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Melissa Harris-Perry: This is The Takeaway. I'm Melissa Harris-Perry. Today is Bicycle Day. I'm going to get there in a second. First, there's a growing movement in the US to decriminalize and to legalize psychedelic substances such as psilocybin. That's the active ingredient in magic mushrooms. New research shows that these psychedelic drugs can be used for recreation, but also for therapeutic treatments.

In November 2020, Oregon became the first state to legalize psilocybin assisted therapy alongside decriminalizing the personal possession of drugs more broadly. In cities such as Denver, Oakland, California and Washington DC, voters have approved bold measures to decriminalize the personal possession of psychedelic mushrooms. Although psilocybin and other psychedelics remain illegal under federal drug laws, there are several prominent universities studying psychedelic-aided therapy, and its effectiveness in treating mental health conditions, including depression, anxiety, PTSD, and addiction. Of course, we're talking about all of this again on Bicycle Day.

Michael Pollan: Bicycle Day is a new holiday, April 19th. It commemorates the first acid trip. It goes back to 1943 where Albert Hofmann, the discoverer or inventor of LSD, took LSD for the first time deliberately, and had the first acid trip.

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Melissa Harris-Perry: That's Michael Pollan.

Michael Pollan: I'm the author of How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence. I'm also a co-founder of the Berkeley Center for the Science of Psychedelics at UC Berkeley.

Melissa Harris-Perry: Michael, thank you for joining The Takeaway.

Michael Pollan: Sure, Melissa. Good to be here.

Melissa Harris-Perry: Tell us a little bit more about Hofmann.

Michael Pollan: Albert Hofmann was a chemist at Sandoz Laboratory in Switzerland. He was doing what chemists often do, looking for new drugs, which is take natural compounds and fuss with them in various ways. Add a molecule or add an atom, take another one away. He was working with a fungus called Ergot, E-R-G-O-T, which appears on grain and rye in particular, in particularly wet years. It was known to be psychoactive and have all other effects too. People who ingest it would have hallucinations. St. Vitus Dance, it was called in mediaeval times. Some people believe that the Salem witch trials was a result of a consumption of Ergot by women in Salem, and they were acting very peculiar and seemingly possessed.

Hofmann was not looking for a psychoactive. He was looking for a drug that would help women during childbirth by staunching bleeding. He was going through making a series of variations on a theme of this molecule. One of them which he called lysergic acid dimethylamine 25, the 25th derivative that he made, he tested it on animals or however they test these things and it had no reaction and he put it up on the shelf and just went on to 26, 27, 28. This happened in 1938. That's when he created that compound.

For some reason, that remains mysterious. In 1943, five years later, he had what he called a pre-sentiment, that there was something important about that compound and he resynthesized it. He managed somehow to get a little bit in his body, whether it was touching his eye or finger to his mouth or something. He accidentally ingested a tiny, tiny amount and started feeling very strange.

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This told him that this compound had psychoactive properties. A few days later, on April 19th, 1943, he deliberately took a dose. If you're testing a drug, you start small, especially if you're testing it on yourself, and he started with 0.25 milligrams. It's 250 micrograms. It's a tiny dose of any drug except LSD, because LSD is powerful at smaller doses than any other compound. He took what amounts to a significant dose and had the world's first acid trip. Actually, it was the world's first bad trip. What happened to him he described was absolutely terrifying. The walls started to move, the furniture took on evil connotations, and he realized he had to get home. He couldn't hang in the lab anymore.

He told his lab assistant that he needed to go home and call a doctor. They got on a bicycle. They each got on bicycles, because it was wartime and gasoline was being rationed. Nobody was driving. He had what must have been one of the most wobbly and harrowing bicycle trips in history as he made his way home. The gargoyles on the buildings were coming to life and everything was pulsing, and he got home and he called the doctor. The doctor could find nothing wrong with him. Physiologically he was fine except his pupils were a little dilated. He endured this what he described as terrifying experience until it began to subside.

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He headed out into his garden, and the whole complexion of the experience changed to become wondrous, awe-filled. He felt like Adam on the first day of creation. With all of the plants glistening with dew and the flowers in bloom, and he had this afterglow experience that was one of the most pleasant in his life. That's the first acid trip. Everyone since in one way or another has been influenced by his account. People who are devoted to psychedelics commemorate this day, 4/19/43, the day before 4/20, of course, which is another drug holiday commemorating-- [crosstalk]

Melissa Harris-Perry: Basically, a good week for a lot of drugs.

