John Oliver discusses psychedelic assisted therapy: its history, its potential, and what it has to do with A$AP Rocky’s relationship to rainbows. 

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-♪ ♪ -♪ ♪ Our main story tonight concerns drugs.

You know, the substances that gave us most music, seasons 1 and 2 of The West Wing, and this spectacular clip of a BBC reporter getting inadvertently wasted.

Burning behind me is 8 and a half tons of heroin, opium, hashish, and other narcotics.

That deserves the Pulitzer Prize for Reporter on Most drugs.

I'm not sure what my favorite part is there, his little giggle, the idea that someone thought, let's put a guy downwind from an 8 and a half ton pile of burning narcotics, or the fact that his main effect on him seems to be to turn him into a total sweetie pie.

Specifically, we're gonna talk about psychedelics, a category that includes drugs like psilocybin, LSD, and MDMA.

And let me first say, I know, anyone with my face, voice, and generally off-putting aura who talks about drugs is usually warning you about the devil's lettuce.

In college, I practically majored in herbology with a minor in gangeneering.

They called me Sonic the Hedgehog because I rolled tightly.

Also, I've done Blow on Tour with Ozzy Osbourne, who's also my dad, by the way, so I'm in the scene, okay?

The truth is, lots of people use psychedelics.

Some for spirituality, some for healing, and some, like A$AP Rocky, just for fun.

The first time that he did LSD, it started to kick in just as he was having sex, with some surprising consequences.

I had no idea why there was a rainbow coming out of my penis.

Every sentence is better than the last there.

It had a sound with it like a piano or some shit?

I have no idea why there was a rainbow coming out of my penis.

Now he's introduced suspense to the story.

Also, I'm pretty sure that ASAP Rocky just gave Skittles their next commercial.

Ding, ding, ding, ding, ding, ding, ding, ding, ding, ding, ding ♪ -♪ Ding, ding, ding, ding, ding, ding, ding, ding, ding, ding, ding, ding,

ding ♪ But tonight, we're going to focus on 1 particular use of psychedelics, in therapy.

It's a field that you may have heard about recently in stories featuring testimonies from some very satisfied patients.

I had all this access to my mind, and I could control where I was thinking and going.

It connected me back to my body, like I could feel my body again.

You know, because, you're not afraid of dying.

It's like doing therapy while being hugged by everyone who loves you in a bathtub full of puppies licking your face.

It would sound nicer if a rainbow also shot out of your dick, but that's only because A$AP Rocky has now raised the bar on what constitutes a pleasant human experience.

That last guy is a veteran who claims that psychedelic treatment not only helped him with PTSD, but saved his life.

And he is not the only vet who has benefited.

But The effects after the first treatment were profound.

I would have said a 60% reduction in, my symptoms immediately.

It is not often you see those kind of results after your first therapy session, especially now that so much of it happens over Zoom.

Usually, day 1 is spent for introductions and trying to figure out what the fuck that thing behind your therapist's head is.

A recent clinical trial of MDMA-assisted therapy found that for those suffering from PTSD, just 2 months after treatment, 67% no longer qualified for a PTSD diagnosis.

And that is not even getting into the promise that psychedelics have shown in treating conditions like addiction and depression.

The fact is, all of this is hugely encouraging.

But it is worth knowing, we've actually been here before with psychedelics, and we've fucked it up.

And if we are not very careful in the years ahead, we could go backwards again.

So tonight, let's talk about psychedelic therapy.

Its history, its potential, and what the pitfalls ahead might be.

And let's begin by acknowledging, a lot of these medicines, especially psilocybin, are nothing new to indigenous communities.

They've been conducting rituals involving mushrooms, peyote, ayahuasca, and other ceremonial medicines far longer than Western civilization has.

But interesting psychedelics outside of indigenous communities really picked up around the middle of the last century.

LSD was first synthesized in a Swiss lab in 1938.

Gordon Wasson popularized magic mushrooms after hearing about an indigenous Mexican woman named Maria Sabina who used them in healing ceremonies and tracked her down in 1955.

