{"id":1212,"date":"2020-04-15T09:29:14","date_gmt":"2020-04-15T16:29:14","guid":{"rendered":"http:\/\/danschmidtforsenate.com\/blog\/?p=1212"},"modified":"2020-04-15T09:29:14","modified_gmt":"2020-04-15T16:29:14","slug":"pandemic-placebo","status":"publish","type":"post","link":"https:\/\/danschmidtforsenate.com\/blog\/?p=1212","title":{"rendered":"Pandemic Placebo"},"content":{"rendered":"\n
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Pat Wellenbach\/AP<\/em><\/figcaption><\/figure>\n\n\n\n

The buzz drummed up around hydroxychloroquine by our\nPresident as a treatment for Covid19 doesn\u2019t surprise me. Honestly, a lot of\npolitics is snake oil and he\u2019s proven to be really good at selling it to some\nof us.<\/p>\n\n\n\n

But it\u2019s a great opportunity to consider what pills we are\nwilling to swallow. I find hydroxychloroquine quite bitter. Maybe you don\u2019t.<\/p>\n\n\n\n

Lots of what we do in this modern medical industrial complex\nis mysterious, but don\u2019t think for a minute its more complicated than human nature.\nPlacebos tell us something about human nature, so it would be wise to\nunderstand them if we can. It might tell us something about ourselves, and\nabout the prescriber. <\/p>\n\n\n\n

Kind of like Idaho Democrats, placebos have a bad name they\ndon\u2019t deserve. Why disparage something that really has an effect? I guess it\ndepends on the effect you want. It turns out, our bias effects our outcome.\nWhat you believe about your treatment influences the effect the treatment has\non you. <\/p>\n\n\n\n

They frequently do work; placebos I mean, not politicians. <\/p>\n\n\n\n

When a placebo is given to a patient it can have an effect\non the measured outcome; the \u201cplacebo effect\u201d. \nPlacebos make headaches better, lower blood pressure, improve pain, ease\nanxiety and improve performance, the list is long. Believe it or not, they can\nhave side effects too. They can cause nausea, ringing in the ears, all number\nof unpleasant things. Don\u2019t forget that these effects, desired or not, are as\nreal as we perceive them to be. Even the color of the pill can have an effect.\nWe are such marvelous mysterious creatures. <\/p>\n\n\n\n

For a drug to be FDA approved it has to show an effect\ngreater than a placebo. That requires a lot of hard, expensive work. The\npatient has to be blind to whether the drug is a placebo or \u201creal\u201d and further,\nthe treatment team needs to be blinded to the nature of the treatment also. The\nfaith that patients place in their treatment, and the faith that providers\nhave, has an effect. The standard for an effective drug is that it must clear\nthe placebo hurdle of faith. That\u2019s a high bar. Isn\u2019t it refreshing to know our\nfaith is so powerful?<\/p>\n\n\n\n

The effect of hydroxychloroquine on the Covid19 illness has\nnot been held to these standards. One very small report<\/a>\nwithout blinded patients or providers reported some benefits; two larger\nones<\/a> showed no effect. Trying a novel treatment in the face of a novel\nvirus in the midst of uncertainty is not irresponsible. Honestly reporting it\nfor others to consider and test is responsible. Testing the treatment against a\nplacebo would be responsible. Such testing might provide some evidence. But\nsuch testing takes time, effort and discipline. Do we lack such resources now?\nShould we be buying snake oil?<\/p>\n\n\n\n

I remember my pharmacology lectures in medical school. The\npharmacist professor wore a long white coat as he stood on the stage addressing\nthe large theater of students. He spent a whole hour, after beta blockers and\nbefore tricyclic antidepressants, talking about the placebo effect. He\nemphasized how real the placebo effect was, how powerful it was, and how\nfoolish we would be to minimize it. He encouraged us to tell patients the treatment\nwould work. \u201cUse this effect for your patients benefit.\u201d At the time I felt he\nwas leading us down the road to be snake oil salesmen. But it\u2019s really not as\nsimple as that. I think he was encouraging us to choose a treatment we had\nfaith in, and impart that faith to our patients. The foundation for that faith\nshould come from tested evidence. It\u2019s a sad fact that many medical treatments\nhave no such evidence, yet they are prescribed daily.<\/p>\n\n\n\n

Maybe that was why I was such a lousy Idaho politician. I\ncouldn\u2019t sell blue pills when red ones were in demand.<\/p>\n","protected":false},"excerpt":{"rendered":"

The buzz drummed up around hydroxychloroquine by our President as a treatment for Covid19 doesn\u2019t surprise me. Honestly, a lot of politics is snake oil and he\u2019s proven to be really good at selling it to some of us. But … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1212"}],"collection":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1212"}],"version-history":[{"count":1,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1212\/revisions"}],"predecessor-version":[{"id":1213,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1212\/revisions\/1213"}],"wp:attachment":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1212"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1212"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1212"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}