An Area Research Center Wants to Harness the Placebo Effect
To many experts, the placebo effect is merely a quirk of medical research. To Ted Kaptchuk, it could be a way to revolutionize it.
As director of the Program in Placebo Studies & Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical Center (BIDMC), the Harvard Medical School professor is seeking to unravel how the placebo effect works, and how doctors can take advantage of it. “The placebo effect is widely regarded as a nuisance—a way of interfering,” Kaptchuk says. “There’s never been much interest in what this effect actually is, let alone what it can do for us.”
Since 2013, PiPS has investigated how a patient’s understanding of a procedure can affect treatment, looking at things like the amount of information a patient hears about his or her medication. Now, Kaptchuk is looking into the behaviors that actually amplify the placebo effect.
“We’ve started experimenting with drugs that rely on placebos, specifically for IBS and pain and depression medication,” he says. “The hope is that these drugs can slow down the process of putting people on more powerful prescriptions. Maybe they can start with a lower dose, or a placebo, and wait a few more weeks to see if they really need something stronger.”
Kaptchuk’s team looks at placebos as a way to examine the human dimension of healthcare—in other words, what happens when a nurse or doctor tells a patient they’re on a certain brand or dose of a drug? Does its effectiveness depend on patient-to-doctor relationship? And how can hospitals use these results to improve holistic healthcare?
“We’re not just looking at sugar pills, but the human variables that influence actual, effective medicine,” Kaptchuk says. He cites the administration of morphine as a powerful example: If it’s given to patients without them knowing, morphine has been shown to be 50 percent less effective at reducing pain. (Kaptchuk says a similar effect occurred when he changed the label of a popular migraine-fighting pill to an unknown brand.)
Right now, PiPS is the only multidisciplinary center in the world studying the placebo effect in a comprehensive way. Kaptchuk believes the medical system’s lack of interest is due to an increasingly narrow focus on drug brands. “Medicine is so pharma-centric; it’s all about this bag of tricks that’s been siloed into hundreds of prescriptions,” he says. “We think everything can be solved with miracle drugs and surgery. There’s no incentive to look at the commonality that healers share.”
Kaptchuk’s end goal, he says, is to determine which behaviors encourage a significant placebo effect, and to educate hospitals about how those behaviors can be used for good.
“I really care about improving systemic healthcare,” he says. “If you engage the patients and make the providers more aware of their influence, our drugs can be more powerful.”