Articles on quackery and placebo effet

[IreneF]

I sometimes see narratives hear on PR that seem to be accounts of the placebo effect. Typically, "I did great on xxx but then it stopped working." I have never commented when I see these because I think it would be unwelcome.

On the other hand, when you're sick with a mystery disease you'll often try anything, which leaves you open to all kinds of snake oil.

 

[IreneF]

I used to be very interested in alt med. Then I volunteered at a consumer health library where I had access to a database that had some of the research done on herbal medicine and other modalities. It was terrible. Most of it was in vitro and very shoddy. No comparison to what you'd read in a medical journal.

Then there's the fact that the National Center for Complementary and Integrative Health (NCCIH), which is supposed to research alt med, hasn't had any positive research results in 19 years on any significant health problems.

 

[arewenearlythereyet]

I think this thread is about quack treatments and placebo, not conventional medicine and the flaws of doing everything you can to elliminate bias. I think sometimes I see this argument presented in defence of unproven treatments here and elsewhere in the Internet. It effectively a red herring used to divert the topic of conversation.

Of course conventional medicine doesn't have all the answers, of course we should all have an open mind. But that is a separate issue ...we could have a long conversation about a lot of things (e.g the side effects of taking Epilim while pregnant, let alone it's long term effects on folate).

I think we should critically examine the mechanism of how these treatments succeed. So how are crystals supposed to work, or ozone therapy for that matter? I haven't seen a persuasive explanation for why a lot of these things work. I think that part is unethical. If you don't know how it works how do you know it's not doing harm?

Herbal medicine is rife with this...taking poisons on some pretext that it has a healing effect for example, or any other number of unrefined drugs hiding as "herbs". Regulation is what's needed ...that's how Epilim got in the news...because it went through trials and the side effects were known and not properly reported.

I wonder how many unreported unregulated cases of herbal medicine are out there?

 

[Woolie]

I'm probably being a broken record here, but I don't think there's anything to say that the placebo effect is ever "real", in the sense that the person is actually better off health wise because of the treatment.

You might attend slightly differently to various symptoms while under a treatment, and then when asked to recall later, you might think about those symptoms a bit differently in the light of the treatment. If you have a goodish period, you might attribute it to the treatment, and if things get worse, you might think its a sign of the treatment "working". But these are just perceptions, and even if they are positive perceptions, they won't last.

As @IreneF says, we all see that principle in action when try some treatment and it "seems" to work for a while, then it stops working.

Some people will say, "but isn't that something good?". Well, I don't think so because you pay for that later when you realise its not panning out the way you thought. Any treatments that aim to capitalise on positive thinking, positive expectation or hope are just robbing Peter to pay Paul.

If I'm right with this interpretation, then being vulnerable to the placebo effect doesn't make you stupid or anything, it just makes you normal. We're designed to construct patterns based on a combination observation and prediction. So its just the mind working as its supposed to.

 

[IreneF]

@arewenearlythereyet some US states regulate naturopathy, including herbalism, but not necessarily effectively.

Most herbs are reasonably safe. Mistakes do happen--in March, two people were hospitalized and at least one of them died after drinking herbal tea prepared by a shop in San Francisco's Chinatown.

The herbs that have observable medicinal effects were the source for actual medicines. Think digitalis. Many of these natural products were superseded as organic chemists managed to tweak the active molecules into safer or more effective forms. This is how Bayer made a fortune on aspirin.

The reason why people choose herbs or any other alt med cure has little to do with rational evaluations or mechanisms of action. The hand-waving discussions of toxins, for example, are going to make more sense to nearly everyone than biochemistry, even if they're wrong.

I have to go to bed now.

 

[TrixieStix]

Yes, I was thinking about how sham acupuncture seems to work as well as the real thing. A person should still have some training in the whole sticking-needles-into-people thing.

If sticking needles into people works,then a person ought to be able to do self acupuncture, but it could be that there's something about the whole experience that helps people.

If people can do crazy piercings on people with just minimal training I think we can train/ people to randomly stick acupuncture needles into people's skin. It could still be made to be a nice experience.

 

[Barry53]

However, if someone's life improves because they believe that magic crystals or whatever are helping them, is that a bad thing?

No it's not, provided people don't then try to misrepresent that as being a biomedical improvement. When they do, then it becomes a very bad thing, because it screws up so much for many other people.

 

[Barry53]

TBF a lot of medical treatments are just to mask symptoms, particularly prescription painkillers, so that particular one, whilst valid, isn't just related to quack and placebo thingies.

But they do come with warnings to see a doctor if you need to keep taking them, and long term or heavier duty pain killers are only on prescription by doctors, and you are then taking them under medical supervision.

 

[Wonko]

But they do come with warnings to see a doctor if you need to keep taking them, and long term or heavier duty pain killers are only on prescription by doctors, and you are then taking them under medical supervision.

True, true, depending upon your definitions

e.g Despite being on what could be considered a fairly high amount of opiate painkillers (prescribed with 8 30/500 co-codamol per day, 200ml of oramorph a month etc) I haven't seen my doctor in over 2 years, and haven't had any blood tests to check how the paracetamol etc is affecting kidney/liver function), so not exactly "supervision" used as it would be under any conditions.

