This investigation for the Telegraph Magazine reveals how high-potency skunk has taken over Britain’s cannabis market - flooding NHS mental health wards with new cases of psychosis and destroying lives even in affluent families.

1. It accounts for up to a quarter of new psychosis cases. It triples the risk of hearing voices, delusions and erractic
behaviour. And it’s getting ever more potent… Martina Lees reports on the growing drug epidemic facing Britain

2. J
osie Laurent has lost not
one child, but two. Her
four-year-old daughter
died of a brain tumour;
now, cannabis-induced
psychosis has seen her son,
Henri, 24, sectioned for
the third time. ‘To all
intents and purposes, I’ve
lost Henri too.’
Laurent, 64, recounts
matter-of-factly how her
son– a budding young pho-
tographer – fell apart after
smoking super-strength
cannabis from the age of 15. The good-looking public school-
boy, ‘always immaculate’, threw away most of his clothes. He
shut himself in his room for 20 hours a day. Stopped going out.
Stoppedwashing.Stoppedeating.Henribecamesothinthathe
wasatriskoforganfailure.‘Heheardvoices.Hehadagirlfriend
who never existed.’ He ‘pushed and shoved’ his mother;
brawled with his father and brother, now 25. ‘The brothers
don’t want to see each other. It destroyed my family.’
On a shelf in Laurent’s new Chelsea pied-à-terre, a collage of
family photos harks back to what once was: two happy boys,
so alike, fishing with their father near their holiday home
in France. Boxes still surround the kitchen table where we sit.
Laurent, a successful businesswoman, and her husband,
Pierre, 72, moved here two days ago, partly because the flat
has only one bedroom – leaving no room for Henri once he is
released from a secure psychiatric ward. ‘We would not have
him back, as he’s so disruptive.’
The council will place Henri in supported housing, but
‘they have no idea whether he will be able to get better, have
a job, have a normal life. He wanted to run an advertising agency
– that was his dream. There’s nothing left of his dreams now.’
For this, Laurent blames skunk: the highly potent form
of cannabis that, in a recent study based in south London, was
found to be responsible for a quarter of new cases of psychosis.
The LancetPsychiatry study found that smok-
ing it triples the risk of hearing voices, suffer-
ingdelusionsorexhibitingerraticbehaviour–
and using it daily increases the risk five-fold.
Neither privilege nor a happy family could
protect Henri. ‘It’s random as to whom it
affects,’hismothersays.‘Youcan’ttaketherisk.’
Breakdowns caused by skunk, like Henri’s,
aresoaring.NHSfiguresshowhospitaladmis-
sionsfordrug-relatedmentalhealthorbehav-
ioural problems have more than doubled over
the past decade to 82,000 a year. Most are can-
nabis-related:overthesameperiod,newcases
of adults treated for cannabis [WHAT?
RELATEDILLNESS?DEPENDENCY?]rose55
per cent – driven by under-25s.
Why this surge? It seems counterintuitive,
as drug use – from heroin to cannabis – fell by
a fifth over the past decade, to 8.4 per cent of
adults under 60. But ask those on the front
line and they pin it on two combined forces:
that cannabis has become up to five times
more potent, while mental-health services
have been cut back.
High-strength skunk has taken over Brit-
ain’s cannabis market. ‘There’s a sort of arms
race to develop more powerful cannabis
drugs,’saysSirRobinMurray,professorofpsychiatricresearch
at King’s College London.
In the 1980s, when cannabis was mostly smoked as dried
leavesorresin,ithadfivepercenttetrahydrocannabinol(THC)
– the active chemical that makes you ‘high’. But Dutch growers
started to cross-breed skunk, made from the flowering buds –
channelling the plants’ strength there, away from leaves and
stalks. ‘It’s now not unusual to be up to 25 per cent,’ says Tony
Saggers, who has just retired as head of drugs threat and intel-
ligence at the National Crime Agency, Britain’s FBI. Growers
createdmorethan100skunkstrains–‘somemorepsychedelic,
others more mellow and long-lasting’.
