The origin of the placebo can be traced back to a nurse in World War 2. When the U.S. army’s morphine supply level is low, she would inject wounded soldiers with salt water and reassured them that the potent painkiller would soon take effect. Henry Beecher, the anesthetist the nurse was assisting, was amazed to see how those soldiers soon find relief and was thus prevented from entering shock.

Of course, Beecher didn’t know what alleviated the pain and the mechanism behind its release. But as any good scientist would do, he began to question the effectiveness of the painkillers he prescribed. Was it the placebo effect at play or was it the drug?

So when the war ended, he conducted the first study ever on the placebo effect. His paper, published in the Journal of American Medical Association in 1955, titled “The Powerful Placebo” induced a sensation. His finding: The act of consuming a pill itself is somehow therapeutic.

Exactly how effective are placebos?

The short answer: very. Perhaps even more effective than the drug itself. From 2001 to 2006, cases where drugs fail the test against a placebo increased 20%. And for those that reach late-stage trials, half of them drop out because they could not beat the effectiveness of placebos.

But it’s not just new drugs that are failing against placebos. Even old dogs such as Prozac and Valium are falling off their throne.

In fact, two studies, conducted to find out the effective of placebos since the 1980 found statistically significant increase in the power of placebos. One of them found the effect of placebos has doubled since then. This is especially true for brain-related drugs.

But in the latest trial for drug to cure Irritable Bowel Syndrome, Harvard Medical Researcher Ted Kaptchuk found placebos do work – and their benefits persisted for weeks after the sham, contrary to popular belief that the placebo effect is short-lived.

Exactly why are placebos so effective?

The question is why?

The latest research has found the brain’s ability to release various opiates and hormones to be the culprit. Mere expectations that something will cure you causes your brain to release the cure itself.

For example, under stress, the brain will produce its own analgesic compound called opioids. This compound not only relieve pain, it also regulate heart rate and respiration. Opioids can also be triggered by placebos.

Factors that govern the effectiveness of placebos

The many researches on placebos since Beecher discovered it has pointed us to one thing: not all placebos are created equal. Some appear to be more effective than others. Here is a list of the factors that affects the effectiveness of placebos:

1. The size of the pills. The larger it is, the more effective the placebo is.
2. The more doses you require, the stronger the effect
3. The price you charge for the placebos do matter: more expensive placebos are more effective than cheaper ones.
4. Even the confidence of the doctor prescribing the placebos matters.
5. The color of the placebo matter and its effect vary from country to country due to cultural variation.

Can you see how prescribing a medicine is very much like marketing it? It’s a lot about persuading the patient that the pill will work.

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