Dr. Joe’s Brain Sparks: 178 Inspiring and Enlightening Inquiries Into the Science of Everyday Life by Dr. Joe Schwarcz

Author:Dr. Joe Schwarcz [Schwarcz, Dr. Joe]
Language: eng
Format: epub
ISBN: 9780385669313
Publisher: Doubleday Canada
Published: 2010-11-02T05:00:00+00:00

An American veteran suffering from Gulf War syndrome was prescribed Obecalp. When he did a little research into this drug, he became upset. Why?

Obecalp is placebo spelled backwards. The veteran had been given a sugar pill that contained no active ingredient and assumed that the physician had not taken his condition seriously. Mike Woods, like a number of other veterans, suffered from Gulf War syndrome, a collection of symptoms including numbness in the extremities, chest pain and occasional blackouts. There is no doubt that veterans suffer from it, but the question is what exactly they are suffering from. All sorts of theories have been put forward, ranging from exposure to chemical warfare agents to aspartame-sweetened soft drinks that released methanol when subjected to the heat of the desert. But many physicians believe that the symptoms originate in the mind, and they therefore feel it is the mind that needs to be treated. And that is why Woods’s physician prescribed Obecalp, a sugar pill that is stocked by some pharmacies for use by physicians who feel that a placebo is appropriate treatment.

Ethical questions certainly have been raised about giving an inactive pill to a patient without his or her consent. But the argument can be made that if a patient is suffering from a condition for which there is no known treatment, there is nothing to lose, and maybe something to gain, by prescribing a placebo. After all, placebos are known to offer relief in many conditions, with success rates often approaching 50 per cent. And actually, whether a placebo really contains no active ingredient is debatable. It may not contain a physiologically active substance, but it can certainly trigger physiological activity.

This was recently shown in an elegant fashion by researchers at Columbia University who placed volunteers in a PET scanner to investigate brain activity as their arms were subjected to uncomfortable heat after having been treated with a topical cream. When the volunteers were told that the cream was a powerful painkiller, activity in parts of the brain that are normally stimulated by opiates was significantly increased, while no such effect was noted when they were told that the cream had no medicinal value.

Obviously, then, the relief afforded by a placebo can be very real, and prescribing a sugar pill is not immoral, as some have suggested. Of course, that’s assuming there is no known proven other treatment. Unfortunately, in the case of Mike Woods, the placebo did not work, which led to his feeling of having been somehow tricked because the physician did not consider his condition to be real. He was wrong on that count: the physician considered the condition very real but, having no known treatment to offer, decided to take a chance on a placebo. This is no worse than trying a variety of different medications when a physician is frustrated, a practice that is a common feature of medicine.

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