Painkiller placebos becoming a real headache for US drug trials

One in ten high school seniors in the US admits to abusing prescription painkillers. Painkillers are the second-most popular choice for those using illicit drugs for the first time in the US. Of course, this phenomenon is not limited to the US – but one curious fact is… the placebo effect of dummy painkillers is getting stronger there, but nowhere else.


The problem is becoming so acute that it is actually making it harder to design trials for new painkillers in America. This is a real issue given the fact that around 100 million Americans are currently dealing with chronic pain.


So why could this be happening – what makes the US different from other nations where painkillers are widely used?


Addiction certainly happens elsewhere - over 30,000 people are addicted to painkillers in the UK for example.  But the placebo effect is not increasing there.


The study was published recently in the journal, Pain, and analysed over 20 years of trials data. As the study's lead author pointed out: "Either there's something about Americans, or there's something about American trials."  However, even the trial’s authors cannot agree on what’s actually behind the trend.


The US is one of only nations where consumers can be bombarded with glossy adverts for prescription meds – with the full weight of marketing agencies behind them, maybe the ads are having a pervasive effect on the national psyche?


US trials are especially well funded and slick – maybe people are impressed by the whole procedure or feel strangely obliged to get better? The US version of Good Clinical Practice is dictated by the FDA but, in most important respects, it is similar to that followed elsewhere. The US rules are covered in the Whitehall Training course, ICH GCP Adapted for the US.


My overriding question is - I wonder if many US people are becoming addicted to fake painkillers too?


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