Psychedelic Assisted Therapy: Last Week Tonight with John Oliver (HBO)

♪ ("LAST WEEK TONIGHT" THEME MUSIC PLAYS) ♪ Our main story

tonight

concerns drugs. You know, the substances that gave us the most music, seasons one and two of The West Wing, and this spectacular clip of a BBC reporter inadvertently getting drunk. Behind me burn eight and a half tons of heroin, opium, hashish and other narcotics. (LAUGHS) Burning from behind-- (LAUGHS) Shh! Quick, quick, quick, we just need one more. (LAUGHS) Exquisite. That deserves the Pulitzer Prize for Most Drug Reporter. I'm not sure what my favorite part is there. His little giggle, the idea that someone thought, "Let's put a guy downwind of an eight and a half ton pile of narcotics on fire," or the fact that its main effect on him seems to be to turn him into a candy. cake.

Specifically, we are going to talk about

psychedelic

s. A category that includes drugs such as psilocybin, LSD and MDMA. And first let me tell you that I know someone with my face, voice, and generally nasty drug-talking aura is usually warning you about devil's lettuce. But I'm not a fucking narco. In college, I pretty much majored in herbology with a minor in ganjaneering. They called me Sonic the Hedgehog because I rolled hard. Also, I've been on tour with Ozzy Osborne, who's also my dad, by the way, so I'm in the scene, okay? I understand. The truth is that a lot of people use

psychedelic

s.

Some for spirituality, some for healing and some like A$AP Rocky just for fun. The first time he took LSD, it kicked in just as he was having sex, with some surprising consequences. It's not a lie, a rainbow shot out of my penis. And it had a sound like... (MIMICS PIANO RUN) Like a piano or something. I have no idea why a rainbow was coming out of my penis. I don't even like rainbows. Excellent. Every sentence is better than the

last

there. "A rainbow shot out of my penis", fantastic. "It had a sound like a piano or something," I love it. "I have no idea why a rainbow was coming out of my penis" has now introduced suspense into the story. "I don't even like rainbows," what a way to nail the landing.

Also, I'm pretty sure A$AP Rocky just gave Skittles his next commercial. "Skittles, try the rainbow of dick." ♪ (PIANO RUN) ♪ But

tonight

, we're going to focus on one particular use of psychedelics. in

therapy

It is a field that you may have heard of recently in stories with testimonials from some very satisfied patients. I had all this access to my mind and I could control where I was thinking and where I was going. It connected me back to my body. As if I could feel my body again. It made me feel more comfortable with life, you know.

Because you are not afraid of dying. It's like going to

therapy

while being hugged by everyone who loves you in a bathtub full of puppies licking your face. Wow. That's a pretty powerful endorsement. He makes it sound great there. It would sound better if a rainbow came out of your penis too, but that's only because A$AP Rocky has now raised the bar on what constitutes a pleasurable human experience. That

last

guy is a veteran who claims that psychedelic treatment not only helped him with PTSD, but also saved his life. And he's not the only vet who has benefited.

C.J. HARDIN: I had three experiences with the full dose. But the effects after the first treatment were profound. I would have said a 60 percent reduction in my symptoms immediately. I felt that a great change had occurred. Sixty percent immediately. It's not often that you see those kinds of results after your first therapy session. Especially now that much of this is happening via Zoom. Usually the first day is spent introducing yourself and trying to figure out what the hell that thing is in the back of your therapist's head. That can't be what I think it is, right?

It just can't be. And look, it's not just anecdotal. A recent clinical trial of MDMA-

assisted

therapy found that for those suffering from PTSD, just two months after treatment, 67 percent no longer qualified for a PTSD diagnosis. And that's not even getting into the promise that psychedelics have shown in treating conditions like addiction and depression. The fact is, this is all very encouraging, but it's worth knowing that we've actually been here before with psychedelics, and we screwed it up. And if we're not very careful in the next few years, we could go backwards again. So tonight, let's talk about psychedelic therapy.

Its history, its potential and what could be the pitfalls that lie ahead. And let's start by acknowledging that many of these medicines, especially psilocybin, are nothing new to indigenous communities. They have been performing rituals with mushrooms, peyote, ayahuasca and other ceremonial medicines for much longer than Western civilization. But interesting psychedelics outside of indigenous communities really emerged in the middle of the last century. LSD was first synthesized in a Swiss laboratory in 1938. And a JP Morgan banker named R. Gordon Wasson popularized magic mushrooms after learning that an indigenous Mexican woman named Mariá Sabina, who used them in healing ceremonies, had located in 1955.

