What are some effects of opiate drugs such as morphine, and presumably endogenous opioids too? (5 points)
What is meant by the placebo effect when it comes to pain medication is that the analgesic effects of “medications” that are in fact not medications at all but …show more content…
Describe the study design in the accompanying manuscript. What does it tell us about a biological basis for the placebo effect? (20 points)
The study was on patients who had surgery to remove their impacted mandibular third molars who were given N2O, diazepam, and mepivacaine to block nerves before and during the surgery. Originally the experiment was based on the premise that patients would be told they would receive morphine, saline, or naloxone (or in the terms they put it in a drug that would help with the pain, a something that wouldn’t help or hurt, and a drug that would increase the pain) at 3 hours after the surgery and 4 hours after the surgery and pain would be recorded and compared on the visual scale. Instead, researchers focused strictly on those receiving the placebo saline and naloxone. After the surgery, at 3 hours, the patients were randomly in double blind conditions given either naloxone or a placebo and an hour later, were given randomly in double blind conditions either naloxone or a placebo again. After each dose, the patients were asked to rate their pain on a visual scale. Patients given naloxone of course reported more pain than those given placebos, an expected experimental result. Patients given placebos for the first trial were either responders or nonresponders. …show more content…
They have been found to have legitimate clinical effects in some studies and an actual biological mechanism as well. As Kaptchuk said, “Other outcomes’ besides objective measures of disease severity may be ‘more clinically relevant”. It’s up for debate in studies as to whether placebo effect is actually clinically observable, and that is a fair point of dispute. Obviously there needs to be recognition of the fact that placebos are not effective in the same manner as drugs specifically created to impact a biological process. However, there needs to be recognition of the place placebos could have in our healthcare systems for people whose needs aren’t being addressed properly by conventional medicine. As someone who has worked as a nurse aide and seen the importance of quality palliative care to people who are at the limits of conventional medicine, healthcare is so much more than strictly diagnosing, treating, and curing diseases. There is an importance to making people feel better even if it is in the absence of a clinical effect and that impression of improvement is a critical part of healthcare. I can’t count the times the nurses gave an unruly dementia patient who constantly requested pain medication apple sauce “with a crushed pain pill in it”, while of course the patient actually just received plain apple sauce. The patient always calmed down immediately and wouldn’t complain of pain until they forgot they had