Dr. Jim Coyne on exaggerating the “power” of placebo, for ScienceBasedMedicine.org:
The opioid crisis and growing awareness of the dangers of addiction to pain medication are prompting renewed calls for the use of pill placebos in place of active treatments, backed by familiar claims about the magical powers of the placebo.
This is a critique of Vachon-Presseau et al, a recent study that claims to have found evidence of psychological and neurological traits that predict the potency and duration of placebo response. It’s seriously flawed science, and the PR buzz and hype about it is even worse.
Note that this article in no way asserts that the brain is not involved in pain (something some critics have jumped on). Of course it is; rest assured that Dr. Coyne knows that. This is about some problems with using brain scan studies to support exaggerated claims of placebo efficacy. Placebo is interesting, but it’s not magic or even a form of a medicine, as I have argued extensively.
The post is also clearly intended to be a bit of a crash course in how to critically analyze studies of the brain. Brain studies are impressive and a bit intimidating. Most of us — and I include myself — are not equipped to confidently question their validity and significance. Dr. Coyne walks us through the basics, based on his extensive experience. It’s dense reading, but worthwhile for anyone with the slightest interest in the problem of placebo hype and/or the pitfalls of brain scanning.
The concluding section is a great summary: “Takeaway tools for skeptics.” If you get bogged down, skip down to that. 😉Debunking the magical power of the placebo effect for chronic pain (yet again)