Last Week Tonight with John Oliver (2014–…): Season 5, Episode 12 - Rehab - full transcript

Rehab is a billion dollar industry of USA. But this enormous addiction treatment industry is not regulated enough. That is why they can claim a high success rate of their facility without ...

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Welcome to Last Week Tonight !
I'm John Oliver.

Thank you so much for joining us.

Let's dive straight in with the fact
that yesterday saw a royal wedding.

As you knew, if you were anywhere
within earshot of CBS's Gayle King.

Hello, I'm Gayle King
of CBS This Morning.

I have one big goose bump.

I'm gonna change hats every hour.

We saw James Blunt go in.
He does that song, "You're beautiful".

That's all I'm gonna sing.

I feel like crying. My gosh !

This is very good
and very moist.

"You're beautiful." Do you know that ?
I won't sing, I won't sing anymore.

I love that song.

Pippa got a lot of attention.
Everyone was raving about her bottom.

I thought is that a big bottom ?
I don't think so.

She got attention for her bottom
that people thought was perfection.

I've seen big bottoms,
I didn't think that was one, but ok.

You know what that's fair Gayle.

We British people are not
exactly known for our taste in butts.

The actual Sir Mix-A-Lot
was a sixteenth-century nobleman,

so inbred
that when a girl walked in

with an itty-bitty waist
and a round thing in his face,

he just sneezed out of his elbow
and died.

A little bit of history.

Perhaps the most notable part of the
service was Bishop Michael Curry,

who delivered
an impassioned ode to love,

which led to some pretty
awkward reaction shots.

There were some old slaves
in America's antebellum south

who explained
the dynamic power of love,

and why it has the power to transfo...
they explained it this way,

they sang a spiritual even
in the midst of their captivity.

They said if you cannot preach like
Peter and you cannot pray like Paul,

you just tell the love of Jesus,
how he died to save us all,

that's the balm in Gilead.

This way of love
it is the way of life.

They got it.
He died to save us all.

That is the wrong room there, buddy.

Believe me, those are some
of the most repressed people on earth.

Talking to the queen about love
is like talking to her

about the transformative power of the
Taco Bell 5 $ Chalupa Cravings box.

"Don't tell me about this,
I'm not interested,"

"it sounds disgusting, and if I ever
experienced it I'd break out in hives."

"Good day to you, sir.
I said good day to you now."

So let's move on to North Korea.
A country led by a man

who is both a brutal dictator
and also the only person

who's ever been excited to get
a picture taken with Mike Pompeo.

The proposed summit between
Donald Trump and Kim Jong-Un

is scheduled on June 12th,
but this week, it hit a major snag.

North Korea says

it may call off Kim Jong Un's meeting
with President Trump

over U.S. demands to denuclearize
the Korean peninsula.

The summit is in jeopardy,
for a number of reasons

From the fact that both sides

apparently have different definitions
of what "denuclearization" means,

to North Korea's objections
to the U.S. and Sout Korea

holding a joint training exercise
called "Max Thunder."

Which sounds way too much like
a porn name for a military exercise.

It's as if the Bin Laden raid
has been called


Negotiating with North Korea is
the tightest of tight ropes to walk.

And instead of a professional walker,
Trump has brought in a big ol' walrus.

Specifically this big ol' walrus,
John Bolton,

the brand new
National Security Adviser,

who's been appearing on TV
making a pretty alarming statement.

Is it a requirement that Kim Jong Un
agree to give away those weapons

before you give
any kind of concession ?

That's right. I think we're looking
at the Libya model of 2003/2004.

Yes, the Libya model.

That may not sound like much to you,
but Bolton bringing up Libya

is literally the worst thing
he could have said in this situation.

It's like if your wife says,
"do these jeans make me look fat,"

and you say,
"I'm fucking the babysitter."

Anything would be better
than that !

The Libya model involved
a deal the U.S and others struck

to get Libya to give up
their nuclear weapons program.

But for dictators like Kim Jong Un,

that example is somewhat tainted
for reasons so obvious,

even the human throw-pillows
on "Fox and Friends" could understand.

Maybe John Bolton
shouldn't have mentioned Libya

because a lot of people think,
"How did that end ?"

"Gaddafi was dragged
through the streets..."

- It's the one thing you remember.
- Yeah, exactly.

Yeah, exactly. Exactly. Except
they're also missing out a key detail,

as before Gaddafi was dragged
through the streets and killed,

his enemies
"sodomized him with a bayonet."