After several attempts, he finally convinces Maria Sabina to let him taste the magic mushrooms, as they came to be called.

He comes back and writes an account of his adventure that is published in Life magazine of all places.

Thousands of words in the biggest magazine in America.

This article, when it's published, is a sensation.

Watson was basically the very first white guy who did shrooms and then made it his entire personality.

-...that article started a stampede of hippies and celebrities into Maria Sabina's village that turned her neighbors against her to such a point that they burned her house to the ground.

So, you can add magic mushrooms to the list of things completely ruined by Finance Bros, along with vests, dating apps, and the middle class.

But it wasn't just bankers and hippies drawn to the power of these substances.

Military actually conducted experiments to see if they could be dropped on enemy troops to incapacitate them.

And lucky for us, they filmed those experiments for posterity.

Here is a group of normal soldiers responding correctly to a series of routine drill commands.

After receiving a small dose of LSD, they're confused and undisciplined.

Those soldiers went from tightly choreographed parade to tourists trying to decide where to have lunch.

And all it took was a tiny bit of chemical warfare.

But even as the army was dicking around, trying to invent a literal love bomb.

Some researchers were using LSD as a mental health treatment.

In 1966, CBS News actually followed a man who received LSD as part of his treatment for alcoholism and reported on its startling results.

6 months after treatment with LSD, 6 months after his release from the alcoholics ward at Spring Grove Hospital, Arthur King has started over.

At the age of 33, he has gone back to school, something he talked about doing for years.

In evening classes, he's studying accounting.

Have you had anything to drink, for example?

And I haven't had any desire to drink anything.

I know that I'm hardly 1 to talk as a legal 45, but a spiritual octogenarian.

People sure aged a lot worse back when we painted everything with lead and let people smoke in the delivery room.

--LAUGHTER --Unfortunately, by the late 1960s, psychedelics became increasingly associated with the counterculture, and as the government cracked down on that movement, they began an era of anti-psychedelic hysteria, and it was intense.

Junk studies made dubious but terrifying claims, like that LSD could warp your chromosomes, and education films employed a wide range of tones and scare tactics like these.

This is a fetus from a mother not receiving LSD, a normal fetus.

This is a fetus from the mother receiving LSD.

I know doctors, and I know lawyers, And I know the most stable people in the world that have taken trips on LSD and are still waiting to return.

Unfortunately, these dreamy, psychedelic trips are very often 1 way.

That is Quite the smear campaign there, from the hamster fetus that looks like dino nuggets, to the woman screaming at you about all the doctors and lawyers she knows, to the hearse that apparently makes house calls.

And while all of that was nonsense, I do kind of miss the days when we used to get dressed up to watch our drugged out relatives get carted off to the morgue.

Honey, they'll be hauling Jimmy's body to its final stop before hippie hell.

The neighbors may see, they're gonna think we're poor.

Get it together, Helen, and find my tie clip.

-♪ ♪ -♪♪ Tall tales about LSD ran rampant.

At 1 point, a Pennsylvania state commissioner claimed half a dozen tripping Pennsylvania college students stared at the sun so long that they went completely blind.

He later admitted the hoax, saying that he'd attended a lecture on the use of LSD by children and became so concerned, he wanted to scare people away from the drug.

But the hysteria hit its absolute peak when Nixon passed the Controlled Substances Act, which placed LSD and psilocybin in the most restrictive legal category possible, alongside drugs like heroin.

Essentially, stopping medical research dead in its tracks.

1 researcher described the work as being put in the deep freeze.

And when scientists started working with MDMA, it too got swept up into the panic with a journal science alleging that just 1 use can cause permanent brain damage in monkeys, a study that got a lot of attention before being retracted after it was found that the monkeys hadn't actually taken MDMA at all, but instead, had been given meth.

Any study's result is gonna change if the independent variable is suddenly and unexpectedly fucking meth.

We've studied the vaccine for COVID, and the participants are going ape shit for it.

But in recent years, perceptions have finally begun to shift, with the FDA granting breakthrough status to support the study of MDMA for treating 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 ones can work in different ways.