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Michael Pollan: It's a very big week for drugs.

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A psychedelic is a drug, chemical compound that causes a very unusual psychic experience. The word psychedelic means mind manifesting. It brings certain things about the mind into conscious awareness that might not otherwise be. These drugs all act on the same receptor, 5-2A receptor and produce things like hallucinations, the impression that everything is conscious or alive, unusual visual patterns, unusual emotional reactions. They often surface lots of unconscious mental material. The modern history of psychedelics really dates to the 20th century and Albert Hofmann was a key figure with the invention of LSD.

His discovery of LSD led not just to its counterculture use, flash forward to the '60s, but before that, to a renaissance of research into psychiatry. We learned great things about the brain from LSD. It really taught neuroscientists although they weren't called that at the time, that if such a tiny amount of a drug could have such a profound effect on consciousness, chemistry must be very important to the working of the brain. This line of inquiry leads directly to things like the SSRI antidepressants. Our chemical understanding of the brain can be traced to Albert Hofmann and his discovery. It was a really big deal.

There was this very rich period of research all through the '50s into the '60s where LSD and also mescaline and psilocybin, which is the compound in magic mushrooms, they're all related, are being used to treat mental illness of many kinds. It was a very vibrant period of research with a lot of very promising findings, that psychedelics could be used to treat alcoholism, depression, the fear and anxiety of people with cancer diagnoses. This research lasted until the backlash against psychedelics which begins in the mid '60s.

Melissa Harris-Perry: All right, I want to walk through a couple of different pieces of that broad story that you've set out for us. Let's actually start towards the end there. Here you have a bit of an accidental discovery of something that teaches us about the human brain, and therefore potentially also about the human mind, and emotion and the physiology of our experience, what we think of as our real experience, yet that experience is clearly deeply affected and impacted by the chemistry of our physical brains.

Why does this become a set of illegal substances rather than simply another discovery in the world of all the other mind, brain drugs that you've been talking about here, in terms of SSRI, reuptake inhibitors and those other kinds of certainly regulated by prescription but not illegal?

Michael: Pollan You're right. There are lots of psychiatric medicines that do not become popular in the culture at large because the effects they have are not pleasant or interesting to people. The thing about psychedelics that was different was that it created an experience that people wanted to have. I don't think anyone feels that way about SSRIs antidepressants. The phrase that you hear is that the drug LSD escaped the laboratory. In other words, escaped the confines of medicine and psychiatry, and indeed it did.

This happens earlier than most people think. In the late '50s there are a whole bunch of psychiatrists in Los Angeles who were using LSD in their therapeutic work and getting very good results with it. As was very common at the time, the doctors would try the drug themselves to see what it was like. In fact, it was considered the most responsible and ethical thing to do that you don't give people a psychiatric drug without trying it first yourself, even though now we look down on that practice and most psychedelic researchers at least claim not to have tried the drug and it would prejudice them in favor if they did.

They started having group get togethers, parties, and people would all take LSD or psilocybin and then in the '60s the drug is taken up by people who are challenging the status quo. People in the anti-war movement. It is or was a very disruptive experience. In other words, LSD, people reported, made you question authority. LSD suggested that the world could be very different than it was and this was challenging to people. You can look at the whole history of drugs in general as there's certain substances that lubricate the smooth working of the machinery of society and there are other ones that are sand in the gears challenge the smooth workings of society.

Their identities may change but if you think of caffeine here is another powerful drug widely used and it's perfectly legal and indeed its consumption is encouraged in all sorts of ways. Caffeine is a really good drug that makes people better workers with more endurance and more focus and more safety, so capitalism loves caffeine. Society loves caffeine. It's contributed to civilization in all sorts of ways. "LSD by comparison made people want to tune in, turn on and drop out," as Timothy Leary famously put it. The dropout part was really terrifying to parents and to the powers that be.

