Conducted over the past two months by Amos Irwin, the program director for Law Enforcement Action Partnership (LEAP*), and Ricky Morris of BRIDGES, the survey indicates growing support for SCS. Individual responses show candidates considering the specifics of SCS implementation and illustrate just how many have been personally affected by the overdose crisis.

“We realized that with the primaries coming up, it was important to find out where candidates stood on overdose prevention sites so that people knew,” Irwin told Filter. “Also it gave us a chance to talk to the candidates while they were still interested in listening.”

Baltimore’s primary election is on June 2. It is the election that matters because the city is so deeply Democratic that that Democratic nominee almost always goes on to win the general election.

“On the phone you can talk to candidates, you can answer their questions,” Morris told Filter. “I had conversations that lasted 40 minutes because they had a strong opinion in the opposite way or they were on the fence and they wanted to know why we would want it.”

Along with the upcoming election, Baltimore was chosen because according to LEAP Executive Director Neill Franklin, the possibility of SCS is strongest there.

“The state of Pennsylvania didn’t move policy forward but the city of Philadelphia is moving policy forward with Safehouse,” Franklin told Filter. “And we think that we have an opportunity to do that here in Baltimore. And that’s the importance of this survey.”

A bill that would have permitted SCS statewide in Maryland stalled earlier this year, for the sixth legislative session in a row. In Baltimore, however, City Council President and mayoral candidate Brandon Scott passed a resolution for an informational hearing on SCS earlier this year and has been consulting BRIDGES as he drafts a bill authorizing SCS in the city.

“There’s nothing that says we can’t do it,” Scott told Filter back in January. “So we can do it.”

Scott is a mayoral candidate frequently polling in the top three, along with Sheila Dixon (Baltimore’s mayor from 2007 to 2010, when she stepped down due to corruption charges), and former Obama Treasury Department official Mary Miller.

BRIDGES’ survey marks both Dixon and Miller as “unsure.” Dixon is reportedly “open to the idea [but] believes more research and learning needs to take place on OPS to determine feasibility to succeed in Baltimore.” Miller, the survey says, “wants to wait until OPS are established in other US cities before investing in them in Baltimore.”

Current Baltimore Mayor Bernard “Jack” Young—who became mayor last year when his predecessor, Catherine Pugh, was also indicted for corruption—is characterized in the survey as being, “unsure how positive results elsewhere might transfer to Baltimore.”

“We hear this a lot from politicians: ‘When we see it somewhere else, we’ll do it.’”

Franklin was not surprised by the responses from those “on the fence.”

“We hear this a lot from politicians: ‘When we see it somewhere else, we’ll do it,’” Franklin said. “‘Let’s see what happens in Philadelphia.’ But by that time, so many lives are lost.”

Concern about community input came up frequently in the survey. In Baltimore, a deeply segregated city with a majority black population pushed to heavily divested neighborhoods, this makes sense, Franklin explained. It also misunderstands what makes SCS effective.

“People who are economically well-off who still have a substance use problem—even if they’re still not in a program—have homes and places where they can go use,” Franklin said. “You have to understand that most of these sites are going to be in our poor communities. They can’t be in a location that’s difficult to access for the people who need the services.”

BRIDGES was established in part to gauge community support. Its street outreach over the past few years has involved going out to working-class Baltimore communities to familiarize people with SCS. Morris, who has been doing naloxone and other harm reduction training throughout the city for years, already sees the support. West Baltimore’s Simmons Memorial Baptist Church, he said, is one of a few churches willing to offer its space for SCS once the city allows it.

“If you got churches wanting to implement and backing overdose prevention sites, then you can’t say no one would want them in their area,” Morris said. “What nobody wants is people dead in the house with needles in their arms or in alleys—that’s what’s not wanted.”

Back in the early ‘90s, Morris himself overdosed. There was a bad batch going around, one that is now infamous among veterans of Baltimore City’s drug scene. There were horse tranquilizers in it.

“Twenty-one people died and I got hit too, but I was lucky enough to survive because I was around some family members when I used,” Morris said. “And I just snorted back then, you didn’t even hear of people OD-ing from snorting.”

A few years later, Morris’s brother and cousin both overdosed. Only one of them survived.

