James* first took heroin in 1996 aged 18. He was given it by his cellmate whilst serving a sentence at Northallerton Young Offenders Institute for motoring offences. His cellmate told him it was very similar to marijuana.

Within days of his release, James was taking heroin every day. He paid for it by shoplifting and dealing drugs. He would shoplift in Central Middlesbrough, Stockton and at Teesside Park. He would steal items he knew he could get rid of easily in local pubs and clubs – joints of meat, big jars of Nescafe and blocks of cheese.

The best James could hope for was half the value of the items – he would steal £80s worth of goods every day, to fund his £40-a-day habit. When James was dealing drugs, he had to steal more as he was taking more and more heroin – up to £200-£300 a day.

James spent regular spells behind bars. After serving one lengthy sentence he made the decision he wanted to go into rehabilitation. He was told he would have to be six weeks clean to take part. Unfortunately, that wasn’t possible and he was back on street heroin before then.

James’ partner Clare*, also a long term street heroin user, turned to drugs when her parents were sent to jail when she was 14 and she was left to fend for herself.

She joined the IOT programme in 2020. At first James said he would not use drugs in their home to try to help her. Clare had been on IOT for just two weeks when he noticed a massive change. After speaking with Danny Ahmed James agreed to join the programme in December 2020.

James* says IOT works because it removes the temptation of street heroin and the constant need to commit crime to pay for it. For hm the self-injecting deals with the ‘needle fixation’.

“It’s hard to explain but I needed to feel the needle going in, it was part of the addiction.”

After 15 months of treatment James and Clare feel well enough to come off the programme. They are clean of heroin and building a life together in their own council house.

James* says even if someone put a gun to his head he wouldn’t take street heroin again.

“What made me change was the realisation of what I was putting into my body. By using medical grade heroin I was getting a hit safely, that allowed me time to think. Instead of going down town and stealing £200 of stuff every day to pay for heroin and then trying to sell it for half the price, I could think about what I was doing to myself. I realised I could have a life with Clare which previously was not open to me.”

The couple are decorating their council house and plan to marry. James has reconnected with his family, including his teenage daughter. For the first time in their adult lives they are planning for the future, they have a stable address, a bank account and have booked a few days holiday in a caravan on the Yorkshire coast.

“It actually feels good to pay bills, work out what you have and budget. Seems crazy, I’m 44 and just learning about these things for the first time,” says James. “If it wasn’t for the programme I wouldn’t have a life, I tell everyone I know who is still on heroin about it, there is a way out.”

James has spoken to local politicians and the media about his experience in the hope of encouraging others to get help, he hopes to find work as a gardener and he and Clare have integrated into the local community.

“There’s an old guy who gives me some of his pension each week and I go into town and do his shopping for him. That level of trust would never have happened previously, I’d have been straight off to buy heroin with the money,” says James.

*names have been changed.



A familiar sight around Middlesbrough, Ricci Lauro is known for his beaming smile and positive outlook on life.

He always has time for people, whether that’s over a cuppa at Middlesbrough’s homeless café or handing out naloxone kits to the vulnerable on the streets.

Reunited with his family and looking forward to a Mediterranean holiday, Ricci is living proof that with the right help you can overcome street heroin dependency – and Ricci is happy to help anyone who wants to do the same.

“I have thought about how many people my choices impacted in the past, the victims of my crimes, my family and all those people affected. I had a wonderful partner but it doesn’t matter how much love and kindness they show, your addiction comes first,” said Ricci.

The turning point for Ricci came when he saw first-hand the transformation a new form of treatment was having on long term street heroin users and was approached by Foundations partner Danny Ahmed and offered a place.

“I saw how people, just like me, who thought there was no hope had progressed on the scheme, how they built homes together and new lives. I said yes to Danny and it saved my life,” said Ricci.

Raised on Grove Hill, Ricci appreciates his loving mum did all she could but by ten he was using solvents and by 14 was using cannabis regularly and had stopped attending school.

His sister’s partner at the time, a renowned local car thief, became the male figure Ricci looked up to and it was through him he first tried heroin and then burglary to pay for the drug.

Time on the run, then lengthy spells in prison followed. Many times he tried to give up but to no avail and he lost his job as a result and was living on the streets.

“I remember millennium eve. Lying in a derelict building with the pigeons, freezing cold, looking up at the nightsky through the hole in roof,” he said.

Further lengthy spells in prison followed and it was whilst undertaking an education course behind bars that Ricci started to reflect on his life.

“I was young and naïve when I first went to prison, I got bullied and at one point attempted suicide. I began to realise I’d seen my sister’s partner as the role model. I’d felt that to be anyone I had to be part of his gang.”