President Nixon became convinced that the reason American boys were refusing to fight in Vietnam was because of LSD and other psychedelics so he worked to ban LSD and really began the modern drug war because he saw these drugs as a threat. What's interesting now, I think, is to watch psychedelics move from being this threat to the status quo to actually being the basis of medical treatments that would help resolve all the mental health difficulty that we're dealing with. In other words, psychedelics may move from being a disruptor to a drug that actually makes society work better.

Melissa Harris-Perry: Let me push in on that a bit. The way you frame that, something that could help our society to function better, and even as you are framing the difference between caffeine which as you say, capitalism loves, I get that, that makes perfect sense to me, versus a drug or sets of substances that make people question authority and imagine a different world. I still wonder who would get to define better in this case and the ways in which a variety of medications those that reduce pain reduce suffering also sometimes adapt us to circumstances that create pain and create suffering.

I guess what I'm wondering here is if psychedelics are so inherently threatening the status quo that it would be hard to imagine them as ever central to what we think of as a treatment philosophy or if we do have a treatment philosophy if that moves psychedelics out of their most potentially revolutionary capacity.

Michael Pollan: They could lose their revolutionary capacity. The idea that they are a threat to the status quo may be very contextual. In other words, it may not be something inherent in the drug so much as who was taking it and for what purpose. They were being taken at a time where there was a lot of rethinking going on and they encouraged that rethinking. The common denominator may be that they are drugs that also disrupt the status quo in the head, in your mind. They tend to make the mind more plastic and capable of changing. Many people talk about their effect on habit, habits of thought, habits of behavior.

Many of the mental illnesses that psychedelics appear to be effective in treating according to the research we have, share a quality of rumination or brains that are very rigidly trapped in patterns. Depression, addiction, anxiety, they're all very similar in that you are caught in these loops of thought that you can't break out of. I can't get through the day without another drink. My life is crap. The future's going to be worse. You play these narratives over and over and over again in your mind. The more you play them the more deeply ingrained they become in your mind. What psychedelics appear to do is disrupt those patterns temporarily and actually rewire the brain for a period of time.

As the drug releases the hold of these deep grooves of thought, new patterns have an opportunity to take place and that's where the guide or the therapist becomes very important in helping you make sense of the experience, integrate it. You don't do this alone if you're doing it therapeutically. There's always a guide who's preparing you and sitting with you, at least one, and then helping you apply whatever insights you've gained to your life. Psychedelic therapy is not just pharmacology. It's not just about taking a pill. It really is a new model of doing psychotherapy because it involves a chemical agent, psilocybin in most cases or MDMA, ecstasy, which is sometimes called a psychedelic, and talk therapy.

You have somebody and usually it's a man and a woman in the current trials that are going on at diad, as they say, who prepares you very carefully so you now what to expect and how to deal with difficult times such as Albert Hoffman had, the scary bits. They tell you how to deal with that often by giving you advice to surrender to what's happening in your mind. It's really when you fight what's going on in your mind and what's going on may feel really crazy that you get anxious and paranoid and you have what's called a bad trip. If you surrender to it, let's say your ego is which is a common thing on a high dose of psychedelics and your sense of self is essentially, I mean, I had the experience of myself exploded into a cloud of blue post-it notes and then fell to the ground in a puddle of blue paint.

That could be a terrifying thing. You could decide you're losing your mind or if you're being guided properly you could surrender to this. It actually becomes quite a wonderful experience because when you lose your sense of self you merge with whatever is around you and the barriers of the ego come down and you have this wonderful sense of unity with with nature, with the universe, with a piece of music. That experience you see, if you're not prepared for it properly, can really freak you out.

Melissa Harris-Perry: I want to ask an ethics question then on the guide as you say that. I suddenly had a great terror of what an unethical guide might do or even maybe one who might have ethics by some set of practices, but what we would think of as more typical talk therapy practices, but how being asked to be in that level of vulnerability, especially maybe for folks who are survivors or survivors of various kinds of traumas. I'm wondering about those who are trained to do this therapy. What else do we know about about the ethical guidelines here, because that did suddenly terrify me. Less the post-it notes and more the being told to simply go with whatever is happening in a moment.