“Both of them got their heroin together and both of them got a bad batch but my cousin, he went back home to his bathroom and when he OD-ed, he fell and his wife heard him and was able to get him help,” Morris said. “But my brother, he was sneaking because he was ashamed. So he goes up in an [abandoned building] and uses, and there was no one to help him. He ended up OD-ing and dying. When they found him he was cold.”

An SCS in Baltimore, Morris explained, would have provided his brother with a place to use drugs, someone to watch over him if he overdosed, and possibly, a “safe haven,” where he could have better processed the shame he felt about using drugs.

Only four of the 74 candidates said they do not support SCS in Baltimore.

Over the phone, some candidates told similar stories about friends and family. Republican mayoral candidate Catalina Byrd has been “directly affected by addiction through family members [and] supports OPS as a way to stop overdose,” the survey says. In one district, both of the leading council candidates, Joseph Kane and Odette Ramos, frame their support through how SCS could help people in their own families.

“This was really personal for many of the candidates,” Irwin said. “There are a tremendous number of candidates who have been personally affected by addiction, both the candidates themselves and through family members.”

Nearly every high-profile candidate running for mayor or city council answered either “yes” to supporting SCS or is “unsure.” Only four of the 74 candidates that could be reached (there are a total of 102) said they do not support SCS in Baltimore.

“The results of this survey were very encouraging,” Irwin said. “It’s time to start answering the questions about location and start making plans. We’re past ‘Should we do it or not?’ and onto, ‘How could we do this most effectively?’”

*LEAP was previously the fiscal sponsor of The Influence Foundation, which operates Filter.

Photo of Baltimore’s City Hall by Marylandstater via Wikimedia Commons/Public Domain.

The post Most Baltimore Primary Candidates Back Safe Consumption Sites appeared first on Filter.

On this day though, amid the coronavirus and after Maryland’s governor announced a “stay at home” order, Pinkett noticed some of the dealers were wearing gloves and masks (or at least, bandanas and other cloth wrapped around their faces) as they did their hand-to-hands, grabbing cash and passing back bags, bupes and anything else their regular clientele comes to purchase each morning.

Pinkett fired off a frustrated tweet: “Yesterday the Gov. shut down all non-essential biz. Meanwhile this morning @ Penn North drug dealers are wearing gloves & masks. Forgot dealing is an essential biz at least in some parts of #Baltmore. While we’re #flatteningthecurve how about we enforce the law? #accountability.”

The tweet, in which Pinkett encouraged drug warrior tactics during a pandemic, was roundly criticized. More important than Pinkett getting ratio’d though, was that he had seemingly missed a crucial point: The coronavirus has severely interrupted and complicated Baltimore’s drug trade as well as requiring sellers and buyers to get creative in practicing harm reduction. 

Whether he’ll “sell out” his regulars to cash in on desperate county-ites is a tough decision.

It reflects what Filter has learned over the past two weeks. One heroin dealer Filter spoke with, who mostly services Baltimore’s midtown area full of universities and arts districts—“We got the art kids and the old heads”—has stopped making deliveries via dirt bike. He’s not darting around the city but having people come to him outdoors, which gives him time to wash his hands and “reset” between transactions, he said, and not potentially spread the virus around.

He also characterized growing panic among clientele and dealers. Everybody’s money will dwindle soon and supply has been severely disrupted. There has also been an opportunity to price gouge, especially when selling to panicked (and primarily white) Baltimore County customers who are driving into the city, trying to stock up on dope.

“They want to buy in bulk,” he said, adding that whether he’ll “sell out” his regulars to cash in on desperate county-ites is a tough decision.

COVID-19 has also moved local harm reductionists, such as the Baltimore Harm Reduction Coalition (BHRC) to monitor the virus’s effects on the drug economy and reimagine how to do its work, assisting the already-vulnerable while protecting themselves at the same time. It is a crisis within the crisis they’ve already been dealing with for years.

“Any disruption of the normal flow of the aboveground economy and the underground economy and people’s access to drugs that they trust, that have been expected, is all up in the air now,” Harriet Smith, BHRC’s executive director, said at the organization’s monthly meeting on March 17.

She was talking to nearly 50 local harm reductionists over the video conferencing application, Zoom. Usually, the monthly meeting is in-person, at the office, where BHRC also held events such as safer snorting practice discussions, fentanyl testing strip demonstrations, or a community-focused space-themed dance party. The online meeting changed topics: homelessness and harm reduction in light of COVID-19.