But for instance, research shows that MDMA dampens the response in the amygdala, which is the threat-detecting center of the brain, meaning you're able to confront and process trauma that you can't otherwise face.

Here is 1 researcher explaining how it works with a story about taking MDMA recreationally in his younger days.

I can remember 1 time, after a rave, all of us lying around, all loved up, and somebody said, oh, wow, this is amazing, it's so beautiful, Everything's so perfect.

And someone said, let's think of the worst possible thing we can imagine.

And someone said, let's imagine our mums dying.

And then someone said, it's not that bad.

And I didn't know it then, but that really was what MDMA does.

It allows you to think about and go to those dark, difficult, forbidden, avoidant memories that you normally wouldn't be able to touch.

That is fascinating, and I'm so glad that that worked out for him.

It sounds like a rave DJ'd by Werner Herzog.

Life is fleeting, let's imagine our mom's dying.

As a solemn reminder that all we have is tonight.

Now, wave your hands in the air as if our slow passage towards oblivion makes you just not care.

Now, to be clear, Psychedelic therapy involves much more than just taking a pill.

These drugs alone don't automatically produce results.

Usually treatment entails multiple sessions lasting most of the day, in which you may 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 watch this former firefighter narrate video of himself undergoing MDMA-assisted therapy.

This is your first medicated treatment session.

This is the beginning of some interesting revelations on this video.

And are you feeling completely conscious and you're in control?

And I felt like I was able to relax, even when I was talking through probably my most traumatic memories.

I don't think I'd seen a dead person until then.

It was like being able to take a big breath, you know, after being stuck underwater for a long time.

And you can see the utility of having 2 people either side of that man talking him through the experience.

And if it sounds like I'm treating having 2 people to talk to about your feelings like a radical idea, you do have to remember that I was born tragically and medically British.

-♪ Laugh track ♪ -What is interesting is, though, It is not just that your fear is muted.

Your brain's ability to make other connections and forge new neural pathways is also heightened, meaning that these sessions can fundamentally alter the way you process things.

That is thought to be 1 reason why psychedelics are so promising for treating conditions like addiction and depression, and why they are proving especially useful for dealing with trauma.

That is what makes this form of therapy particularly appealing to veterans, as PTSD is an urgent issue for them.

In 2019, over 6, 000 veterans died by suicide, a rate substantially higher 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 mental health care from the VA that he initially received.

They gave me 6 Xanax, told me not to take them all at the same time, because it might kill me.

They asked if I had guns at home, and I said, -"Yeah, it's a lot."

They said, if I asked if I had ammo, I said, yeah, plenty.

They said, okay, when you get home, give all your guns to a neighbor.

And they said, come back after the holidays.

Okay, I knew the VA's mental health services were subpar, but I didn't know they stooped to here's a bunch of ways to kill yourself, but on a system, don't, and anyway, see you after the saddest time of the year.

--LAUGHTER --Thankfully, that guy saw such a profound change from MDMA therapy that he's now helping to lead a movement to allow psychedelics to be used to treat conditions like PTSD, enlisting help from Democratic lawmakers like AOC, and even Republican lawmakers like Rick Perry and Dan Crenshaw.

And that kind of bipartisan consensus has brought us to the tipping point that we're at right now.

Because so far in the U.S., these drugs have only legally been available to people in clinical trials.

But over the next year, it is widely anticipated that the FDA will approve MDMA for clinical use, with psilocybin expected to follow a few years later.

Meaning that we may be about to finally realize some of the huge potential of psychedelics, which is great.

But, it is worth being very careful at this point to make sure that we don't repeat past mistakes, or indeed, make new ones.

And those who work in this field point to a few big areas for caution.

The first concerns how psychedelics are administered and by whom.

Because while people have used these drugs recreationally forever and will continue to at parties, at raves, in nature, or to really liven up a baptism.

-♪ ♪ -♪ Psychedelic-assisted therapy is not for everyone.

For example, anyone with a history of schizophrenia or psychosis may want to steer clear.

