Emergency services have told Sky News they are dealing with a city-wide "epidemic" of violent psychotic patients hooked on a synthetic drug known as monkey dust.
The emergence of the illegal substance in Stoke-on-Trent and North Staffordshire over the last two years has escalated this summer with violent and psychotic episodes now almost a daily occurrence for police, paramedics and hospital staff.
While cities around the UK deal with former legal highs such as spice, black mamba and other drugs – increasing numbers of users in and around Stoke have become hooked on dust that they can pick up for as little as £2.
Exclusive footage from police body-worn cameras in the city shows a user jumping from the roof of a building and then immediately leaping to his feet and grappling with police officers.
In another video a man who had a bone protruding from a serious arm wound carries on fighting paramedics – the patient seemingly unable to feel any pain.
PC Rich Frost, a police response officer in the city, has become all too familiar with the risks of dealing with violent users.
When you are trying to restrain them it’s like you are dealing with someone who thinks they are the Incredible Hulk, the strength is unbelievable, he said.
Also referred to as MDPV, monkey dust stops users from feeling pain, leads to hallucinations and causes severe paranoia.
Users commonly believe they are being chased and often try to climb buildings, lampposts or lash out at anyone around them.
Among a group of users next to a hostel in the city we found 30-year-old Cherry who is homeless.
She explained she’d never heard of the drug before moving to Stoke-on-Trent.
Ninety percent of the people I know are on the dust, she said. They just lose their heads.
It’s bad… but you can’t do anything to stop it.
In a recent staff survey among staff at West Midlands Ambulance Service one paramedic wrote: Drove through Stoke two nights ago and it was something like a scene from the Living Dead.
It’s not becoming a problem. It’s already an epidemic.
The service which covers the whole of the West Midlands has recorded 178 incidents since April where monkey dust was logged as part of the call – 131 of those calls were in North Staffordshire.
Senior paramedic Ann Armstrong, who has worked for the service for 16 years, told Sky News there have been some very volatile situations.
You just don’t know what they will do… I’ve had one trying to set my trousers on fire as I was treating him, she said.
It is an epidemic and something needs to be done.
The effects of the drug can last two or three days meaning patients require protracted after-care to ensure their safety.
It means police, hospital and mental health services are all devoting significant time, resources and money in picking up the pieces.
The most serious cases get taken into The Royal Stoke Hospital Emergency Centre where consultant Dr Chris Pickering said the first patient that spat at me was on monkey dust.
We used to see drugs of recreation, we are now seeing this as a drug of abuse, he said.
The only way to calm them is sedation and we are talking massive doses… anaesthetic-type doses to allow them to start to come down.
Staffordshire police have been carrying out raids to seize monkey dust but cannot yet say where the supply is coming from.