A senior government drug advisor has been drawn to a small town in north-west England, at a time when alcohol and drugs are killing more people than ever. Birkenhead is trying to find a way to help addicts and save lives.
Mike looks professional in his grey suit and white shirt. The 28-year old isn't at college or university on graduation day. He has just completed the last stage of the recovery academy. Mike is now 443 days sober.
In his late teens, he began to drink heavily and developed a destructive relationship with cocaine and alcohol. It got worse when Margaret, his mother, discovered that her breast cancer had spread elsewhere in her body. She wouldn't survive.
Mike says that "when Mum died, everything just kind of fell apart." Mike says he ended up in a dark, sinister place and calls it "the madness".
"I felt like I was in my movie because I was the star when I was drunk. The ego. Obsessive Mike. Controlling Mike
He would eventually lose his home, job, and relationship with his son and partner. He almost lost his liberty.
He was taken into police custody on February 2020 for alleged bodily injury. He realized that he needed to make a change in his life in order to avoid being sent to prison while in custody.
"I was destroying people who loved me and cared about me. But I was also destroying my own self."
Mike was fortunate that the police did not charge him. Instead, they gave him a leaflet about a local support service for drug and alcohol abuse. Mike knew the Wirral Ways team because he had quit drinking four times previously. He felt that this time it would be different, and he got in touch.
Birkenhead is quickly becoming one of the most popular places in England to receive addiction support. Local organisations have made a significant change in the way they collaborate and now form a "recovery community".
The "village" is an amalgamation of existing services and organizations that are all located within one mile. Now they have come together to provide coordinated support for those who are undergoing treatment. It covers education, employment and health services as well as housing and support groups for rehabilitation and recovery.
Mike points out a row of bars and pubs across the street, and recalls his days on cocaine and beer. He met us at Nightingales Cafe, a place that has been helping him get sober.
"It all depends on which side you choose to go, doesn't that? He says. "I have flashbacks of me being kicked out of one the pubs because I'm too pissed."
Nightingales is a cafe that Wirral Ways runs. Here you can grab a cup of coffee and a bite, meet new people, and receive support. The Cafe staff are all on their own addiction journeys and want to get back to work and give back to the community.
There are also specialist services upstairs. There are support groups, courses, and an intensive rehabilitation program. Staff can also give practical advice on housing and employment. Mike received the support he needed.
Nightingales' upstairs session leaders have firsthand knowledge of addiction. It is about honesty and reflection, not forgetting the past or living with regret.
Recovery addicts must find their core values, and be open to the pain and destruction they may have caused.
One woman says that she used to drink a lot of wine on her way home from work, even though she lives only five minutes away. A man on the other hand explains how he is in a better place than ever before. "On the surface, it seems like I have lost everything. But this place has saved me and given me direction."
Meetings like these are about believing in people and meeting their specific needs. They also help them give back to the community. Andrew Cass is services manager at Wirral Ways. He is part of Change Grow Live, a national organisation.
Birkenhead has many people who are in need of this kind of support. The 1980s recession ravaged the town. The shipyards collapsed and the unemployment rose, heroin took root.
"Young people didn’t see a bright future. Andrew says that Birkenhead was one of the first places where [the national] heroin epidemic began."
Birkenhead's geographical location has made the problem worse. It's like an island, surrounded by water and a motorway. The River Mersey can be seen on one side and Liverpool's iconic skyline is visible in the distance. The M53 acts as a barrier and separates the town from the Wirral's wealthier suburbs.
Andrew moved to the "recovery community" concept because of Birkenhead's socioeconomic complexities. Jennifer, a recovering addict, believes that the open-door policy is crucial. She works at the Spider Project, which provides training and activities such as pottery and drama to drug and alcohol addicts.
"It's not the worst thing to have doors shut on you. Many of us have experienced doors being shut constantly. We won't kick someone out if they are still using [drugs]. We will make sure that they receive the help they need."
Recent statistics show that more people are dying from alcohol and drugs than ever before. More than 4,500 people were poisoned in England and Wales in 2020. This is the highest death toll since 1993 when records began. It also represents an increase of more than 60% compared with 2010.
Senior government advisor, Dame Carol Black, described last year the state of addiction support in England as "not fit to purpose". She highlighted decades of underfunding, depleted services, and a discredited workforce in an independent report.
Dame Carol was able to convince the government to provide PS780m funding. This is less than she requested, but enough to allow for innovation and change in treatment services.
"If people are given good treatment and recovery programs, we know that murders decrease, acquisitive crimes [when offenders gain materially] go down, and fewer people end up in prison.
Although it may seem like a lot, the new funding is only a fraction of what drugs cost England every year.
"The cost of drug addiction is currently at PS19.2bn per year, compared with PS780m [of funding]. She said that she believes this is a very good equation.
Birkenhead was the first place where the "village" concept was developed before Dame Carol's Report. They believed they were on the right track.
We see Mike again in September 2021, a few months after his father Kevin passed away. It would have been Margaret, his mum's 68th Birthday. To place at her grave, the family will have flowers, cards and balloons. Mike reads the message he wrote for her.
"I know that you are helping me along the right path and I am proud of you. You are so loved by me. You will be greatly missed.
