

you are right, however keep in mind that the main point is that if the person knows that an effect is placebo, then by definition it no longer is.

That being said, Placebo is not limited to drugs/pharmacology, but can refer to any kind of fake stimulus or imagined effects.

No - this is true for a "placebo" i.e. the physical pill - if you know the pill is sugar it ceases to be a placebo. To say "a person knows an effect is placebo" is meaningless...

Of course, I would suggest that a bit of something like placebo is inherent to all drug effect, even when there IS an active agent.

There might be "something like placebo", but most certainly NOT placebo, since that defeats the whole purpose of this word. The term was coined specifically to describe an experience for which the stimulus was deliberately faked.

Grue means, of course, "the placebo effect" - to use "placebo" in this sentence renders it meaningless - replace it with "placebo effect" and it would be perfectly correct.

Ebola's suggestion up two posts from this is right...

I won't go into the different "wrong uses" of placebo in the first post... it should be obvious that confusions caused by the use of one term when two should be used...

"imagined perception of a drugs effect"

I've got to take issue with this.. most placebos in the medical literature are not percepted at all. Suppose a placebo caused a % change size of tumours in cancer patients - who is "perceiving" these effects? And what is imaginary about statistics of actual physical changes? Or Shulgin's classic example of being fed a placebo sugar solution that the thought was anaesthetic, which promptly knocked him out. Not much "imagination" or "perception" going on there...

That's before we even get into the wonderful twisted of world of imaginations, hallucinations, and perceptions. Most psychedelics have as one of their effects, the creation of perceptions of imaginary things, in my experience. So that would make a placebo effect of psychedelic the "imaginary perception of a perception of the imaginary". And what does that even mean? Don't think psychedelics are all about visuals? Lets pick another effect - sense of oceanic boundlessness, perhaps, or a positive mood lift. What is an imaginary perception of oceanic boundlessness? How would you tell what was an imagined perception, and one a "real" perception (i.e. caused by an actual psychedelic)?

These sort of statements are about "real" and "imagined" psychedelic experience are at best highly contentious, because you're trying to make objective distinctions about purely subjective phenomenon. Good luck with that! (long argument for those who want to slog through it here: http://www.bluelight.ru/vb/showthread.php?t=221736)

The original first post of this thread sort, unwisely in my view, to frame this discussion from the point of view of psychedelics, when it should have started with the medical definitions and then perhaps go on to discuss what those mean when applied to psychedelic drugs.

One last thing to throw in - evidence of chemical effects of the placebo effect:

That case has been strengthened by the recent work of Fabrizio Benedetti of the University of Turin, who showed that the placebo effect can be abolished by a drug, naloxone, which blocks the effects of endorphins. Benedetti induced pain in human volunteers by inflating a blood-pressure cuff on the forearm. He did this several times a day for several days, using morphine each time to control the pain. On the final day, without saying anything, he replaced the morphine with a saline solution. This still relieved the subjects' pain: a placebo effect. But when he added naloxone to the saline the pain relief disappeared. Here was direct proof that placebo analgesia is mediated, at least in part, by these natural opiates

http://www.newscientist.com/article/mg17022924.600-the-power-of-nothing.html

*I'd draw even a third term out here "The Placebo Effect" (with caps) which seems to have emerged in popular culture, which has quasi-philosophical angle - a global term for the power of the mind to affect the body, and by extension culture to affect the body, a move away from realism, both scientific and philosophical perhaps?