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Thursday 4 October 2018

Placebo. Homeopathy and other natural therapies are often dismissed as being "no better than placebo". So what is wrong with that?

Homeopathy is often dismissed as being "no better than placebo". So exactly does this mean? Is it important to patients? Why has the concept of a 'placebo' become such a problem in recent years? And why do so many people want to disassociate themselves from it?

A placebo is usually defined as a substance ‘containing no medication’ or ‘an inactive substance’ that is given to patients to help him/her get well. Or a placebo is a substance that has ‘no intrinsic value’ but manages to trick someone into feeling they are better.

Most standard definitions explain placebo using the concepts highlighted above, or similar. It is used in the context of medicine, drugs, active substances that make sick people better. It is supposed to help us distinguish between substances that ‘work’ and substances that don’t ‘work’.

So the value of the term ‘placebo’ should become clearer. It has become a weapon used by those who claim to make people well through ‘active substances’ and ‘medication’ - by conventional, or 'scientific' medicine. Everything else is of ‘no intrinsic value’, merely a confidence trick. The term has been hijacked by the pharmaceutical companies and their supporters, to attack natural medical therapies, to dismiss them as worthless, as being ‘no more, no better than placebo’.

So why is placebo a problem?

It is a problem because most natural therapies utilise methods that are designed to stimulate the body’s own healing mechanisms, not necessarily through 'active substances'. This may be through essential oils, or homeopathic remedies, or the needles of the acupuncturist, or the hands of the reflexologist. So for this reason such therapists can be routinely dismissed and discounted as users of ‘placebo’. Their patients don't really get well. They just think they get well (and presumably they are too stupid the recognise the difference)!

So is this a problem for the patient?

People who are genuinely sick have one main, over-riding priority - to get better. I have never treated a patient, and made them better, who then asked

* “how did you do that?”
* “I hope there was an active ingredient in what you gave me!”
* “I hope what you did had some ‘intrinsic value’!”
* “If it’s just a placebo I will be unhappy”.

Patients want to get better, and largely that is all they want. They don’t ask about the number of randomised double blind trials the treatment has been subjected to. If the treatment does not hold, if the illness returns, the patient will not use the therapy again. Therapies that don’t work for patients don’t survive, especially when they do not have government subsidy! Essential oils, homeopathy, acupuncture have all been around a long time. Patients use them to get better, and they do so because they know that it does make them better.

Conventional medicine may not like this, and no doubt they will continue to rail against us, and dismiss natural therapies for being “no more than placebo”.

But as far as most patients are concerned, they don’t give a damn!