The head of the only NHS clinic treating psychosis in cannabis users has called for more specialist centres to open as she revealed staff are forced to turn patients away on a daily basis.
Professor Marta Di Forti, lead clinician at the NHS Cannabis Clinic for Psychosis (CCP) in London, told The i Paper she has “no doubt” more clinics are needed having fielded calls from colleagues around the country asking for help.
Her plea comes as research found the clinic, based at the south London and Maudsley NHS foundation trust, offers a “feasible and effective treatment strategy” to help young adult cannabis users to significantly cut down and even stop smoking the drug.
The study, published in the journal BJPsych Open, analysed data from the first 46 patients who completed their treatment. At the time of their referral, 43 people (93 per cent) were using high potency cannabis, and 42 (92 per cent) were using cannabis daily.
Patients were given weekly one-on-one consultations with a mental health professional and access to an online weekly peer support group.
Following the treatment, researchers found that 34 people (74 per cent) stopped using cannabis, while 12 people (26 per cent) reduced the frequency and potency of their cannabis use.
Patients also reported reductions in their feelings of paranoia, delusion, anxiety and depression, as well as a “remarkable improvement” in their levels of day-to-day functioning, such as returning to studying or work.
The results suggest it could be used as a blueprint for other clinics elsewhere, the authors said.
Professor Di Forti, the study’s first author and the clinic’s lead clinician from the trust, said: “There is an assumption that cannabis is largely safe. The young people I see in my clinic represent a minority that are using cannabis in a harmful way to the point where it is impacting their ability to manage day-to-day life as a result of developing clinical psychosis with disabling paranoia and intrusive delusional thoughts.
“This study shows that, with the right kind of help, which uses a flexible and personalised model of care that combines expertise in managing psychosis and addiction, young adults with a psychotic disorder can be supported to decrease the regularity and potency of their cannabis use with clinically relevant drops in levels of paranoia, delusion, depression and anxiety – conditions that can all get in the way of someone thriving in their life.”
Professor Di Forti, a consultant adult psychiatrist and lecturer at King’s College London, decided to launch the clinic, which is funded by the Maudsley Charity, in 2019 after being overwhelmed by the number of psychosis patients with a history of cannabis use.
She said heavy cannabis use is the most preventable risk factor for poor outcomes among patients with psychosis, defined as when people lose some contact with reality.
Young adults with a psychotic disorder who continue to use cannabis are more likely to be readmitted to hospital, have shorter times between relapses, are more likely to be admitted compulsorily under the Mental Health Act, and are less likely to regain good function.
When asked what impact her paper should have on NHS policy, Professor Di Forti said: “I hope this paper will encourage Mental Health Trust across the country to develop similar services.
“I receive enquiries regularly from colleagues across the country asking for advice about care to adults with psychosis and cannabis use, as well as referrals from family seeking help for their loved ones.
“I have no doubts about the need for more Cannabis Clinics for Psychosis and our data show that such services can be developed even with minimum resources while still meeting the needs of those they care for.”
A spokesperson for NHS England said: “It is encouraging to see local NHS organisations create a service that addresses community needs – especially given that excessive cannabis use, contributing to psychosis, is known to negatively affect mental health and derail personal, social and financial prospects.
“Nationally, those struggling with substance use can get support for their mental health through community mental health support teams.
“If you or anyone you know is struggling, please speak to your GP surgery or reach out to your local mental health services online.”
In October, a KCL study became the first to suggest that the use of high potency cannabis – defined as having THC content of 10 per cent or greater – leaves a distinct mark on DNA, providing valuable insights into the biological impact of cannabis use.
The research also showed the effect of cannabis use on DNA is different in people experiencing their first episode of psychosis compared to users who have never experienced psychosis, suggesting there could be potential for DNA blood tests to help characterise those cannabis users at risk of developing psychosis to inform preventative approaches.
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