In late 2022, as the fentanyl drug overdose epidemic raged across America, police officers making street busts of the synthetic opioid began experiencing what they believed were “life-threatening” reactions.
In Florida, an officer lost consciousness after touching a powder she thought was fentanyl. She felt “light-headed … I was choking. I couldn’t breathe,” the officer told a local Florida TV station.
Her department blamed her frightening reaction on fentanyl exposure.
In Ohio, the arresting officer in a fentanyl case who discovered a “speck” of white powder on his sweatshirt suddenly became disoriented and unsteady on his feet. He told BuzzFeed News at the time that he remembered “panicking, trying to talk,” and then falling.
NYPD cops were not immune.
In 2024, during a fentanyl bust in a Bronx apartment, two responding officers suddenly became ill.
EMS was called as fumes from the lids holding the drug filled the apartment. One cop was treated at the scene; the other at St. Barnabas Hospital.
Again, fentanyl was blamed.
But, “things are not quite what they seem,” writes Dr. Helen Pilcher in “This Book May Cause Side Effects: Why Our Minds Are Making Us Sick” (Abrams Press, out now). There is a “misplaced belief” among cops, Pilcher notes, that “fentanyl can do this … is strong enough [in minute quantities] to skew the brain’s prediction machinery and cause … frightening symptoms.”
But, the author asserts that the officers “did not overdose at all. They had functional seizures. They collapsed because they expected to collapse.”
Pilcher writes that these instances are prime examples of “the nocebo effect,” which she describes as “the placebo effect’s evil twin, night to its day, yin to its yang, Hyde to its Jekyll.”
When people wrongly attribute positive health outcomes — like a headache subsiding or a cough quelling — to a useless sugar pill, it’s a placebo effect.
When they wrongly believe they have been exposed to something toxic, contagious or otherwise harmful and feel poorly, it’s a nocebo.
“When people are warned to expect symptoms, they become more likely to experience them,” Pilcher writes. “Positive expectations lead to positive health outcomes. Symptoms improve, illness fades,” while “dark expectations can sometimes spawn truly dark realities.”
She cites the instance of a patient in Nashville, Tennessee, who died of esophageal cancer after doctors told him the cancer had spread and there was nothing more they could do.
The autopsy showed no evidence of widespread cancer. Files had been mixed up and the poor man had been given another patient’s diagnosis.
“The doctor’s words were as effective as poison,” Pilcher writes.
In Germany during COVID, some people developed symptoms like chronic jaw pain, fatigue and shortness of breath overnight after watching a YouTuber talking about his case.
Pilcher believes the viewers’ symptoms were generated through subconscious processes in the brain.
The World Health Organization also noted that media coverage on the spread of COVID and its symptoms led many to feel ill even though they didn’t actually have the virus.
The nocebo effect has been around for at least 200,000 years, according to Pilcher. Throughout history, there have been instances of hex deaths — people dying after they believed they’d been cursed by some powerful authority.
In 1857, Portuguese naturalist Gabriel Soares de Sousa wrote of how, while exploring South America, he witnessed men die after being cursed by a medicine man.
Three hundred years later, a Brazilian historian corroborated the story that when they were told to die by a medicine man — they did.
Physiologist Walter Cannon from Harvard Medical School coined the term “voodoo death” in 1942, writing that psychological threats can trigger a physical one. The adrenaline rush, initially helpful, can become toxic.
Living through a pandemic, an earthquake, or a shaman’s voodoo curse increases the risk of a fatal heart attack — “an ominous and persistent state of fear can end the life of a person,” Cannon wrote.
In recent years, social media has exacerbated the nocebo effect, “turbocharging the spread of nocebo-generated symptoms.”
Pilcher advises people to be wary of turning to Doctor Google or looking to TikTok for medical advise.
“If you have symptoms and you are worried, go see a real doctor” and “choose that doctor carefully, because all doctors are not created equal,” she writes. “Our experience of illness is heavily influenced by the world around us, by the thoughts we have towards different ailments and by the expectations we have of our bodies to deal with them.”
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