In the heart of London, a unique clinic is fighting an unseen battle against a rising tide of psychosis linked to cannabis use. This is a story of hope and resilience, where individuals like Isiah, Aaron, and Katie are finding the strength to overcome their struggles.
'I was running down the road, thinking I was God'
Isiah's journey began on a fateful night in 2023, when he found himself on the roof of a shopping center, contemplating a leap. Exhausted by his paranoia, which had grown alongside his cannabis habit, he felt he had no other choice. But here's where it gets controversial: Isiah's story is not unique. In fact, it's becoming increasingly common, especially in certain parts of London.
The Cannabis Clinic, based in Denmark Hill, is the only one of its kind in the UK, offering specialized support to adults with psychosis who want to reduce their cannabis use. And it's needed now more than ever. A study by King's College London, published in The Lancet Psychiatry, estimated that a significant percentage of new psychosis cases across Europe are linked to high-potency cannabis use. In London, where potent strains dominate the market, this figure is alarmingly high.
Consultant Diego Quattrone, who runs the psychiatric intensive care unit at University Hospital Lewisham, a few miles from the clinic, reports that at least 80% of new admissions involve cannabis use. He believes the dangers of this drug are often overlooked, and its use is strongly associated with violence before and during admission. Daily use of high-potency cannabis is linked to a distinct subtype of violence driven by psychotic symptoms, such as paranoid delusions and hallucinations.
The clinic's clinical lead, Dr. Marta Di Forti, a professor of drug use, genetics, and psychosis at King's, is passionate about her work. She has helped 90 people since the clinic received its NHS commission, and the results are impressive: 74% of those who completed the clinic's intervention have stopped using cannabis, and 91% of that group have returned to education or work. However, the demand for these vital one-on-one sessions is high, and people are waiting months for them, which Dr. Di Forti finds devastating.
Isiah has been on the waiting list for two months. Despite receiving therapy and medication after his hospital admission, he still uses cannabis daily. His mother, Nicci, accompanies him to the clinic's monthly brunch group, where they are surrounded by tables full of distractions like jelly sweets, fidget toys, and coloring books. Nicci's eyes reveal her exhaustion, and she knows all too well the financial and emotional toll of her son's habit.
At the brunch, service users create 'cravings boxes' filled with items to help them cope during difficult moments. This lighthearted activity is just one example of the clinic's holistic approach, which tackles both the practical challenges of withdrawal and the psychological issues with minimal pressure.
Senior practitioner Jodie Lynn explains other strategies: role-playing difficult conversations, setting boundaries with peers, and keeping cannabis diaries to identify triggers. Sleep and dreaming are also crucial aspects of recovery. Heavy cannabis users often never dream, so when dreams return during withdrawal, they can be terrifying, posing a significant obstacle.
Many users experience auditory hallucinations, grandiose beliefs about their powers or celebrity status, and visual hallucinations. The clinic offers online one-to-one sessions to accommodate these complexities, especially for those who may be paranoid about leaving their homes.
Aaron, 23, describes his psychosis as a 'dissociation from reality,' leading to erratic behavior and arrests. Kenneth, 31, on the other hand, is well-spoken and poised but insular. His psychosis is dominated by sounds, often emanating from inanimate objects. Both young men are part of a generation living in a hotspot for psychosis, with cannabis use identified as a contributing factor.
While cannabis use is declining in England and Wales, those who do use are doing so more frequently. Dr. Di Forti points to a large study called 'Cannabis and Me,' which found that 50% of participants were daily users, consuming an average of 17 joints per week. The high potency of modern cannabis is a key concern, with THC levels in street cannabis in London averaging 14-16%, compared to just 3% forty years ago.
Dr. Di Forti's husband, Sir Robin Murray, a professor of psychiatric research at King's, describes the situation as the beginning of an epidemic. He compares it to the fast-food obesity crisis of the 1980s, warning that as cannabis becomes more available and potent, we will see even more cases of psychosis.
The clinic's impact is evident in the transformation of individuals like Katie, who grew up in care and started using cannabis at eight years old. By the time she was 20, she was smoking 20 joints a day and hearing commanding voices telling her to harm herself and others. After being admitted to the hospital, she was sectioned 50 times over the next two decades. But a year after finding the clinic, she is now abstinent and living a healthier life.
Katie's story is a testament to the power of the clinic's integrated approach. It offers a beacon of hope in the face of a rising threat, and its impact could be seismic if implemented more widely. As Katie puts it, 'I'm not better, but I'm healthier, and I can do a lot more.'
And with that, she's off to enjoy a well-deserved sandwich.
