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  • By Dominic Hughes and Natalie Wright.
  • Health Correspondent, BBC News

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Paul is about to embark on a journey of intense oblivion.

“Hug my mom again. I’d love that, that would be special.”

Paul Earnshaw is in tears as he talks to us.

He has struggled with alcoholism for years, but is now trying to break free.

It’s going to be a rough ride.

way of recovery

The enormity before us is sinking in.

Paul is about to begin a course of withdrawal, followed by up to six months of rehab.

“I have to do it. I won’t let anyone down, I won’t let myself down.”

Sitting on a sofa in the Blackpool offices of Charity Development, Paul ponders where he’s ended up.

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Paul’s support worker, Dave (R), has been instrumental in helping him get to this point in his recovery.

“I don’t want to pick up a can every day, walking down the streets, people thinking, ‘Oh, look at him, he’s drinking again, he’s still doing this, he’s still doing that.’

“Nah, I don’t want to do this. I’m 40, I’m not getting any younger. It’s time to move on, it’s time to live my life differently. It’s a chance – if I don’t. Don’t take it, I don’t get it anymore, but I’m taking it, I’m doing it.”

Dave, Paul’s one-time fan, gives him a big hug, and for a moment you feel like Paul will never let him go.

“Death of Despair”.

Blackpool is a city plagued by high numbers of preventable deaths linked to alcohol, drug abuse and suicide – collectively described by health researchers as the tragic phrase “deaths of despair”.

Studies show that Paul’s hometown of Blackpool has one of the highest death rates.

The rate for every 100,000 deaths in Blackpool is 83.8.

Compare that to the area with the lowest rate, Barnet in Greater London, where the figure was 14.5 deaths per 100,000.

Steven Brown, a senior member of the Empowerment team, has lived a similar life to Paul, and against the odds, has somehow come out on the other side.

“I’m from a council estate in Leyton in Blackpool, and I started going around with older people, my brother, and a lot of us started doing drugs, then a lot of us couldn’t stop doing drugs,” he said.

“I was stuck in that revolving door cycle that I couldn’t get out of. [of].”

The drugs led to crime, which led to prison, but after more than 20 years in and out of jail, a key moment came when Steven gave a prison speech to an ex-addict who ran a charity for ex-offenders.

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Steven, who grew up in Blackpool, survived a life of addiction and is now helping others get clean.

“I didn’t know that people recovered or you went to jail – you were locked up – or you died.

“For someone like me, who didn’t go to college and didn’t get an education — and I know they’re at the same level I’m at — they were speaking my language.

“And that hope is, ‘How did you do it? I want what you have. How can I follow you?’ And I guess that little bit of hope changed my life.

While recovering, a man told Steven that he needed to change only one thing in his life: “Everything – people, places and things.” Steven understood what his friend meant.

Everyone on the Empowerment team has what’s known as “life experience,” meaning they’ve all lived the chaotic and dangerous lives of the addicts, homeless people, and alcoholics they’re helping.

More than seven years clean, Steven’s life couldn’t be more different than what he’s left behind – a steady job he loves, a partner, a child, a home.

Rich but unequal

So being from the North, being white, male and working class, doing manual labor, having a low level of education – these are all risks.

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Christine Camacho, who reports on the deaths of despair, says health inequalities are making things worse.

But as the report’s author, Christine Camacho, explains, these factors together add up to more than the sum of their parts.

“The pandemic is a little bit like some of the effects that we saw in Covid, which worsened some of the inequality,” she said.

And the bad news for the northern coastal city of Blackpool is that the death rate is higher than anywhere else in England.

“England is a rich country but it is an unfair country – our wealth is not distributed equally. And the death of despair is one inevitable consequence of that unequal distribution,” she added.

Breaking the cycle

25 members of the Empowerment charity working in Blackpool and the surrounding area are trying to offer Steven a little hope that changed his life.

They work with social workers, the town hall and the local NHS, trying to find housing, healthcare and support and provide practical help to the homeless, providing clothing and essential hygiene items.

Helping to prevent overdoses is also an important part of the job, and the staff distributes the overdose drug naloxone, a treatment that Steven says has saved his own life more than once.

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The drug naloxone can save a person’s life if they overdose on heroin.

Support workers build relationships of trust with people whose lives have been thrown into chaos.

Kate – not her real name – is now in her 30s, and “I started drinking and doing drugs at a very young age, sometimes to the point of forgetting.”

She was in recovery for a while but dropped out of school last fall, found herself pregnant, homeless and still in the grip of her addiction.

However, Kate’s support worker stuck with Empowerment and did not give up.

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Blackpool has the highest rate of drug, alcohol or suicide related deaths in England.

Kate has been clean for more than 100 days and said: “It was really hard, but I’d had enough of living on the streets, being next to needles in abandoned hotels, it was horrible.

“It was the transformation and support of these people that got me and myself to where I am today. For someone to be there and have that support from when I was so bad with addiction to now being clean.” And whether I’m there or not, it’s an amazing feeling to have someone still trying to support me.

“I wouldn’t be where I am today if it wasn’t for her.”

Kate and Paul were both at risk of becoming statistics, but with the help of the empowerment team, they began the long and difficult road to recovery.