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I have a love of life. Some may call me a cynic but I'm truly an optimistic realist. I work on the philosophy “If you expect the worst but aim for the best, you'll land somewhere that's comfortable.”

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22 May 2017

Do Medicines Discriminate Against Blind People?

I've been playing with a hypothesis for a while now. What if in the words of The Verve, the drugs don't work, because I'm blind?

What difference would that make I hear you ponder. Well, there is some evidence that suggests the colour of a drug influences the outcome for the patient, even only if perceptually. In a review study from 1998, red, yellow and orange are suggested to be good for stimulents and blue or green for calming drugs. There is a whole load of colour combinations and cultural factors too but the previous is true for western folks. (While finding the sources to link to I also found this article from The Atlantic discussing "The Power of Drug Color")

Although I'm not totally blind, I don't have enough sight to see the colour of my pills every dose.

There has also been a recent study on the power of open label placebos. Open label means that the researcher and the participant/patent both know what is in the pill/substance. Placebo, is a control pill/substance that contains no active ingredient. I've an amusing anecdote about using a placebo on someone which I'll save to the end.

In the study report it doesn't say how many patients, if any, where blind or visually impaired so i'm going to presume 0. The study found, in brief, that the body can sometimes fix itself by power of suggestion. That is not to say the people with the conditions are faking it or are deluded rather the ind is a powerful thing. I suspect that the 1998 study about colour plays a part in this too. Since the participants knew they had been given a medical sweet – it can only be put down to two things:

• Physical Action
The action of taking a pill and expecting that pill to have an effect, despite knowing it has nothing in it. Then feeling slightly better and then this becoming a gradual but significant improvement. It helped last time, why shouldn't it help this time?

• The Colour
This pill is, insert colour of your choice, therefore the patient feels less pain. In this study the pills were presumably white. I can't find a description of them other than being OLPs. In the 1998 study, white was noted as improving perception of pain and pooping problems.

It's really quite impressive how good our bodies are at fixing themselves, despite being told by big pharmer for the last few hundred years that we need to take X, Y and Z. I also find it a little worrying how easily our minds have bent to think a pill of colour X can help with problem K. This is NOT to say we don't need drugs at all.

Big pharmer doesn't want to make us better, they want to make money. The truth is, some of their products we do actually need. In fact we need more of their products. We need cures and vaccines along with medicines to manage conditions. Colours aren't just used to trick our silly little brains. They are used to help identify medicines along with their shape. In an ideal world, all pills would be white and the same shape. That would then allow a better look at what works 'really' and what works through the power of suggestion.

In drug trials, before the drugs are tested on the people with the problem, they are tested on animals. The animals are injected with the substance more often than not, in my understanding at least. This allows the developers to see if it helps or not. It also gives them an idea of potential risks and side effects. Then human trials, healthy humans are tested upon. This is to see if the drugs will be harmful in humans, which sometimes it turns out they are. If you take part in a drug trial you are generally told:
• How much they'll be paid
• how long they will be needed for
•What they will be expected to do, rub on a cream, take a pill or be injected for example.
• What the drug is being designed for
Not always in this order, generally – what the drug/treatment is being designed for is one of the first things people know.

When you are paying someone to test drugs with the expectation of a certain outcome, especially with the knowledge or the two previously mentioned studies, along with the fact everyone wants to be approved of and help sick/ill/disabled people get better; all you can test for is side effects.

In phase two and three trials the drugs are tested on people with the problem. Unless it is something that isn't based on perception like an infection or growth, I'm not sure how we can be sure these drugs actually work. Of course drugs are tested against other drugs but when you are chronically ill you will, will anything to help. Obviously, with pain we can look at neuro-functions under the influence of substances and the same is true for other issues in the brain. But what can't be done is ask a desperate person for a non-bias opinion of how they feel a substance is helping them. I know, I would try anything to fix my body's dysfunctions. I would take any pill or injections or eye drop. I have tried many drugs for many things and they all for for a while. Maybe in light of the placebo trial we need to be asking, is it drug tolerance we develop or is is that we stop believing that the drug is helping?

As well as questioning if I'm not getting the full effects of the pills I pop. I wonder, maybe I just don't want to get better? It's not a case of the pills don't work, it's a case of I don't want them to work… Maybe, I need to be more positive and be demanding of myself. This is partly a true thought but also slightly sarcastic. I know I can't think mountains smaller or places closer. Bodies and drugs sometimes get on and sometimes not. But, when someone is desperate they'll generally reach out weather that be for a hand, pill or something else. We, I, need to accept it's ok to not be ok. Never-the-less it's crap to feel crap.

Final note; The Open Label Placebo trial had 83 people at the end and it only lasted 3 months. It's a small number of people and a short time. For it to be more useful you'd want more people taking part and the assessment period to be much longer. I also think a mixture of pill colours, shapes and sizes would be useful. After all, it's the concept of a placebo you're testing not if that one placebo pill works.

The placebo-dote:
my partner had a practice test before their driving test. I had floated the idea of them taking one of my beta blockers to help calm their nerves. They weren't sure it would be a good idea incase they had an accident and they had a drug that was prescribed to them in their system. I used their trust in me to convince them to blindly take a pill, which would definitely help calm them. They went away and aced the practice test and came home happy and confident. Since they did better than what they thought they could, they demanded to know what I had actually given them because they didn't want to take the test without knowing what it was.

It only served to give them more confidence the next day in their actual test, which they passed, when I told them it was a multivitamin and nothing more…

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