Discussion in 'Just Talk' started by retiredsparks, Apr 18, 2018.
I suspect the vino has made me somewhat verbose......
Yeah cut to the chase will ya
Yes, I agree with you completely regarding the placebo effect. What I am saying is that homeopathy itself when double blind trialed against a placebo shows no effect whatsoever and is nonsense. That it works on a placebo level is no doubt true, but what I am saying is that there would be no difference in that effect if you were taking a "real" homeopathic remedy or tap water as long as the person taking it didn't know.
So to repeat, yes I agree with you on the placebo effect, but this has nothing to do with any homeopathic medicine working in any way on a medical level. That the homeopathic remedy directs attacks the condition it has been taken for has been proved to be false other than on a placebo level. So yes, take the stuff if you believe in it and you may see a limited effect, but it won't be because of the homeopathic remedy itself. The homeopath may as well be giving you distilled water, which is what it is after all, it will make no difference.
Yes. I think we're agreeing, albeit with an argumentative tone.
The thing is, the context is really important. You can't just chug tap water and get the (real) benefit.
Sham injections are more effective than sham pills https://www.ncbi.nlm.nih.gov/pubmed/10787112
Different placebos even use different mechanisms to produces their effect. That's amazing (to me). According to type of placebo the brain/body uses different biological strategies to treat itself. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633056/
The context is important to placebo effectiveness https://pdfs.semanticscholar.org/0baa/6343fad5baa372d90552a583b8cef02306ab.pdf
...and it's this last link that's the key. The context, the ritual, of the "treatment" is very important.
CAM has evolved a set of contexts to maximise their effect (for those conditions where it is possible to cause an effect - mainly pain management).
I can't be dismissive of a solution that works.
 even a ridiculously dilute solution.
Genuine apologies for tone, this is an interesting discussion.
The placebo effect is interesting and the various subtleties in its action are intriguing.
Can we agree as follows, and I think you agree (but maybe not):
There is nothing in the homeopathic "remedy" in itself that has any effect, it is all placebo?
I agree that there is no pharmacological effect.
Many people improve their mental health through counselling. There no active organic molecule in that. Is that “all placebo”?
Social isolation can have physical effects on people’s health. They’re not missing an essential nutrient. Is reducing their social isolation and thereby improving their health “all placebo” because there’s no biologically active chemical administered?
I think it’s that the term placebo has come to mean “nonsense” or “ineffective” that I have a problem with. But I have to agree to use that word, because what other word is there? “Non-pharmacological” is a confusing mouthful. “Non-chemical medicine” sounds like something a scientifically illiterate new age hippy would say (and everything is made out of chemicals - so it’s false too).
If I were inclined to conspiracy theories I’d suggest that drug companies have trained us into thinking that only pharmacy is effective. I’m not sure I really believe that though.
Oh, and I like argumentative tones! No apology necessary.
Ah, but surely there is? As with mental health counselling. Except that, in both cases, the drugs are not external administered but released by the body itself.
So, homeopathy and placebos can and do undoubtedly sometimes work - but only if the patient is actively involved in its use.
Without much question I think it can be seen that placebos do ‘work’ in their aims, as do crystals, heated pebbles, prayer and the laying-on of hands for some folk. The extent of their success, however, must be very limited; it ain’t going to restart a heart or repair a sclerosised kidney. But even here, there may well be cases where homeo has contributed to a major cure such as overcoming a cancerous growth. There are certainly tales of where tumours have regressed after being considered incurable or inoperable, where advanced diseases and major ailments have seemingly been spontaneously reversed; the victim’s body has somehow effected the cure, perhaps by developing some pretty serious anti-bodies to the illness, in which case virtually everything which has helped promote a positive attitude and hence the release of endorphins and other chemicals in the body will likely have played a part, however small. It could even be that the body itself was virtually on the ‘brink’ of developing a challenge to the illness within it, and the added rush from the placebo effect actively tipped it over to success.
Possibly. Even probably. Given the number of ‘beings on the planet, one could say that this has almost certainly happened. Tho’ surely very rarely.
There’s an ethical element to this, tho’ – even if it ‘works’ in such very rare but dramatic cases, is it morally right to try and effect a cure using what is effectively ‘deception’?
When the Vatican’s desire to beatify Mother Theresa became unstoppable, they reckoned they had all the reasons nicely in place and all it needed was a certified miracle which could be ascribed to her posthumously. Whoobedoo, such a miracle cure took place in a wee Indian village when a devout Catholic woman with a cancerous stomach tumour declared she was fully cured after having held a statue or picture of MT close to her abdomen and prayed to her for help.
Is this just harmless fun for non-devout observers? I don’t think so. It is not only a deliberate and world-wide manipulation of susceptible people’s beliefs, but the more deluded may well seek such similar cures for themselves rather than trust proper doctors; I think we can all guess at the likely outcome.
Does homeo 'work'? In some cases, almost certainly ‘yes’. But in every case it’s effectively by deception; with the patient being involved in the belief that it will help. Should it be financed by the NHS? You have got to be kidding. Why not if it sometimes works? Because you should also include astrological readings, crystals, heated stones and the laying on of hands in that mix if you do. Or, to put it another way, where should we draw the line at the deliberate deluding of patients? I'd suggest at the truth.
Any other reason why it shouldn't be paid for? YEAH, TOO RIGHT! 'Cos it wouldn't work on me - and that's not fair...
To continue from bee-too's point, it would certainly be good to see some more active counselling amongst patients, to help them through their ordeal and help promote a positive resolve towards a cure.