ANNOUNCER: After several attempts, he finally convinced Mariá Sabina to let him try the magic mushrooms, as they came to be called. He returns and writes an account of her adventure that is published in Life magazine of all places. Now this is amazing. This is 1957 when she comes out. Thousands of words in the largest magazine in America. This article, when published, is a sensation. It's true. Wasson was basically the first white guy to make mushrooms and then turn them into his whole personality. That article started a stampede of hippies and celebrities in Mariá Sabina's town that turned her neighbors against her to such an extent that they burned her house to the ground.

Therefore, he can add magic mushrooms to the list of things completely ruined by financial bros along with vests, dating apps, and the middle class. (AUDIENCE LAUGHS) But it wasn't just bankers and hippies who were drawn to the power of these substances. The US military actually ran experiments to see if they could be dropped on enemy troops to incapacitate them. And lucky for us, they filmed those experiments for posterity. NARRATOR: Here is a group of normal soldiers responding correctly to a series of routine exercise commands. After receiving a small dose of LSD, they are left confused and undisciplined.

Yes, you really have them there. Those soldiers went from a tightly choreographed parade to tourists trying to decide where to have lunch. And all it took was a little chemical warfare. It is brilliant. But even as the military was messing around trying to concoct a literal love bomb, some researchers were using LSD as a mental health treatment. In 1966, CBS News actually followed a man who was given LSD as part of his treatment for alcoholism and reported on his amazing results. NARRATOR 2: Six months into LSD treatment, six months after his release from the alcoholic ward at Spring Grove Hospital, Arthur King has started anew.

At the age of 33, he is back in school, something he talked about for years. In night classes, he is studying accounting. Has he had anything to drink, for example? No, I haven't. Nothing at all. And I haven't felt like drinking anything. That is incredible. But also, is that guy 33? I know I'm not one to talk like a legal 45, but rather a spiritual octogenarian, but holy crap! I bet people aged a lot worse when we painted everything with lead and let people smoke in the delivery room. Unfortunately, by the late 1960s, psychedelics became increasingly associated with the counterculture, and when the government cracked down on that movement, they began an era of anti-psychedelic hysteria.

And it was intense. The junk studies made dubious but scary claims like that LSD could distort chromosomes. And educational films employed a wide range of scare tones and tactics like these. SPEAKER 2: This is a fetus from a mother who is not on LSD. A normal fetus. This is a fetus from the mother receiving LSD. I know doctors, I know lawyers, and I know the most stable people in the world who have taken LSD trips and are still waiting to return. NARRATOR 3: Unfortunately, these psychedelic dream trips are very often one way. Well well. That's quite the smear campaign there, from the hamster fetus that looks like dinosaur nuggets, to the woman who yells at you about all the doctors and lawyers she knows, to the hearse that apparently makes house calls.

And even though all of that was silly, I long for the days when we used to dress up to watch our drugged relatives being wheeled off to the morgue. "Honey, they're transporting Jimmy's body to their last stop before hippie hell. Quick, where's my tie clip? Helen, tie clip! The neighbors can see, they're going to think we're poor! Gather up, Helen , and find my tie clip! The boy is dead! (AUDIENCE LAUGHS) Fantastic stories about LSD ran rampant. At one point, a Pennsylvania state commissioner... But the truth is, he was told he made up. He later admitted to the hoax, saying that he had attended a conference on LSD use by children and became so concerned that he wanted to scare people into giving up the drug.

But the hysteria peaked when Nixon passed away... ...along with drugs like heroin. Essentially stopping medical research in its tracks. One researcher described the work as "frozen." And when scientists started working with MDMA, they also panicked with Science magazine claiming that a single use can cause permanent brain damage in monkeys. A study that drew a lot of attention before being retracted after it was discovered that the monkeys had not actually taken MDMA at all, but rather had been given methamphetamine. And that's a very different drug. The outcome of any study is going to change if the independent variable is suddenly and unexpectedly fucking meth! "We have studied the vaccine for COVID and the participants are going crazy for it!" But in recent years, perceptions have finally begun to change, with the FDA granting breakthrough status to support the study of MDMA to treat PTSD and doing the same for psilocybin to treat depression.

