Placebo is the Medicine of the Masses

I just read a very interesting article on the placebo effect that you can read here if you want. It's not really anything new about placebos other than the fact that they seem to be working to greater effect lately.

But this got me thinking...there's a serious catch-22 with the placebo effect.

On one hand, a placebo that replaces an actual drug will alleviate any possibility of negative side-effects related to whichever drug was replaced. That's obviously a good thing. Plus it shows the power our minds and bodies have to alleviate symptoms without the use of powerful and potentially dangerous chemicals. Plus a placebo hardly costs anything considering that it will usually be made out of sugar and water (along with minor costs from faux-branding and coloring). This means positive results with less risks for less money. It's a win-win situation!

But on the other hand, a placebo doesn't work if the patient knows it is a placebo. Obviously. And a dead giveaway is the cost. If I go in to pick up an anti-depressant and I am handed a bill for $10 with no insurance, I am going to wonder if what I am taking is actually a helpful drug. To our consumer culture, expensive = quality (much like wine drinkers experience a perceived better taste when drinking more expensive wine regardless of actual quality). Solution? Jack up the price! Insurance will cover it! But wait, then we're charging people tons of money for sugar and water and the insurance carriers won't pay for that because it won't be medically necessary.

So we're at a standstill. A working placebo cannot be given in anything but a clinical trial because there is no way to distribute it without breaking the effect. Either the patient is told it is a placebo and it stops working, or the patient is lied to and somebody has to pay much more than sugar and water is actually worth.

And that's not taking into account the possible lawsuits from any patient who harms himself/herself or someone else while on a placebo, the possible lawsuits from patients who were lied to and found out (even if the placebo worked), the fact that the pharmacies would have to be in on it as well as the insurance carriers, and the fact that the Rx world is a big business and they would do everything in their power to stop placebos taking over their drugs.

It seems like the only solution would be to take those patients who responded positively to placebo and send them to therapy to try and convince them that their symptoms are almost all psychological and that they have the power to overcome said symptoms sans-drugs. But that would likely fail.

Basically we have a potentially powerful answer to all the drugs prescribed and all the side-effects those drugs result in and all the cost that people are stuck with because there is no other way to alleviate symptoms...but we can't use it.