Cancer treatment, four day weeks and cannabis: how London became the ultimate testing ground

‘If I could go back and press reset, I would,’ says Daniel*, 30. ‘If I could go back to 16 I would tell myself, don’t get into weed.’ In south-east London, another new trial that could shake up the way young people are policed is expected to be underway this month. The pilot would target 18- to 24-year-olds, sparing them from arrest if they’re caught with small quantities of cannabis. Instead they’ll be offered ‘deferred’ arrests pending the completion of an eight-week course on the dangers of drug use, similar to those doled out to speeding drivers.

A previous drug-diversion scheme by Thames Valley Police found that 80 per cent of young offenders completed the course offered. Critics have voiced concerns that the programme could lead to decriminalisation, but Sadiq Khan told Sky News that the scheme is simply an acknowledgement that ‘we’ll never be able to simply arrest our way out of the problem’. Instead, educating and supporting young people, ‘rather than putting them through the criminal justice system’, could lay a path for a safer future.

Daniel agrees. Now a personal trainer, in his early life he was arrested for being in possession of a tiny amount of weed (‘literally, less than a penny’s worth, probably’) during one of many times he was subjected to stop and search, and spent time in prison for a separate offence. This pilot taps into something bigger, he says — black people are nine times more likely to face stop and search, and 12 times more likely to be prosecuted for cannabis possession.

‘I know a few friends who also got a criminal record like me; it sets you back, for years potentially,’ says Daniel. After his time in prison he spent years flitting from job to job, eventually spiralling into a severe depression. ‘Everyone is different, but for me it [weed] changed my mindset and influenced the choices I made. If I’d have been offered that course, I would have done it. I’m not saying it would have 100 per cent changed the outcome. For some, it won’t. But if it’s there for the young people who want help, just to allow them to think about things a bit more, then that’s a really good thing.’ With vital support from his family and after rediscovering his love of exercise, Daniel was able to begin to manage his depression and find a career, too.

Figures released by the Office for National Statistics showed that one in five adults self-reported experience of depression early last year, compared with one in 10 before the pandemic. Late last year, National Institute for Health and Care Excellence (Nice) draft guidelines changed the organisation’s position on offering SSRI antidepressants as first-line treatment, instead suggesting a ‘menu’ of options such as cognitive behavioural therapy and exercise should be prescribed to patients with new presentations of depressive disorders. What they failed to address, according to commentators, was lack of access in an already stretched health care system.

‘One of the limiting aspects at the moment is availability of therapists,’ explains Dr Carol Routledge of Small Pharma . ‘The number is not high enough to deal with the demand.’ Routledge is heading up a trial currently in its second phase in east London, using DMT-assisted therapy to treat depression. DMT — or N,N-dimethyltryptamine — is a hallucinogenic tryptamine drug with similar psychedelic properties to LSD or magic mushrooms.

‘The psychedelic experience is part of the therapeutic mechanism behind the drug — though it is very short in DMT, which offers more clinical flexibility.’ The idea is that, while SSRIs don’t modify neural connections, psychedelics are able to both infiltrate or suppress ruminating negative thought processes, while also stimulating serotonin receptors. ‘They increase brain plasticity,’ Routledge continues, ‘and that also means that those neural connections are more modulating — there’s an increase in connectivity and the formation of new connections. That helps the mind to become much more receptive to therapy.’

In short, trials like these — there are several, including a pioneering research project at Imperial College Healthcare NHS Trust — could revolutionise the way we treat depression, notably by reducing the amount of therapy (often a long, costly process) we need to enter recovery.

Similar opportunities in medical care are being found in Proton Beam Therapy (PBT), an innovative type of radiotherapy that is so highly targeted that it reduces the risk of damage to surrounding healthy tissue in cancer patients. A new centre at UCLH has gone some way to democratising access to this treatment, usually most suited to children and young adults, which was previously only available at one centre in Manchester in the UK, while the majority of patients had to travel abroad to undergo PBT.

The centre, which, UCLH’s Dr Yen-Ching Chang tells me, has been meticulously designed to be ‘patient-focused’, down to providing a kitchenette for families staying over during treatment, opened this month and sees 650 patients per year. ‘What is really exciting is that now London is able to attract the brightest minds in radiotherapy physics — radiographers who really want to do something special now want to come and work with us.’

For PBT, this is just the beginning — and, for the many other tests and trials that London is serving as a sort of guinea pig for, any long-standing change will rely on a shift in collective ideology. Universal basic income, for instance, an idea that has been on the agenda of Jeremy Corbyn, has also been piloted recently in London — and beneficiaries are calling for it to be rolled out across the UK.

In 2022, there’s a lingering sense that London’s eyes are open. Across the city, new ways of thinking are leading the charge for a reimagined world, where we’re all a little safer financially, work is more balanced, care replaces criminalisation and health care sees essential reform materialise. Isn’t it time we asked, what if?

*Some names have been changed