Rick raises some big questions, all of which are interesting.

A careful examination of the mechanisms associated with placebos should also
include conditioning mechanisms that produce attenuation of the
pharmacological effect of active drugs (like the tolerances that are
classically conditioned to alcohol, opiates, and other drugs that create
dramatic changes in physiology).

The effect of conditioning is probably not uniform.  It might vary with the
degree to which the substance ingested can produce homeostatic imbalances.
And the association with environmental cues during conditioning will play a
role, as evidenced by the problems with ODs when the large tolerance dose of
an opiate is ingested in a novel envrionment.

I expect sorting all this out will take some time and the answer won't
be simple!



Claudia Stanny

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