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Placebos and Their Role in Science

© Dr. David L. Phillips

Lately there has been a flurry of studies into placebo medicine. Placebos are usually referred to as "sugar pills"; however, this is not always the case. In the science of drug or supplement development, the true test of effectiveness is a "double blind, randomized, controlled trial" or RCT. Only these studies are considered real proof that a product, therapy or substance works to improve human health. Individual clinical trials, testimonials and practical experience are not considered scientific proof by any measure.

Many times the biggest challenge when designing an effective trial is the decision of what to use as a comparable, non-therapeutic agent to counter the treatment or substance that you are attempting to study. Studying acupuncture is a good example of this difficulty. How do you perform a sham needle treatment? Chiropractic therapies are in a similar bind. To attempt to compare spinal manipulation to another type of treatment is fraught with placebo problems.

With research into drugs placebos are more straightforward. As long as the pill or substance being administered looks the same, i.e., same size, colour, etc. then the trial should be accurate. In a double blind trial, neither the patient nor the doctor administering the pills knows which is real or which is placebo. Therefore, preconceived notions can't prejudice the study, theoretically at least.

A classic case of trial influence was seen during the "Cola Wars" of several decades ago. One of the large cola companies began a widely viewed series of television commercials based on so-called "taste tests", if you recall. A subject was placed in front of 2 white sleeves, each covering a bottle of cola. A sample of each of the colas had been poured into a glass. The subject, your average person-in-the-street, was asked to taste each cola and give his/her opinion as to which tasted better. This seemed at the outset to all of us in televisionland like a fair and reasonable trial. What we in the audience didn't see was that on the front of each of the sleeves, visible only to the subject, was printed a letter of the alphabet. Apparently, the cola company had employed a team of psychologists to subtly prejudice the results in favour of the sponsoring cola company, which, of course, wanted favourable results. The psychologists had discovered that certain letters had a more positive influence than other letters on the human psyche. The letter L or M for example would be chosen more often than the letter W or X. This was the secret trick behind the cola war commercials.

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