And Even if you are a good match, because these drugs can put you in an incredibly vulnerable state.

Experts emphasize the importance of trying them in a controlled setting, which ideally would involve 2 people present at all times, and even videotaping the session, like that 1 that you just saw earlier.

They advise this not just for your own safety, but also because for all their potential benefits, these drugs aren't always a bathtub full of puppies.

We tell people that their experiences may vary from very positive to transcendent and lovely, to literally hell realm experiences.

As frightening an experience as you have ever had in your life.

Although, to be fair, you don't need to take drugs to get to the Hell Realm.

After all, that is why airports have Sbarro's.

It is important to note that even those in studies who've reported Hell Realm-type experiences have often still felt that they benefited from the treatment.

There are also concerns over accessibility.

These treatments are likely to be very expensive.

And there are some players angling to make them even more so.

Just look at Compass Pathways, a for-profit psychedelic company backed by Peter Thiel.

It sought and obtained patents to protect its formulations of psychedelic compounds, which already seems pretty aggressive for a drug that, remember, has been around for thousands of years.

And Compass's executives seemed pretty defensive when they were pressed about this.

Do you really believe that your form of psilocybin is novel and non-obvious?

Well, it doesn't really matter what we believe.

Patent Office believes, what Germany, what Hong Kong believes.

And all of them believe that actually it is because we have the granted patents.

Okay, but we shouldn't necessarily trust the U.S.

Patent Office as an arbiter of good judgment.

This is the same place that issued patents for an umbrella for your beer, a tricycle with a lawnmower attached to it, and a stick.

That's it, Just a stick for animals to play with.

Someone in the patent office saw that and said, we've never seen a stick before.

So, take what they believe is important with a big pinch of salt.

And look, it is not just the drug formulation.

Compass has also tried to patent other aspects of what's often called the set and setting of treatment, from the room comprising soft furniture, or being decorated using muted colors, to the subjects lying on a bed or on a couch, or a therapist responding to things a patient is saying, which is just the entire fucking concept of therapy.

It'd be like me patenting the concept of wearing a suit while sitting at a desk.

I'm clearly not the only person who does this.

Now, if I were to patent the concept of doing that while making you wonder why the fuck your TV is still on after The Last of Us has ended, then yeah, that would be uniquely my thing.

Now, those set and setting patent applications are still pending, but the very fact they applied for them at all is a pretty clear sign of just how aggressive companies in this space intend to be going forward.

And it is not like these treatments are going to be cheap to start with.

Experts project a course of psychedelic therapy is likely to cost upwards of $15, 000.

And given that, as we've discussed before on this show, there's currently a massive shortage of mental health professionals in this country, due in part to how fucked up our health insurance system is.

You can see how this could quickly and easily become a big mess, or only accessible to the wealthiest Americans.

So there is a lot to figure out here, even before you get into questions like who will regulate psychedelic therapy?

Because the FDA is in charge of drugs, but it doesn't regulate the practice of medicine.

Now, state laws could cover it, a state regulatory agencies could, or professional organizations might.

Because if they don't, people are likely to get hurt, which could then send us all the way back to fear-mongering bans and research getting put on ice, which is the last thing that we should want to happen.

These treatments have shown that they can sometimes have lasting effects.

Remember the world's oldest 33-year-old that you saw earlier?

Whose LSD treatment seemed to have curbed his alcoholism?

CBS caught up with him a quarter century later to see how things were going, and the answer was, pretty well.

There was a problem that I had to resolve, and I faced it, and it disappeared.

As far as I'm concerned, I wouldn't take a million dollars for the peace of mind that I obtained from this therapy.

It was that good, that refreshing, that rejuvenating.

30 years later, he was still feeling benefits from the treatment, which is striking.

And you would think that we'd have acted on evidence like that, but instead it seems we've spent the last half century terrifying people with bogus science and giving meth to monkeys.

But the good news is we are finally moving forward, and hopefully we will do that with real caution and real care.

Because if we do, maybe, just maybe, 1 day you will see ads for psychedelic therapy on TV with a voiceover warning

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