“People are talking about quarantine and how we should deal with people who are experiencing alcohol withdrawal and should we limit or alter shelter rules to allow folks to smoke,” BHRC’s legislative advocacy intern, Dave Fell, explained on the call. “Perhaps it would be the best in this situation to temporarily provide people with what they need so that they stay to complete the quarantine if it’s necessary.”

It was two weeks ago that BHRC began working remotely—except for Smith, who still goes into office each day. She’s there so that people can drop by for supplies if they ring the doorbell or call, text or social media message ahead of time.

“We are ramping up our efforts using postal mail to get people needed supplies.”

“Knowing some people do not come inside for any service, much less go to places that might be harder to get into now more than ever, we thought we might need to do some distant, whenever possible not-touching kind of outreach to meet some of the basic needs of folks who are really disconnected from almost every service,” Smith told Filter.

From the office, Smith also prepares packages of safer use supplies. At the end of the day, she stops by the post office to send supplies to those who have requested them. Requests are increasing, in part because the counties surrounding Baltimore have fewer harm reduction services and those that exist have reduced outreach.

“We are ramping up our efforts using postal mail to get people needed supplies, particularly naloxone, but also fentanyl testing strips, condoms, and injection drug use supplies, snorting supplies and things like that,” Smith said. “We are definitely prioritizing people who need the supplies directly and less ‘the worried well’ who might want naloxone generally.”

For people who use drugs in Baltimore, the concerns are similar to anywhere else. But there are some specific challenges to this post-industrialized, deeply segregated city whose “opioid crisis” is older than in some other places. People experiencing homelessness who use drugs live in, or temporarily take advantage of, some of the city’s nearly 20,000 vacant homes. 

It is tough to “social distance” when you don’t have a home and shelters seem scary, because they’re full of people who might be infected, on top of them being hostile towards people who use drugs or do sex work. And the difficulty of gleaning accurate information about the pandemic from peers when so many are staying inside makes many feel even more disconnected.

“What would I tell someone if they asked, ‘What should I do right now?’,” Fell told Filter. “It’s like, I don’t even know what the answer to that question is, even though it’s within my purview to read and think about this stuff. The infrastructure isn’t there and even small little things like a coffee shop bathroom is taken away in a crisis like this.”

“Telling their officers to use their discretion doesn’t necessarily mean a moratorium on arrests.”

And then there are Baltimore’s notorious police. On March 18, Baltimore City State’s Attorney Marilyn Mosby announced that prosecutors in her State’s Attorney’s Office would not prosecute crimes including drug possession, in an attempt to encourage cops to reduce arrests. It’s a decision Smith and Fell praised, though its effects could be more substantive with a more cooperative—and trustworthy—police force. In response to Mosby, the Baltimore Police Department said that it would be “giving guidance to officers in using their discretion.”

“Telling their officers to use their discretion doesn’t necessarily mean a moratorium on arrests,” Fell said. “It’s like, ‘Use your discretion’ which can mean, ‘You can still hassle these folks.’”

BHRC members still see one another “IRL” at least once a week. They continue their outreach in Baltimore on Tuesdays and have discussed adding another day because other groups, understandably, are now ramping down their street outreach.

Wearing gloves and bandanas over their noses and mouths but making sure to “smile with their eyes” and look warm and inviting, BHRC hands out safer use supplies as well as soap, water, and snacks, providing up-to-date information about COVID-19 and checking in on folks.

“There are all the conversations we are prompted to have as people meet us. Those have really ranged from, ‘I’m so glad you’re out here’ to talking about childhood trauma,” Smith said. “And it isn’t exactly the time or place for that talk but there was a real big need just to talk and to digest a little bit of what’s going on with everyone.”

Last Tuesday, they met a man shaking from dehydration and lack of nourishment who had been staying in a vacant building. His thoughts were a little scattered and he had been fairly disconnected from resources and solid information. They gave him supplies, talked about the coronavirus, and just listened to him.

“The ‘being a listener’ aspect is so important, I mean, it always is with this work, especially doing street outreach, but right now especially,” Fell said. “I love playing that role in street outreach, just being like, ‘Talk to me about anything you want.’ Because you can’t actually be there for the community if you’re not actually listening to the community, if you’re still trying to impose your version of what you think is right.”