And that is the worst way to die,
right after being in a port-a-potty

when Beyoncé walks in on you
and you're not wearing pants,

and you're so embarrassed
that you slam the door on her

and the force of the slam
knocks the port-a-potty over a cliff,

and as you fall down you
hear Beyoncé yelling,

"you'll never do anything
as funny as carpool karaoke"

and as you land upside down,
it hits you

that the only one who can save you
from drowning in your own feces

is Dustin Hoffman

and the last words you hear are,
"remember me, motherfucker ?"

I assume that that fear is universal.
Anyway, it's not important.

It's not just Kim Jong Un who is touchy
about what happened in Libya.

Gaddafi's death is a common obsession
among autocrats.

Even Putin apparently
thinks about it a lot.

Putin watches that tape
over and over and over again.

It's all he can talk
about for quite some time.

Vladimir Putin was determined
Gaddafi's fate would not be his own.

I am not actually surprised by that.

If you told me that there is a video
that Putin watches over and over again,

I would guess
it's of someone being murdered.

That's his "Big Lebowski."

He just throws it on in the background
whenever he's folding laundry.

In fact, for a sense of just
how badly Bolton screwed up here,

Trump actually walked
his comments back.

Yes, Donald Trump, a man who would
double down on a fucking typo,

went on TV and said this.

The Libyan model
isn't a model that we have at all

when we're thinking
of North Korea.

That is the President
of the United States

directly contradicting
one of his top advisers

a man who was standing
in the room the whole time.

And look, John Bolton:
How can I put this to you,

what you did in terms
that you might understand ?

Your decision
to say "the Libya model"

may have put your time
in the White House

on the path of The Scaramucci Model,
a model which means

you shoot your mouth off,
get fired quickly,

and end up posing for photos
in front of a frozen yogurt shop

with which you share
a dumb nickname.

And in terms
of sheer pain and humiliation,

that exit truly is the equivalent
of a bayonet up the ass.

And now this !

And now: local news gets a little
too British for the Royal Wedding.

If you enjoy phony British accents,
this is the week !

Tell us the details
and do it in a British accent.

Hello gov'na.

Cheerio, everyone !
Cheerio this morning.

Cheerio !
I made it to merry old England.

The Royal Wedding.

Hello !

You cheeky monkey.

Maybe a spot of tea ?

A spot of tea.

We do have three accidents
in town this morning.

Cheerio. You know the last time
we spoke with some type of accent,

we made it on HBO.

That's right the John Oliver Show,
yes, maybe we'll do it again.

From the town of Windsor !
Top o' the morning !

Moving on.

Our main story tonight concerns rehab:
the most common place to go

after hitting rock bottom,
other than Dave & Buster's.

Don't let their smiles fool you,
every one of those men

is at the lowest point in their
lives in that photo.

Rehab is a place where people can
address an addiction to drugs, alcohol

something that, until recently,

was seen as a moral failing that could
be overcome with sheer willpower,

perhaps best epitomized
by this amazing PSA from the 80's

starring singer Belinda Carlisle.

I used to do drugs
and one morning I woke up,

I looked in the mirror and said
you look frightening.

I got sick of it so I quit.

And now, life's a beach !

RAD. Rock Against Drugs.

Rad. Incidentally, Belinda Carlisle
has since admitted that,

after that PSA was shot, she used
cocaine for another twenty years,

to a point where, I am quoting her,
"I'm surprised I still have a nose."

Which is the kind of statement
you only normally hear from toddlers

who just spent the afternoon
with their uncle.

"He told me he got it in his fingers,
and I fucking 'flipped' man."

"I was crying, screaming...
I'm surprised I still have a nose."

"Is it still there ?
The guy's fucking crazy !"

Now, thankfully there is now
a broader understanding

that addiction is complex,

and that nothing about getting
off alcohol or drugs is easy.

Experts now view addiction
as a medical problem,

often likened to a disease,
or a chronic condition.

And a common way of treating it
is through stints in rehab.

It is a $35 billion industry,

with over 14,000 rehab facilities
across the United States,

some of which have fancy names
like Promises, Passages or Milestones,

names that sound like perfumes
worn exclusively by widows.

And some rehabs can even afford to run
TV commercials like this.

Cliffside Malibu has been helping
people just like you for over 12 years.

We accept most insurance.

Our experienced, compassionate staff
will help you get your life back.

Call the number
or go to the site below, now.

Don't wait because your tomorrow
may never come.

