Capturing Cardiff: Heroin addicts' stories

[Katherine Cowan]

In spite of Cardiff’s shiny and new public facade, like any city its retained a ‘dark side’ where the city’s outcasts live in its shadows .Whilst the public buildings of the Bay are a symbol of the city’s ambition, people with aspirations of a more basic kind find themselves neglected due to an anomaly in Wales’ services for heroin addicts.

“You have to enter the criminal justice system and commit a crime to have any hope of treatment”

That’s the message Mark Isherwood AM believes substance misuse services in Cardiff and the rest of Wales sends out to heroin users.

A 1998 survey of arrestees found that 18% tested positive for opiates and almost a third of all the arrestees’ total income would be be spent on illegal drugs.

This very real link between heroin and crime has dominated public discussions about the drug and has in turn been the focus of the UK’s drug policy over the last ten years. In fact many drugs services are funded directly by the Home Office in a bid to tackle crime.

Speaking to Nigel Coakley, at the Huggard Centre, a homeless shelter in Cardiff, about his ten year addiction I understood why;

“I went from shop lifting to theft from vehicles, and every day I faced going to prison. In the last ten years that I have been using heroin I’ve been in prison every year.”

It’s been estimated that for every £1 spent on drug misuse services there’s a £3 reduction in the cost of crime. One would think this would inspire the Assembly and local authorities to ensure substances misuse services were well funded but that’s just not the case

Earlier this month a report into residential drug and drink rehab services in Wales was leaked to the Assembly and press. It described “Referral and commissioning pathways” as “seemingly designed in many instances to prevent clients from accessing treatment”. Hardly a glowing report.

Cardiff’s in-patient provisions are relatively good, but the majority of heroin users are treated as out-patients, with methadone substitution.

It’s easy to see why. Methadone not only helps the individuals taking it, it’s also been proven to dramatically reduce drug related crime, primarily because users no longer need to offend to pay for their habit.

At Inroads, a street agency and registered charity that offers a drop-in advice and support service for illegal drug users, I asked drugs worker Mags Lyons how successful she thought Cardiff’s drugs services were.

What she described was a strange and potentially dangerous two-tier system in which people who’d committed a crime would receive a methadone script almost immediately whilst those not caught up in the criminal justice system faced a wait of six months or longer.

Put simply by ex heroin user Ali, 38, who I met at the Huggard centre “you’ve got to get into trouble before they put you on methadone....but they should put you on it before you get into trouble”

And, says Nigel, “six months is a long time in a heroin users life, you’ll either go to prison or you’ll go over and die”

Lives can be completely destroyed or at worst lost.

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And of course, during that wait the community remains at risk because the heroin user still has to fund his or her habit.

Ali waited 18 months for a script; “you could do something stupid and you could be doing life in jail or something....you could end up doing a burglary that went wrong, something could go off in the house, anything could happen.”

I asked clinicians working in substance misuse services in the city why the criminal justice system was the only fast route for those wanting help. They explained that whilst the Home Office funds and sets policy for services for drug users caught up in the criminal justice system throughout the UK, Wales’ devolved health service has no equivalent to England’s National Treatment Agency for Substance Misuse which sets standards of care for addicts generally, including maximum waiting times, over the border.

Shadow minister for social Equality Mark Isherwood has followed this issue closely. He told me that the disparity in services is so bad that he’s heard of clinicians advising patients to commit a crime if they want to access services.

And switching from heroin to methadone has a huge impact on the lives of heroin addicts themselves.

Of the homeless people at the Huggard, those who’ve switched from heroin to methadone finally feel able to share in the city’s sense of optimism

Nigel has been on Methadone and out of crime for the past three years. He now volunteers at the Huggard centre seven days a week. Understanding what transformed Nigel’s life is to understand what the current system, by delaying treatment, is denying other heroin users.

“My son’s with me every day now and every day gets better and better. The more I think I’m doing, the more I’m enjoying life and just getting some self-worth and going for everything. It’s great”