Lisa used to be married. She had two jobs and was a mum to five kids. She calls it her normal life.
Now there’s only one thing on her mind. It’s all Lisa has been thinking about since she woke up.
Heroin.
Sitting in a friend’s house, she unwraps the foil carefully. “0.2g in weight, £10 in money,” she says, her eyes fixed on the brown powder. Reaching for a syringe, she wipes away a tear.
Staring straight at the heroin, she admits: “I put it before my children.”
We have no idea where Lisa got the money for her latest fix, or where she bought it from. We don’t ask.
In complete silence she unwraps the foil, reveals the brown powder, and gets the syringe ready. Next the injection - she’s breathing heavily as the heroin courses through her veins.
After a while, her eyes drop. She has a moment in her own world.
This is Lisa’s life. It’s the same routine day after day. And in a few hours, she’ll be searching for more.
Lisa calls it “rattling” - the feeling she has without heroin. “Legs aching, body sweating, hallucinations, diarrhoea, sick.” And in that moment what does she need more than anything?
“Brown powder to put everything right, automatic fix.”
The desperation never ends. Even with her prescription of methadone, which is supposed to be a longer-acting substitute for heroin, to help addicts stabilise, she still craves the real thing.
Lisa’s life has been this way for 12 years, on and off. She shakes her head as she describes the panic of waking up every morning addicted to heroin.
It controls everything. Being an addict is a full-time job
Lisa
“I think, 'Where am I going to find the money today to score?' Money to get a bag [of heroin] to get myself better.”
“It controls everything, it controls every part of your day,” she says. “It is a disease, all of addiction is a disease.
“I said to the woman at the job centre I haven’t got time to get a job - being an addict is a full-time job. It’s ridiculous.”
As Lisa talks she looks down, mumbles. Her face is hollow, gaunt - the effects of years of addiction. She describes how she ended up here. She faced violence and, struggling to cope, she turned to alcohol, heroin, and then the final despair.
“I lost my oldest daughter and I’ve been on it ever since. I haven’t really dealt with her death - I’ve just buried my head in the sand.
“People that don’t know me might find it hard to believe that I had a normal life. I would want nothing more than to have a boring life again, just to wake up in the morning and have it all back.”
The place that Lisa calls home for tonight is a mess - the laminate flooring pulled up like scattered jigsaw pieces, plates with uneaten food left on the table.
Her friends get high in the kitchen. It’s mostly cannabis - one laughs and shows off about £10 worth. “There’s weed everywhere, a lot more [than cannabis] as well.”
They’re getting ready for a Friday night out. Some drink white wine, others smoke cannabis. There’s a fire burning in the back yard - thick black smoke billows, and there’s an overwhelming stench of burning rubber.
But in the middle of all this, there are signs of normality. A pet dog wanders, looking for attention, and heart-shaped family photos stare out from the mantelpiece.
Lisa now sofa-surfs. She’s staying with her best friend, but she wants something better.
“It’s not easy, it’s a fighting battle, it’s a stigma that goes with it all, it’s really hard to get that first foot in the door, to get the strength and support.”
The North East, where Lisa lives, has the highest rate of death from drug misuse in England and Wales, but here radical change could be on the way.
County Durham’s police and crime commissioner has made tackling heroin addiction one of his priorities. Ron Hogg wants to bring in a form of heroin-assisted treatment - centres to give long-term addicts medical-grade heroin on prescription.
For some it’s highly controversial, but Lisa says it offers people like her hope.
She allows us to be with her and film while she’s shooting up. Why? Because she wants change, she wants people to see how addicts like her live and how they inject street drugs - without any idea of their purity or safety.
Heroin was the drug feared most in the 1980s. There was an epidemic. Remember Grange Hill and Zammo’s Just Say No campaign?
Adverts on TV warned that “heroin screws you up”, with young actors standing in dank, concrete stairwells and listing the dangers. Some now refer to the “Trainspotting generation” after Irvine Welsh’s story of addicts in Edinburgh.
A 1987 health education campaign on the dangers of heroin
But now the number of deaths from heroin are at the highest level since comparable records began.
In the past five years death rates have doubled in England, Wales and Scotland.
On average in 2016, every five hours someone died after using heroin and/or morphine.
The government says the reasons behind the increase are complex and highlights an ageing population of heroin users who first started using in the 80s and 90s. These addicts are now more susceptible to overdoses after decades of physical and mental health conditions.