Michael Pollan: Without question, there are ethical risks involved in psychedelic therapy and there are at one level the same risks involved in any therapy. We've had unethical therapists doing conventional and psychoanalysis, but the patient in psychedelic therapy is much more vulnerable. They're in a state of extreme suggestibility, they don't have all their faculties, they can't get up and leave, and so that the ethical integrity of the therapist is paramount. We have had cases where people receiving psychedelic therapy especially in the case of MDMA or ecstasy have been in one way or another abused by their therapists. Therapy abuse is a real risk.

I think it's going to be a challenge for the field going forward. In the case of MDMA, the drug creates such a bond with the therapist that an unscrupulous therapist can take advantage of that. We know of cases where that's happened. People talk about the warmth and affection and the hugginess around MDMA. Even though it's not an erotic drug, it does make people feel very huggy.

There is also the issue of touch in psychedelic therapy. It's not unusual for psychedelic guides to put a hand on your shoulder or hold your hand during a different period, and of course in conventional therapy, that's a boundary. You don't cross, you don't touch your patient. I think it's something the field has to grapple with without question. I think it's going to be one of the challenges.

Melissa Harris-Perry: I keep thinking about the movie Dumbo I saw as a child.

Look out! Look out!

Pink elephants on parade

Here they come!

Hippety hoppety

They're here and there

Pink elephants everywhere

Michael Pollan: Been a while.

Melissa Harris-Perry: In the movie, again, it's one of the earliest Disney films. It's happening not long after this initial bicycle day. In the movie, Dumbo gets drunk. He seems to have had something to drink, but the effect is that he has this what is sometimes-

Michael Pollan: Pre-psychedelic, yes.

Melissa Harris-Perry: Yes, the pink elephant dream moment. Here is a little baby elephant who's lost his mother to a pretty horrifying set of circumstances that elephant imprisonment, maybe even elephant enslavement death of the mother. Again, Dumbo also later can fly. There's a lot going on here around psychedelics and around imagining the world differently. I ask about Dumbo in part because being presented these ideas as a very small child, I think, feels different than the sense of control that I immediately wanted to reassert. As you were talking about being guided in the therapeutic process, my little ex-gen soul jumped up and said, "Hey, hey, hey, no."

My ego is good and strong, it hasn't turned into blue paint and really wants to be sure that it can assert control over whatever set of potentially damaging circumstances or challenging circumstances I might encounter. Talk to me about the ways that imagining or not imagining, but redefining this kind of therapeutic techniques and therapeutic drug therapy may also require us to reimagine what constitutes the good. Being in control of everything versus being in less control.

Michael Pollan: Well, it's interesting, some of the people I spoke to, I remember talking to one man who participated in an early psilocybin trial, and he came out of it thinking the great lesson was that surrender was a very important philosophical principle for life and that our desire to control everything, which is futile, is really the source of much suffering and that surrendering to things as they are, that was the lesson he took from it. It's not the lesson everyone does, but he had been given in all this training by the guides that if you see a monster, don't run away, walk right up to it. If you see a staircase, climb it, and if you see a door go through it.

It was just a different attitude toward life and he found it enormously helpful. I think of myself as a control freak, so I wasn't sure that psychedelics were for me. I didn't have much to do with them until I was in my late 50s. I got involved late at a time when your ego's pretty well-formed and your mental health is precious and you don't want to mess with it. I was surprised that in the event I was able to surrender and that wonderful things came from that. I think it's something to think about. Is control a good thing or not necessarily a good thing?

It's not to say that to take a psychedelic is to give up control of yourself for all time. It's an episode. You're doing it to cure a problem in some cases. You're doing it with intention and for a purpose but it is a radically different way of approaching life, and especially if you're struggling with mental illness you do things that might seem risky. Many of the people who participate are doing it because they're desperately unhappy or struggling, and that their idea of control is drinking every day or taking other drugs. They're addicted. The addict is looking for an illusion of control over his or her life.

The promise that psychedelic therapy holds out, and this isn't from me and this isn't even from the proponents of it, but it's from talk to a mainstream psychiatrist, is the promise of possibly curing mental illness, some mental illnesses, not simply addressing symptoms. Most of the psychiatric agents we have, drugs we have, do not address causes. If psychedelic therapy works and we still have to do more research to confirm that, it will because it fundamentally attacks these problems at the root and allows people to change.