And at this point, let's talk about exactly why psychedelics can be so effective. Different may work in different ways, but for example, research shows that MDMA dampens the response in the amygdala, which is the brain's threat-detecting sensor. Which means that you are able to confront and process trauma that you might not otherwise be able to deal with. Here's a researcher explaining how it works with a story about taking MDMA recreationally in his youth. BEN SESSA: I can remember once, after a rave, all of us laying down, lovelies, and someone said, "Oh wow, this is amazing, this is so beautiful, everything is so perfect." And someone said, "Let's think of the worst thing we can imagine." And someone said, "Let's imagine our moms dying." And then someone said, "It's not that bad." And I didn't know it then, but that's really what MDMA does.

It allows you to think and go to those dark, difficult, forbidden, avoidant memories that you normally wouldn't be able to touch. That's fascinating. And I'm so glad that worked for him, but "Let's imagine our mothers die," doesn't sound like an amazing moment. It sounds like a rave played by Werner Herzog. (IMMITATING WERNER HERZOG) "Life is fleeting. Let's imagine our mothers dying as a solemn reminder that all we have is tonight. Now, wave your hands in the air as if our slow pace into oblivion prevented us from you care." (AIR HORN SOUND) Now, to be clear, psychedelic therapy involves much more than just taking a pill.

These medications alone do not automatically produce results. Typically, treatment involves multiple sessions that last for most of the day. In which you can take MDMA or psilocybin under the supervision of medical professionals and then follow up with processing and aftercare. They are not a replacement for conventional talk therapy. They just seem to make you significantly more receptive to it. Just look at this former firefighter narrating a video of himself undergoing MDMA-

assisted

therapy. Is this his first medical treatment session? Correct. This is the beginning of some interesting revelations in this video. And you feel fully aware and in control and...?

Yes. And I felt like I could relax even when I was talking about my probably most traumatic memories. I don't think I had seen a dead person before. The first one was also awful. It was like being able to take a big breath, you know, after being trapped underwater for a long time. Yes. And you can see the utility of having two people on either side of that man talking to him about the experience. And if it seems like I'm considering having two people to talk to about your feelings as a radical idea, you must remember that I was born tragic andmedically british. (AUDIENCE LAUGHS) What's interesting though is that it's not just that his fear is muted.

Your brain's ability to make other connections and forge new neural pathways is also increased. Which means these sessions can fundamentally alter the way you process things. That's thought to be one reason why psychedelics hold such promise for treating conditions like addiction and depression. And why they are proving especially helpful in dealing with trauma. That's what makes this form of therapy particularly appealing to veterans. As PTSD is an urgent problem for them. A substantially higher rate than the general population. And it's not like the VA's current treatment methods are particularly effective. Remember the guy from earlier who compared psychedelic treatment to a "bathtub full of puppies"?

Listen to him describe the VA mental health care he initially received. I drove to the Womack Army Medical Center at Fort Bragg. And I said I was going to kill myself. They gave me six Xanax and told me not to take them all at once because it could kill me. They asked me if I had any weapons at home and I said, "Yes, a lot." And they asked me if I had ammo, I said, "Yeah, lots of it." They said, "Okay, when you get home, give all your guns to a neighbor." This is like four in the morning.

And they told me: "Come back after the holidays." Well. I knew VA mental health services were mediocre, but I didn't know they stooped to say, "Here are a bunch of ways to kill yourself, but respect the system, don't do it, and anyway, I'll see you after dinner." saddest time of the year. ." Fortunately, that guy saw such a profound change in MDMA therapy that he's now helping lead a movement to allow psychedelics to be used to treat conditions like PTSD, enlisting the help of Democratic lawmakers like AOC and even lawmakers Republicans like Rick Perry and Dan Crenshaw, and that kind of bipartisan consensus has brought us to the tipping point where we are now because, until now, in the US, these drugs have only been legally available to people in clinical trials.

But within the next year, it is widely anticipated that the FDA will approve MDMA for clinical use and psilocybin is expected to follow a few years later. And maybe even LSD one day. Which means we may be on the verge of finally realizing the enormous potential of psychedelics, which is great, but it pays to be very careful here to make sure we don't repeat the mistakes of the past, or indeed make new ones. And those who work in this field point to some important areas that require caution. The first concerns how psychedelics are administered and by whom.

