At a time when deaths from drugs and alcohol are at an all-time high, a town in north-west England has caught the attention of the government’s senior drug advisor. Birkenhead is trying a new way to support addicts and save lives.
Mike looks smart in his white shirt and pressed grey suit. It’s graduation day – but the 28-year-old is not at college or university. Instead, he has just finished the final stage at the recovery academy. Mike is 443 days sober.
His destructive relationship with alcohol and cocaine began in his late teens with nights out drinking. But it got worse aged 23, when his mum Margaret found her breast cancer had spread to other parts of her body. She would not survive.
“When Mum passed away, everything just sort of fell away,” says Mike. He ended up in a nasty, sinister place, he says, describing it as “the madness”.
“I felt like I was in my own movie, because I was [the star] when I was drunk. The ego. Obsessive Mike. Controlling Mike.”
He would eventually lose his job, home and relationship with his partner and young son. He also nearly lost his liberty.
In February 2020, he was arrested on suspicion of actual bodily harm. It was while in the police cell he realised he had to change his life to avoid ending up in prison.
“I was destroying people who loved and cared for me, but I was also destroying myself in the process.”
Fortunately for Mike, the police didn’t charge him – instead officers gave him a leaflet for a local drug and alcohol support service. Mike already knew the team at Wirral Ways, as he had stopped drinking four times before. But this time, he felt it would be different and got in touch.
Birkenhead is fast becoming regarded as one of the best places in England for addiction support. Here, local organisations have completely changed the way they work together and are now all part of a “recovery village”.
The “village” is a range of established services and organisations – which are all based within a square mile – now they have come together for the first time to give coordinated support to those in treatment. It includes education, employment, health services, housing, support groups as well as recovery and rehabilitation.
“That place is the devil,” says Mike, pointing at a row of pubs and bars across the street and remembering his nights on beer and cocaine. He has met us outside Nightingales Cafe – a place that’s been front and centre helping him get sober and off drugs.
“It depends what side of the street you want to be on, doesn’t it?” he says. “I get flashbacks to me being kicked out [of one of the pubs] because I’m too pissed.”
Downstairs at Nightingales, run by Wirral Ways, you can get a coffee and a bite to eat, make friends and get support. Cafe staff are on their own addiction journeys, getting back into work and giving something back to their community.
Upstairs, there are more specialist services. An intensive rehabilitation programme, support groups and courses – as well as staff who can give practical advice with housing and employment. It is where Mike got the help he needed.
Those running upstairs sessions at Nightingales come with first-hand experience of living with addiction. They know it is about honesty, reflection and encouragement – not about wiping out the past, living with regret or forgetting.
Recovering addicts are challenged to find their core values and accept the hurt and destruction their actions may have caused.
“I used to neck a bottle of wine on my way home, even though I only live five minutes from work,” says one woman – while a man explains how he is probably in a better place than he has ever been. “On the face of it, I’ve lost everything – but this place has saved my life and given me a new direction.”
Meetings like this are about believing in people, meeting individuals’ specific needs and helping them give back to their community – says Andrew Cass, services manager at Wirral Ways, part of national organisation Change Grow Live.
There are plenty in Birkenhead who need that kind of support. The town took the full force of the 1980s recession. As the shipyards failed and unemployment rose, heroin took hold.
“Young people didn’t see a future. Some estates in Birkenhead were among the first places where the [national] heroin epidemic started,” says Andrew.
Birkenhead’s geography has compounded the problem further. It is like an island – encircled by water and a motorway. On one side, there is the River Mersey with Liverpool’s recognisable skyline in the distance. On the other, the M53 sweeps around like a barrier, separating the town from Wirral’s more affluent suburbs.
Birkenhead’s socio-economic complexities were part of the reason why Andrew moved towards the “recovery village” concept. The open-door ethos is important, says Jennifer, a recovering alcoholic working at another local organisation – the Spider Project – which offers training and activities, such as music, pottery and drama, to addicts who have stopped taking drink or drugs.
“There’s nothing worse than having doors closed on you. A lot of us, we’ve experienced doors constantly being closed. Even if someone is still using [drugs], we’re not going to kick them out. We’re going to make sure they get the necessary help.”
Latest figures show more lives are being lost to drugs and alcohol than ever before. In 2020, more than 4,500 people died from drug poisoning in England and Wales – the highest number since records began in 1993, and up more than 60% on 2010 figures.
Last year, across England, support for addiction was described as “not fit for purpose” by senior government advisor Dame Carol Black. In an independent report, she highlighted decades of underfunding, decimated services and a shattered workforce.
Dame Carol managed to get the government to commit to £780m of funding – less than the £1bn she requested – but still enough, she argues, to bring innovation and change to treatment services.
“If you get people into good treatment, and good recovery programmes, we know from research in this country, murders go down, acquisitive crime [when offenders gain materially] goes down, and less people go to prison.”
While the new funding may sound like a lot of money, it is a small fraction of the amount drugs cost England each year.
“The total cost of drug addiction at the moment is £19.2bn a year – compared to £780m [of new funding]. I think that’s quite a good equation,” she said.
In Birkenhead, the “village” concept was created before Dame Carol’s report came out. They felt they were already on the right path.
We meet Mike again a few months later – in September 2021 – at the family home he shares with his dad, Kevin. It would have been his mum Margaret’s 68th birthday. The family has cards, flowers and balloons to put by her grave. Mike reads us the message he has written for her.
“I know you are guiding me on the path I’m on and I hope you are proud. I love you so much. You are sorely missed.”
Mike picks up a photo taken on the day she died. In it, Mike’s arm is around his dad. “I’m probably under the influence there, believe it or not. I am so thin there. My life was just drinking and using.”
