Was John Oliver Right About Psychedelic Psychological Treatments?

Recently on Last Week Tonight With John Oliver the famously acerbic host spent the majority of the show’s run-time exploring the history — and the potential future — of psychedelics-as-psychological medication, and conjecturing at what the future might hold.  The video is worth a watch, if you haven’t seen it.  Like all long-form John Oliver segments, it plays like a decently researched college paper written by that guy who still subscribes to Mad Magazine — who doesn’t know exactly when or how to turn it off.  It collects and juxtaposes soundbites and videoclips in a cogent way, brings in historical facts and anecdotes at appropriate intervals, and satirizes the pretentious and the hypocritical with the perfect blend of flippancy and hostility. 

Usually, for all their merits, Oliver’s long-form segments are lacking in one particular way: they don’t present any original ideas or solutions.  It’s deconstructionist criticism: he pulls apart and atomizes an argument, but he doesn’t add to it. Maybe it’s a lot to expect from a comedian — an argument but it’s something that many of the best comedians have managed to do. 

Funnily enough, his segment on psychedelics was the rare exception: He never comes out and truly says it, but it’s clear that Oliver and his staff are whole-heartedly in favor of exploring these kinds of treatments.  

The irony is, this is one area where caution is warranted.  Oliver is quick to call out the “junk science” and anti-drug propaganda from the 60s that gave the government an excuse to go after the hippies who were making, using, and distributing psychedelic drugs, but by the same token he mentions only one contemporary study on the efficacy of these kinds of treatments.  Which isn’t to say that there aren’t other studies out there, and that the results of these studies aren’t promising: but there isn’t as much as Oliver leads us to believe.  The anecdotal evidence the segment relies on is compelling, but as any scientist or doctor would tell you, putting your faith in anecdotes — as opposed to data — is risky business. 

Oliver does nod toward the potential dangers of psychedelic treatments — he even shows a clip of a doctor telling Anderson Cooper that the spectrum of outcomes ranges from euphoria to “hell-realm” experiences.  Unfortunately though he immediately undercuts the risk by pointing out that most of us have been to a Sbarro’s in a shopping mall, so we know what a hell-realm experience is like.  A decent joke, sure enough, but as is typically the case with humor, a form of deflection. 

That isn’t what worries us, though — lots of medications and treatments have potentially horrifying side-effects. What worries us is the possibility that the use of psychedelics can trigger dormant conditions. There is some evidence out there that drug-induced psychosis can trigger schizophrenia, for instance. 

If carefully administered in controlled, monitored environments, the risk of these kinds of side-effects is greatly mitigated.  But is it altogether eliminated?  Another question that comes to mind: would these dormant psychotic conditions have emerged without the triggering effects of psychedelics? 

Obviously we can’t answer these questions.  But that’s exactly the point — and why, at this early stage, caution is warranted.