But critics point to the effect of budget cuts on treatment services.
From 1993 to 2000, heroin and morphine deaths in England and Wales rose dramatically. Then they slowly declined.
But in 2010 death rates started to rise sharply again.
There has been a fundamental change in how drug treatment services are organised. Before 2012 they were jointly commissioned by the NHS and local authorities, but the Health and Social Care Act changed this.
The new law made local authorities solely responsible for commissioning drug treatment and their spending was no longer ring-fenced.
With reduced central government funding, councils were having to make savings across the board. That meant cuts.
The government’s Advisory Council on the Misuse of Drugs (ACMD) warned this year about funding of drug treatment falling.
The ACMD said if resources were spread too thinly, there could be increased levels of blood-borne viruses, drug-related deaths and drug-driven crime.
“A lack of spending on drug treatment is short-sighted and a catalyst for disaster,” said Annette Dale-Perera, who chairs the ACMD’s Recovery Committee. “England had built a world class drug treatment system, with fast access to free, good quality drug treatment.”
The government says every drug overdose death is a tragedy and that it has made it easier for addicts to receive naloxone, a medicine that reverses the effects of a heroin overdose.
“Since 1 October 2015, a regulation came into force to make this life-saving medicine more widely available."
Lisa is no stranger to death. In her small County Durham town she has lost many addicted friends over the years.
“There is loads, aye there’s loads… at least 20,” she says.
Lisa is typical of the kind of people who are at risk of dying from heroin overdoses. Long-term users in their late 30s, 40s and even 50s.
The problem north of the border is even more acute than in the North East.
According to National Records of Scotland, there were 473 deaths related to heroin or morphine in 2016 - more than double the figure from 2011.
Any heroin or crack addict not in a treatment programme commits crime costing an average of £26,000 a year, according to Public Health England.
The annual cost in England of looking after children of drug-addicted parents is more than £42m. The cost of drug misuse to the NHS in England is £488m every year.
In Switzerland, heroin-assisted treatment has been credited with reducing burglaries by half.
And the programme has deprived criminal gangs of funds as users stop buying illicit heroin for themselves.
Four police and crime commissioners, including Mr Hogg, have told the BBC that in the right circumstances, they would be in favour of decriminalising illegal drugs including heroin.
Seven PCCs have said they would consider or support heroin-assisted treatment. The Mayor of Greater Manchester, Andy Burnham, has said heroin treatment centres could be another tool in providing support for users.
The government says that since funding decisions for drug treatment are now made by local authorities, the power lies with them to find the best ways of helping addicts.
Change might come first in Scotland. Glasgow Health and Social Care Partnership has said plans for heroin-assisted treatment have been confirmed in principle.
They also want to provide what’s called a consumption room or safe injecting facility (SIF), a place where addicts can bring their own street heroin and inject safely. The Home Office opposes this, saying SIFs are likely to lead to a range of criminal offences being committed and that they are costly to run and divert money away from better treatment options.
There is small but growing support for heroin-assisted treatment clinics among local politicians and PCCs across the UK but with the potential controversy, it seems many are waiting for someone else to set up the first permanent programme.
Despite the government’s supportive tone, many politicians are wary, worried about the headlines. And they will have to find the money themselves at a local level out of stretched budgets. It takes a big financial commitment to set up a heroin clinic. The proposals in Durham are yet to go before the council for a decision.
So Lisa carries on with her street heroin. The only constant in her life is her addiction. Her previous life, she says, is a blur.
“I don’t know who that person is now,” she says. The heroin is in control. “I’m not the same person I was.”
On our final day with her, Lisa is feeling positive. She hopes her part of County Durham will get a heroin treatment centre sooner rather than later.
We spoke to addicts in Durham who thought heroin-assisted treatment wouldn’t work for them and feared it would prolong their addiction. But Lisa believes it would give her a second chance.
“It would mean everything. I could actually start living again without having to start running about like a headless chicken to try and sort my day out. By the time I do get sorted, it’s time to start all over again. That’s all every day consists of, there’s nothing else.”
We leave Lisa as she walks into town to pick up fresh needles and syringes for her next hit. She’ll soon be shooting up alone, risking everything for heroin.
“People that don’t know me might find it hard to believe that I had a normal life”
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Warning: Depictions of drug use
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