[CogitoCogito]

> How do you study mind-altering drugs when every clinical-trial participant knows they’re tripping?

Are there really no protocols for research in which participants can tell whether they have received a certain drug or not? I mean sure I think that double-blind is best for research, but are there really not other cases in which they deal with the patients knowing?

Edit:

> By striving to cleave the drug’s effects from the context in which it’s given—to a patient by a therapist, both of whom are hoping for healing—blinded studies may fail to capture the full picture.

Okay I see the issue is that patients not being blind to the treatment is (thought to be) necessary for the treatment to work. Okay yeah so that means it's hard to make the participants blind in anyway. Still I'm surprised there aren't approaches to deal with this. Of course it might mean by definition double-blind trials aren't possible, but then again maybe that's not always appropriate. I can see the pandora's box being opened by allowing drug studies to bypass these restrictions though so I guess I see why people don't like it.

Later in the article:

> In an email, an FDA spokesperson told me that blinded RCTs provide the most rigorous level of evidence, but “unblinded studies can still be considered adequate and well-controlled as long as there is a valid comparison with a control.” In such cases, the spokesperson said, regulators can take into account things like the size of the treatment effect in deciding whether the treatment performed significantly better than the placebo.

[jerf]

Yes, there are, which honestly makes this entire article premise a bit bizarre. Double blind and all that is an ideal, not a requirement. It can't be a requirement, because whether we can run double-blind or any other kind of study is not always a matter of how good we are or how much effort we are willing to put in, but a characteristic of the thing we want to study, as it is here. It's hardly the only drug where the participants can have a pretty good guess whether they're on a placebo or not. As just an example off the top of my head, I doubt there were a whole lot of chemotherapy testers who thought they were vomiting for days and losing their hair due to a placebo.

Contrary to frequently-expressed opinion online, we are not in fact constrained to running only super-massive-sample-size triple-blind preregistered peer-reviewed gold-plated scientific studies and only permitted to say we might have an opinion if a metanalysis of multiple of those concurs. It's nice when we can do that, but the universe is not always so accommodating.

[sigtstp]

Side-note: I believe in many such cases (cancers and other serious diseases), the "placebo" is actually the existing standard treatment (not sugar pills), as it would be unethical to withhold treatment.

[instagib]

There has to be some options other than sugar pills for the placebo. Niacin that gives a flushing effect. By pill or powder for long or short release respectively. Combine that with something else or a cocktail literally.

Possibly take another drug that gives you a ‘high’ at a dose which has no effect on the condition under test.

Get enough psychedelic and marijuana users at a focus group for a long list of possibly coherent ideas.

I read that they have no way of double blind testing cupping because it is painful and visibly leaves marks on your body.

I would put numbing cream on each participant’s back, put isolation headphones on them, put some pressure on the persons back, and then apply a temporary tattoo with an electronic bandaid that detects if a person removes the bandaid covering the cupping/fake marks.

[plasticchris]

Just find people who have never done any drugs, they will have no idea what to expect and the placebo effect will be strong enough. I ate a regular brownie once in college (my friend left it on my door knob as a nice surprise). I was freaking out for a bit, having no idea what a pot brownie was like. Sat down next to someone playing wow and asked them to tell me if I started acting oddly.