BHRC has also made coronavirus-specific packages with hand sanitizing wipes, water and snacks for handing out to people around Baltimore and a small note that reads, “You are loved, stay safe,” on one side and “Wear gloves, clean your hands, clean your phone, moisturize cracked and dry skin” on the other. They wanted to provide something COVID-specific—a message that was simple, and easy to remember and pass onto others.

“We’re trying to balance the harm reduction call of meeting people where they are and being outside,” Fell said. “And the larger public health call of staying inside and trying to figure out where we fit there. It’s a tough one.”

Photos of BHRC members and supplies courtesy of the Baltimore Harm Reduction Coalition

The post Baltimore Harm Reduction Grapples With the Crisis appeared first on Filter.

“Let me be clear, Baltimore has had an overdose crisis my entire life and what we have been afraid of or unwilling to do is address it as the public health issue that it is,” said City Council President Brandon Scott at the hearing. “And since 2015 there has been 3,500 fatal overdoses in Baltimore. That outweighs the number of people we lost even to gun violence in Baltimore City. This is about us rehumanizing people and understanding that our brothers and sisters, our mothers and sons who are struggling with addiction are human, and they deserve to be treated fairly and they deserve to get the help that they need.”

20-0189R: Informational Hearing—Overdose Prevention Sites is the beginning of Scott’s brash approach to establishing these sites in Baltimore. Emboldened by Philadelphia’s Safehouse—which in October 2019 won a federal court case against a US Attorney’s attempt to stop it opening⁠—Scott is working in collaboration with local harm reduction advocates, and making an end-run around politically cautious legislators. Scott, who is also running for mayor, announced the resolution with little warning to entities such as Baltimore’s health department, mayor’s office and police department.

“There’s nothing that says we can’t do it,” Scott told Filter in his office, a week before the resolution went public. “So we can do it.” 

City Council President Brandon Scott. Photo by J.M. Giordano.

Bills to establish safe consumption sites (SCS) on a state level in Maryland have failed for the past five years (yet another will be introduced in 2020 by state Delegate Shelly Hettleman). Maryland’s Republican governor, Larry Hogan, has in the past called SCS “absolutely insane.” 

Meanwhile, a 2017 report, “Safe Drug Consumption Spaces: A Strategy for Baltimore City” published by Baltimore’s Abell Foundation, stated that SCS could be established if the health department declared a state of emergency, with the authorization of the mayor or council.

“Saving the lives of Baltimoreans is worth the risk of making some other government body mad.”

“If the state or the law department or someone else doesn’t think the council has the authority to authorize, then we’ll have the discussion,” Scott said. “But saving the lives of Baltimoreans is worth the risk of making some other government body mad or running the risk of having to defend why we want to save lives.”

Neither the Baltimore Police Department nor the Health Department responded to Filter’s requests for comment about the resolution. The mayor’s office said it is looking into the issue. “The Law Department is in the process of reviewing the resolution,” wrote James Bentley, press secretary for the Mayor’s Office. “As soon as they give us some advisement on the legality of this all we can discuss further.” 

One likely supporter is Baltimore City State’s Attorney Marilyn Mosby, who signed onto an amicus brief regarding United States v. Safehouse last year and has spoken publicly, along with Scott, in support of SCS.

Sitting in the front row during the January 13 council hearing and applauding was Harriet Smith, executive director of Baltimore Harm Reduction Coalition (BHRC). Yet Smith’s excitement was hedged, she said. After all, this is just a resolution to hold an informational hearing—nothing more.

“Like, they’re not even supporting it,” Smith told Filter. “I keep reminding myself of that.”

Scott supports SCS, however, and plans to introduce a city ordinance to establish them in Baltimore soon. He is currently working on the legislation and running it by harm reduction groups for feedback.

Since 2015, when the first Maryland state bill to establish safe consumption sites was introduced—by then-Delegate Dan Morhaim, an emergency room doctor—the research-based argument for SCS has received support from local organizations such as Abell Foundation and Open Society Institute-Baltimore (OSI).

The issue for folks out there on the sidewalk doing grassroots work, however, was whether people who use drugs in deeply segregated, majority-black Baltimore, with its profoundly corrupt police department, would trust these sites. 

“Baltimore City has been specifically targeted by the racist, anti-black war on drugs for decades,” BHRC’s Community Organizing Coordinator Rajani Gudlavalleti told Filter. “And that positions this city and our country in a different way than places that currently have overdose prevention sites [another term for SCS].”

