As rates of drug-related deaths in Norwich remain one of the highest in the country, 'hidden poverty' in a divided city has been cited as a factor.
Of the 135 people who died as a result of drug misuse in Norfolk between 2015 and 2017, 45 were in Norwich, data from the Office for National Statistics, released last week, reveal.
It means the city continues to see one of the highest rates of deaths from illegal drugs in the country.
At a rate of 12 deaths in every million, the only towns nationwide with a higher rate are Swansea, Port Talbot and Hartlepool.
Deaths as a result of heroin misuse have been climbing over recent years - and have been attributed to the so called 'Trainspotting' generation, those who became addicted in the 80s and 90s now succumbing to health issues.
But Dan Mobbs, chief executive of the Mancroft Advice Project, expects the rate of drug-related deaths to fall as 'fewer people are taking drugs' in general.
But he says the lack of quality control on the illegal market means when they are taken, 'the risks are higher'.
'Last year we had young people really concerned about some friends that had died as a result of Spice,' he said.
'People do not understand what Spice is. They think it is an artificial form of cannabis, but it has nothing to do with cannabis at all. It is a very dangerous chemical.
'The main problem is there is no quality control. Now you really can't tell what a substance is going to be. There is thousands of different chemicals now and one of the reasons the changed the legislation to ban all these drugs is there were more drugs being created which were legal but potentially more dangerous than illegal drugs.'
The Psychoactive Substances Bill of 2016 was introduced to counter 'legal highs' flooding the market, which appears to have had an impact on use.
Mr Mobbs added: 'Overall young people are taking a lot less drugs, smoking a lot less and drinking a lot less. But when they are being taken - the risks are higher.'
Mr Mobbs said the rate of drug-related deaths could be closely linked to low social mobility and high rates of poverty in the city.
'The more street sleeping, the more chaotic lifestyle you have, the more ill people get and the more risks they are going to take,' he said. 'We know Norwich has a really poor side to it. It is a very divided city and a lot of the poverty is hidden. That is why we have very low levels of social mobility, and is probably the issue that needs addressing most as we look towards Norwich in the future.
'We have the resources emotionally and financially but other people do not have access to those opportunities and life is very different for them.'
A spokesman for Change, Grow, Live said it is 'a tragedy for Norwich' that the rate of drug related deaths in the city is so high.
'Most drug-related deaths in England and Wales are caused by heroin and the majority of people who are dying are not engaged with treatment,' they added. 'The high rate of drug related deaths in Norwich is specifically associated with an ageing cohort of long-term heroin users in the city.
'This cohort of individuals are displaying increasingly complex health problems, often exacerbated by long-term substance misuse. Engagement with treatment protects vulnerable people using drugs from harm. Treatment services support people using drugs to identify and manage existing health problems, as well as helping to protect against drug overdoses through harm reduction initiatives.'
They added since taking on the contract for adult drug support service in Norwich in April, they have been 'working to reach out to people using drugs and not currently in treatment'.
'We are making our treatment as accessible as possible, by proactively partnering with other agencies to increase our presence across Norwich,' the spokesman added. 'There is a real commitment from commissioners and agencies across Norfolk to deliver proactive healthcare to this vulnerable cohort of people. Change Grow Live staff are currently working in hostel accommodation and several GPs surgeries across the city and increasing shared care with GP surgeries is one of our top priorities. 'We also work in partnership with colleagues from Norfolk and Suffolk Probation service, the Prison Service and the Community Mental Health Trust, to name but a few. Our primary focus is being out there in the community, so that vulnerable people using drugs do not have to struggle to find help.'
Deaths are preventable
Karen Tyrell, executive director of alcohol and drug charity Addaction, said: 'The truth is that most drug-related deaths are preventable.
'People who use opioids often have cumulative physical and mental health problems.
'Most of them have had very difficult, often traumatic lives and we're letting them down if we don't give them the best care that we can.
'Nobody wakes up in the morning and decides to become dependent on drugs.
'Everyone deserves help, and we know that every person can recover with the right support.'
Contact Change, Grow, Live for advice and support on 01603 514096.
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