On release from prison and desperate to be freed from street heroin addiction Ricci borrowed £7,000 from his mum to fund a rehabilitation course in Luton.

“Within one month I was back on heroin, it was a complete waste of money. I was a real mess, no veins left in my arms so was injecting in my legs. I caught pneumonia from a dirty needle. I was lying in hospital and the doctors told me it was time I realised I wasn’t bullet proof. Danny came to see me and told me about the Diamorphine Assisted Treatment programme.”

DAT sees heroin dependency as an illness. Each patient is assessed and prescribed a twice daily dose of diamorphine which they self-administer under medical supervision in a dedicated treatment room within the Foundations clinic.

With the need to commit crime in order to fund drug addiction removed, patients are able to better focus on their health and wellbeing and engage with specialists from other agencies including in health, housing and welfare to address issues that may be contributing to the root causes of their addiction.

This reduced offending brings respite to local shopkeepers and residents, hope for patients and their families as well as savings to police, ambulance and other public services.

As progress is made and lives stabilised, patients are able to reduce their dosage without falling back onto street heroin. Once free of opioids they can return to society or engage with other rehabilitation services such as recovery connections.

“When you use street heroin you spend all day looking for money to buy it and then all night recovering. The difference with this treatment is that when you inject the diamorphine, it feels exactly the same as heroin,” said Ricci

With this need met, Ricci found DAT gave him time to reflect, to meet his family without the constant demand to fund drugs always on his mind. He also had money to spend on food and clothes.

“My family saw a difference in me and were happy to support, I realised what I now had and didn’t want to give it up,” said Ricci.

“I wasn’t a bad kid, it was drugs that got me into the world of crime, now I choose family and volunteering. I don’t want my own son to have a life like mine.”

During his treatment programme Ricci, 47, undertook a street degree and had to devise his own project.

He decided to clear up drugs paraphernalia from the street and whilst doing so, connect with homeless people and street heroin users.

Through these contacts he was able to educate about naloxone and distribute life-saving injectable packs of the medication that can rapidly reverse the effects of opioids.

After two years of treatment and having re-built his life, Ricci felt able to come off the DAT programme. He hasn’t used heroin since and has continued working as a volunteer, happy to strike up a conversation about naloxone and the help available to heroin users.

“Part of recovery is that it does put you in a position to help others,” he says.

“On the wall of the homeless café there are photos of all the people who have died of heroin. So many people I knew who are no longer here. If it wasn’t for DAT I would also be a photo on that wall.”

James Fowler

The roots to James Fowler’s addiction lie in his formative childhood years growing up in Darlington.

“I was born into a world of poverty and despair really. Family members dying of alcohol use. drugs sold around me, people smoking weed around me,” said James.

“When you are a kid growing up that looks tempting. 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.

“I just carried it on. I didn’t feel I could amount to anything other than that, I was never shown anything better than that, never shown what love was or support was. To me it was a dog eat dog world, have to fight for what you want, and that’s where I ended up.”

Where James ended up was as a 20-year-old in a bail hostel in Middlesbrough, on remand for assaulting a police officer when drunk. He was already taking ecstasy, cocaine and cannabis and selling drugs, but it was whilst at the hostel he had his first experience of street heroin.

“I was a social creature, so if people I was knocking about with were doing heroin that’s what I would do. Heroin was introduced to me and I was straight on board with it.

“I smoked it first, then second time intravenously. Within three months I had a problem. I was selling stuff, shoplifting, constantly asking for money, to pay for heroin.”

James, 41, has spent 20 years on street heroin, been to jail ten times for various offences all linked to his addiction. He tried many times to quit and many different forms of treatment, none worked. The personal cost was enormous.

“I lost my kid, lost my home, lost relationships, family disowned me. There were many times I reached the point where I wanted to change but usually it was financial. If I could get money I could justify taking heroin, I could carry on and take losing everything else in my life.

“Rehab was something I wanted to do but you have to be clean in order to begin that and that was just something I wasn’t able to do.”

James told how social services became involved in his life.

“I have a little girl but don’t get to see her. Whilst I was out in the madness I ended up falling on my daughter and had her taken away. I haven’t seen her since. Then I had little boy and was told I could not have contact.”

A clinician from Foundations spoke with James about the Diamorphine Assisted Treatment, how it treated addiction as an illness, removed the need for street heroin and worked to help people turn their lives around.

“For me the programme was never something I intended to stay on for a long time, it was a step to getting clean so I could go into rehab. because otherwise there was a danger I would lose all contact with my child.

“Methadone wasn’t enough, I would still go out to get heroin. On DAT they find a dose that is high enough to take that need away then gradually come down.

“This gave me a purpose, I had to be somewhere a couple of times a day, had to dedicate myself to it. I knew I didn’t have to go out to get money to buy street heroin, there was stability in my life, I was secure in my addiction if you like.

