What does a placebo look like?

Placebo is Latin meaning “I shall please you”. It has its historic origins as a deceptive act of a patient receiving a fake treatment from a physician who knew his patient wanted some treatment, any treatment, for their discomfort. The word has evolved over the years and is more scientific today. Today placebos play a key role in establishing whether a drug is effective or not effective. However, the mystery, illusion, and deceit still lurk over the use of placebo. 

Today the American Society of Pain Management Nursing defines a placebo as "any sham medication or procedure that is void of any known therapeutic value". 

Despite the fact that placebos are not real medicines, it has been established that their effects are real. You may know about the power of placebo and how perceptions can alter human behaviors but have you ever seen how it works? What does a placebo look like? If it's just a belief game then how is the belief converted into something tangible? 

Placebo Pill & Injections

Placebo treatments can be dummy pills or fake injections that contain an inactive substance with no pharmacologic value. They may contain starch, sugar, or saline. The pill may not contain any active pharmacological ingredient however the packaging is clinical and the expectation that it may help holds more value than a real drug. 

It has also been observed that the color, size, shape, branding, price, and texture of the pill has significant and measurable effects on symptoms to be treated. Research has shown that capsules are more effective than a round tablet for some conditions. Colored capsules are better than plain capsules for other conditions. It's almost like food tastes better when served in a fancy manner. Or a gift-wrapped package entices more pleasure and love in the recipient towards the giver. 

Also, placebo injections are proven to be more effective than placebo pills for some conditions. It is true that the more complex or credible the placebo treatment is, the more powerful its effect is. None of these treatments have any pharmaceutical quality but it is the belief and patient expectation that makes it real and generates a strong physiological effect in the brain.

Sham Surgery

Beyond physical placebo pills, other treatments have also been used, such as inactive acupuncture devices and invasive fake surgery. In such treatments, participants undergo an imitation of surgical procedures just the way an actual surgery goes but they do not receive the actual treatment, just the sounds, and sensations of surgery. Research has observed that invasive surgeries generate a more powerful placebo effect than non-invasive ones.

No matter how the placebo looks or feels, it is important to understand that the placebo effect is not fake or deceitful. It is not just something the human mind produces or imagines but an actual biological response is observed through placebo. The placebo can look like a pill, injection, or surgery but the effects are determined by your expectation from their use. They instruct your conscious brain to generate specific neurotransmitters that help with your symptoms.  They can calm you down, ease your pain, and make you feel a whole lot better without having you take real drugs. 

The stimulus might be fake but the human mind and belief can make placebo effects to be real and worth trying.

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When are placebos used in clinical trials?

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How do placebos reduce pain?