Community buy-in, Gudlavalleti said, had to involve “organizing within a racial justice framework.” So in 2017, members of BHRC and other harm reduction groups, like peer-run Bmore Power and Charm City Care Connection, worked with groups such as OSI to form the BRIDGES (Baltimore Resources for Indoor Drug-use Grassroots Education and Safety) coalition, doing direct outreach about SCS throughout Baltimore. 

During the summers of 2018 and 2019—inspired by Safe Shape, and Vancouver’s Overdose Prevention Society, which Gudlavalleti visited in 2017—BRIDGES set up tents that offered people a sense of what a safe consumption site looks like. These played a part in engaging thousands of residents in support of the idea. BRIDGES also invited city council members to see the tents, and Scott, who had visited Barcelona to see sites there in action, was moved. 

This experience also made Scott—one of the subjects of the 2018 violence interrupter documentary Charm City—realize that harm reduction intersected with the public health approach to understanding gun violence that he already promoted.

Now—as SCS go from being what Gudlavalleti jokingly calls, “a thing from Europe,” to something people who use drugs in the US want, to a political reality—it is important that the community input is not once again forgotten.

“With the news of the City Council considering this, it has opened up a lot more public conversation about overdose prevention sites that we as people who have been organizing around this for years now hadn’t seen,” Gudlavalleti said. “And now we’re seeing people having a lot of questions and it’s really important to remember that a lot of those nerves, particularly in Baltimore, are there because there is a lot of distrust and mistrust of systems.”

“Overdose prevention sites already exist in a very informal way. They are the vacant, they are the bando.”

Even the language employed by Scott’s resolution and OSI to describe these sites—“overdose prevention sites” or “overdose prevention services”—is in part politically motivated, if entirely accurate. It is harder to oppose “overdose prevention” than “safe consumption.”

Baltimore harm reductionists are quick to point out that underground SCS are already operated throughout the city by people and peers whom drug users trust: from groups of friends looking out for one another in a basement to health clinicians allowing a patient to “get right” in the bathroom while agreeing to check on them and keep it all hush-hush.

“Overdose prevention sites already exist in a very informal way. They are the vacant, they are the bando,” said Smith of BHRC, using Baltimore slang for abandoned properties. “But wouldn’t it be great if those places either became authorized or those places had stable support? “So let’s really do this. Let’s move a little quicker now because we can’t continue the same timeline and if we do … we’ll lose a lot of people.”

The same week Scott introduced his resolution, OSI brought three representatives of acclaimed SCS programs—Aura Roig of Metzineres in Barcelona, and Beverly Lightfoot and Russell Maynard of Vancouver’s Insite—to Baltimore. They spent the week meeting with local harm reductionists, legislators (including Scott), police and community groups to give a sense of how SCS operate. They answered questions and gave advice—especially on the important issue of maintaining community connections. 

“Push back against the gravitational pull of the bureaucracy within the health authority.”

“It’s very important to have those grassroots organizations always there with a strong voice at the table,” Lightfoot said. “People asking, ‘What about these communities themselves?’”

“Constant dialogue keeps it real and keeps it focused, that’s imperative,” Maynard said. “Push back against the gravitational pull of the bureaucracy within the health authority.”

Lightfoot and Maynard, along with Roig, were also part of a public forum on SCS in Baltimore County, which has been hit almost as hard as the city by the overdose crisis. Moderated by Natanya Rabinowitz, executive director of Charm City Care Connection (and author of a report about Barcelona’s overdose crisis and what Baltimore could learn), the forum included John Torsch of the Daniel Carl Torsch Foundation, one of the few harm reduction groups operating in the county. 

Torsch spent the past year visiting a number of safe consumption sites around the world—which he described as “from very informal to totally illegal to world-class, with full wraparound services”—to get informed. 

He told Filter that he was excited about Scott’s resolution. It is a possible fix to state-level legislation which hasn’t passed for the past five years, he said—and would help the county too, because many  people who use drugs in Baltimore County end up in the city to cop and to use Baltimore’s more robust services.

“It’s unfortunate we’ve been trying for five years to do this statewide, and it’s unfortunate because if you make it a citywide ordinance you’re still opening yourself up for possible state prosecution,” Torsch said. “But I love that Brandon Scott’s taking it to the next step.”

Top photo of sign outside community SCS event by Brandon Soderberg.

The post Inside Baltimore’s Unique Bid to Open Safe Consumption Sites appeared first on Filter.