Whole lot of speculation in this article.  I would guess more people know about the placebo effect in the U.S., than they did 20 years ago?  Twenty years ago, we didn&#x27;t question the efficacy of these drugs?  Everyone I know now is very leery of any claims by drug companies, and their Wonder Drug.<p>&quot;For companies trying to develop treatments, one remedy might be to compare new drugs against their best competitors instead of against placebo — or to go back to conducting smaller, shorter trials.&quot;<p>Lets Not do this.  Lets continue to look for drugs that actually work on pain.  The last thing we need is another drug that works slightly better than an ineffective pain drug that squeaked past the FDA?  In the mean time there&#x27;s a whole bunch of patients who are in extreme pain, and doctors are afraid to prescribe opioids.   Doctors know opioid type medications work, but are afraid to prescribe them for a lot of reason, but mainly they don&#x27;t want the
FDA breathing down their backs.<p>My best friend died  a horrid natural death a few years ago.  He was in bad shape, but the doctors couldn&#x27;t find anything really wrong with him besides being very old, and had a very bad case COPD.  He was in constant daily pain.<p>I bought him to &quot;the best pain clinic in San Francisco&quot;.  They wouldn&#x27;t alleviate his pain?  They offed to cut some nerve, but wouldn&#x27;t medicate him.  (To that clinic, if you are going to stereotype patients, and offer no help--Close down?  You are of no service to anyone.)<p>I brought him back to his apartment, and offered my support every night.  All I could do is cook for him, and offer hope.  He died in his sleep a few months later.  Those few months he were hell. All he had was ibuprofen, and some other safe&#x2F;no potential to abuse drug.   We looked into Hospice, but his doctors said he wasn&#x27;t sick enough.  Sometimes I think they have just seen too much, and  common sense is lost?<p>My point is I have seen too many people die in extreme pain, including my father who was under medicated by Hospice.<p>I got off track.  This is about painkiller trials, and placebo. I just don&#x27;t want ineffective pain medication on the market.<p>I am shocked this group of researchers are trying to blame patients.  It&#x27;s your ineffective new medications?   Lets not run off to some third world country and get &quot;positive&quot; results, or rely on a bunch of smaller studies that can be buried--if not satisfactory?. (By the way, this is going on as we speak, and has been for years.  They offshore these double blind studies to the lowest bidder, and surprise,  &quot;Our drug worked better than we could have predicted!&quot;.  Present their wonder drug to the FDA, and start the Marketing Party.<p>Right now, a drug only has to be slightly better than placebo in order to get past the FDA.  That statistical difference is so small, in so many instances; I think if some of you knew just how slightly your drug works better than placebo, you might just go off the medication.<p>MY father died 11 years ago, and I still have weekly nightmares of his absolute misery.  His last words to me were &quot;Son when will this end?&quot;.  If I could do it over, I would have gone to the bad part of my county, and bought him Heroin.