Anyhoo, on the bigger picture, shouldn’t we be simply educating folk towards the truth? A half-millennium ago the masses believed in witchcraft. Today, a similar number have at least a partial belief in astrology.
And most of them voted Leave. See? Deluded
Maybe a slight alteration then, "there is no pharmacological effect due to an active ingredient in homeopathic medicine"; which as the dilution of most homeopathic medicines is such that they are nothing less than distilled water would be a given. But then the believers in homeopathy would then point to the magical and unprovable "memory" that the water holds, and that memory is only activated by shaking the diluted solution. It's all nonsense to me but I suppose if, as you say, someone believes it works then the placebo effect may have some limited influence on the patient.
From NHS web site:
"Homeopathy is a "treatment" based on the use of highly diluted substances, which practitioners claim can cause the body to heal itself.
A 2010 House of Commons Science and Technology Committee report on homeopathy said that homeopathic remedies perform no better than placebos (dummy treatments).
The review also said that the principles on which homeopathy is based are "scientifically implausible".
This is also the view of the Chief Medical Officer, Professor Dame Sally Davies."
That's enough for me...if homeopathy worked, the NHS would be using it. But it doesn't, so they don't.
Good reply. Too long to take point by point, so I’ll split into four areas.
We agree that it works but the mechanism is debunked.
2. NHS and ethics
I believe it’s only recently that the NHS stopped using homeopathy. I can see both sides. It can work for some people. It is relatively expensive.
But most importantly the NHS doesn’t use placebos. JJ bought this up earlier. One problem is related to the reverse of the placebo effect, the nocebo effect. The mind can also have negative health effects. If people thought there was a chance that their doctors was fobbing them off with sugar pills then this can reduce the effectiveness of real drugs, as well as causing stress and a lack of confidence in health services.
Allowing patients to self select whether they want private CAM seems the best way to go.
If someone is in pain and trying to avoid it then I don’t think it’s fair to suggest that they are in some way deluded. Anyway, it turns out that some placebos can be effective even when you know they are placebos.
4. Teaching people the truth instead
If someone is in pain then we should be trying things that might relieve that pain, not inviting them to a discussion on epistemology.
But outside of that. Sure. But that truthful discussion needs to accept (as we do) that these treatments can work and research how to maximize the effect at the lowest cost.
2) That's interesting. I thought that when trialling new drugs on 'hopeless' cases (conditions which remain terminal under current provision), the voluntary patients know that some are being given the new 'treatment' and some 'control' drugs. I wonder if the small 'chance' of being given a potentially successful new drug is an overall plus? I'd have thought so. Mind you, it takes a 'positive' type of patient to agree to the new trial in the first place.
3) Deluded only in the potential effectiveness of the actual treatment. I'm happy with folk doing whatever it takes to help them through. People can do whatever they want, as long as (a) we aren't paying for their weird beliefs and (b) they don't try and impose their beliefs on others.
4) Good point. I would expect/ hope /be happy with a doctor or carer telling any terminal patient whatever it would take to ease their emotional and physical pain. All that matters is that they have the most calm and 'stress-free' ending. 'Cos a split-second later it doesn't matter at all.
Am I being too clumsy again? Too bad...
One of the most fascinating features of these YouTube imbeds is what appears when it comes to an end or is paused. What suggested clips come up?
I've been given two suggestions - a 2013 Steve Howe interview and more Harry & Paul clips...
It’s weird, but check the medical literature for placebo without deception.
It’s been found that you can explain to people that there are no active ingredients, label the bottles “PLACEBO” and there’s still an effect.
It’s still an active area of research.
Many drugs are discovered by looking at compounds that are used “in the wild”. Willow bark was used to relieve pain, from this aspirin was isolated.
I think CAM is like this. It’s an effective folk medicine, and researchers are trying to distill and purify the placebo into placebin? That needs a better name it reads as “place bin”. Placeibin?
 Eg. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663432/ or follow cites from the article.
Effectiveness depends on the illness here.
It has a decent record with some sorts of pain and some allergies. Although I think you tried an over the counter homeopathic hay fever treatment without success. Do I recall correctly?
I think it’s dependent upon what you have been watching on YouTube previously. What came up after the clip finished for me was “ Idiot Supercar Crashes “ and “ Roger Hodson ( Supertramp ) School.” Strangely these were some of my recent watches on YouTube.
I got Stormy Daniels.
Homeo works best when accompanied by a half-hour consultation with the doctor, not so much when it's pills quickly bought over the counter or through the post. I think that answers the placebo effect equally well, whichever explanation - pro or nay - is provided alongside it.
I am quite cynical, as you may have noticed, but still get a 'buzz' from the rare occasions I need to see a doctor. I am not prone to genuflection, exactly, but am somewhat in awe; I am touched that they seemingly 'care'. I leave feeling better. And then go to the chemist with my prescribe.
I totally get, for example, that overuse of antibiotics is a bad thing, so enthusiastically agree with the doctor when they have suggested holding off for a bit on that course to see if my poor bod can tackle things on it's own. I leave with a flush of pride that I 'get' & support what the doctor is saying, but disappointment that I ain't holding a piece of paper...
What the? That was decades ago...
'Compound H' as I recall - jeez. It was on the recommendation of my very healthy sis-in-law, and I had no idea what homeo stuff actually was at the time, other than it was supposed to be 'natural'. I popped them pills with genuine expectation, but my nose still ran like a tap. With no max dosage on the bottle, I chucked them down my throat like a true addict - it's a wonder I didn't OD.
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