“I had already been thinking of going into rehab. Now I was around people trying to guide me there and introducing me to other services.”

After a year James was able to leave DAT and move to recovery connections, a six month residential rehabilitation programme. Now he has his own place and works as a chef and recently addressed – and cooked for – a Home Affairs committee into drugs.

“It’s crazy to think a couple of years ago I was committing crime and begging in the street, now I’ helping run a restaurant.

“My little boy is three now. Previously, I could only have contact when social services were there. Now I have him on my own, he stays overnight and weekends, it’s amazing. The love and bond that’s there between me and him is just worth all of this.”

Though his time on DAT is complete, James feels his journey continues. He still hopes to reconnect with his siblings and in time his daughter.

“I’m in contact with my mam by phone and have my little boy back in my life, but my siblings are going to be a harder nut to crack, but I just know if I keep going it will sort itself out.

“It’s only been two years since I walked through door to get clean after 20 years showing them 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.”

James believes through DAT and recovery connections he has a second family.

“I am part of a fellowship, we know each other from rehab. or streets, we all got clean together or watched people get clean, they are people I consider to be my family.”

James is currently completing a college access course so he can go to University to complete a degree in Humanities and Social Sciences. He is also a street volunteer.

“I would love to work in trauma therapy and I believe I have what it takes to do something like that. I just want to help other people, give something back. All those years, I was out there I didn’t have people come up to me and show me a way out. Now, I go out, meet people where they are at, give clean needles, tell them about recovery, try to get them on prescription. That’s the way I see myself going, showing them there is a way out, life is so much better when clear of drugs. Yes, there are struggles. Life’s not all bed of roses but it’s far better than that hardness on the street.”


Louise first took heroin when she was just 15. A friend gave her some.

“I was just a kid who knew nothing, I thought it was just a smokeable form of ganga.”

“I remember at the time someone said to me, I hope you don’t like your rings because they’ll be gone soon. I said “shut up, don’t be daft”. Within six months I had sold them all and everything else.”

She hid her addiction for two years. When her father found out he tried to keep her in the house to stop her getting drugs.

“The reality is you will never come off it until you want to in yourself. There’s always someone who will get some for you. My sister was also taking heroin and she smuggled some in for me.

“Once I was 18 I thought you can’t stop me and walked out he house. After that it was a roller coaster, began shoplifting to get money for heroin, would steal anything I thought I could sell to get drugs, would sneak round the back of the counter to see if I could get money from the till.”

She lost her front teeth when a dealer punched them out because she refused to shoplift to pay a drug debt and she became a dealer herself to pay for her drugs.

“I’ve been an addict for 20 years, nothing stopped me, including being locked in at home, jail, methadone and other treatments. Looking back devastates me, I would say all the time I don’t want this life, but then it was I’ll just do this today and then stop tomorrow, but tomorrow never came,

“The places we lived weren’t habitable, they were just somewhere to do drugs. My younger brother was on cocaine, instead of trying to get out he killed himself, wish I could have guided him more.

“When I heard about Heroin Assisted Treatment (HAT) at first I was sceptical, they told me it would work, I thought that’s what you said about all the other treatment.

“In the first couple of weeks it can be tricky, if the dose isn’t right you can still look for heroin like before. I was caught shoplifting in Boots and the store detective was going to call the police. James told him I had just got onto HAT, he pleaded for him to let me go. The guard

had heard of HAT he said ok, if you promise me you’ll finish HAT I’ll give you a chance. He let me go and from that day I have never shoplifted or taken heroin.

“Difference is because of the aftercare. Weren’t just put on methadone and sent away, on this after our dose we went from room to room to talk about housing, health, mental struggles we were having. There was a person for every different thing and it was all in the same place. “

Through HAT, Louise and her partner, James, were linked with a charity Myspace specialising in helping find homes for tenants most landlords wouldn’t touch.

After six months without trouble and paying all rent, they were offered a Home through a Housing Association on a Middlesbrough estate and have been there over a year. Together they have decorated the house.

“In the past the furniture, anything that we could move would have been pawned for drugs. Thanks to DAT we have made a home, it’s great to look round and say we decorated this, we bought this furniture. We have two credit cards we pay off every month. The phone company offered an upgrade because we’ve had the contract for two years – previously the phone would have been sold after a week for drugs, bills just thrown away and move on.”

The couple are looking forward to the future, Louise is taking driving lessons, a holiday in Spain is booked and a wedding planned for next year. Louise hopes one day to have children.

“I have always wanted to be a mum but because of the life I led I would never have brought a child into that world. Now I am able to have my nephew and niece stay over, James has been re-united with his daughter and hopefully we can start a family one day.”

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