That is a hard turn there.
That's like Frosted Flakes

ending a commercial with Tony
the Tiger getting shot by poachers.

Now, in recent years,

it has gotten easier
to get insurance to pay for rehab.

That's largely thanks to the fact
that George W. Bush passed,

and Barack Obama expanded,

laws requiring health insurers
to increase coverage for it.

But while we use "rehab" as shorthand,
it is worth knowing

that there is no set definition
for what it should consist of.

There are no federal standards for
counseling practices/rehab programs.

And while many rehabs are staffed
by people doing their best to help,

"the vast majority of people
in need of addiction treatment"

"do not receive anything that
approximates evidence-based care."

And for a sense of just how bad
things can be, look at Florida

a state whose rehab industry has seen
an epidemic of overdose deaths, fraud,

to the point where one local official
issued a chilling warning.

The message would be, stop sending
your loved ones to South Florida

because we're sending them
back in body bags.

Holy shit. That is the worst,

and yet possibly most honest, tourism
slogan for Florida I've ever heard.

"Come to South Florida !
We'll send you home in a body bag."

So let's look at what rehab is,
and why the industry's so troubled.

Rehab should never be seen
as a quick fix.

It's often just the first step
in a lifetime of recovery.

Yet many operators make huge claims
about their success rate.

Take Passages, in Malibu.
The father and son who run it

make some pretty big promises
about what they can do for you.

When you send patients home,
what do you say to them ?

- You're cured.
- Totally cured. Hundred percent.

You will never use drugs
and alcohol again.

Your dependency has been cured,
have a wonderful life.

Bullshit. For a start,
there is no way, when patients leave,

this asshole doesn't say "ciao."

There is no fucking way that sound
doesn't come out of his lips.

But lots of rehabs feel free to make
suspiciously impressive claims,

as one researcher found out.

We called inpatient programs, asked
them what their success rate was.

And the lowest rate
we got quoted was 80 percent.

I do know that about 80 percent
of the clients who have come in here

are now sober, long-term.

We've had about an 80 percent
success rate here at 180.

And then we would ask,
on what data do you base that ?

And no one had any data.

They had no hard data
to back up their claims.

But why not say you have
a 140 percent success rate ?

"For every 10 people that come here,
14 emerge completely sober !"

"Where did those extra four people
come from ? We have no idea !"

That's the thing-rehabs' success rates
are based on selfreported statistics,

involving them simply
calling former clients.

Those results
can be problematic,

as a man who's participated
in one of those studies can tell you.

They call you up
and they ask how you're doing,

and you just lie.

I just said, you know, I'm fine.
You know, but yeah, I was drinking.

Yeah, like, I mean,
it's crazy, you know,

but I was embarrassed to say
I didn't stay sober.

You can kind of understand
that for every reason.

It can be hard to admit
that you've relapsed,

plus, it's a phone call, so you'll say
whatever it takes to make it end.

Getting sober may be hard
but nothing is harder

than an 8-minute phone call
with another human being.

Nothing at all.

For all those claims of success,
it is very hard to know

what you're getting
at any given rehab.

You might get the traditional
12-step-based approach,

which works for some,
although most experts argue

there should also be consistent
access to newer treatments,

like behavioral therapies
or medications like these.

But rehabs
are not required to offer those.

And because a rehab can be
whatever its proprietor says it is,

they can frame almost anything
as treatment.

Many high-end rehabs offer
something called "equine therapy".

If people respond to it,
that's great.

There is no empirical evidence that,
as a treatment for addiction, it works.

Which means some people
who paid a high price for it

can have this experience.

They had the whole equine thing.
You go and fucking pet horses.

What is petting horses
gonna do for me ?

It didn't do a goddamn thing.
I don't even fucking like horses.

First of all,
I absolutely love that guy.

Second of all, he's right.
Horses can go straight to hell.

Why do we even need them anymore ?
You could ride one somewhere,

or you could drive a car,
which is like a horse,

except it can play music and
it doesn't shit everywhere.

You're an idiot, Patches.
An idiot.

One of the places that offers
equine therapy is Cliffside,

the place from the ad
you saw earlier.

A month of treatment there
costs tens of thousands of dollars.

Its founder, Richard Taite,
gets defensive

when asked
if it's worth the price.

$73,000 sounds like a lot,

but if you go to the Four Seasons
for 30 days, ok ?

That's gonna be 40 grand.
What did you get ?

Was there any life-changing
thing going on there ?

Everything we've done
here is mindful.

It only seems like horseshit to
people that don't know better.