Similarly, yes most of my drugs, most of the time, come with an information leaflet, in such small print I haven't been able to read any of them for at least 5 years.

 

[Valentijn]

If people can do crazy piercings on people with just minimal training I think we can train/ people to randomly stick acupuncture needles into people's skin. It could still be made to be a nice experience.

I helped my friend pierce her belly button (with her mother's approval) when we were 16. It got infected and she had to take it out

 

[TrixieStix]

I helped my friend pierce her belly button (with her mother's approval) when we were 16. It got infected and she had to take it out

ahhh man I remember people piercing their own ears with safety pins. Ouch! who does that? lol

 

[Wonko]

I helped my friend pierce her belly button (with her mother's approval) when we were 16. It got infected and she had to take it out

Not to mention....when I was in my late teens to early 20's I, with some success, expended a fair amount of effort in attempts to stop people shoving sharp bits of metal into me. It stuck, as an approach to life, if someone is going to stick sharp lumps of metal into me I at least want them to know what they are doing

 

[Learner1]

So if you see your doc and are given a prescription for painkillers, are you going to reject it because it just masks your pain? Mostly your body heals itself, and the pills keep you more or less comfortable while that's happening.

Could this be at the root of the opioid epidemic?

There are other treatments for pain that have been helpful for patients, like acupuncture, prozone, prolozone, cortisone injections, arnica, DMSO, curcumin, Boswellia, CBD oil, etc. Admittedly, not every one will work in every situations, but doctors prescribe opioid s without even bringing up any of these alternatives.

 

[Snowdrop]

Methotrexate is a chemo drug for cancer. When it was repurposed for RA my mother was given it. That was at least twenty years ago. She still takes it, is in her eighties and is far more active than I am. I'd take the hard drug if that's what works.

 

[AndyPR]

First published in March but I couldn't find it on PR.

Medicine with a side of mysticism: Top hospitals promote unproven therapies

They’re among the nation’s premier medical centers, at the leading edge of scientific research.

Yet hospitals affiliated with Yale, Duke, Johns Hopkins, and other top medical research centers also aggressively promote alternative therapies with little or no scientific backing. They offer “energy healing” to help treat multiple sclerosis, acupuncture for infertility, and homeopathic bee venom for fibromyalgia. A public forum hosted by the University of Florida’s hospital even promises to explain how herbal therapy can reverse Alzheimer’s. (It can’t.)

This embrace of alternative medicine has been building for years. But a STAT examination of 15 academic research centers across the US underscores just how deeply these therapies have become embedded in prestigious hospitals and medical schools.

Some hospitals have built luxurious, spa-like wellness centers to draw patients for spiritual healing, homeopathy, and more. And they’re promoting such treatments for a wide array of conditions, including depression, heart disease, cancer, and chronic pain. Duke even markets a pediatric program that suggests on its website that alternative medicine, including “detoxification programs” and “botanical medicines,” can help children with conditions ranging from autism to asthma to ADHD.

“We’ve become witch doctors,” said Dr. Steven Novella, a professor of neurology at the Yale School of Medicine and a longtime critic of alternative medicine.

https://www.statnews.com/2017/03/07/alternative-medicine-hospitals-promote/

 

[skipskip30]

No it's not, provided people don't then try to misrepresent that as being a biomedical improvement. When they do, then it becomes a very bad thing, because it screws up so much for many other people.

I suffer from OCD so magical thinking can be incredibly dangerous for me and other people with similar problems. Once you start down that rabbit hole it can cause a huge amount of harm for many people. So I don't believe these things are harmless, far from it in fact.

 

[IreneF]

First published in March but I couldn't find it on PR.

https://www.statnews.com/2017/03/07/alternative-medicine-hospitals-promote/

They make money on it.

 

[Wishful]

Acupuncture is supposed to trigger some neurochemical release (endorphins?). Since my muscle aches aren't physical, but something involving the nerve signals or processing of them, I'm not overly surprised that it actually had an effect. It would have been interesting to do it as a proper double-blind experiment, with sham needles and needles in places other than the 'correct points'. Not interesting enough for me to pay for it though.

It was a very restful experience though: dim lighting, soft music. Most pleasant medical treatment I've ever had. Hmmm, maybe I need to replicate just the dim lights and music...

 

[IreneF]

Could this be at the root of the opioid epidemic?

There are other treatments for pain that have been helpful for patients, like acupuncture, prozone, prolozone, cortisone injections, arnica, DMSO, curcumin, Boswellia, CBD oil, etc. Admittedly, not every one will work in every situations, but doctors prescribe opioid s without even bringing up any of these alternatives.

Even though I react badly to opioids, I think they're excellent for short-term pain. They are very effective and safer than other painkillers. The vast majority of people who take them have few problems.

The causes of the opioid epidemic are complex, and it has resulted in the demonization of a useful group of drugs.

 

[Learner1]

Even though I react badly to opioids, I think they're excellent for short-term pain. They are very effective and safer than other painkillers. The vast majority of people who take them have few problems.

The causes of the opioid epidemic are complex, and it has resulted in the demonization of a useful group of drugs.

Agreed. But there are other treatment modalities that are effective that many doctors and patients won't consider.

Above all, it makes sense to get to the root cause of the pain, and treat that...