Month: May 2026

Reading of the Week: Placebo & Practice – the New Lancet Psych Paper; Also, Mortality & Opioids and Mental Health Awareness Campaigns

From the Editor

The tone of our voice when discussing a treatment. The way we emphasize its benefits. Mention of our hopefulness. As clinicians, we are aware that small things can improve patient outcomes. To speak more technically: we harness placebo effects.

In an impressive new Lancet Psychiatry review, Dr. Matthew J. Burke (of the University of Toronto) and his co-authors examine placebo effects with an eye to the implications for clinical practice. They discuss imaging and physiology; they also mention depression and offer suggestions (including, yes, harnessing placebo effects). “The thoughtful application of placebo and nocebo effects has promise in enhancing patient care and treatment outcomes, but more research is needed to validate specific approaches.” We discuss the paper and its implications.

What is the survival rate after an opioid overdose? In a new research letter just published in JAMA, Dr. Robert A. Kleinman (of the University of Toronto) and his co-authors attempt to answer that question. Though they walk on a well-travelled path, they drew on data in this, the era of fentanyl. “Mortality was higher than estimates from previous research conducted prior to the widespread availability of fentanyl (5.3%-5.5%).”

And in the third selection from The Globe and Mail, Dr. Lester Liao (of McGill University) and his co-authors write about mental health campaigns. They note the unintended consequences, including overdiagnosis of disorders like ADHD and autism. “We started out with the greatest of intentions. Unintended consequences have arisen. That’s okay. We learn along the way. Now it’s time to change course.”

There will be no Reading next week.

DG

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Reading of the Week: GLP-1 Receptor Agonists for Obesity & Alcohol – the New Lancet Study; Also, Drs. Liao and Fombonne on Autism Overdiagnosis

From the Editor

It could be lifesaving for those with diabetes. And many others are taking GLP-1 receptor agonists, ranging from people with medical conditions such as obesity to those who have cosmetic interests. GLP-1 receptor agonists are having a moment. Could they also be helpful for patients with substance problems? Some small studies suggest yes.

In a major new Lancet study, Dr. Mette Kruse Klausen (of Copenhagen University) and her co-authors attempt to answer that question. They report on a RCT involving patients with both obesity and alcohol use disorder. 108 Danish participants were randomized to the GLP-1 receptor agonist semaglutide or placebo. At six months, adults taking semaglutide reported five heavy drinking days in the previous months (down 41%) compared to nine days in the placebo group. “To our knowledge, this RCT is the first to show that once-weekly semaglutide reduces heavy drinking days and WHO drinking-risk levels in treatment-seeking patients with alcohol use disorder and comorbid obesity.” We consider the paper, the accompanying editorial, and its implications.

In this week’s other selection, a Viewpoint paper from JAMA Pediatrics, Drs. Lester Liao (of McGill University) and Eric Fombonne (of the Oregon Health & Science University) write on autism and overdiagnosis. “Diagnostic practices geared to accessing resources, incorrect diagnostic practices, increased attention, changes to diagnostic criteria and thresholds, and fundamental cultural shifts have contributed.”

DG

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