In traditional weed, cannabidiol (CBD) cushions THC’s
hazards, but the levels have plunged in skunk as THC rose.
Since 2008, more than 160 types of synthetic cannabinoids,
often collectively called ‘spice’, have been made in laboratories
to mimic THC. These have no CBD and were made illegal last
May. ‘They can produce really agitated and aggressive states
that you don’t see with cannabis. [Patients] are proving hard to
treat,’ says Derek Tracy, a consultant psychiatrist and clinical
director of Oxleas NHS Foundation Trust, which provides
mental-health services in south-east London.
Cuts to NHS mental-health services compound this: psychi-
atric beds have halved over the past 20 years to about 18,500.
‘We’ve cut to the bone and gone deeper again,’ Tracy says.
Meanwhile, many community drug services, funded by the
Government’s shrinking public-health grant to local authori-
ties, have shut down. The result? Instead of dealing with the
deep-seated problem of chronic skunk use, the only support is
the sticking plaster of anti-psychotic drugs on a hospital ward
forthemostseriouscases.Thefarlargergroupofcannabisusers
suffering anxiety or depression usually get no help at all.
‘If you don’t have medical insurance or rich parents, there is
nowhere to get residential treatment in London,’ says Louisa
Kulukundis,whocounselsprivateclientsfromtopLondonday
schools,aswellasyoungoffendersviacharitySteps2Recovery.
‘With both sets of clients, smoking skunk is so normalised,’
shes says, adding that both are ‘very unparented’, and both
suffer the same mental devastation.
‘It’s everywhere, but nobody wants to acknowledge it
because the schools are worried about their reputation, and
parentshavetodealwith,“MaybeI’mnotpresentenough”.Itis
something they are so ashamed of that it can’t be discussed.
Then the problem gets bigger and bigger.’
That stigma kept Eva Kelly, 21, from telling her doctors that
she smoked skunk after being admitted to the Priory for men-
tal-health problems at 17. ‘There’s a worry that they going to
judge you. You don’t want to admit to doing something you
know is illegal.’ Doctors only factored it into her care after her
father found her smoking and told them.
Kelly started smoking skunk at 16; a year later, she dropped
out of her A levels – despite having achieved seven A* GCSEs at
a private co-ed. At her exclusive London sixth-form, joints were
as common as cigarettes. ‘It’s easier to get hold of [cannabis]
than alcohol when you’re under-aged. Drug dealers don’t ask
for ID.’ Now a hotel manager, she gave up skunk after suffering
episodes of paranoia. ‘I ended up being affected much more
than I thought,’ she says.
But for Rupert Green it is too late: he killed himself in Janu-
ary, aged 21, after suffering psychosis that his family attributes
to his use of skunk. Rupert’s father, Lord Nicholas Monson,
spoke openly of the need for a ‘war on skunk’ – prompting The-
resaMaytotellhiminaletterthatshesharedhis‘concernsover
the use of skunk’. Families whose children have similar issues
have contacted Monson from around the country. ‘It is not a
black swan event. I seem to be in a field of black swans,’ he tells
me. ‘I don’t want it happening to any other young man or
woman. It’s like a wrecking ball smashing through the family
life. We grieve for what Rupert might have been – his mother’s
happiness was anchored in him.’
Rupert’s death highlights the growing impact of skunk,
amplified by cuts, on the NHS. Two weeks after being sec-
tioned last October, he was released from hospital. A nurse
later told his mother, Karen Green, that they had run out of
beds. In January, Rupert asked to be readmitted, frightened
byvoicestellinghimtokillhimself.Anurse‘didherdamnedest
to get him taken into any NHS hospital in that region. They all
refusedbecausetheydidn’thaveanybeds,’Monsonsays.Three
days later, Rupert disappeared into woodland at his grand-
mother’s home in Surrey and never returned.
AninternalinvestigationbySurreyandBordersPartnership
NHS Foundation Trust ‘did not identify any mental-health care
and treatment issues that might have led to a different out-
come,’ says Lorna Payne, its chief operating officer. ‘My heart
goes out to Rupert’s family.’ NHS data shows acute adult men-
tal health beds at the trust are 99 per cent occupied, while the
Royal College of Psychiatrists recommends 85 per cent.
