‘i’d Run Down The Road Thinking I Was God’: Cannabis Users On Their Psychosis – And The Clinic Trying To Help Them

It’s 2 years since Isiah recovered himself connected nan tile of a southbound London shopping centre, astir to jump. “I was very done,” he says of that nighttime successful November 2023. “It felt location was nary different way aliases option. First, I did a locomotion astir everyplace important to me: superior school, secondary, college.” Then he headed to Lewisham shopping centre. “I retrieve my caput was telling me: ‘You’re astir apt amended disconnected doing this.’”

He was exhausted by his paranoia, which had grown successful tandem pinch a cannabis habit. Now 29, he first tried marijuana astatine 14, becoming a regular personification by 17. At university, studying arena guidance during nan pandemic, he smoked much “because this is really you meet people”, but remembers increasing “feelings of suspiciousness”, first towards his housemates, past to his workmates astatine a part-time agency job. He struggled to sleep, “started to isolate”, and cannabis became a measurement to cope. In nan end, smoking 3 joints a day, he felt he could spot nary one.

Boyish and smiley successful spite of his trauma, he is telling his communicative astatine nan monthly brunch group of nan Cannabis Clinic for Patients pinch Psychosis, surrounded by tables afloat of jelly sweets, fidget toys and colouring books, each designed to return users’ minds disconnected their cravings. Based successful Denmark Hill successful southbound London, this is nan only session successful nan UK – indeed, its founders believe, anyplace – to connection master “dual-diagnosis” support for adults pinch psychosis who are trying to trim their cannabis use.

That nan Cannabis Clinic stands unsocial successful tackling these issues astatine nan aforesaid clip seems remarkable, fixed nan links that person been established betwixt them. A 2019 study by King’s College London, published successful nan Lancet Psychiatry, estimated that crossed 11 locations successful Europe, 12% of caller cases of psychosis were linked to nan usage of high-potency cannabis (meaning thing consisting of 10% aliases much tetrahydrocannabinol, aliases THC). In London, wherever high-potency strains predominate nan market, nan fig was 30%.

A fewer miles from nan clinic, astatine University Hospital Lewisham, advisor Diego Quattrone, who runs nan psychiatric intensive attraction unit, says that astatine slightest 80% of caller admissions study cannabis use. He feels nan dangers of nan supplier are overlooked, adding that usage is “among nan strongest factors associated pinch unit earlier and during admission”. Meanwhile, “daily usage of high-potency cannabis” is associated pinch “a chopped subtype of unit driven by psychotic symptoms, specified arsenic paranoid delusions and hallucinations”.

Daria Semikina moving a group convention astatine nan Cannabis Clinic. Photograph: Christian Sinibaldi/The Guardian

It is not astonishing past that nan Cannabis Clinic, which useful intimately pinch King’s College London’s Institute of Psychiatry, Psychology and Neuroscience, reports accrued request for its services. It takes conscionable 16 group astatine a time, mostly men successful their 20s, offering them play one-to-one meetings for up to a year, lively play online support sessions, and nan monthly brunch group we are attending today. Patients connected nan waiting database (14 currently) are invited astatine nan brunches, and besides get regular reassuring telephone calls.

It was nan sheer persistence of 1 woman, Dr Marta Di Forti, a professor of supplier use, genetics and psychosis astatine King’s, that brought nan session into being, first successful a proceedings by nan Maudsley Charity, past pinch a committee from nan South London and Maudsley NHS instauration trust. She is its objective lead, and pinch 2 part-time practitioners has helped 90 group since nan NHS commission. Of those who completed nan clinic’s intervention, 74% person stopped using, and 91% of that group have gone backmost to acquisition aliases work. Di Forti is devastated that group are now waiting months for nan captious one-on-one sessions. Is it dangerous? “Of course,” she says. “It is simply a immense wasted opportunity. The chances of them getting a terrible position of their psychosis and needing infirmary admittance is betwixt 3 and 4 times greater.”

Isiah has been connected nan clinic’s waiting database for 2 months. Despite being taken to infirmary that nighttime connected nan tile aft an worker sewage to him “in nan nick of time”, and receiving therapy and medication, he still uses cannabis daily. Overall, he consumes little than he did, and his intelligence wellness has improved, but he is incapable to stop. No work has supported him successful tackling his addiction. Here, he has been encouraged to subordinate group sessions while he waits.

‘There were moments he could only conscionable astir spot me’ … Isiah pinch his mum, Nicci, astatine nan clinic. Photograph: Christian Sinibaldi/The Guardian

His mum, Nicci, 53, is pinch him, sitting close, her eyes revealing really drained she is. Isiah lives astatine home. She recalls his distressed calls from university. Later, he would show her that his workmates “were successful interaction pinch each other, trying to … harm him”. He had erstwhile been a fun-loving teen keen to return up acting. “I conscionable didn’t recognise my son,” she says. “There were moments he could only conscionable astir [trust me].” Both financially and emotionally, his wont haunts them. “He has to travel disconnected it,” she says. “Because it’s for illustration nan king. It’s ruling everything. It’s location each day.”

As we speak, 9 work users, predominantly young men, are creating “cravings boxes”, afloat of items to distract them erstwhile needed. This apparently lighthearted task exemplifies nan clinic’s stance of tackling nan applicable hurdles of withdrawal alongside psychological issues, each pinch arsenic small unit arsenic possible. Senior practitioner Jodie Lynn explains different approaches. “Sometimes we do role-play: really to person difficult conversations. Some group find it really difficult to group boundaries pinch their peers. And location are cannabis diaries: we get group to grounds erstwhile they’re having joints, really they were emotion earlier and afterwards – nan triggers.”

