By Tommy Ellis for Open Democracy. I saw my older brother inject himself with heroin for the first time when I was seven years old. Both he and my aunt have a history of drug addiction. That was in 1993, the year in which 155 people in England and Wales died from heroin abuse. Twenty years later, the annual death rate has risen to 765, and visits to hospitals and prisons have become part of my life.

Much later on at a family wedding, I went to the toilet and saw my brother inside the cubical shooting up. He was pricking the sole of his foot with a syringe since the veins in his arms and neck had long collapsed. ‘Hurry up’, I said. ‘I need a piss.’ You could say I’d already become resigned to the realities of my world.

Growing up, I told myself a common story that was prevalent at the time: ‘Heroin takes all. It gives a high so catastrophically charming that addiction is inevitable from first use. Few can be saved. Helping is almost futile.’

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