England’s highest acute adult mental-health bed occupancy
is 106 per cent at Barnet, Enfield and Haringey Mental Health
NHS Trust, in north London. A source close to the hospital says
‘three-quarters’ of the patients on the acute psychiatric assess-
mentwardtypicallyhaveusedskunkorspice.‘Youusedtohave
a half-and-half mix of psychosis and things like depression and
anxiety; now you just have a ward full of people with psychosis
induced or exacerbated by cannabis or cannabinoids.
‘For every one you discharge, you get one coming back,’ the
source adds. Many don’t think they have a problem and lack
community support, so use again as soon as they are out and
‘relapsealmostimmediately’.Datashowshalfkeeponsmoking.
Barnet also loses the most bed days in England (31 per cent)
due to care transfer delays. The acute ward is not for long stays,
yet one patient was there for almost a year, the source says.
‘Finding accommodation for these people is what keeps them
in hospital the longest.’
Staying on a secure NHS mental-health ward costs £500 a
day,comparedto£130adayinacarehome.Patientsareincreas-
inglysenttoprivateprovidersatacostof£800adaytotheNHS.
Theanswer‘isn’tfront-loadinghospitals,’saysDerekTracy,but
making a long-term investment in community drugs services.
O
ver the 17 years that his son, Steve, 37, has lived with skunk-
induced schizophrenia, Terry Hammond, 70, calculates
the cost to the taxpayer as £420,000 – consisting of health-
care (£215,000), benefits (£132,000) and lost taxes (£73,000).
Stevehaslearnttolivewiththevoices,butis‘plaguedby indeci-
sion’ about the simplest things and can’t work, says Hammond,
a former regional director at Rethink, a mental-health charity.
With their daughter, Victoria, 41, her husband and two
children, Hammond and his wife Chris, 69, bought an eight-
bedroomhouseinLeicestershirelastyear,sothefamilycanlook
after Steve. ‘I’ve seen too many families where people with
schizophreniahavegoneindependent,andfallenintotheabyss.’
ForNeilSimons,38,ittook15yearstogethislifebackontrack
after 20 joints a day tipped him into schizophrenia. He had his
first puff aged 13, at the end of his school playing field in south-
east London. ‘You listen to music and it sounds better; you see
a film and you’re into it deeper,’ he says. ‘For me, it’s addictive.’
One in six cannabis users who start young become addicted,
according to a Lancet study. By his early 20s, Simons thought a
bug had been planted in his brain and ended up in hospital. ‘I’d
go for days without showering or brushing my teeth. Your
body weighs so much, you feel like you can’t lift your arm.’
Only once he accepted that he had to stay on
medication could he inch towards recovery. Still
livingwithhisfather,Simons now does voluntary
research for the NHS on mental health. ‘I’ve
wasted 15 years of my life. Do you want to lose 15
years? Everyone thinks, “Oh, it won’t happen to
me,” but skunk really does this.’
For years, scientists have contested whether
cannabis does, in fact, do this. Like a key that
fits in a lock, brain chemicals attach by shape to
receptors on your nerve cells – thereby activating
them.BecausetheTHCmoleculesincannabislook
likethoseofthebrainchemicalanandamide,they
can affect parts of your brain that have clusters of
these receptors. For example, it impairs your
reaction time while you’re high, doubling the risk
of a car crash. But does it cause lasting damage?
‘The data is moving the same way as smoking
and lung cancer,’ says Steve Moore, of the Volte-
Face drugs think tank. ‘Smoking doesn’t give you
lung cancer, but it raises the chances of getting it.’
Because we can’t yet fully model psychosis in
animals,thementalequivalentofpaintingtobacco
tar on mice to prove carcinogenicity isn’t possible.