Mike shares news that he has got some temporary work supporting addicts at Wirral Ways. “He really has done marvellous,” says dad Kevin proudly.
But despite that, Mike and his girlfriend Hannah say it has been a rough few weeks. Mike has stumbled in his recovery. He has not turned to drink or drugs, but he has felt very low.
The summer has been stressful. He wants to see more of his young son. And living in a home where there is alcohol – his dad admits that he too has a drink problem – has also proved challenging.
But Mike and Hannah have a plan for the future.
On Market Street in Birkenhead, a tall, thin, bookish-looking man walks into Wirral Ways for a scheduled appointment. Tony is 58 and has been addicted to heroin for nearly 40 years – a survivor of the 1980s drug “epidemic” that swept the town.
“We feel love and hate like everybody else. We’re human beings. Most drug addicts have a reason they’re addicted,” he says.
Tony has paranoid schizophrenia and is under the care of a community psychiatric nurse. He says the condition was triggered by the deaths of his parents when he was a teenager – and heroin helps him control it.
For the past week, he has resisted taking any street heroin he may have bought. “It’s been murder,” he says – but he is determined to show the doctor that he wants to address his drug misuse and continue to collect his weekly prescription for methadone, a medical substitute for heroin.
The prescription gets approved, but during the appointment there is also a chance to talk about Tony’s mental health – all part of Birkenhead’s “joined-up” approach. The doctor works with Tony’s psychiatric nurse and key worker, John, who helps Tony navigate through the range of services in the “village”.
Tony invites us to his flat – it is modest, clean and tidy. There are music keyboards and synthesisers – and a whiteboard covered in quantum physics equations which he has written out. On the walls are professional-quality photographs he has taken.
“I’m mentally ill, that is a fact. I’m good at looking and being normal. But, at base level, I struggle to hang on to reality sometimes,” he tells us. He accepts there is a stigma to being an addict with mental health issues. “I get called a junkie and crackhead. It’s not nice but, at the end of the day, that’s what I am.”
Loneliness is perhaps the worst thing. “I sleep on my own. I wake up alone. I’m not good with women. I’ve got no self-confidence. So I’m just single. It’s the best policy for me.”
During another visit to Tony’s place, he suddenly needs a “fix” and smokes heroin while we are there. “I am not ashamed,” he insists, as the acrid smell fills the air. Doesn’t he realise how dangerous heroin is?
“Of course I do, yeah. It could kill me. It could kill me.”
He says he appreciates that he “wouldn’t be here” if it wasn’t for the professional support he receives.
Does his continued use of heroin mean Tony is a failure? Has the “village” failed him?
Key worker John, who has helped Tony for more than five years, doesn’t think so. For him, success isn’t as simple as measuring how many people come completely off drugs or drink. It is more subtle than that – about understanding that addiction is a chronic illness which needs long-term support.
Tony, for instance, came off crack cocaine. It was threatening his life. John says that was a big step forward. “As long as he’s not using [drugs] all day, every day – and his life isn’t unravelling in front of him – I think he is sustaining his life,” he says.
If you have been affected by any of these issues in this story you can visit BBC Action Line.
It is early December, and Mike and Hannah have taken a big step forward. They have found a home to rent. Mike proudly gives us a tour.
He shows us the bedroom they are preparing for his son. Mike has already started seeing him again and is looking forward to him staying overnight.
Hannah says Mike is getting better all the time and is less stressed now they have their own place. Mike says he still enjoys his job at Wirral Ways’ recovery centre. “I can help people like myself. It’s really a privileged position.”
Just around the corner from where Mike works is a trendy new coffee shop with a difference. Funded by the NHS – and yet another part of Birkenhead’s “recovery village” – Compañeros offers a sanctuary to many.
Anyone who considers themselves to be in a mental health crisis can come through the door.
Inside, there is on-the-day help from experienced support staff – many of whom have had mental health issues themselves. Even if they can’t talk to you straight away, you are encouraged to stay, to try to relax and maybe take part in a group activity – such as music discussion, creative writing or yoga.
The hope is it will help relieve pressure on A&E and other services.
Compañeros has already worked for Rob who, in his early 40s, had hit rock bottom. He would drink every day. “Parts of my family, my circle of friends, don’t understand how ill I was. How close I was… this place did, they got it.”
Compañeros saved his life, he says.
Cafe manager Joe Ackland is proud of what has been achieved in just a few months. “This is a place where people can feel safe and be heard. To be honest, I just wish [these cafes] could be all over the country.”
It is March 2022 and Dame Carol Black has asked to visit the “village” to see the joined-up work for herself.
She meets Mike in the room above Nightingales Cafe where he has previously confronted some of the harshest realities of his addiction. He proudly announces he has been sober and clean for two years to the day. He also says he has become a peer-to-peer mentor, a former addict who helps people still using. It is an essential support role highlighted by Dame Carol in her report.
“I’ve got a real passion for this and I really want to help people.”
Dame Carol’s face breaks into a beaming smile. “Fantastic,” she says, “that makes me very happy.”
Dame Carol is excited by what she has seen in Birkenhead – describing the approach as not just about treatment, but “a real attempt at recovery”.
“I simply hope that people who, in my opinion, have been treated rather like lepers, are now on a journey which treats them as people with a health condition.”
Meanwhile, Mike knows he is on his journey for the rest of his life.
“I’m extremely happy. Not depressed. There’s a lot of things that alcohol and drugs stripped me of, but there’s a lot of things out there that I’m rebuilding.”
Photography by Emma Lynch and Stephen Fildes