You don't have to know better,
your life didn't depend on it.

You didn't go through it.

Calm down, bro. You're being
unfair to the Four Seasons.

Plenty of life-changing things
happen there.

Jaden Smith claimed the one
in Toronto

"spiked his pancakes with cheese",
after kicking him out of his room.

And if a handful of Canadians
tricking an evicted child millionaire

with undisclosed ricotta
isn't a "life-changing thing",

I don't know what is anymore.

$73,000 sound like a lot,
because it is a lot of money.

You would hope that they could
account for every moment of treatment

but that does not seem
to be the case.

- Where are your patients at today ?
- I don't know. Where are they ?

Where'd they go ?
Rob's not here.

I have no idea.

They probably went to...

Whatever they did,
there's a therapeutic...

... meaning behind it.

Good save, bro. 'Cause you
were in trouble for a minute there,

but the "therapeutic meaning"
line was inspired.

Anything can have
a therapeutic meaning.

His patients are stroking horses ?
Could be therapeutic.

They're biting owls ?
That could be therapeutic.

Even the act of them being lost
could be therapeutic.

It's called "inadvertent wilderness
therapy", 140 per cent successful.

We've just talked about the fancy,
high-end residential facilities.

There are oversight problems
throughout this system,

the barrier to opening
a rehab can be dangerously low.

In Idaho, if you are not operating
a residential program for adolescents,

you don't need a license.

In California, as long as you
take private-pay clients,

anyone can start
an outpatient rehab center.

In Florida, if you want to open
a "sober home",

a group home where people stay,
while receiving outpatient treatment,

there is nothing in state law
to stop you.

O.J. Simpson could open one, which
would be called "The Juice Cleanse",

and there would be nothing
standing in his way.

Florida provides a window into
how the flood of insurance money

caused massive problems,
the industry boomed there

and unscrupulous operators found
it too easy to game the system.

Take urine testing.
Insurance covers drug tests

and some places have
exploited that,

arranging for kickbacks
from testing facilities.

The more urine they take,
the more money they make.

And it adds up fast.

For a single $30 store-bought
urine test,

you could get up to 1,500 dollars
in payouts from insurance companies.

Let's do the math. If you run
five tests a week on a single addict,

that's 7,500 dollars.

6 addicts at 5 tests a week,
$45,000 dollars.

That's over 2.3 million a year.

Exactly. Urine is so valuable
that in the recovery industry,

it is known as "liquid gold".

Peeing liquid gold sounds
like the symptom of an STD

you can only contract
from fucking C-3PO.

No, I don't think all women born
after 1990 have it anyway.

Unless you're sleeping with
all women born after 1990, C ?

Are you doing that, C ?
You're a dog, C, you're a metal dog.

With money like that
to be made just from urine,

some have gone to extreme lengths
to attract patients with insurance,

even engaging in something
called "patient brokering"

or "junkie hunting",
here is how that works.

Mercedes Smith,
a recovering addict herself,

told us sober home operators compete
for addicts with good insurance,

enticing them with promises of free
rent, free food, free cigarettes.

We would have to drive
around Delray.

And anybody with suitcases we would
have to ask them:

"Do you have insurance ?
We have a place you can go."

In terms of questions to ask people
from the window of a moving vehicle

"do you have insurance ?"
is barely less sinister than

"would you like some candy ?"
or "what size of flesh are you ?"

It gets grimmer. There can be
more money in a patient relapsing

than in them recovering.

This system encourages a cycle
of admission, relapse,

readmission and relapse again.

Even has its own term,
it's called "the Florida shuffle".

If you are not extremely lucky,
this is how it ends.

In the "Florida shuffle",
you go in and out of recovery,

in and out of rehab centers,
in and out of sober homes,

milking the individual for their
insurance until that person dies.

The Florida shuffle turns out to be
horrific, and not, as I'd assumed,

a party where everyone gets
to fuck their neighbor's alligator.

If at this point you're thinking:

"I need to be extra careful when
I'm looking for treatment",

that is the final big problem.

It can be nearly impossible to find
good, unbiased information.

Let's say you see this ad,
which plays a lot.

We are the Addiction Network
and if you have a problem

with drugs or alcohol you need
to call the number on your screen now.

Addiction is a disease
and you can't go it alone.

The call is free
and so is the consultation.

So why haven't you called ?

Why haven't you called ?
That is a hostile tone

that you would not
tolerate elsewhere.

Tampax tampons,
why isn't one in you right now ?

Seriously: explain yourself.

