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Comment by ButlerianJihad | Hacker News Reader

> You know it's just sugar,

That is not the definition of a placebo.

You take the placebo (whatever it is: could be a pill; could be some kind of task or routine) and you believe it is medicine; you believe it to be therapeutic.

The placebo effect comes from your faith, your belief, and your anticipation that it will heal.

If the pharmacist hands you a pill and says, “here, this placebo is sugar!” they have destroyed the effect from the start.

Once on e.r. I heard the physicians preparing to administer “Obecalp”, which is a perfectly cromulent “drug brand”, but also unlikely to alert a nearby patient about their true intent.

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> That is not the definition of a placebo.

But, puzzlingly enough, it's the definition of open-label placebo, in which the patient is told they've been given a placebo. And some studies show there is a non-insignificant effect as well, albeit smaller (and less conclusive) than with blind placebo.

This is exactly what I meant. Poor specificity on my part.

One, a placebo does not need to be given blindly. A sugar pill is a placebo, even if the recipient knows about it.

An actual definition: "A placebo is an inactive substance (like a sugar pill) or procedure (like sham surgery) with no intrinsic therapeutic value, designed to look identical to real treatment." No mention of the user's belief.

Two, real hard data proves that the placebo effect remains (albeit reduced) even if the recipient knows about it. It's counter-intuitive, but real.

  In psychology, the two main hypotheses of the placebo effect are expectancy theory and classical conditioning.[70]

  In 1985, Irving Kirsch hypothesized that placebo effects are produced by the self-fulfilling effects of response expectancies, in which the belief that one will feel different leads a person to actually feel different.[71] According to this theory, the belief that one has received an active treatment can produce the subjective changes thought to be produced by the real treatment. Similarly, the appearance of effect can result from classical conditioning, wherein a placebo and an actual stimulus are used simultaneously until the placebo is associated with the effect from the actual stimulus.[72] Both conditioning and expectations play a role in placebo effect,[70] and make different kinds of contributions. Conditioning has a longer-lasting effect,[73] and can affect earlier stages of information processing.[74] Those who think a treatment will work display a stronger placebo effect than those who do not, as evidenced by a study of acupuncture.[75]

https://en.wikipedia.org/wiki/Placebo#Psychology

The hypotheses hinge on the beliefs of the recipients. "The placebo effect" has always been largely psychological. That's the realm of belief.

To veer even further off-tangent, isn't it hilarious how the Wikipedia illustration of old Placebo bottles indicate that "Federal Law Prohibits Dispensing without a Prescription". Wouldn't want some placebo fiend to O.D.

>”Wouldn't want some placebo fiend to O.D.”

We should be more worried about the rise of placebo resistant bacteria.

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