The Placebo and Nocebo Effects: A Tale of Use and Misuse

Abstract

Over half of physicians in the United States employ pharmacologically-inert or nonevidence-based treatments, known as placebos, in clinical practice. The placebo effect, arising from an interplay between expectations, conditioning, and the physician-patient interaction, can lead to positive health outcomes for patients. Conversely, these mechanisms can also be used to worsen health outcomes, as in the nocebo effect. Despite recent research highlighting the profound potential to use these effects to benefit patients, utilization remains heterogenous. Translation of research findings reveals actionable strategies to maximize the placebo effect and minimize the nocebo effect. Analyzing the history of research into these phenomena, occurring alongside advancements in research methodology, reveals modern manifestations of the placebodriven treatments of the past. Lackluster regulation towards the pharmaceutical and cannabis industry’s advertising efforts has led to the placebo effect being used for profit. Public policy suggestions are made to limit commercial manipulation of these effects and to bring the power of the placebo effect to the people.