Two years after a rooftop crisis, a clinic offers a lifeline
Isiah’s story began with ordinary days that spiraled into a night he describes as almost unreal. “I’d run down the road thinking I was God,” he says, recalling a headlong descent into paranoia and fear that left him standing on a rooftop in south London in November 2023. What followed was a long journey through crisis, diagnosis, and, crucially, treatment that blended emergency care with long-term mental health support. His experience is not an isolated one. Across cities in the UK and beyond, cannabis-induced psychosis has become a focal point for clinicians who are grappling with how best to help people who smoke or ingest cannabis and then lose touch with reality.
Understanding cannabis-induced psychosis
Cannabis can trigger a range of psychiatric reactions, from acute paranoia and anxiety to full-blown psychotic episodes. While many users experience mild effects, others—particularly those with a family history of mental illness or heavy, prolonged use—may develop symptoms that demand urgent medical attention. Experts emphasize that cannabis does not simply mimic schizophrenia; in some cases, it acts as a trigger that accelerates underlying vulnerability.
Key warning signs include sudden mood swings, delusional thoughts, perceptual changes, disorientation, and, in severe cases, thoughts of self-harm or harm to others. The risk is not uniform; potency, method of use (smoking, vaping, edibles), and personal risk factors all influence outcomes. Yet one message runs through every story: early intervention can dampen the trajectory toward chronic mental health challenges.
From crisis to care: what a clinic can offer
The clinic model shown by Isiah’s experience blends crisis response with ongoing therapy, medication management, and social support. After stabilization in an emergency setting, patients are paired with a multidisciplinary team: psychiatrists, psychologists, nurses, social workers, and peer supporters who understand the complexities of cannabis-triggered symptoms.
Therapeutic goals are clear. Clinicians aim to reduce psychotic symptoms, minimize relapse risk, and help patients re-establish daily routines, employment, schooling, and relationships. Importantly, providers work with patients on cannabis use itself—recognizing that reducing or stopping cannabis can be a pivotal step in improving mood, cognition, and overall functioning.
Isiah’s pathway to stability
Isiah’s journey illustrates how hospitals and clinics can support young people through a difficult transition from crisis to recovery. After his rooftop moment, he entered a program that included pharmacological treatment to address acute symptoms and long-term psychotherapy to explore the interplay between substance use, stress, and mental health. Community-based support, including housing guidance and employment programs, helped him rebuild a sense of purpose and normalcy.
“It’s not just about stopping cannabis,” he says. “It’s about understanding why I used it in the first place and building strategies to cope when old habits threaten to return.” This sentiment echoes across many patient stories: recovery is less a single act than a sustained process, supported by access to compassionate, stigma-free care.
What this means for policy and practice
For clinicians, the challenge is to balance urgent safety with long-term well-being. This means ensuring adequate crisis care pathways, reducing delays in assessment, and providing continuous follow-up that integrates mental health services with social supports. For policymakers, the focus is on funding models that sustain community clinics, invest in early intervention, and facilitate reversible, non-stigmatizing approaches to cannabis use and mental health.
Looking ahead
As public conversations about cannabis continue to evolve, so too must clinical responses. Early intervention, tailored treatment plans, and robust community links can help people like Isiah move from sheer survival on a rooftop to a life grounded in stability and hope. If more cities invest in clinics that treat cannabis-induced psychosis with empathy and evidence-based care, the long arc of crisis can begin to bend toward recovery for many others who walk through similar doors.
Note: Names and certain details have been changed to protect patient privacy. This feature highlights real-world pathways to care for cannabis-associated psychosis in urban settings.
