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Dr Ben Goldacre and the nocebo effect

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A man who is gonna give you his own particular side to the world of science. Please welcome to the stage, Dr Ben Goldacre. Hi. Sorry, I talk a bit quickly. Somebody on Twitter last night said I was skull-fucked with my data-cock. I don't know what that means. I wanted to talk about the nocebo effect, which is like the evil brother of the placebo effect. It is the amazing ability of the mind to make you feel really really rubbish. So placebo effect is: You get a sugar pill and you get better. Placebo effect isn't just about you get a sugar pill and get better. It is about the whole cultural meaning of it. Our beliefs and expectations. It's been demonstrated in lots of studies comparing one kind of placebo against another. We know, for example, if you get two sugar pills a day instead of one sugar pill a day... you get better faster from gastric ulcers. And that is an outrageous finding. We know from three different studies from three types of pain that a salt-sater injection is a more effective form of pain relief than a sugar pill. Not because salt-water injection or sugar pill does anything physically to the body, but because it feels like a much more dramatic intervention. We know that fake knee operations improve knee pain, fake angina operations improve angina, and we know that pacemakers improve congestive cardiac failure, after they've been put in but before they've been switched on. So this is properly outrageous findings, right? And I was kind of over it. But then, this month I was giving evidence to the parliamentary select committee for science and technology, which is the ultimate middle-class name-drop, and they said "so we understand you don't think homeopathy works any better than placebo ... but do you think there is any physical adverse consequences, ... do you think homeopathy pills actually harm people?" And I said "No", obviously. But then, a person in the panel came after... they said "No. no, homeopathy pills can have side effects" And that seems like crazy, but they said "No, no, they're so powerful... ... they can have positive effects and they can have side effects." So I started looking into this. And firstly, interestingly, they're wrong. Actyually it's not interesting that they're wrong. When homeopathy is wrong, that's, sort of, dog bites man. But it's a big study comparing the number of people reporting side effects if they're getting real homeopathic sugar pills against if they're just getting normal sugar pills. And there's no difference. But what's mad about this experiment is that it shows people are getting side effects when they're just getting a sugar pill. So then people started studying this in more detail. It turns out that the side effects you get are the side effects you expect to get. So then people started doing these experiments, these really sinister studies, going out of their way to try to make people feel really shit. And I'll tell you about three. Firstly, asthma. Take a hundred people with asthma, sit them down and put a saline nebulizer on their face. Saline nebulizer is this thing that makes a mist of salty water you inhale. And if you've got asthma, won't put you in any harm, just nothing at all. So hundred people down, switch on: Nothing happens. Sit hundred people down with asthma, saline nebulizer on their face, tell them it's an allergen, switch it on. Bang! Half of them have an asthma attack. Next study, puking study. They take a bunch of people, put hthem inside a big rotating drum designed to make them puke. They give them all sugar pills. Half of them are said, we'll put you in this big rotating drum that's gonna make you puke, but we're gonna give you an anti-emetic, that's gonna stop you from puking. They didn't puke. The other half: They said, look, we've been doing these studies on a drug and it looks like it's really effective and helpful, but unfotunately it has this side effect, which is: it massively makes you want to puke. So we just want to work out how much it makes you want to puke. And we're gonna put you in this machine that makes you want to puke, and then we're gonna give you the puking drug. And those people puke. But the third experiment, which is properly insane, is a study on carisoprodol. Carisoprodol is a muscle relaxant drug. This is a big study and they divided people into six groups. Okay? Half the people got the real muscle relaxant. Half the people just got a dummy sugar pill. And they were told one of three stories. They were either told: We're giving you the muscle relaxant. Or they were told: We're just giving you a sugar pill. Or they were told: We're giving you a stimulant drug, that will make you uptight, clenchy, tense,... ...gonna make your muscles tense, gonna improve your reaction time. And we're gonna measure how uptight, clenchy and tense your muscles are, and what your reaction time is like. The results of this experiment are properly insane. Three things: Firstly, the people who just got a dummy sugar pill but were getting a stimulant... they were really clenchy, uptight and tense, and had faster reaction times. The people who were given the real muscle relaxant but were told it was a stimulant were even more clenchy and uptight than anybody else. And that's probably because of something called the active placebo effect. Because they've taken this pill and they can feel it working. They can feel that it's doing something in their muscles, and... "I think I've got the real shit this time... This is really kicking in." And that potentiates, enhances the effects of their beliefs on their body. And it wasn't just enough to overcome the relaxant effect of the drug... it was enough to turn it properly on its head so you were actively, properly more tense. But the third, insane part of this whole study: The people who were given the muscle relaxant, but were told were given the muscle relaxant... ... had higher blood plasma levels of the muscle relaxant than any other group. Because something about their belief that they've been given a muscle relaxant was enough to perpetuate the presence of the muscle relaxant molecules in their bodies. And that is properly insane. And that is the amazing scientific research into the placebo effect. And that is, without question, 8-million metric fuck tonnes more interesting than any faky made-up facts.... purported by some flakey New Age pill-peddling quack. Merry Christmas. Ladies and gentlemen, that was Dr Ben Goldacre.

Video Details

Duration: 5 minutes and 31 seconds
Country: United Kingdom
Language: English
Genre: None
Views: 4,773
Posted by: hakimiyetiilmiye on Jul 12, 2010

The Guardian science columnist Dr Ben Goldacre talks about the "nocebo effect, the evil brother of the placebo effect", in his stand-up act at the Nerdstock

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