One Study Invalidates Much of Medical Science
My lifelong assertion that much of medical science is literally wishful thinking has now been confirmed by new, groundbreaking scientific research involving the, so far, underestimated healing power behind patient expectation. The study, entitled “The Effect of Treatment Expectation on Drug Efficacy: the Analgesic Benefit of the Opioid Remifentanil” may completely crush the principles upon which medical science has built its case, to date. Yet, this finding may also open the door to an entirely new way of treating disease.
Prominent researchers from the University of Oxford, University Medical Center Hamburg-Eppendorf, Cambridge University, and Technical University, Munich found that the ultimate and most influential determining factor of whether a drug treatment is, or isn’t, effective is nothing less than the patient’s own mind. Their research, published in February 16, 2011 in the medical journal, Science Translational Medicine. [Sci Transl Med 16 February 2011: Vol. 3, Issue 70, p. 70ra14, DOI: 10.1126/scitranslmed.3001244], removes any doubt that the placebo effect is responsible for healing, not a drug treatment or even a surgical procedure.
In the study’s abstract, the researchers state: “Evidence from behavioral and self-reported data suggests that the patients’ beliefs and expectations can shape both therapeutic and adverse effects of any given drug.” They discovered how divergent expectancies in patients alter the analgesic efficacy of a potent opioid (painkilling drug) in healthy volunteers by using brain imaging.”
In this study, when test subjects were told that they were not receiving painkiller medications – even though they were – the medication proved to be completely ineffective. In fact, the research showed the benefits of painkillers could be boosted or completely wiped out by manipulating the subjects’ expectations, which basically means it’s entirely up to the patient whether he gets relief, or not.
This particular research also identified the regions of the brain that are affected by patient expectation. “On the basis of subjective and objective evidence, we contend that an individual’s expectation of a drug’s effect critically influences its therapeutic efficacy and that regulatory brain mechanisms differ as a function of expectancy,” according to the study’s findings. Now try telling that to your doctor the next time he hands you prescription medication!
Obviously, this should have important consequences for patient care and for testing new drugs, but I doubt that it ever will. There is no money to be made from telling patients they can heal themselves. Still, alternative and complementary forms of medicine may greatly benefit from incorporating these principles into their approaches.
Your Mind Does Count – More Than You May Think
Now let’s look at some of the specifics of this fascinating research.
A group of healthy test patients who experienced the same intensity of continuous pain caused by heat application to their feet were asked to rate their pain levels on a scale of 1 to 100. All patients were attached to an intravenous drip so drugs could be administered to them without their knowledge.
The patients experienced pain at an average of level of 66.
The first phase of the experiment involved giving the patients one of the most effective and potent medications, remifentanil, without their knowledge. Their rate of pain dropped to 55.
In the second phase, the patients were told that they were receiving an intravenously administered painkiller. With no doubt in the patients’ mind that this was true, the pain score dropped to 39.
Then, without actually altering the dose of the drug, the patients were told the painkiller had been discontinued altogether and to, therefore, expect pain to return; consequently, the pain score went back up to 64. Even though the patients still received remifentanil, they now experienced the same level of pain as they did at the beginning of the experiment, when no drug was given to them.
Professor Irene Tracey, from Oxford University, told the BBC: “It’s phenomenal, it’s really cool. It’s one of the best analgesics we have and the brain’s influence can either vastly increase its effect, or completely remove it.” She further pointed out that the study was conducted on healthy people who were subjected to pain for just a short period of time.
People with chronic conditions who have unsuccessfully tried many drugs would not be as responsive because their expectations were likely dampened too many times before. Consequently, they may readily turn their own doubts (negative expectations) into a self-fulfilling prophesy of non-recovery. In other words, recovery or cure doesn’t depend on the treatment, but rather on what the patient believes it will, or will not, do for him.
“Doctors need more time for consultation and to investigate the cognitive side of illness; the focus is on physiology not the mind, which can be a real roadblock to treatment,” claimed Professor Tracey.
George Lewith, a professor of health research at the University of Southampton, poignantly stated that these findings call into question the scientific validity of many randomized clinical trials: “It completely blows cold randomized clinical trials, which don’t take into account expectation.”