However, there have been 13 epidemiological
studies worldwide, looking at outcomes for can-
nabis users 10 to 20 years on. ‘Eleven have shown
a significant increase in onset of psychosis in can-
nabisusers,andtheothertwohaveshownatrend
[towards it],’ Sir Robin Murray explains, adding,
‘we’re as sure as we can be’ that cannabis causes
psychosis.Resultsdon’tyetfactorinhigh-strength
skunk, as it ‘hasn’t been around long enough’.
The debate on cannabis law is highly charged.
‘The prohibition has created the problem. We should deal with
itbychangingthelaw,’arguesDavidNutt,professorofneurop-
harmacology at Imperial College and the Government’s former
chief drug adviser. Tony Saggers, on the other hand, says legali-
sationwouldnotstemtheswellintreatmentdemand.AndLord
Monsonwantsamiddleground:toreclassifyskunkfromaB-to
an A-class drug, but regulate and tax mild cannabis so people
can know exactly what they’re buying.
Murray, however, backs neither proselytes nor prohibition-
ists.Hefeelsit’s‘probablybesttowaitandlearnfromwhathap-
pens in the USA’, where nine states have legalised cannabis.
The real issue, he adds, is ‘the trend towards more potent vari-
eties of cannabis’. He argues that the public should be educated
on the risks – yet Britain’s new drugs strategy, published last
month, only mentions cannabis in terms of supply restriction,
not treatment or education.
Treatment staff, too, can view it as ‘harmless’ compared to
opiates, says Ian Hamilton, a lecturer at University of York who
previously worked as a psychiatric nurse. He says the surge in
cannabis treatment demand ‘seems to have happened under
the radar of the treatment sector and policymakers.’
‘Ifwerecognisethat we could getrid of25 per centofpeople
with psychosis if they didn’t smoke
skunk,’ Murray says, ‘that would make
the problem of psychiatric [shortages]
somucheasier.’HenriLaurent’s psycho-
sis was avoidable, his mother agrees.
‘This did not need to happen.’
Forhelp,contactsane.org.uk,rethink.
orgoractiononaddiction.org.uk.
NameswerechangedfortheLaurent
family,EvaKellyandNeilSimons.
The truth behind the much of Britain’s
home-grown cannabis is horrifying:
children as young as 11, trafficked
fromVietnam, are forced to tend
illegal cannabis farms in warehouses,
nightclubs and rented homes around
Britain.They sleep on the floor, squeezed
between plants and tangles of open wires
that can spark small fires, says James
Simmonds-Read, a Children’s Society
support worker for trafficked boys and
young men. Between watering the plants
in the morning and evening, they spent
hours ‘utterly alone’ with nothing to do.
Some describe ‘being locked in a room
where they starve without water for days’
if they make a mistake or the crop yield is
too low. Many suffer sexual exploitation
before they arrive; if they escape or are
caught by police, the teenagers are often
re-trafficked within 72 hours.
According to a National Police Chief’s
Council report, there is a ‘new trend of
cultivation sites being controlled
by white British organised crime groups,
which employVietnamese nationals
who are forced to work in cultivation’.
Over the past six months, there has
been an ‘alarming rise’ in boys and
young men who are charged, despite
having been held in modern slavery,
Simmonds-Read adds.
Patrick Burland, who holds a PhD on
human trafficking, says no one has ever
been charged in Britain with trafficking
people for cannabis cultivation.
Wherethecannabiscomesfrom
‘It’seasiertoget
holdofcannabis
thanalcoholunder-
age.Drugdealers
don’taskforID’
Josie Laurent at home
in south London
Skunk’sgrowthbynumbers
By 2008, the last time the Home Office
has recorded potency, high-strength
skunk made up 81% of cannabis seized
from the street – up from 15% in 2002.
Among new cases of under-25s in drugs
treatment, the share who have used
cannabis has more than doubled in the
past decade from 18% (3,300) to 43%
(5,000), Public Health England reports.
Among people with signs of cannabis
dependence, only 14.6% have ever
received any help or specifically for
this drug use, according to a 2017 report
by the drugs think tankVolteFace.
Cannabis, currently a class B drug,
was upgraded from class C in
2009, yet cannabis seizures have
almost halved since 2011.