Sleep and dreaming look arsenic an important area. Heavy cannabis users typically ne'er dream. When dreams return arsenic they withdraw, they tin beryllium terrifying, which tin beryllium an insurmountable obstacle. “It’s conscionable astir supporting them done that,” says Lynn.

Many users perceive voices, often derogatory, harbour “grandiose beliefs” astir their spirituality, powers, moreover celebrity, and acquisition ocular hallucinations. One-to-one sessions tin beryllium online to activity astir these complexities. “We’re moving pinch group who mightiness beryllium a spot paranoid astir coming retired of nan house,” says Lynn.

No one’s psychosis is nan same. Aaron, 23, manipulates a achromatic fidget toy. He started smoking astatine 18 astatine assemblage and nan wont became 3 joints a day. He describes his psychosis arsenic “dissociation from reality”, “a disregard, for illustration apathy”. This resulted successful erratic behaviour that led to him being arrested. “I was large successful public, shouting, moving from police.” He was admitted to infirmary twice. It is 2 weeks since he past used.

‘My patients can’t get clasp of low-potency cannabis’ … objective lead Marta Di Forti (left, standing) pinch practitioners Daria Semikina and Jodie Lynn pinch (sitting) peer-support mentor Stacey and a student. Photograph: Christian Sinibaldi/The Guardian

Meanwhile, Kenneth, 31, observes everything intently. He is well-spoken, poised, but insular. His psychosis is dominated by sounds, which often look to travel from inanimate objects. From nan property 22 he utilized each day; now it’s “once aliases twice” a month. He was utilizing to “socialise, experiment”. To cope? “Without realising it,” he says. “I didn’t deliberation overmuch astir why until I came to nan clinic.” Making connections is cardinal here.

These young group are surviving successful a hotspot. A study successful nan Lancet Psychiatry successful 2019 recovered southbound London had nan highest incidence of psychosis successful Europe and identified cannabis arsenic a contributor. But though this portion of nan superior has a estimation for cannabis consumption, there’s much to this communicative than nan number of users.

Cannabis usage is declining successful England and Wales, according to nan Office for National Statistics, and successful London it is falling sharply: successful 2023-24 only 6.8% of 16- to 59-year-olds had utilized nan supplier successful nan erstwhile year, compared pinch 14% successful 2001-02.

However, Di Forti explains, those who do usage are doing truthful much frequently. She points to a ample study called Cannabis and Me, led by King’s and published successful BMJ Mental Health successful August. This questioned 3,389 erstwhile and existent cannabis users aged complete 18. “Fifty per cent were regular users and nan wide depletion of cannabis per week was 17 joints.” She says decreased cognition of harm is 1 imaginable reason, driven successful portion by nan accrued usage of cannabis for medicinal purposes. While nan NHS prescribes for a mini number of conditions, immoderate backstage clinics prescribe overmuch much freely. “‘If cannabis is medicinal it can’t beryllium excessively bad’: this is thing I get each nan clip from my patients …”

The precocious potency of modern cannabis is key. Forty years ago, dried leafage marijuana recovered successful Britain was commonly 3% THC. In London, skunk-like cannabis of an mean 14-16% THC accounts for 94% of nan thoroughfare market. “My patients will show you they can’t get clasp of low-potency cannabis moreover if they wanted to,” she says.

Di Forti’s hubby is Sir Robin Murray, a professor of psychiatric investigation astatine King’s. Talking shop is intelligibly difficult to avoid. “It does predominate our canine walks,” she admits. He describes nan business starkly: “I deliberation we are astatine nan beginnings of an epidemic.” He compares it to erstwhile glucosuria experts were “banging on” astir accelerated nutrient obesity successful nan 1980s. “We thought, ‘They’re conscionable exaggerating’ – and it turned retired to beryllium existent … As cannabis becomes much available, much potent, past we’re going to spot more, much and much psychosis.”

He cites an summation successful lower-level paranoia, too. “Those who are utilizing a batch are much apt to beryllium a spot paranoid. They’re not sufficiently paranoid to get admitted, but they’re sufficiently paranoid to quarrel pinch colleagues, to beryllium suspicious of friends, to conflict pinch their spouse.”

The session tin consciousness for illustration a mini bastion against this rising threat. Yet 20 minutes pinch Katie and you spot its powerfulness to alteration lives. The 46-year-old grew up successful attraction and was only 8 erstwhile she first tried cannabis. She was a regular personification astatine 12. “I was self-medicating pinch it for galore years,” she says.

She heard voices from a young age. “They’re very intrusive, commanding voices that usually show maine to harm myself aliases different group … to hit group up, stab people, to effort and termination myself.”

Smoking astir 20 joints a time by nan property of 20, she was past first admitted to hospital. “I was moving down nan Old Kent Road wearing fluffy pyjamas and thing connected my feet astatine 2am reasoning I was God.” In nan pursuing 2 decades, she was sectioned 50 times. For each nan medicine and support she received, nary of it was targeted astatine cannabis. Yet a twelvemonth aft uncovering nan clinic, she is now abstinent.

She still hears voices “pinging disconnected successful my head”, but tin unrecorded well. “My paranoia was truthful bad I couldn’t get connected a autobus aliases a train, could hardly get retired of furniture and time off my location astatine my worst … Now I’m present and everywhere,” she says. She is sleeping and eating again.

Hers is simply a seismic transformation. Implemented widely, nan clinic’s integrated attack could stem a tide. “I wouldn’t opportunity I’m better, but I’m a batch healthier – I’m capable to do a batch more,” she says. “And I’m dying for a sandwich!” At slightest location are plentifulness of sweets.