ITV News Social Affairs Correspondent Sarah Corker spent time investigating the impacts of heroin addiction in Middlesbrough
The North East of England has the unenviable title of drugs death capital of the country - yet a pioneering clinic for long term users is set to close as funding is cut.
The Heroin Assisted Treatment (HAT) programme in Middlesbrough, the first of its kind in England, treats addiction as an illness rather than a crime.
Long-term drug users, for whom traditional treatments have failed, are given free medical grade heroin (diamorphine) in a safe, supervised setting.
The idea is that the need for street drugs is removed, which then breaks the cycle of offending and cuts the flow of money and power to criminal gangs.
It also allows people to live less chaotically and reduces the risk of overdosing.
The service was set up three years ago, but the funding has been cut due to a disagreement among local leaders over who should pay for it - and ultimately whether it comes out of the crime budget or public health coffers.
Neither it seems, as the service is due to close within weeks.
James Fowler, 41, used heroin for nearly two decades. He credits the clinic for saving his life. After a troubled childhood, addiction followed.
'I don't want to come back out here and lose my kids, lose my life'
“I was born into a world of poverty and despair really. Family members dying of alcohol use,” he said.
“I remember saying to my dad that when I grow up I wanted to be a drug dealer. All that stuff looks good when you’ve never had anything else and that was the world I came from.”
He was just 11 when he first tried drugs. By 20, he was in the grip of a serious heroin addiction.
Homelessness, shoplifting and prison time followed. The personal cost was enormous.
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“I lost my kid, lost my home, lost relationships, my family disowned me. I thought I’d die on those streets.”
The HAT programme was his ‘last chance'.
Mr Fowler is one of 24 patients who have self-administered diamorphine twice a day under medical supervision since 2019. His doses were gradually reduced, and two years on he’s now drug free, working as a part-time chef and studying for a university course.
“It’s only been two years since I walked through the door to get clean after 20 years showing [my family] I’m a bad person who does all these bad things. They need to see I am not a bad person, that I’m better.”
'The way that we are trying to manage drug use personally, I feel we are failing'
The programme doesn’t work for everyone but at a time when Middlesbrough’s drug problem is playing out in plain sight, many here question why the HAT clinic is being forced to close.
It costs £12,000 to put a patient through treatment for a year. Opponents of the service have long argued that taxpayers money should not be spent on giving free heroin to drugs users - instead budgets should be focused on tackling the root causes of addiction before it spirals out of control.
South Tees Joint Director of Public Health Mark Adams said: “No long-term sources of funding have been identified to allow the pilot to be extended and the council is not in a position to commit further grant funding to the programme.”
Analysis of the first six patients to complete over six months of the treatment found that previously this group had committed 541 detected crimes, with an estimated cost to victims and the public purse of £2.1m.
In the 29 weeks since starting treatment their crime total fell to three lower scale offences.
Danny Ahmed, clinical lead for HAT, said: “Independent evaluation of the treatment has shown conclusively that it has met the aims it was set up to achieve.
“The decision to cease funding is extremely disappointing news and our priority is for the patients currently receiving treatment.”
In Middlesbrough you are more likely to die of a heroin overdose than in a car crash. Poverty breeds addiction. Traditional industries have declined, jobs disappeared and social inequalities widened.
'It’s going to get worse, more people will die over the winter'
At Sue Gill’s café for the homeless, in the Gresham area of Middlesbrough, most of her regulars have drink or drug problems, or both.
While we are filming, a man in his 30s stumbles through the door having just taken a cocktails of drugs. Sue knows them all by name and tells me most use drugs to dull the pain of past traumas.
The man gets a hot meal and a cup of tea, but Sue tells me that heroin in Middlesbrough is cheaper than cigarettes.
“You can buy a bag of heroin for £5. There are dealers on every corner,” she said.
This year, 10 of her regulars have died due to overdoses.
“They aren’t getting enough help. There’s a long waiting list for rehab already. It’s going to get worse, more people will die over the winter.”
For the ninth consecutive year, the North East has the highest rate of drug-related deaths of anywhere in England and Wales, with 255 deaths registered in 2021, equivalent to 104.1 per million people.