In the case of the addicts, they are in about two-thirds of the cases in the case of smoking and alcohol addiction are able to give up their addiction. That's a pretty big deal. That's why I think you find so much openness in psychiatry, a field that certainly recognizes its limitations compared to other branches of medicine but a remarkable openness to exploring the possibilities of psychedelics as a treatment.

Melissa Harris-Perry: What is it that psychedelics teach us about dying?

Michael Pollan: I got involved in writing this book because I had heard about a trial going on at NYU and John's Hopkins giving psilocybin which is very much like LSD to people who had terminal cancer diagnoses. This struck me as the most bizarre idea imaginable. I can't imagine wanting to take a psychedelic when I was faced with the prospect of imminent death. A group of people had, and I interviewed about a dozen of them and they told me the most incredible stories of how a single experience on a psychedelic, a trip, had changed

their thinking about death. Had relieved them of their fear entirely in some cases.

I wrote extensively about a man who had cancer of the bile ducts and was given a short amount of time to live and participated in a trial at NYU, had psilocybin experience, and his paralyzing fear and anxiety was lifted. Exactly how this happened is very hard for us to understand, but he had had an experience that convinced him that his consciousness would survive his death. Now you could say, well, we're selling that man an illusion, perhaps, but, of course, no one's selling it. This was a product of his own mind. The drug does not contain that information.

The drug does not consistently tell people they will have an afterlife, but the encounter of that molecule and that mind produced that comfort and that comfort allowed this man to die with an equanimity that shocked everybody around him, including his wife. That's an incredible blessing. It raises all sorts of philosophical and ethical issues but what else do we have to offer people in that situation? We have opiates, right? We have morphine, which dulls the mind. This sharpens the mind in really interesting and potentially profound ways. It's a very different way of thinking of a psychiatric intervention, certainly. You're administering an experience to someone not simply a drug and that experience apparently has the potential to really change a mind that's gotten locked in very destructive patterns of thought. In this man's case, his paralyzing fear of death. That lifted entirely.

Melissa Harris-Perry: What do you say to skeptics? Those who are listening right now who say, this is about some folks who want to get high, making this about something much bigger, but this is really just about getting high. We need to either treat this in a recreational way and say, well people are also simply allowed to drink or to smoke because, or to take Advil or whatever, because it's a thing they want to do, or we need to really make this illegal because we don't support folks getting high, but that's really all this is about and all the rest of it is just artifice. How would you respond to those skeptical listeners?

Michael Pollan: Well, there are people who are just interested in using psychedelics to, as you say, get high, although that's such a impoverished description of what happens. It is not like alcohol and it's not like opiates in that it's so unpredictable in the effects. Other drugs have a very predictable physiological and psychological effect. You know how marijuana is going to make you feel pretty much. It could be good or bad, but there's a feeling associated with it and the same is true with an opiate. These are unspecific catalysts of mental activity, which can be pleasant or unpleasant. You're rolling the dice every time and some people have horrifying experiences yet they still take them.

They take these drugs because of what they might learn or the potential for a very blissful experience. This is not like when medical marijuana came around, where we did not have much research, but people put forward the idea that marijuana could help with pain, help with epilepsy, help with who were dying or wasting syndrome during aids. There was actually not a lot of research to support that idea. It was anecdotal. Some of it turned out to be true. We're talking here about studies being conducted at our best institutions of medical research. John's Hopkins, NYU, UCLA, UCSF, using the gold standard to trial new drugs.

They are now in phase two, out of phase three and they're already in phase three with MDMA, that are producing results that are capturing the attention of the whole field of psychiatry because of their potential. What I say to the skeptic is read some of the studies. Maybe you can pick them apart. There is a real signal here. These are big treatment effect sizes. Keep in mind too, how little we have to offer people right now and how poor the medicines that psychiatry has. SSRIs are fading in their effectiveness. They were never that effective.

50% of people don't benefit from them. Guess what? In their trials to get them approved by the FDA, they only performed two or three percentage points better than a placebo. The effect size for psilocybin for depression or MDMA for trauma is much higher than that. Follow the research if you're skeptical. That's what I would recommend.

Melissa Harris-Perry: That is perhaps a question or a response that we should have to nearly every skeptical response. Follow the research if you're skeptical. It's a really fine way to proceed in fact. Michael Pollan, thank you so much for joining us today.

Michael Pollan: My pleasure, Melissa. It was good to be here.

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