Site-Specific Conditioning Can Cause Fatal Drug Overdose

August 17, 2008

There is some evidence that drug addicts can die from using their usual dosage of drugs in a novel setting. There is a conditioned tolerance that develops from using an addictive drug like heroin in a familiar place. But taking that same dose elsewhere might kill you. Here’s a link to the original research in Pub Med from the Harm Reduction Journal.

While I’m a severe critic of almost all complimentary and alternative medicine, here is a case study that adds support for a negative placebo effect based on setting and expectation. The brain’s ability to affect our health is a topic that’s often abused by CAM practitioners when they sell their techniques to the public. But that doesn’t mean there’s not a demonstrated effect. Most people don’t understand the placebo effect and how many CAM procedures operate only at the level of a placebo. Clearly the mind does influence how chemicals react in our bodies. . .

The idea of the placebo in modern times originated with H. K. Beecher. He evaluated 15 clinical trials concerned with different diseases and found that 35% of 1,082 patients were satisfactorily relieved by a placebo alone (“The Powerful Placebo,” 1955). Other studies have since calculated the placebo effect as being even greater than Beecher claimed. For example, studies have shown that placebos are effective in 50 or 60 percent of subjects with certain conditions, e.g., “pain, depression, some heart ailments, gastric ulcers and other stomach complaints.”* And, as effective as the new psychotropic drugs seem to be in the treatment of various brain disorders, some researchers maintain that there is not adequate evidence from studies to prove that the new drugs are more effective than placebos.

from The Placebo Effect, The Skeptic’s Dictionary: A Collection of Strange Beliefs, Amusing Deceptions, and Dangerous Delusions by Robert Todd Carroll



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