Mike takes out a photograph taken the day she died. Mike's dad is seen in the photo. "It's likely that I'm under the influence there. There, I'm so thin. My entire life was about drinking and using.
Mike shared the news that he had been offered temporary support for addicts at Wirral Ways. Kevin proudly says that he has done a great job.
But Mike and Hannah, his girlfriend, say that it has been a difficult few weeks. Mike is still struggling with his recovery. Although he hasn't turned to drugs or alcohol, he feels very low.
It has been a stressful summer. He would like to see his son more. It has been difficult for him to live in a home with alcohol. His dad also admits that he has a problem with alcohol.
Mike and Hannah, however, have a plan.
A tall, thin, and bookish-looking man walks down Market Street in Birkenhead to make a scheduled appointment at Wirral Ways. Tony, a 58-year-old man who has been addicted to heroin for almost 40 years, is a survivor from the 1980s drug epidemic that decimated the town.
"We feel love, hate and respect like everyone else. We're human beings. He says that most drug addicts have a reason for being addicted.
Tony is suffering from paranoid schizophrenia. He is currently under the care and supervision of a community psychiatrist nurse. Tony claims that his condition was caused by the death of his parents as a teenager. He also says that heroin helps him to manage it.
He has been refusing to take any street heroin he might have purchased over the past week. He says, "It's murder." But he insists that he will show his doctor that he has a problem with drugs and continue to receive his weekly prescription of methadone (a medical substitute for heroin).
Birkenhead's "joined up" approach to medicine allows for the prescription to be approved. However, Tony can also talk about his mental health during the appointment. John, Tony's psychiatrist nurse and key worker, works alongside the doctor to help him navigate the many services offered by the "village".
Tony invites us into his apartment - it's small, clean, and tidy. There are music keyboards, synthesisers, and a whiteboard with quantum physics equations that he has written on. He has professional-quality photos that he took.
"I am mentally ill. That is a fact. I can look normal and act normal. He admits that he struggles to accept reality at times. He admits that there is stigma associated with being an addict with mental illness. "I am called a crackhead and a junkie." Although it's not pleasant, it's all part of my identity."
The worst thing is loneliness. I sleep alone. I am the only one who wakes up. I don't like women. I've got no self-confidence. Therefore, I am only single. This is the best policy I have."
Tony visits Tony again and suddenly feels the need for a "fix". He also smokes heroin during our visit. He insists that he is not ashamed, as the strong odor of heroin fills the air. Is he not aware of the dangers associated with heroin?
"Ofcourse I do, yes. It could even kill me. It could even kill me."
He said that he is grateful for the professional support he gets.
Is Tony a failure because he continues to use heroin? Is he a failure of the "village?"
John, a key worker who has been helping Tony for over five years, doesn’t believe so. He believes success doesn't depend on how many people have stopped using drugs or drank. It's about understanding that addiction can be a chronic disease that requires long-term support.
Tony was one example. He had smoked crack cocaine. It was threatening Tony's life. John believes that this was a significant step forward. He says that as long as he doesn't use [drugs] every day - and his whole life isn't falling apart in front of him – I believe he is sustaining it."
You can contact BBC Action Line if you are affected by any of the issues discussed in this article.
Mike and Hannah made a huge step forward in early December. They found a place to rent. Mike gives us a tour.
He shows us his bedroom, which he is preparing for their son. Mike is already looking forward to his return and has begun seeing him once again.
Hannah said that Mike is improving all the time, and is less stressed now that they have their own place. Mike said he enjoys his job at Wirral Ways' rehabilitation centre. "I can help people like myself. It's a very privileged position.
A trendy coffee shop is just around the corner from Mike's office. Companeros is a refuge for many, and it's funded by the NHS.
Anyone who feels they are in a mental crisis can enter the room.
You can get help right away from the experienced staff, many of whom have suffered from mental illness. Even if they are unable to talk to you immediately, you can still stay and try to relax, or even take part in group activities such as yoga, music discussion, or creative writing.
It is hoped that it will reduce pressure on A&E as well as other services.
Rob, in his 40s, was at rock bottom and Companeros had already helped him. He would drink every single day. "Parts, my family, and my circle of friends don't get it. They understood how close I was... they got it.
Companeros saved his own life, he claims.
Joe Ackland, Cafe Manager, is proud of the achievements made in just a few short months. "This place is safe and people feel heard. "I'm honest with you, I wish these cafes were all across the country," said one of my friends.
It's March 2022, and Dame Carol Black wants to see the joint-up work firsthand.
In the Nightingales Cafe, she meets Mike. He has already faced some of the most difficult realities of his addiction. He proudly declares that he is sober and clean for the past two years. He claims he is now a peer mentor to former addicts who help them. Carol highlights this essential support role in her report.
"I have a passion for this, and I want to help people."
Dame Carol's smile turns brighter as she looks at it. She exclaims, "Fantastic!"
Dame Carol is thrilled by the Birkenhead experience - she describes it as "a real attempt to recovery" and not just treatment.
"I just hope people who have been treated like lepers are now treated as people with a medical condition."
Mike is aware that he is still on the journey of his life.
"I am extremely happy. Not depressed. Although I lost a lot of my possessions to drugs and alcohol, there are many things I am rebuilding."
Photographs by Emma Lynch and Stephen Fildes