Because while people have used these drugs recreationally forever and will continue to do so at parties, raves, in nature, or to spice up a baptism, psychedelic-assisted therapy isn't for everyone. For example, anyone with a history of schizophrenia or psychosis may want to stay away. And even if you're a good match, because these drugs can put you in an incredibly vulnerable state, experts stress the importance of trying them in a controlled environment, which ideally would involve two people present at all times, and even recording the session. on video. like the one you just saw earlier. They advise this not only for your own safety, but also because for all their potential benefits, these medications aren't always a bathtub full of puppies.

We tell people that their experiences can range from very positive to transcendent and enchanting to literally experiences from the realm of hell. hell realm? The most terrifying experience you've ever had in your life. Now, that sounds bad, although, to be fair, you don't need to take drugs to get to the hell realm. After all, that's why airports have Sbarros. But it's important to note that even those in studies that reported hell realm-type experiences often felt they benefited from treatment. But security isn't the only concern here. There are also accessibility concerns. These treatments are likely to be very expensive.

And there are some players looking to do it even more. Just look at Compass Pathways. A for-profit psychedelic company backed by Peter Thiel. It's... ...seems pretty aggressive already for a drug that, remember, has been around for thousands of years. And Compass executives seemed quite defensive when pressed about this. Do you really think your form of psilocybin is novel and non-obvious? Well, it doesn't really matter what we believe. What matters is what the US Patent Office believes, what the UK Patent Office believes, what Germany believes, what Hong Kong believes. And everyone thinks it's actually because we have the patents granted.

Well. But we shouldn't necessarily trust the US Patent Office as an arbiter of good judgment. This is the same place that issued patents for an umbrella for your beer, a trike with an attached lawnmower and stick. That's it, just a stick for the animals to play on. Someone at the Patent Office saw that and said, "We've never seen a stick before. Thumbs up!" So take what you think is important with a big pinch of salt. And look, it's not just the formulation of the drug. Compass has also sought to patent other aspects of what is often referred to as the "package and configuration of treatment." From the room with soft furnishings or decorated in muted colors, to subjects lying on a bed or sofa, or a therapist responding to things a patient says.

Which is the whole fucking concept of therapy! It would be like me patenting the concept of wearing a suit while sitting at a desk. Clearly I'm not the only person doing this. Now if I were to patent the concept of doing that while wondering why the hell your TV is still on after The Last of Us has finished, then, yeah, that would be uniquely mine. Now, those established and configured patent applications are still pending. But the very fact that they have requested them is a pretty clear sign of how aggressively companies in this space intend to move forward.

And it's not like these treatments are going to be cheap to begin with. Experts project that a course of psychedelic therapy will likely cost more than $15,000. And given that, as we've discussed before on this show, there is currently a massive shortage of mental health professionals in this country, due in part to how screwed up our health insurance system is, you can see how this could quickly and easily. become a huge mess, or only accessible to the richest Americans. So there's a lot to figure out here, even before we get into questions like: Who will regulate psychedelic therapy?

Because the FDA is in charge of drugs, but it does not regulate the practice of medicine. Now, state laws might cover it, state regulatory agencies might, or professional organizations might. But someone has to do it. Because if they don't, people are likely to get hurt, which could send us back to scaremongering, bans, and investigations being frozen. Which is the last thing we should want to happen. Because there is enormous potential here. These treatments have shown that they can sometimes have long-lasting effects. Do you remember the world's oldest 33-year-old man he saw earlier? Whose LSD treatments appear to have curbed his alcoholism?

CBS caught up with him a quarter of a century later to see how things were going, and the response was pretty good. ARTHUR KING: LSD allowed me to see my own mind. There was a problem I had to solve, I faced it and it disappeared. As for me, I would not accept a million dollars for the piece of mind I got from this therapy. CBS REPORTER: That good, that refreshing, that rejuvenating. -And that lasting. Exactly. Thirty years later, I was still feeling the benefits of the treatment, which is amazing. And you'd think we'd have acted on evidence like that, but instead, it seems like we've spent the last half-century terrorizing people with fake science and feeding monkeys meth.

But the good news is that we're finally moving forward, and hopefully we're going to do it with a lot of caution and a lot of care. Because if we do, maybe, just maybe, one day you'll see psychedelic therapy ads on TV with a voiceover warning you that the side effects can include visits to the realm of hell and rainbows coming out of your penis. ♪ (RUNS THE PIANO) ♪