The important thing to understand

is that the Addiction Network
is not a rehab.

It is a referrals business,
they make money by routing your call

to centers all over the country, which
pay them $40 to $50 for your call.

Your individual circumstances are not
being taken into account,

they're placing your fate
in the hands of whoever has $50.

Which is a terrible system.
I have $50,

but I have no idea how to
treat someone with an addiction.

I'd give them a copy of my handmade
anti-drug pamphlet, titled:

"Napping With The Devil:
Please Stop Doing Heroin".

If you're thinking: "I wouldn't fall
for a sketchy looking TV ad"

That is great. Let's say that you saw
that Cliffside ad and you thought:

"That looks good, but I do want
to check it myself first."

which says that Cliffside
is the choice for

"those that have to have
the finest of everything."

Or you might land
on "The-fix-dot-com",

whose review raves that it is

"a great choice for anyone who
has the means to recover there."

What you probably won't see
on either of these websites,

is that both of them are
owned by Richard Taite,

the founder of Cliffside Malibu.

The guy who looks like Matt Lauer
fucked a pair of Oakley sunglasses.

That fact of ownership certainly
casts some doubt

on the fact The Fix awarded Cliffside
a rating of five out of five stars.

One star for every ten patients whose
location he's unaware of.

Let's say someone you love
was truly in crisis

and you wanted information
on Cliffside from an outside source,

like what complaints had
been lodged with the state.

To get that information, you would
need to file a public records request

with California's Department
of Health Care Services

and wait for months for them
to send you what could be

a huge pile of documents.

And that is too long to wait
for urgent information.

It's akin to a pregnancy test

that takes you eight and a half months
to get the results.

That is practically useless
and a huge waste of good urine

which as I now understand it
is liquid gold.

Everything about this industry is
incredibly difficult to navigate.

Even one of its own trade groups
has warned

that some sectors of it
are "out of control".

For a sense of how helpless you can
be in the face of all this,

listen to Tom McClellan,
Obama's deputy drug czar.

You would think that, if anyone
knows this world, it would be him.

Guess what ?

I had become an expert
in the addiction field.

And then my son became addicted,
and I had no idea what to do.

All that training, all that knowledge
about addiction did not prepare me

for the most fundamental
question of all.

Where do you send
your kid for treatment ?

Even the nation's deputy drug czar
couldn't navigate this system.

The tragedy is, his son died.

Remember the funny
guy who hated horses ? He died, too.

So this is a matter
of life and death.

If you're wondering what experts would
advise you to do in seeking treatment,

many suggested beginning
not with a rehab,

but with a doctor who is board
certified in addiction medicine.

It recently become a specialty,
so there aren't many of them around,

but you can find those
that exist at this website.

They may be able to guide you
toward a treatment,

which might well not be
a fancy center

where you have to pay $73,000
to have this guy lose you.

This system needs more expertise
and oversight.

Until then, it may be really important
for all of us to understand that,

the word "rehab"
is so broadly defined

as to be close to meaningless.

It is honestly barely better
defined than the word "building".

If someone were to tell you:
"I have a drug problem,"

"but don't worry,
I'm going to building in Florida",

you would naturally say:
"hold on, what building ?"

Where did you find this building ?
Is it a hospital, or a Hooters ?

Or both, is it a Hootspital ?

What's the proof it works ? What's
the doctor-to-horse ratio like there ?

Now, it can be way too difficult
to get answers to those questions.

So much about battling
addiction is really hard.

Getting clean is hard.
Staying clean is hard.

But getting good, evidence-based,
trustworthy help

should be the easy part.

Now it is way to easy to literally
wind up pissing money up a wall.

And now this.

Just look at this bunch
of Royal Wedding shit.

KFC making sure to get
in on the Royal Wedding.

They're calling it
the Royal Wedding bucket.

Burger King has launched
a new sandwich.

Two onion rings, signifying
the royal matrimony.

Velveeta, they've got crown
shaped pasta and cheese.

Prince Harry and Meghan Markle
Pez dispensers.

- Harry and Meghan paper dolls.
- Bobble heads.

- Crown jewels condoms.
- That just looks creepy.

- Weird earrings.
- One on each lobe.

If you want a more classy biscuit,
45 pounds for the tin,

but they're really beautiful.

Like these, who wouldn't
want these bathing suits ?

There's nothing flattering
about that.

It's where the beard is.
It's the beard that's not right.

That's our show. We're off next
week, we'll be back after that.

Thanks for watching,
good night !